Author: The SASSI Institute

Creation of the SASSI & Fine-tuning of the SASSI

To understand the SASSI, you need to understand how the subtle items were selected.  Dr. Glenn A. Miller considered several thousand potential items. First, he excluded items that reflected either general maladjustment or, conversely, obvious social desirability. He gave questionnaires containing potential items to both individuals in treatment for substance use and to control subjects. Then he looked for items that the members of one group usually answered differently from the members of the other. Although no single question could identify every person who had a substance use disorder, statistical analyses detected a set of questions that people with substance use disorders consistently answer differently than other people.

The only reason any question was included was that it worked to identify substance use disorders, not that it seemed to be related to substance misuse.

Dr. Miller did not base the SASSI upon a theory of substance use disorders, but rather used statistical analyses to empirically select those items that distinguished between known criterion groups of individuals with and without the disorder. For the purposes of screening, we do not need to understand why people with substance use disorders are more likely than other people to answer True to “I have been tempted to leave home.” What matters is that responses to this question can help us identify people who are likely to need further evaluation for a substance use problem. Research has shown that people who answer the questions similarly to people with substance use disorders have a relatively high probability of having a substance use disorder.

To further deal with the resistance that so often characterizes substance use disorders, individuals with known substance use disorders were asked to answer the questionnaire as if they were applying for an important group membership and were directed to try to hide signs of their shortcomings and problems, particularly those related to the misuse of alcohol and drugs. Analyses of answers given under these “fake good” instructions identified two types of items — those items that distinguished people who had substance use disorders from people without such disorders even when people were instructed to conceal problems, as well as items that helped identify defensive responding.

Statistical analyses revealed that the SASSI could most accurately and usefully identify individuals with substance use disorders if the items were compiled into scales, and decision rules were created for analyzing the scores.

Items were tested with various groups and selected to minimize the effects of gender, age, socio-economic status, ethnicity, and drug of choice.

Extracted from:

Lazowski, L. E., Kimmell, K.S., & Baker, S.L. (2016). The Adult Substance Abuse Subtle Screening Inventory-4 (SASSI-4) User Guide & Manual. Springville, IN: The SASSI Institute.

We Would Like Your Feedback!

We want to take this opportunity to inform you of a small questionnaire we are deploying in the coming weeks. We’d really appreciate your feedback and we’d like as many of you as possible to take the time to fill out this brief anonymous form. We feel that if we receive enough responses, it will provide us with critical information on how we might better serve your needs when treating your clients. We consider you our collaborators our ‘feet on the ground’ in this ongoing war against substance use disorder. We will provide links to the survey in various ways and consider you input invaluable.

If you would like to fill out the survey now, here is the link to complete.

Thank you for your consideration.

We Want to Hear From YOU!

Here at The SASSI Institute we pride ourselves on the work we do to provide validated instruments that help you, as well as your clients.  To do an even better job, we are asking for your feedback.  We want to know how our instruments support your work.  But we also want to hear how we can improve our tools.  Our new Feedback Form gives you an outlet to share your ideas and critiques. 

Click here to complete the feedback form.

If you have a heartwarming experience you would like to share about how our instrument has helped you or a client, we would love to hear that too.  Please feel free to share your story* with us at blog@sassi.com.

*Please exclude identifying client information from the submission

A Message to Our Colleagues, Customers and Friends

We would like to take this opportunity to invite you, our many colleagues, to express your views, research findings and other developments within our SASSI Network blog. Our intent with this forum has always been to embrace the opinions and experiences of so many professionals and treatment providers throughout the country and indeed throughout the world. This forum is meant to be one of inclusion, not exclusion. All professionals from the multitude of addiction services provided have value and merit inclusion. These might focus on screening, testing, assessment, treatment, interventions, and others. We invite your submissions, and welcome your viewpoints. We feel this forum provides an opportunity to enrich us all with a collective wealth of knowledge that will ultimately enrich the addiction field. If you would like to contribute, please contact us at blog@sassi.com.

We hope that all of you and your families have managed to stay healthy during this tumultuous year. Our hearts go out to those that have experienced loss, suffering or pain during this Pandemic that has taken far so many lives. We remain hopeful that now that several vaccines are in distribution, and vaccinations are proceeding expeditiously, that we are nearing the close of this chapter in all our lives.

Please consider joining us by contributing your knowledge to our blog!

