ASSIST (Alcohol, Smoking and Substance Involvement Screening Test)
The World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is a questionnaire that screens for all levels of problem or risky substance use in adults. The ASSIST (V3.1 or V3.0) consists of eight questions covering tobacco, alcohol, cannabis, cocaine, amphetamine-type stimulants (including ecstasy) inhalants, sedatives, hallucinogens, opioids and 'other drugs'. A risk score is provided for each substance, and scores are grouped into 'low risk', 'moderate risk' or 'high risk'. The risk score determines the level of intervention recommended ('treatment as usual', 'brief intervention' or 'brief intervention plus referral to specialist treatment').
The resulting scores are recorded on the ASSIST Feedback Report card (PDF 27KB) and are used to provide feedback to clients about their substance use and associated risks as part of the linked Brief Intervention. The brief intervention can be delivered in as few as three minutes by following the Ten-Steps (PDF 27KB). The brief intervention is consolidated by giving clients the booklet Self-Help strategies for cutting down or stopping substance use: A guide.
- The WHO ASSIST Project Fact Sheet (PDF 23KB)
- eASSIST. Use this link to administer the ASSIST from your computer. Instructions and links to the relevant forms and resources are provided. Scores can be printed or saved to client's casenotes.
Clinical forms and client materials
- WHO - ASSIST V3.1 for health professionals (PDF 105KB)
- WHO - ASSIST V3.0 Response card (PDF 8KB)
- WHO - ASSIST V3.0 Feedback Report card (PDF 27KB) - Print as double-sided A3 and fold into booklet
- WHO - ASSIST V3.0 Risks of injecting card (PDF 12KB)
- Self-Help strategies for cutting down or stopping substance use: A guide.
Self-training resources for clinicians
- The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): Manual for use in primary care
- The ASSIST-linked Brief Intervention for problematic substance use: A manual for use in primary care
- The Ten-Step ASSIST-linked Brief Intervention (PDF 27KB)
- Practice in pairs - client script 1: Chloe (PDF 47KB)
- Practice in pairs - client script 2: Dave (PDF 47KB).
Instructional video clips
How to administer the ASSIST and linked Brief Intervention.
Print this completed ASSIST Questionnaire prior to watching the ASSIST Demonstration DVD.
- HO10: Demonstration ASSIST for training Session (Print this completed ASSIST Questionnaire prior to watching the ASSIST Demonstration DVD).
- ASSIST Demonstration DVD (Print this completed ASSIST Feedback Report Card prior to watching the ASSIST-linked Brief Intervention DVD's).
- HO11: Demonstration Feedback report card for training session
- Brief Intervention Demonstration DVD - The Brief Intervention
- Brief Intervention Demonstration DVD - Providing the Brief Intervention to a resistant client.
Drug and Alcohol Services South Australia (DASSA) offers a supported e-learning program designed for Australian health workers. There are several options for self-training, either as an individual or as a group. The individual self-training has two components, depending on how you intend to use the ASSIST with your clients - via the pencil and paper version, or the electronic version eASSIST.
The individual self-training can be completed in your own time and is not assessed, however, an expert is available to help you with queries. The group training can be done with your colleagues and a facilitator, and you can work through the same self-training documents as a team. The facilitator needs to read the below instructions, and prepare the training session accordingly.
All methods of training use some or all of the self-training resources listed above.
For support with ASSIST training email: firstname.lastname@example.org
Instructions for self-training:
- Instructions for individual self-training of the eASSIST version (PDF 67KB)
- Instructions for individual self-training of the Pencil and Paper version (PDF 67KB)
- Instructions for facilitating Group training. (under development)
The University of Adelaide also offers online training for ASSIST and linked Brief Intervention and/or to train others to use the ASSIST and linked Brief Intervention. The University of Adelaide training has been designed for health care workers in the Asia Pacific, but is also available for Australian clinicians. It takes approximately 10 hours to complete self-training, and 20 hours to complete ‘train the trainer’. You need to register for training and you are assessed on your knowledge during the learning process, however the training can be done in your own time. Click on the link above or go to http://assistportal.com.au/.
Administering the ASSIST to young people (ASSIST-Y)
The ASSIST V3.1 has not been validated for use in people under 18 years of age.
