The following questions are frequently asked on our Clinical Helpline, which is free to all customers using the SASSI or BADDS products.  Simply call 800.726.0526 option 2, Monday through Friday between 11 a.m. to 5 p.m. (EST) for assistance with the administration, scoring, and interpretation of an instrument.

I need to take a SASSI, where do I go?

If you are an individual in need of a SASSI screening and evaluation, please use the SAMHSA.com provider locator to find professional services in your area that may offer SASSI screening.

How do you interpret the Supplemental Addiction Measure (SAM)?

SAM scores are used in the Decision Rules to increase the accuracy of other subscales. Interpretation of the SAM is not a function of its use.

How do you interpret the slope of the line formed by the scale scores?

Although some clinicians draw on ‘anecdotal’ reports to predict behavior patterns based on the slope of the line, this practice is not supported by SASSI data and is discouraged. Individual subscales may be interpreted with caution only as directed by the SASSI User’s Guide.

My client wants to get his driver’s license back. He reports abstaining from alcohol for over a year. Should I have him complete the SASSI for a lifetime or for the past year?

Either is acceptable. Your client and the court should be made aware that the SASSI cannot determine if a client is currently drinking. The Face Valid items may show no drinking during the past year, but the subtle scales reflect personality traits that do not change quickly. For instance, someone who is in recovery for an extended period of time will more than likely still show as having a high probability of a substance use disorder.
Another option is to administer the Behaviors & Attitudes Drinking & Driving Scale (BADDS) to determine the extent to which your client may be at risk for drinking & driving.

Should I use the SASSI or the BADDS?

If your objective is to identify those who are likely to have a substance use disorder, screening instruments such as the adult, adolescent, or Spanish SASSI measures can assist you to this end. If your goal is to identify more specifically those who are likely to engage in impaired driving behaviors, or if your goal is to evaluate the effectiveness of an impaired driving intervention, the BADDS is a highly valuable tool.

A client admits to a severe issue with gambling. She is taking several prescribed medications for chronic illnesses. Although her Face Valid scales are low, the SASSI finds a high probability of a substance use disorder. Does this confirm a gambling addiction?

No. The SASSI should not be used to determine whether or not someone has a gambling addiction. However, there does appear to be a high probability that the client has a substance use issue and further exploration into her prescription drug use would be appropriate. For instance, does the client take only prescribed medications in quantities approved and overseen by a single physician?

Is it acceptable to read the SASSI to a client who is illiterate or blind?

Occasionally reading the questionnaire to a client is acceptable. However, we do strongly recommend that clinicians take advantage of our professionally read CD and/or audiotape. Using the professional CD or audiotape will ensure that the questions are read to the client in a way that would not interfere with the accuracy of the responses.

Is it appropriate to give the SASSI to my client more than once?

The SASSI questionnaires have been validated as screening instruments to identify individuals likely (and unlikely) to be diagnosed with a substance use disorder. These screening instruments are not measures of therapeutic change. Therefore, readministration of a given SASSI questionnaire to the same individual is not recommended, except in circumstances where the screening results yield an elevated Random Answering (RAP) score and after conversation with the individual, the clinician determines that instructions for completing the questionnaire were not followed or understood. In addition it may sometimes be helpful to readminister the questionnaire if an individual’s defensiveness (DEF) score is elevated and the clinician feels greater rapport has been established with the client. See the SASSI User Guides for additional information on RAP and DEF scores.

How accurate is the SASSI?

The Adult SASSI-4 has a validated 92% overall rate of screening accuracy in identifying mild, moderate, and severe substance use disorders. The Adolescent SASSI-A3 has an overall empirically tested accuracy of 89%. Validation research on the Spanish SASSI indicates an overall accuracy rate of 84%.

When should I administer the Adolescent SASSI (SASSI-A3) vs. the Adult SASSI (SASSI-4)?

The Adolescent SASSI (SASSI-A3) should be used with youth between the ages of 13 and 18 years. Exceptions can be made. For example, it may be appropriate to administer the SASSI-4 (adult version) to a 17 year old who no longer lives with his/her parents and is full self-supporting. On the other hand, the SASSI-A3 may be more appropriate to use with an 18 year old in high school who is still dependent on his or her parents.

