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Opioid Misuse Assessment

This opioid misuse screening may be used to assess for signs an symptoms of opioid misuse. Please answer all questions as honestly and openly as possible. Choose the following answers that best describe your feelings and situation in the past 30 days. If you are taking this on behalf of a loved one, please note that all of these questions will be phrased as if that person were taking this screening. If suggested, contact us as soon as you can.

Please note, this screening does not serve as a diagnosis tool but can aid your clinician in determining our recommended course of action.

SCORE

0 > None-minimal

ACTION – None

1 – 4 > Mild

ACTION – Please schedule a consultation with Dr. Cruz or your physician.

5 or Higher > Moderate/Severe Treatment Recommended

ACTION – Please schedule a consultation with Dr. Cruz or your physician.

Sources
Humeniuk RE, Ali RA, Babor TF, Farrell M, Formigoni ML, Jittiwutikarn J, Boerngen de Larcerda R, Ling W, Marsden J, Monteiro M, Nhiwhatiwa S, Pal H, Poznyak V & Simon S (2008).
Validation of the Alcohol Smoking and Substance Involvement Screening Test (ASSIST). Addiction 103(6): 1039-1047 Fighting Opioid Misuse (n.d.)
Retrieved from https://opioidscreening.org/
For more information visit: https://opioidscreening.org/resources/