SCREENING OF SUBSTANCE USE PROBLEMS

SCREENING OF SUBSTANCE USE PROBLEMS SCREENING ADULTS ALCOHOL AND DRUGS 1) CAGE AID (Cut, Annoyed, Guilty, Eye Opener Adapted to include Drugs) A modified version of the CAGE screen for alcohol problems, the CAGE AID is a four item conjoint screen for alcohol and substance abuse. Approximate length = 2 mintues. ( Ref : http://www.omh.state.ny.us/omhweb/resources/providers/co_occurring/adult_services/screening.html) ( Ref: http://www.partnersagainstpain.com/printouts/a7012da4.pdf) SCREENING YOUTHS ALCOHOL AND DRUGS 1) CRAFFT / ADOSPA (Auto/moto Détente Oubli Seul Problèmes Amis) Consists of a series of 6 questions developed to screen adolescents for high risk alcohol and other drug use disorders simultaneously. It is a short, effective screening tool meant to assess whether a longer conversation about the context of use, frequency, and other risks and consequences of alcohol and other drug use is warranted. ( Ref : http://www.ceasar boston.org/crafft/index.php) ( Ref : http://www.ceasar boston.org/crafft/pdf/crafft_english.pdf) ASSESSMENT ADULTS ALCOHOL AND DRUGS 1) ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed for the World Health Organization (WHO) by an international group of substance abuse researchers to detect and manage substance use and related problems in primary and general medical care settings. ( Ref : http://www.who.int/substance_abuse/activities/assist/en/index.html) ( Ref : http://www.who.int/substance_abuse/activities/en/draft_the_assist_guidelines.pdf) Cross training program for the South West of Montreal, June 1 st, 2011 session Page 1 of 21

ASSESSMENT ADULTS ALCOHOL AND DRUGS 2) DÉBA A/D (Dépistage/Évaluation du Besoin d Aide Alcool/Drogues) The DÉBA A/D provides an evaluation that can establish an intervention plan for front line services. This tools can help orient persons to the appropriate level of service depending on the severity of their consumption : toward services of the front line (CSSS, CLSC) for those presenting a level of consumption that is deemed at risk or problematic, and toward specialized services for those who are deemed abusive or dependent in terms of their consumption (substance abuse readaptation centres). The DÉBA A/D is presented in two forms, one for the consumption of alcohol (DÉBA A) and the other for the consumption of drugs (DÉBA D). ( Ref : http://www.intranetreseau.rtss.qc.ca/index.php?id=241) ( Ref : http://www.risqtoxico.ca/risq/www/deba.php) ASSESSMENT ADULTS ALCOHOL AND DRUGS 3) GAIN SS (Global Appraisal of Individual Needs Mesure de dépistage GAIN Short Screener) The 5 minute GAIN SS is designed primarily for three things. First, it serves as a screener in general populations to quickly and accurately identify clients whom the full ~2 hour GAIN Initial would identify as having one or more behavioral health disorders (e.g., psychiatric disorders, substance use disorders, or crime or violence problems), which suggests the need for referral to some part of the behavioral health treatment system. Second, estimates of need from the GAIN SS can be used as a common metric across multiple systems or remote staff and as a denominator for quality assurance on the extent to which the rate of diagnoses/referrals are consistent with the estimated mix of problems from the GAIN SS. Such measures of quality assurance can be used for one on one supervision or performance based contracting. Third, it serves as a periodic measure of behavioral health change over time. ( Ref : http://www.chestnut.org/li/gain/gain_ss/gain SS_Manual.pdf) ( Ref : http://www.chestnut.org/li/gain/gain_ss/gs_2.0.1 English.pdf) ASSESSMENT YOUTHS ALCOHOL AND DRUGS 1) DEP ADO Grille de dépistage de consommation problématique d alcool et de drogues chez les adolescents) The DEP ADO was designed to identify the problematic use of alcohol and other drugs. It is made up of Cross training program for the South West of Montreal, June 1 st, 2011 session Page 2 of 21

eight questions addressing frequency of use in the past 12 months, substance use in the past month, the age of initiation, injection drug use, number of five or more drinks in a single occasion in the past 30 days and last 12 months, the negative effects associated with substance abuse (six domains covered); and the frequency of cigarette use. It was developed in Quebec and was tested with a French speaking population, although an English language version is also available. The DEP ADO was designed for frontline workers. ( Ref: knowledgex.camh.net/.../screening.../screening/screen.../dep_ado.aspx) ( Ref : http://www.risqtoxico.ca/documents/dep ADO_ang_V3_2.pdf) ASSESSMENT YOUTHS ALCOHOL AND DRUGS 2) IGT ADO (Indice de gravité d une toxicomanie pour les adolescents) The IGT ADO is used to evaluate the severity of overconsumption of alcohol or drugs and related problems for adolescents. It is also helpful to orient these adolescents toward the appropriate treatment. (Réf : http://www.risqtoxico.ca/documents/fiche_igt_ado_sep08.pdf) ASSESSMENT ADULTS ALCOHOL 1) AUDIT (Alcohol Use Disorders Identification Test) The AUDIT was developed by the World Health Organization (WHO) as a simple method of screening for excessive drinking and to assist in brief assessment. It can help identify excessive drinking as the cause of the presenting illness. It provides a framework for intervention to help risky drinkers reduce or cease alcohol consumption and thereby avoid the harmful consequences of their drinking. It also helps to identify alcohol dependence and some specific consequences of harmful drinking. ( Ref : http://whqlibdoc.who.int/hq/2001/who_msd_msb_01.6a.pdf) (Ref : http://www.automesure.com/pages/formulaire_alcool.html) ASSESSMENT ADULTS ALCOHOL 2) MAST (Michigan Alcoholism Screening Test) The MAST is one of the most widely used measures for assessing alcohol abuse. The measure is a 25 item questionnaire designed to provide a rapid and effective screening for lifetime alcohol related problems and alcoholism. The MAST has been productively used in a variety of settings with varied populations. Cross training program for the South West of Montreal, June 1 st, 2011 session Page 3 of 21

