- ASSIST stands for Alcohol, Smoking, and Substance Involvement Screening Test
- Developed by the World Health Organization for use in primary healthcare settings
- Screens for use of all psychoactive substances, not just alcohol or a single drug
- An 8-question interview taking approximately 5-10 minutes to administer
- Provides a risk score for each substance: low, moderate, or high risk
- Links screening results to specific brief intervention recommendations
- Validated across multiple countries, cultures, and healthcare settings
- Particularly valuable for identifying polysubstance use patterns
Published: February 2026 | Last Updated: February 2026 | Reading Time: 5 min
What Is the ASSIST?
The ASSIST (Alcohol, Smoking, and Substance Involvement Screening Test) is a brief screening questionnaire developed by the World Health Organization (WHO) in collaboration with an international team of substance abuse researchers. First published in 2002, ASSIST was designed to detect substance use and related problems in primary healthcare settings across diverse populations and cultures.
Unlike screening tools that focus on a single substance (such as the AUDIT for alcohol or the DAST for drugs), ASSIST assesses the full range of psychoactive substance use including tobacco, alcohol, cannabis, cocaine, amphetamine-type stimulants, inhalants, sedatives, hallucinogens, opioids, and other drugs. This comprehensive approach makes it particularly useful for identifying polysubstance use patterns.
How the ASSIST Works
Administration
The ASSIST is administered as a structured interview by a healthcare provider, counselor, or trained staff member. It consists of 8 questions that take approximately 5-10 minutes to complete. The questions cover lifetime substance use (which substances you have ever used), frequency of use in the past 3 months, frequency of strong desire or urge to use, frequency of health, social, legal, or financial problems related to use, frequency of failure to meet expected responsibilities, whether anyone has expressed concern about your use, whether you have tried to cut down or stop and failed, and whether you have ever injected any substance.
Scoring
Each question is scored on a numerical scale, and scores are calculated for each substance separately. This produces a substance-specific risk score categorized as low risk (0-3 for drugs, 0-10 for alcohol) where no intervention is needed, moderate risk (4-26 for drugs, 11-26 for alcohol) warranting a brief intervention, or high risk (27+ for any substance) warranting referral to specialist assessment and treatment.
Clinical Applications
The ASSIST is designed to be integrated into routine healthcare visits. When a patient's score indicates moderate risk, the provider delivers a brief intervention — a 3-15 minute structured conversation providing feedback about risks, advice about reducing use, and encouragement to set goals. When scores indicate high risk, the provider facilitates referral to specialized substance use assessment and treatment services.
Strengths of the ASSIST
The ASSIST offers several advantages over other screening tools. It screens for all substances simultaneously, providing a comprehensive picture. It directly links results to evidence-based interventions. It has been validated in multiple countries and cultural contexts. It takes only 5-10 minutes to administer. And it can be used by a wide range of healthcare professionals, not just addiction specialists.
Frequently Asked Questions
Who should be screened with the ASSIST?
The WHO recommends ASSIST screening for all patients in primary healthcare settings, particularly those presenting with conditions that may be related to substance use, those in high-risk populations, and those seeking help for mental health concerns.
Is the ASSIST available as a self-assessment?
While the ASSIST was designed as an interviewer-administered tool, self-report versions have been developed and validated. The WHO ASSIST Self-Help Strategy guide allows individuals to score themselves and access tailored feedback.
How does the ASSIST compare to other screening tools?
The ASSIST is unique in its multi-substance approach and its direct linkage between screening scores and intervention levels. While tools like the AUDIT and CAGE focus specifically on alcohol, ASSIST provides a single comprehensive assessment across all substance categories.
References
- World Health Organization. (2010). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): Manual for Use in Primary Care.
- Humeniuk, R., et al. (2008). Validation of the ASSIST. Addiction.
- WHO ASSIST Working Group. (2002). The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Addiction.
- Henry-Edwards, S., et al. (2003). Brief Intervention for Substance Use: A Manual for Use in Primary Care. WHO.
- Newcombe, D.A., et al. (2005). WHO ASSIST validation study. Drug and Alcohol Review.
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