Cut-off scores to denote the passage from low to moderate risk, and moderate to high risk, have been determined for an adult population. They are not appropriate for young people whose brains and bodies are still in the process of growth and development, and who have limited life experience compared with adults.
Recently DASSA developed the ASSIST-Y, under the guidance of the World Health Organization and using expert clinical consensus and the best evidence to date. There is an ASSIST-Y questionnaire and ASSIST Feedback Report card for 10 to 14 year olds, and another for 15 to 17 year olds. Clinical instructions for providing the appropriate intervention have also been developed. Please be aware they are draft versions. The ASSIST-Y and associated materials are currently being tested for face-validity, but have not had extensive psychometric testing. We would like to get feedback from any clinicians using the ASSIST-Y and associated resources, based on the attached list of evaluation questions (PDF 33KB).
- ASSIST-Y questionnaire for 10-14 year olds DRAFT Oct 2011 (PDF 45KB)
- ASSIST-Y questionnaire for 15-17 year olds DRAFT Oct 2011 (PDF 45KB)
- ASSIST-Y Feedback Report card for 10-14 year olds DRAFT Oct 2011 (PDF 50KB)
- ASSIST-Y Feedback Report card for 15-17 year olds DRAFT Oct 2011 (PDF 50KB)
- ASSIST-Y Instructions for Clinicians 10-14 year olds (PDF 65KB)
- ASSIST-Y Instructions for Clinicians 15-17 year olds (PDF 65KB)
Please email your feedback to: email@example.com
- WHO ASSIST Working Group (2002) The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility. Addiction, 97:1183-1194. doi: 10.1046/j.1360-0443.2002.00185.x
- Newcombe D, Humeniuk RE & Ali RL (2005) Validation of the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): report of results from the Australian site Phase II Study. Drug and Alcohol Review, 24(3): 217-226
- Humeniuk, R (2006) Validation of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and Pilot Brief Intervention: A Technical Report of Phase II Findings of the WHO ASSIST Project prepared by Rachel Humeniuk & Robert Ali, on behalf of the WHO ASSIST Phase II Study Group.
- Dennington V., Humeniuk R., Newcombe D., Ali R. and Vial R. (2007) Results from the Australian arm of an International RCT of a Brief Intervention for illicit drug use linked to the scores on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) (PDF 913KB) Drug and Alcohol Services Council Monograph No 23. Research Series.
- Humeniuk, R., Ali, R., Babor, T. F et. al (2008), Validation of the Alcohol, Smoking and substance Involvement Screening Test (ASSIST). Addiction, 103: 1039-1047. doi: 10.1111/j.1360-0443.2007.02114.x
- Humeniuk, R (2008) The Effectiveness of a Brief Intervention for Illicit Drugs Linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in Primary Health Care Settings: A Technical Report of Phase III Findings of the WHO ASSIST Randomized Controlled Trial [electronic resource] / prepared by Rachel Humeniuk, Victoria Dennington and Robert Ali, on behalf of the WHO ASSIST Phase III Study Group.
- Holmwood C, Marriot M & Humeniuk R (2008) Substance use patterns in newly admitted male and female South Australian prisoners using the WHO ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). International Journal of Prison Health 4(4): 198-207
- Humeniuk RE & Holmwood CB (Nov 2011) Developing the eASSIST: The WHO Alcohol, Smoking and substance Involvement Screening Test Questionnaire in Electronic format for Australian Clinicians. Drug and Alcohol Review, Vol 30, Supp 1, Paper 60, p41-42.
- Humeniuk RE, Holmwood CB & Kambala A (Nov 2011) Developing the WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for Young people (ASSIST-Y). Drug and Alcohol Review, Vol 30, Supp 1, Paper 59, p42.
- ASSIST-Y poster presented at the 2011 Australian Professional Society for Alcohol and other Drugs (PDF 106KB).
- Humeniuk, R., Ali, R., Babor, T., Souza-Formigoni, M. L. O., de Lacerda, R. B., Ling, W., McRee, B., Newcombe, D., Pal, H., Poznyak, V., Simon, S. and Vendetti, J. (2012), A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health-care settings in four countries. Addiction. doi: 10.1111/j.1360-0443.2011.03740.x