( Ref : http://pubs.niaaa.nih.gov/publications/assesing%20alcohol/instrumentpdfs/42_mast.pdf) ( Ref : http://www.ncadd sfv.org/downloads/mast_test.pdf) ASSESSMENT ADULTS DRUGS 1) DAST 20 (Drug Abuse Screening Test) The DAST 20 is designed to provide a brief, simple, practical, but valid method for identifying individuals who are abusing psychoactive drugs and yield a quantitative index score of the degree of problems related to drug use and misuse. This five minute questionnaire, used in an interview or self evaluation, can help gauge the severity of addiction to drugs other than alcohol. ( Ref: http://www.camh.net/publications/camh_publications/drug_abuse_screening_test.html.) ( Ref : http://www.emcdda.europa.eu/html.cfm/index3618en.html) TREATMENT ADULTS ALCOHOL 1) Alcochoix+ Alcochoix+ is a secondary prevention program that aims to prevent the problem of alcohol consumption from becoming more severe. It is a program that aims to control consumption by using different approaches in the treatment of alcohol use. ( Re : http://www.intranetreseau.rtss.qc.ca/index.php?id=241) Ref: http://dependances.gouv.qc.ca/index.php?alcochoix_accueil) GENERAL DISTRESS 1) K6 OR K10 SCREENING OF MENTAL HEALTH PROBLEMS These scales were designed to be sensitive around the threshold for the clinically significant range of the distribution of nonspecific distress in an effort to maximize the ability to discriminate cases of serious mental illness (SMI) from non cases. (Ref : http://www.hcp.med.harvard.edu/ncs/k6_scales.php) (Ref:..http://www.hcp.med.harvard.edu/ncs/ftpdir/k6/K6+self%20admin 3 05 %20FINAL.pdf) French version: http://www.statcan.gc.ca/concepts/health sante/pdf/distress detresse fra.pdf (notez que ce document est sous forme d entrevue plutôt que de questionnaire) Cross training program for the South West of Montreal, June 1 st, 2011 session Page 4 of 21

2) SF 36 (Short Form (36) Health Survey) QualityMetric's SF 36 Health Survey asks 36 questions to measure functional health and well being from the patient's point of view. (Ref: http://www.qualitymetric.com/) 3) BASIS 24 (Behavior And Symptom Identification Scale) The BASIS 24 is designed for use by mental health providers, researchers, purchasers of mental health services, accreditation agencies, and internal quality assurance departments to measure the change in consumer self reported symptom and problem difficulty over the course of treatment. (Ref : http://ebasis.org/) SPECIFIC DIMENSIONS 1) PATIENT HEALTH QUESTIONNAIRES, PHQ (Questionnaire de santé du patient, QSP) The Patient Health Questionnaire (PHQ) is a diagnostic tool for mental health disorders used by health care professionals that is quick and easy for patients to complete. (Ref : http://www.phqscreeners.com/overview.aspx?screener=01_phq) 2) MOOD DISORDER QUESTIONNAIRE (MDQ) The Mood Disorder Questionnaire is a brief, self report screening instrument that can be used to identify patients most likely to have bi polar disorder (Ref : http://www.dbsalliance.org/pdfs/mdq.pdf) (Ref : http://www.blackdoginstitute.org.au/healthprofessionals/resources/assessmenttools.cfm) French version: Weber Rouget et al. (2005). Screening for bipolar disorders using a French version of the Mood Disorder Questionnaire (MDQ). Journal of Affective Disorders, 88, 103 108. DIAGNOSIS OF MENTAL HEALTH AND/OR SUBSTANCE USE DISORDERS 1) MINI (Mini International Neuropsychiatric Interview) The M.I.N.I. was designed as a brief structured interview for the major Axis I psychiatric disorders in DSM IV and ICD 10. (Ref : https://www.medical outcomes.com/index.php) Cross training program for the South West of Montreal, June 1 st, 2011 session Page 5 of 21

