Substance Abuse Evaluation | What is it and why does it matter?

A substance abuse evaluation is a clinically-based interview process that serves as the cornerstone of any effective treatment program. It pulls out all the available information about someone’s substance abuse or chemical dependency, and uses this to create a treatment plan. Through the evaluation, a licensed treatment provider looks at all facets of someone’s substance abuse: 

  • Whether the person has a diagnosable addiction
  • The severity of the chemical dependency, if it exists
  • Which substances have been abused, how much, how frequently, and for how long 
  • How deeply it affects the person’s life and health
  •  The root cause(s) of the abuse
  • The appropriate treatment 

When someone realizes that they have a substance use problem that is negatively affecting their life – or when people close to them notice this – this evaluation is the first step towards addressing the problem. It can be court-ordered, initiated by family or friends through an intervention, or sought out by choice. 

It is possible to carry out a substance abuse evaluation in a number of ways. Generally, it is done by therapists, medical and psychiatric professionals, or both, usually through a series of in-person and written interviews. Sometimes it includes a physical exam. However it is done, the point is to examine the problem as thoroughly as possible and begin looking at solutions. The evaluation is done in as sensitive a manner as possible, but since total recovery is the end goal, honesty and directness are crucial. 

Components of a Substance Abuse Evaluation

There is no universal formula for a substance abuse evaluation. Sometimes they are done informally as a conversation with a therapist, and in other situations the process is more formal. When an evaluation comes from a court, for instance, some states have a standard process for every case while others do not. However, all professional evaluations explore some of the same basic points.

1. Addiction Severity

The first part of a substance abuse evaluation is often meant to find out whether someone has a substance use problem or dependency. A psychiatric evaluation also helps determine how severe the chemical dependency is. Understanding the advancement of someone’s addiction helps to determine their placement in the appropriate programs. The facilitator asks matter-of-fact questions about drug types, amounts, and frequency of use. They also pay close attention to how deeply this use is affecting and damaging the person’s life and well-being. 

2. Type of Abuse or Addiction

Getting a clear dependency diagnosis is also crucial for moving forward into treatment. Although some people have a clear-cut abuse history with alcohol or a specific drug or medication, the situation is often more complicated.

Polysubstance abuse is the concurrent abuse of two or more substances at the same time. People sometimes mix substances on purpose to produce a particular high, or they take one drug to “treat” the negative effects or withdrawal symptoms of another.  Different drugs and drug combinations cause radically different withdrawal problems and require unique treatments. 

When someone is abusing multiple drugs, one or more of them is often a legal substance like alcohol or a prescription medication. This is often confusing for someone struggling with addiction as well as for their family and friends. They possible know they have a problem with a certain drug, but do not understand how alcohol or other substances play into their addiction. 

3. Underlying Issues and Co-occurring Disorders

The root of addiction is almost never at-face-value. People often begin abusing alcohol and drugs to self-treat other problems in their lives. If these underlying issues aren’t assessed and dealt with, real recovery is stopped in its tracks.

For complete and lasting recovery, substance abuse patients need to be treated not only for their chemical dependencies, but also for the factors that may have triggered the substance abuse in the first place.

Family history at times deeply influences addiction and substance abuse. During an evaluation, the practitioner not only looks at someone’s personal history, but frequently also asks questions about parents and family members. This is not nosy or pointless, and sometimes is the most relevant part of the process. People with a family history of alcohol and drug addiction are statistically much likelier to experience it themselves than the general population. Knowing other family history factors, such as parents with mental illness, strained relationships, emotional or physical abuse, and even economic status also help pinpoints where abuse and addiction began. 

Co-occurring disorders, or co-morbidities, should also be looked at. Co-morbidity refers to one person dealing with more than one disorder at one time.  Many mental health problems sometimes function as triggers for substance abuse. People living with depression, mood disorders, anxiety, or other conditions have a higher likelihood of turning to drugs or alcohol as self-treatment. Many prescription medications for mental health problems are also highly addictive. Further, what is meant as treatment sometimes spiral into a more serious problem with misuse and abuse.

Treatment Recommendation

After closely evaluating a patient’s case, the provider has the necessary information to decide on the next steps. Medical and psychiatric evaluation determines whether clients are able to immediately enter inpatient or outpatient therapy, or whether a medically-assisted detoxification is needed. 


In some cases, immediate detox is necessary before beginning any other treatments. Depending on the type of drug withdrawals someone is experiencing, detox takes several days. Every drug causes unique withdrawal symptoms, and some of these can be severe or even life-threatening. Withdrawal from benzodiazepines, for example, is frequently dangerous without clinical supervision and proper detox medication. For someone with a dependency, with simply stopping drugs like these there is the potential to result in deadly seizures or other fatal problems. 

People usually need medical detox if they are addicted to:

However, there is no way to predict anyone’s individual needs without a professional evaluation.

Inpatient and Outpatient Treatment

Depending on the severity of an addiction, inpatient and/or outpatient treatment may be prescribed after a substance abuse evaluation. Everyone’s needs are unique, so treatment plans are unique to each individual by information from the evaluation. For some people, outpatient treatment, group meetings, and counseling sessions are the best course of action. 

This doesn’t work for everyone. Many people need some form of inpatient treatment to overcome their substance abuse, drug addiction, or alcohol abuse disorder. In severe cases, treatment begins with detox before moving into inpatient and finally outpatient treatment or other recovery measures.

Treatment for Substance Abuse and Addiction

At Reflections, it  is an important part of our process with every person we admit. Our team of medical professionals and counselors conduct full psychiatric and personal evaluations as part of the admissions process. This ensures that each of our clients is in the right program and set on track for a lifetime of sobriety. 

For more information on our process and programs, contact us today. 

Addiction Help at Reflections Recovery Center

At Reflections Recovery Center in Prescott, AZ, we take a different approach to prescription drug addiction rehabilitation. By combining clinical treatment and holistic therapies, we provide our clients with all the tools they need to achieve a life free from addiction.

See How We Treat Our Clients