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What to Expect in a Substance Abuse Disorder Assessment

Your substance abuse disorder assessment
Your substance abuse disorder assessment

You might be a little nervous about getting a substance abuse disorder assessment. After all, you’re putting yourself out there and sharing private information with a total stranger. It’s natural to be nervous and even embarrassed about the whole process.

Actually walking in the door for the substance abuse disorder assessment will be the worst part of your experience. Knowing what to expect during the assessment can do much to relieve your anxiety. You need to know that you will not be judged for the things you’ve done, and nobody will be asking you to explain or apologize for your past.

The reason why the assessment receptionist and counselor will never question your behaviors is because substance abuse disorder is a medical diagnosis. Its symptoms cause people to make poor choices. For the wreckage that you’ve left in your past—a common expression in recovery—your only fault would be if you fail to take advantage of treatment options. And the doorway to all kinds of treatment options opens with that all-important substance abuse disorder assessment.

Most treatment professionals at the local level differentiate between abuse and dependency. Substance abuse means that you have an intense desire to use a drug that you’ve tried and that you want to keep increasing the amounts that you use. Substance dependence refers to the addiction that your body develops when you keep using that substance. When you become preoccupied with a drug because you need it just to get through the day and not because you are doing it for any recreational purpose, and when you must have an increased amount of it to feel any effect from it, you have stepped into the dark shadows of dependence or addiction. At your substance abuse disorder assessment, your counselor can explain that more fully.

The Staff Are There to Help You

Wouldn’t it be wonderful if you could just walk into your local methadone clinic and have a substance abuse disorder assessment whenever you want? It could mean the difference between getting help at the exact moment when you feel brave enough to begin treatment versus continued addiction because you can’t get help exactly when you’re ready. However, just like any medical or counseling office, methadone or buprenorphine (Suboxone) treatment programs function on a schedule. Some programs may be able to offer a substance abuse disorder assessment if you walk in early in the morning. However, others will want you to stop by or call and schedule an appointment.

Don’t be afraid to ask the receptionist what the process is, or simply tell that person that you want a substance abuse disorder assessment. In many clinics the receptionist is not qualified to talk with you about different drugs and so that person will probably not ask you much about what drugs you’ve been using.

No appointment in any line of healthcare begins without some kind of paperwork, and the receptionist can get you started on that. Some programs will give you the paperwork to take with you and turn in at the time of your appointment. Other programs may even email the paperwork to you. In some cases you will simply fill it out at the clinic right before you see the assessment counselor.

When you come for your appointment, you should bring your state-issued photo I.D., like a driver’s license, and your health insurance card if you have one. Some programs bill insurance and some do not, but they will need to know about your insurance. If you don’t have insurance, the receptionist can tell you where to find your local Medicaid office.

Can You Qualify for Medicaid?

During your assessment the methadone program should designate someone to discuss payment with you. Some programs will bill your insurance and some will not. In most states, Medicaid covers at least the partial cost of your methadone program treatment. What is covered varies from state to state, and so does income eligibility.

A Medicaid case worker might deny benefits if you cannot prove that you are disabled. Many of them will recognize a substance abuse disorder or an emotional disorder as a disability under the Americans with Disabilities Act.

Requirements of a Substance Abuse Disorder Assessment

The Commission on Accreditation of Rehabilitation Facilities (CARF) certifies programs that meet its guidelines. It has issued specific requirements of an appropriate substance abuse disorder assessment.

  • The person you speak with must be trained and knowledgeable according to state licensure or professional certification requirements.
  • A substance use disorder diagnosis can only be given if the person is qualified according to state and CARF regulations.
  • The process of the assessment is designed to elicit information from you, from your family and friends if you approve of their participation, from referral sources if you authorize communication with them, and with any external resources qualified to provide information—again, only if you authorize communication.
  • The questions asked are designed to identify your goals and expectations of treatment.
  • The assessment must consider your life status and other significant needs that you identify.
  • The assessment cannot be complete if the counselor cannot gather sufficient information about your mental health and stability, your preferences, your past treatment history, your family history, medication history, physical health status including past hospitalizations, social history, spiritual beliefs, employment and education history, and legal stressors.
  • The assessment counselor will also ask you questions about trauma you’ve experienced, such as sexual assault, violence, neglect, or abuse. Questions should be included to determine if you’ve taken risks with your safety.
  • The substance abuse disorder assessment must utilize assistive technologies to help you through the process. For example, if you cannot read or write, or if you are hearing-impaired, there should be people or devices that aid you.
  • The assessment counselor will also ask you if you have advance directives. These would indicate your wishes, for example, if you lost your ability to make your own decisions through some medical ailment or other catastrophe.

After the assessment process, the counselor must either arrange for your admission into the methadone program if you so desire or refer you to another level of care. The counselor cannot just send you away without giving you a clear idea of what to expect next. While the program rules may require you to detox from alcohol or benzodiazepines, for example, or to become stabilized mentally, there has to be some clear direction for you to take.

Why not visit your local methadone program today and ask about a substance abuse disorder assessment? That’s all you have to do, and then the process will begin. You can get the help you need, if you’re finally ready.

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