This guideline on screening and risk assessment for substance use in adults (≥18 years old) was developed by the New York State (NYS) Department of Health (DOH) AIDS Institute (AI) for use by primary care providers and in other adult outpatient care settings in NYS to achieve the following goals:

• Increase the identification of unhealthy substance use among NYS residents and increase access to evidence-based interventions for appropriate patients. “Unhealthy substance use” refers to a spectrum of use that increases the risk of health consequences and ranges from hazardous or risky patterns of use to severe substance use disorder (SUD).
• Increase the number of clinicians in NYS who perform substance use screening and risk assessment as an integral part of primary care.
• Provide clinicians with guidance on selecting validated substance use screening and risk assessment tools and on providing or referring for evidence-based interventions.
• Promote a harm reduction approach to the identification and treatment of substance use and SUDs, which involves practical strategies and ideas aimed at reducing the negative consequences associated with substance use.

Contents

• Purpose and development of this guideline p. 2
• Role of primary care providers in New York state p.2
• Development of this guideline p. 2
• Definition of terms - screening and risk assessment p.3
• Goals of screening and risk assessment p.5
• Substance use screening for all adult patients in the primary care setting - alcohol, tobacco, drugs p. 6
• Screening tools p.9
• Risk assessment p.11
• Candidates for risk assessment p.11
• Risk assessment tools. P.12
• Management of low-, moderate-, and high-risk substance use p.13
• Diagnosis of substance use disorder p.15
• All recommendations p.17