Is the SASSI-4 accurate for older adults?

Yes. Validation research on the SASSI-4 found an overall accuracy rate of 93.5% for adults 60 years or older.

Will SASSI stand up in court?

If you mean will the judge always agree with the results of SASSI decision rules, we actually hope not. For example, the Adult SASSI-4 is a highly accurate screening instrument but does not agree with clinical judgment 100% of the time. In 7% of cases of adults diagnosed with mild, moderate or severe substance use disorders, the SASSI screening results will likely fail to identify the disorder (i.e., the SASSI-4 demonstrated 93% sensitivity in validation research). Similarly, in 10% of adults diagnosed by a clinician as NOT having a substance use disorder, the SASSI-4 decision rules are likely to indicate a high probability screening result (i.e., 90% specificity). This is why we encourage counselors to use their judgment and other information from interviews with the individual and family members when possible, as well as other information on treatment and court records when formulating their diagnoses. The SASSI does not yield a clinical diagnosis but rather a screening result that can be used as one piece of information when conducting clinical diagnostic evaluations

Does the SASSI command high credibility in the court?

Yes. One reason is the accuracy of the screening results. One important part of this credibility is that many other screening measures deliberately set their cutoff scores very low in order to maximize sensitivity of their instruments, often at the cost of misidentifying those without substance use disorders as test positive (i.e., low specificity). In contrast, one goal in developing the SASSI decision rules was to balance the false positive and false negative error rates.

Does the SASSI identify those with substance use disorders specifically, or does it classify as test positive anyone who may have another psychiatric disorder or problems in adjustment and functioning?

Another reason the SASSI-4 has high credibility is that while other screening instruments may misidentify individuals with emotional problems as if they were alcoholic or drug addicted, the SASSI was developed to not confuse difficulties associated with other psychological conditions with substance use disorder. Research on the SASSI-4 has found that patients who are receiving clinical services for psychiatric disorders such as anxiety or depression, for example, but who do not have alcohol or drug problems are correctly identified with “low probability” SUD screening outcomes 93% of the time (i.e., with a 93% specificity rate). In addition, the SASSI-4 showed a 98% accuracy rate in identifying dual diagnosis clients with “high probability” SUD screening outcomes (i.e., 98% sensitivity in a sample of individuals with co-occurring SUD and other disorders), indicating the instrument is highly accurate in detecting the presence and absence of SUD even when non-substance related psychological symptoms are evidenced.

What happens if the SASSI results are subpoenaed?

Counselors who have their diagnoses, including test results subpoenaed by defense attorneys have told us that they often offer instead to loan the attorney a copy of the SASSI manual. Frequently the attorney will review the manual and successfully convince their client to plea bargain rather than try to challenge the diagnosis.

How well utilized is the SASSI among courts?

The SASSI is not only accepted, but is actually required in a sizeable number of courts. For example, we are aware of five states that require everyone arrested for a DUI (DWI) to be given a SASSI and Behaviors & Attitudes Drinking & Driving Scale (BADDS) as part of the evaluation. Other examples of government mandated administrations occur in areas such as detention and correctional facilities, and probation departments.

LGBTQA issues: What side of the Profile Sheet to use in cases where gender is in question?

Score the side of the profile sheet that the transgender client self-identifies with. Not when or if they started hormones, or in a current state of transitioning, or they identified as a different gender when the legal offense happened.

This is discussed in detail in a previous blog post, click here to view the full version. 