Adolescent SASSI-A3 Available December 1st, 2020

Our Team at the Institute has been working tirelessly on a two-year research project to bring you an updated adolescent instrument that is validated against the DSM-5 diagnostic criteria.  Our research has produced multiple publications and allowed the SASSI-A3 to include some new features, including a brief scale, Prescription Drug (Rx), to accurately identify teens likely to be abusing prescription medications. The updated version also includes new subtle items to reflect current teen alcohol and drug use patterns, as well as several updated questions using contemporary teen verbiage, and additional Face Valid items to identify symptoms in the DSM-5.  The instrument also distinguishes likely Substance Use Disorder (SUD) from other psychological disorders; thus, the SASSI-A3 can accurately identify the presence and the absence of SUD, even when other psychological symptoms are present.

The SASSI-A3 will be available through SASSI Online immediately upon release and SASSI Online users can begin using it immediately on December 1st.  Paper & Pencil product will be available for pre-order starting November 1st, with our first shipment of SASSI-A3 product/s scheduled for December 4th.  After December 1st, the Adolescent SASSI-A2 Paper & Pencil material will remain available for purchase for a limited time, or while supplies last. 

Adult SASSI-4 Substance Use Disorder Screening Accuracy with Criminal Offenders

The Substance Abuse Subtle Screening Inventory (SASSI) has been used successfully in correctional screening in multiple settings since its release. These include outpatient evaluations of offenders as well as assessments of incarcerated individuals in federal, state, and local correctional centers.

Many clients served in behavioral health and substance abuse treatment programs have histories of involvement with the criminal justice system in addition to mental health and substance use disorders. Samples in the SASSI-4 validation study included assessments in community corrections, probation and parole and drug courts, as well as cases from DWI and DOT education and screening programs. SASSI-4 overall screening accuracy in criminal justice settings was 95%; in DWI and DOT education programs SUD screening accuracy was 91%, and these accuracy levels were found not to differ significantly from the overall accuracy rate for all settings (92%). In addition, many cases included routine information on clients’ number and types of arrests and blood alcohol levels. Analyses revealed that SASSI-4 screening accuracy was 92% for clients with a history of criminal offenses, and 90% for clients who had no such histories.[i]

Interestingly, of those who had been diagnosed with a substance use disorder, criminal offenders acknowledged significantly less illicit drug use and consequences as well as less alcohol use and consequences on the SASSI-4 face valid scales than did clients with diagnosed substance use disorders in settings other than criminal justice programs — suggesting offenders minimized reported use and substance-related problems. By contrast, offenders with substance use disorders showed no differences in their endorsements of subtle items on the SASSI-4 compared to individuals with substance use disorders in other types of assessment settings. Despite offenders’ attempts at minimization, SASSI-4 overall accuracy in the offender samples was 94%. Together these findings illustrate strengths of using SASSI-4 to screen criminal offenders as compared to entirely face valid screens such as the AUDIT, CAGE or DAST. That is, the inclusion of subtle items on the SASSI-4 as well as a scale to identify clients’ level of defensive responding strengthens the ability of the SASSI-4 to accurately identify clients with substance use disorders.

In addition to legal offenses and possible substance use disorders, offenders also often have other mental health problems, which can affect their responses on many types of assessments they are given. Research on the SASSI-4 has shown its screening sensitivity is 98% in dual diagnosis clients; specificity is 93% in persons diagnosed with nonsubstance-related psychological disorders only, for an overall accuracy rate of 97% in people suffering from other psychological disorders. Moreover, accuracy was shown to be unaffected by ethnic background, and other demographic variables such as age and education.

For information on integrating the SASSI-4 into correctional programs, contact us at 800.726.0526.


[i] For additional validation information please refer to: Lazowski, L.E. (2016). Estimates of the reliability and criterion validity of the Adult SASSI-4. Springville, IN: The SASSI Institute.

Download PDF: Criminal Offenders and the SASSI-4

SASSI Plan for COVID-19: Exposure, Prevention, Preparedness, and Response

The SASSI Institute takes the health and safety of our employees very seriously.  With the spread of COVID-19, the Company must remain vigilant in mitigating the outbreak.  We are committed to helping people who suffer from substance use problems and the professionals who serve them. In order to be safe as we reopen operations, we have developed this COVID-19 Exposure, Prevention, Preparedness, and Response Plan.  Of course, we will continue to monitor the related guidance that CDC and OSHA provide.

Read more