Substance Abuse Assessment and Diagnosis in Medical Rehabilitation

Misuse of alcohol and other drugs negatively affects medical rehabilitation in several ways. Assessment of patients for substance abuse is a fundamental tool for addressing life-style and/or addiction-related risks for substance abuse. Assessments for substance abuse are most effective when they are individualized and prescriptive, sensitive both to the conditions that reinforce abusive behavior and the resources available for meaningful change. This article describes the theoretical perspectives most applicable to assessment within medical rehabilitation. Physical and psychological indices of substance abuse are reviewed and criteria for rating the severity of a problem are presented. Strategies for establishing substance dependence diagnoses and subsequent health care billing are discussed. Intervention and treatment options are presented from the perspective of rehabilitation.