Sample Profile Interpretations:

Adolescent A3 – Emphasis on COR Scale

This profile is a good example of needing to be careful with assumptions. Overview of CORRECTIONAL (COR) SCALE The COR scale provides information pertaining to the possibility that the client may have a relatively high risk of experiencing legal problems. It is composed of items that differentiated between people who had a history of involvement in the juvenile justice system and those who did not. It is very important not to over-interpret elevated COR scores.… Read more

A SASSI-4 Profile: When the Drug Use is Marijuana

It is no news that the use of marijuana is viewed by many, no matter what the demographic, as innocuous and far less than alcohol and certainly any other drugs. It has become increasingly difficult to convince users of the harm associated with marijuana use when the legal status ranges from fully illegal, to medicinal and/or decriminalized to fully legal. Users often describe marijuana as simply a plant so it is a natural and therefore… Read more

SASSI-4 Profile of Adult Male Involved in a Custody Suit with ex-Spouse

A substance use evaluation administered on an individual involved in a custody suit can reliably be fraught with issues. This one presents a number of them. This 39-year-old client was instructed to complete the FVA/FVOD questions for his whole lifetime. A significant issue was his history of 4 DUI’s from 2020 – 2021 while in the process of separation and divorce. He denies his current use is anything like it was during that period. The… Read more

Elevated RAP/ High Probability Results on an Adult SASSl-4

This profile on a 21-year-old female with the FVA and FVOD, based on the last 12 months, is interesting primarily because it is so unusual. As you look at the profile graph, all the scale scores are within the norm, i.e., between the 15th and 85th percentiles except for the SYM score which is above the 85th percentile. This tells you that she is acknowledging symptoms and consequences of her use and indicates she is… Read more

Pre-employment Screening / A Profile Review on the Proper Use of the SASSI-4

A recent caller wanted help in interpreting a profile completed by a 33-year-old male. He was instructed to complete the FVA/FVOD side of the questionnaire for the last 12 months. The administrator revealed during the call that the assessment was a pre-employment screening for the Department of Transportation. The helpline does receive regular calls from counselors who administer the SASSI-4 for the Department of Transportation after a driver has failed a drug or alcohol test… Read more

SASSl-4 Profile Analysis – DOT Client

We frequently receive calls requesting clinical interpretation of profiles done on Department of Transportation (DOT) clients. These clients have failed their drug/alcohol screening and their license to drive has been suspended pending an evaluation. In this particular case, the client is a 68-year-old female whose alcohol level registered above the DOT threshold. Her SASSI result indicated a high probability of a substance use disorder based on Rule 9. As you see on the graph, most… Read more

Addressing the Ethical Issues of Mandated Client

This sample profile is about a 27-year-old, Sally, who is a single mother of two small children. Sally was ordered by the court to report for a substance abuse assessment following an arrest for illegal possession of a controlled substance. Sally is also being investigated by the county’s Child Protective Services Agency, who has placed her children into foster care pending the outcome of the case. An initial review of Sally’s scores indicates that, although… Read more

Reviewing an Adolescent SASSI-A3: Vaping Issue

This is an issue that may be turning up in your clinical practice. The caller wanted help with a profile interpretation on a 13-year-old male who had turned in a vaping pen. The school was mandated to do a substance use evaluation as a result. The online report indicated “inconsistencies” in the results so the counselor wanted more information. The client was instructed to complete the FVA/FVOD side for his whole lifetime. The overall result,… Read more

Profile Configurations: When the OAT is higher than the SAT vs when the SAT is higher than the OAT     

One question we field often on the clinical helpline is what does it mean when either the OAT (Obvious Attributes) is higher than the SAT (Subtle Attributes) or when the SAT is higher than the OAT when both are elevated above the 85th percentile? Read more

A SASSI-4 Profile Analysis: Prescription Drug Abuse

A caller requested help interpreting the result of a SASSI-4 questionnaire on a male client who presented himself as having an opioid addiction. ‘Curtis’ is a 36-year-old married man. He and his wife have no children. He works as a landscaper which he describes as physically very demanding. His parents smoked marijuana while he was growing up and Curtis also smokes marijuana. His older brother died ten years ago, and Curtis is still grieving. His… Read more

A SASSI-4 Profile Analysis: Context Matters

If you have attended one of our trainings either in-person or online, you know the section on how to administer the SASSI to a client is one of the most important. A thoughtful approach can set the tone for the entire assessment by helping a client feel more at ease and engaged in the treatment process. We emphasize the importance of first establishing rapport with the client. The questionnaire is presented as an aid, not… Read more

