ASSIST (WHO Substance Screen)

WHO ASSIST v3.1: The Alcohol, Smoking and Substance Involvement Screening Test. Evaluates the lifetime and recent use of substances and risks associated with use.

In the past 3 months, how often have you had a strong desire or urge to use alcohol?

In the past 3 months, how often has your use of alcohol led to health, social, legal or financial problems?

In the past 3 months, how often have you failed to do what was normally expected of you because of your use of alcohol?

Has a friend or relative or anyone else ever expressed concern about your use of alcohol?

Have you ever tried and failed to control, cut down or stop using alcohol?

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Comprehensive substance use screening in primary care, psychiatric, and emergency settings

Identifying hazardous, harmful, and dependent use across 10 substance categories

WHO-recommended instrument for international substance use epidemiology and research

Baseline assessment in addiction medicine and substance use treatment programmes

Pre-employment screening in safety-sensitive occupations

Substances Covered

Tobacco products

Alcohol

Cannabis

Cocaine (including crack cocaine)

Amphetamine-type stimulants (excluding MDMA)

Inhalants

Sedatives or sleeping pills

Hallucinogens

Opioids

Other drugs (specify)

How it Works

Question Structure

Q1: Lifetime use of each substance class (yes/no)

Q2–Q5: Frequency of use, craving, and problems in the past 3 months (scored 0–6 or 0–8)

Q6–Q8: Dependence indicators, injection history, and concern from others (scored 0–6)

Risk Stratification

Substance Involvement Score	Risk Level	Recommended Intervention
0–3 (alcohol) / 0–3 (other)	Low risk	Brief education and feedback only
4–26 (alcohol) / 4–26 (other)	Moderate risk	Brief intervention (BI) + feedback
≥ 27 (alcohol) / ≥ 27 (other)	High risk	Referral to specialist assessment and treatment

Injection-Specific Risk

If Q8 (injection use) is positive, the patient is at high risk for blood-borne viral infections (HIV, HCV, HBV) regardless of the substance involvement score. Immediate referral to harm reduction services, hepatitis B vaccination, and blood-borne virus screening is indicated.

Clinical Pearls

Key Clinical Points

The ASSIST is the only validated brief screening tool covering multiple substance classes in a single interview

The ASSIST-lite (6-item) version exists for ultra-brief screening where time is limited

Scores for each substance are calculated independently — do not sum scores across different substances

The ASSIST has been validated in over 30 countries and is available in over 40 languages

Q3 (frequency of use) and Q5 (problems related to use) are the most predictive items for dependence risk

ASSIST vs AUDIT

Feature	ASSIST	AUDIT-10
Scope	10 substance categories	Alcohol only
Administration time	10–15 minutes	2–4 minutes
WHO recommended	Yes (primary care)	Yes (alcohol-specific)
Substance-specific scores	Separate score per substance	Single alcohol score
Dependence detection	Moderate	Limited (not diagnostic)

Last Comprehensive Review: 2026-07-17

In Recent Clinical News

Scanning Medical Journals

No new significant updates or guidelines matching this topic were found today. We will check again soon.

ASSIST (WHO Substance Screen)

When to Use

When to Use

Substances Covered

How it Works

Question Structure

Risk Stratification

Injection-Specific Risk

Clinical Pearls

Key Clinical Points

ASSIST vs AUDIT

Next Steps

Intervention by Risk Level

The Evidence

Primary Validation

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility.

Validation of the Alcohol, Smoking And Substance Involvement Screening Test (ASSIST).

Origins & History

Development

In Recent Clinical News

ASSIST (WHO Substance Screen)

When to Use

When to Use

Substances Covered

How it Works

Question Structure

Risk Stratification

Injection-Specific Risk

Clinical Pearls

Key Clinical Points

ASSIST vs AUDIT

Next Steps

Intervention by Risk Level

The Evidence

Primary Validation

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility.

Validation of the Alcohol, Smoking And Substance Involvement Screening Test (ASSIST).

Origins & History

Development

In Recent Clinical News