2) SCID I (Structured Clinical Interview for DSM IV Axis I disorders) The Structured Clinical Interview for DSM IV Axis I Disorders (SCID I) is a semi structured interview for making the major DSM IV Axis I diagnoses. The SCID II is a semi structured interview for making DSM IV Axis II: Personality Disorder diagnoses. (Ref : http://www.scid4.org/) REFERENCES Boîte à outils en dépendances : http://www.intranetreseau.rtss.qc.ca/index.php?id=241 CAMH (2006). Méthodes de dépistage des troubles concomitants. www.camh.net Comité permanent sur les troubles concomitants de la Fédération québécoise des centres de réadaptation pour personnes alcooliques et autres toxicomanes (2008). Trousse de dépistage d un trouble mental chez la clientèle présentant un trouble lié à la consommation ou au jeu. http://www.acrdq.qc.ca/ Deady, M. (2009). A Review of Screening, Assessment and Outcome Measures for Drug and Alcohol Settings. Network of Alcohol & other Drug Agencies. http://www.nada.org.au/ MSSS. Orientations relatives à l organisation des soins et des services offerts à la clientèle adulte par les équipes en santé mentale de première ligne en CSSS http://publications.msss.gouv.qc.ca/acrobat/f/documentation/2011/11 914 01F.pdf Rouillard, P. (2004). Rôle des médecins dans le dépistage et l intervention brève en toxicomanie au Québec. Comité permanent de lutte à la toxicomanie. http://publications.msss.gouv.qc.ca/biblio/cplt/publications/role_medecinsvfweb.pdf Cross training program for the South West of Montreal, June 1 st, 2011 session Page 6 of 21

EXAMPLES Cross training program for the South West of Montreal, June 1 st, 2011 session Page 7 of 21

http://www.partnersagainstpain.com/printouts/a7012da4.pdf Cross training program for the South West of Montreal, June 1 st, 2011 session Page 8 of 21

http://www.who.int/substance_abus e/activities/assist_v3_english.pdf Cross training program for the South West of Montreal, June 1 st, 2011 session Page 9 of 21

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http://www.risqtoxico.ca/risq/www/bref.php Cross training program for the South West of Montreal, June 1 st, 2011 session Page 13 of 21

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http://www.chestnut.org/li/gain/gain_ss/gs_2.0.1 English.pdf Cross training program for the South West of Montreal, June 1 st, 2011 session Page 15 of 21

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http://www.risqtoxico.ca/risq/www/bref.php Cross training program for the South West of Montreal, June 1 st, 2011 session Page 17 of 21

http://whqlibdoc.who.int/hq/2001/who_msd_msb_01.6a.pdf Cross training program for the South West of Montreal, June 1 st, 2011 session Page 18 of 21

http://www.ncadd sfv.org/symptoms/mast_test.html Cross training program for the South West of Montreal, June 1 st, 2011 session Page 19 of 21

DAST 20 http://www.ensuringsolutions.org/usr_doc/dast.pdf Cross training program for the South West of Montreal, June 1 st, 2011 session Page 20 of 21

Accroché! Pas moi! Ce questionnaire est confidentiel. Il est important que tu sois honnête envers toi-même. Ce questionnaire a pour but de t aider à prendre conscience des changements de comportement qui sont liés à ta consommation. Si tu as de la difficulté à choisir entre le «oui» et le «non», choisis la réponse qui correspond généralement à la façon dont tu te sens. Oui ( ) Non ( ) 1. Est-ce que la plupart de tes amis boivent ou consomment de la drogue? 2. Évites-tu les personnes qui n approuvent pas ta consommation? 3. As-tu l impression d avoir utilisé une drogue juste pour avoir du plaisir? 4. La drogue a-t-elle affecté ton rendement à l école? Dans ton rapport avec les autres? 5. Les choses qui comptaient beaucoup avant te semblent-elles moins intéressantes? 6. Dois-tu consommer plus qu au début pour obtenir un effet? 7. Utilises-tu de la drogue lorsque tu es tendu, déprimé ou pour t aider à faire face aux situations déplaisantes? 8. Passes-tu beaucoup de temps à penser à ton prochain «high» (high veut dire «trip», «brosse», etc.)? 9. As-tu déjà fait quelque chose dont tu as honte à cause des drogues? 10. Gardes-tu de la drogue en réserve afin de ne pas paniquer si tu en manques? 11. Quand tu penses à ce que tu as l intention de faire au cours de la journée ou de la semaine, s agit-il généralement d activités où il est possible de consommer de la drogue? 12. T arrive-t-il de consommer plus que tu l avais prévu? 13. As-tu déjà essayé d arrêter de consommer et tu as recommencé par la suite? 14. As-tu déjà été incommodé physiquement ou émotivement lorsque tu as essayé d arrêter de consommer? 15. T es-tu déjà menti à toi-même ou as-tu déjà menti aux autres concernant la quantité et le type de drogue que tu consommes? 16. As-tu déjà volé quelqu un pour obtenir de la drogue? 17. Consommes-tu lorsque tu es seul? Cross training program for the South West of Montreal, June 1 st, 2011 session Page 21 of 21