Category: Uncategorized

Local Encounters with Those Facing Extreme Poverty

A young man asking me to call an ambulance because he was experiencing snakes biting him. The paramedics came and were wonderfully caring and gentle with him.

A man I’ve known for more than a decade who regularly volunteers and gives money to us. He also struggles with a severe mental illness that’s usually managed well with medication. But unfortunately, he’s become homeless and is living out of a van.

Another man struggling to find a safe place for himself and his wife. She’s dealing with some severe disabilities and needs nursing home care, but they’re struggling to find a place that takes their health insurance (we’re working on that). They’ve been together for 30 years.

A Wendy’s employee recognizing me (I stopped in for an iced tea in between meetings) and offering me a free Frosty and saying, “We appreciate what you do for us.” (I often get credit for what our staff, volunteers, and all you supporters deserve).

These all happened within two hours of us opening the day center this morning.

Written by Forrest Gilmore the Executive Director at Beacon, Inc in Bloomington Indiana

Originally posted to Forrest’s Facebook page and shared here with his permission.

The SASSI in Community Corrections

The Substance Abuse Subtle Screening Inventory (SASSI) is a valuable tool used in various contexts, including community corrections programs. When used in community corrections settings, the SASSI serves several important purposes:

  1. Screening for Substance Use Disorders (SUDs): One of the primary functions of the SASSI in community corrections is to screen individuals under supervision for potential substance use disorders. It helps probation and parole officers identify clients who may be struggling with substance abuse issues.
  2. Risk Assessment and Management: The SASSI provides valuable information about the level of risk that an individual poses in terms of problems related to their substance use. This information helps community corrections officers make informed decisions about supervision levels and interventions. For clients with co-occurring substance use and criminal justice issues, the SASSI helps community corrections officers manage risk more effectively.
  3. Treatment Planning: For individuals identified as having substance use issues, the SASSI results can inform the development of individualized treatment plans. It can help determine the appropriate type and intensity of substance abuse treatment needed to address the client’s specific needs.
  4. Referrals: If the SASSI identifies a client as having a high likelihood of a substance use disorder, community corrections officers can make referrals to specialized substance abuse treatment programs or other appropriate services.
  5. Resource Allocation: The SASSI results can help allocate limited resources within community corrections programs more effectively. As a result, officers can prioritize clients with higher substance abuse risk for more intensive interventions.
  6. Compliance and Accountability: Incorporating the SASSI screening tool into community corrections programs can enhance client accountability and motivation to get treatment, especially among clients who may be unaware or sincerely deluded about their substance use issues.
  7. Documentation and Reporting: The use of the SASSI screening tool in community corrections ensures that evaluations are conducted in a standardized and systematic manner, which is essential for documentation, reporting, and legal compliance.

It’s crucial to note that the SASSI should be administered by professionals who understand the nuances of substance use screening and the ethical considerations involved. Additionally, confidentiality is an important aspect of using the SASSI in a community corrections context, as clients’ rights and privacy must always be protected.

What is a Substance Use Disorder Screening Instrument and the SASSI

A substance use disorder screening instrument is a tool that is used to identify individuals who may be struggling with substance abuse or addiction. There are several different types of screening instruments that may be used, but one of the most common is the Substance Abuse Subtle Screening Inventory (SASSI).

The SASSI is a self-administered questionnaire that asks a series of questions related to an individual’s past and current use of drugs and alcohol, as well as their behavior and attitudes related to substance abuse. The questions are designed to identify patterns of behavior that may be indicative of a substance use disorder, such as a tendency to lie about drug or alcohol use, or a history of legal or financial problems related to substance abuse.

The SASSI also includes subtle scales which help to identify individuals who may be attempting to conceal their drug and alcohol use. There are several benefits to using the Substance Abuse Subtle Screening Inventory (SASSI) as a substance use disorder screening instrument:

  • Standardization: The SASSI is a standardized tool that has been extensively researched and validated. This means that it provides a consistent and reliable method for identifying individuals who may be struggling with substance abuse.
  • Efficiency: The SASSI can be administered quickly and easily, either in paper or electronic format. This makes it a convenient tool for screening large groups of people, such as in a primary care or community health setting.
  • Sensitivity: The SASSI is designed to be sensitive to a wide range of substance use disorders, including those that may not be immediately apparent to healthcare providers or other professionals.
  • Validity: The SASSI subtle scales increase the accuracy of the results and ensure that individuals receive appropriate treatment based on their level of need.
  • Flexibility: The SASSI can be used with a variety of populations, including adults, adolescents, and those with co-occurring mental health disorders.

Overall, the SASSI provides a useful tool for healthcare providers, substance abuse professionals, criminal justice entities and others who are involved in identifying and treating substance use disorders. It can help to ensure that individuals receive appropriate care and support, which can ultimately improve their health and well-being.

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

Addiction Professional Spotlight: Charlie Stookey, MA, LADC, LADC-S

I have had the pleasure of being on staff at The SASSI Institute for 22 years. Throughout that time, I have had the opportunity to work closely with many addiction professionals. Their dedication and passion for helping individuals in recovery or in need of recovery have always astonished me.

One of these professionals whom I have known throughout my time at the Institute is Charlie Stookey, MA, LADC, LADC-S. Charlie was a trainer for the SASSI when I started my career at the Institute. He presented training on the earliest versions of the SASSI, having been taught by none other than our late Founder and SASSI creator, Dr. Glenn Miller. Charlie retired from training many years ago, and while we have never met in person, we have stayed in touch over the years, and I am glad to call him a friend. He attended Whitman College and the University of Nevada, Reno, and is currently a substance abuse counselor in Reno, Nevada. Charlie also has a passion for poetry and has been published in the West Coast Poetry Review, Blue Moon, and The Meadow. He believes in the gift of the Wounded Healer and Joseph Campbell’s The Hero’s Journey. I want to share one of his poems with all of you today and encourage you to take the time to read it peacefully.

Charlie asked me to share that he hopes the heroine in Phases of the Moon, finds the beginning of her sober journey in the reflection in the detox mirror. And that she finds the “life that awaits us.” In our groups, we are in a gathering of miracles and he is grateful for the opportunity to sit with them.

Phases of the Moon The new moon is a cat’s claw in the night sky. Clint C. Ricketts

Beneath Thunder Moons and Corn Moons, she names her four rescued cats, Moon Beam, Moon Light, Moon Shadow, and, of course, Moon Shine. The phases of the moon
are tattooed on the nape of her neck “to honor the mystery and permanence of the moon over time. It’s reliable.” It’s so easy to turn the course of her disease into the curse of the disease 
with its hungry ghosts. No glass Japanese floats lie atop the scarred nightstand; but earrings, ER receipts, doubts, matches, butt ends of relationships.
She regrets the drunken, meth-fueled fights with her husband, who later committed suicide. “Killed himself over…whatever. Me,
all that lottery money, heartache, whatever.” Moonlight creek sings to Cottonwoods in the darkness. Grief waxes and wanes.
When loneliness strikes, she writes lamentations: Full October moon Drowns pinpoint constellations. I miss your bright eyes.
The riptide from the fifth of a gallon a day floods the road of good intentions. Its ebb leaves tide pools of anxiety and depression ripening in a sour stomach. 
Each morning’s hangover brings the pounding of relentless reality, the ever-present eternal goddam now. Last night’s shame haloes her head in hangover vises. She pukes. Starts the hands-and-knees
search party for dimes or quarters or pennies for a half-pint of mercy. She ignores the snores of an anonymous cowboy under a throw and the spray of clothes.
She wipes withdrawal’s sweat from her face, swipes at the brain fog. The riptide created by her moons leaves an empty curse. She flings the empty purse
of promises into the furthest corners of cobweb resolve, another tourist attraction. When the new moon slides between sun and earth, the eclipse covers her soul like a shawl.
She peers into the silvered glass of the detox bathroom mirror, where a stranger greets her. A shadow of comfort arises when she strokes her new moon, colored and frozen on her neck

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!