SASSI Identifies Rx Abuse (with video)

 ‘Reggie’ is a 37-year-old married man. He and his wife have two children. He works as a warehouse worker where he was recently injured in a shipping dock accident. He recently returned to work after being on worker’s comp for several months during which time he was prescribed opioids for his pain. He was sent to his employer’s EAP provider for evaluation after returning to work and struggling with coping with the continued pain and… Read more

BADDS Sample Report

Mr. M. is a 38-year-old Caucasian male, presenting to the DUI Court with a second DUI offense. His first offense occurred and he was sentenced to time served (1 day), one year probation, paid a $500 fine, and his driver’s license was suspended for 90 days. Mr. M.’s probationary period from his first offense ended successfully.    A year later, Mr. M. was arrested and entered into a no contest plea for drinking and driving under… Read more

A SASSI-4 Profile Analysis: Reading Aloud the Questionnaire and Interpretation of Low Scores

We regularly get inquiries about the acceptability of reading the questionnaire to a client who may have difficulty with their reading skills. We discourage the evaluator from reading the questionnaire to the client for a variety of reasons, but the primary one concerns the validity of the results. No matter how careful the reader might be, the tone of voice or emphasis on a particular part of the question may lead the client in one… Read more

A Review of a SASSI-4

The SASSI-4 I am reviewing is interesting for what it is not. The client was instructed to complete the FVA/FVOD for the last 12 months.The client is a 34 year old male with a history of drug and alcohol use. He reports that two and a half years ago he successfully completed treatment. He stopped doing drugs but continues to consume alcohol. He was being evaluated by the order of the court for an “altercation… Read more

The “Unaware” Client

The client, Carol, is a 43-year-old married female, a successful business woman and mother of two children. She recently was arrested and charged with her first DWI after leaving a business dinner with sales associates. This is the first significant consequence related to her drinking. She claims that she does not have a drinking problem; however, she characterizes her mother as an alcoholic. As we take a look at her scores, first notice that Carol… Read more

Interpreting the Spanish SASSI

Carlos C. is a 36-year-old Mexican-American male who’s Spanish SASSI results indicate that he has a high probability of having a substance use disorder based on “yes” answers to Rules 1, 2, 3, 4 and 6 and because his FPOS score is 5 or less (FPOS=2). Validation studies indicate that 86% of the people who have substance use disorders are correctly classified by the Spanish SASSI based on the Decision Rule (High Probability) and the… Read more

Interpreting the Results of an Adolescent SASSI-A3 with a High OAT Score

Happy New Year everyone! I received my first Adolescent A-3 call on the helpline and was so excited and when I heard the numbers, I knew exactly why the clinician was calling. As you look at the profile, you can see most of the numbers are within the norm. He meets Rule 6 so comes up with a High Probability of a Substance Use Disorder and no Prescription Drug Abuse.  So, what clinical information can… Read more

Client’s High SAT Score Indicates Lack of Awareness

Bob is a 43-year old male who was referred by his attorney for a substance evaluation following a traffic fatality in which he was driving under the influence. Bob seems to have understood the items and responded in a meaningful way (RAP = 0). There is no significant evidence that Bob was defensive (DEF = 7). The most salient feature of the profile is the significantly elevated SAT score, which is a key feature in… Read more

Differentiating between Substance Use and a Substance Use Disorder in Teens Using the SASSI-A3

This sample case is based in part on SASSI-A3 scale scores that were called into our clinical help desk. The client, Josh (not his real name), is a 17-year-old male who was a senior in high school at the time of the assessment. Josh was referred to the school counselor after he was caught drinking beer on the school campus with some of his friends during a school-sponsored activity. Josh, an above-average student with no… Read more

SASSI Results Highlight Excessive Drug Use Including Rx Abuse

Angela T. illustrates a profile often seen in people who acknowledge that they use drugs excessively and have come to rely on them as a coping resource. Angela’s scores on the SASSI-4 meet the criteria for classifying her as having a high probability of a substance use disorder. Angela’s score on the Rx scale also indicates a high probability of prescription drug abuse. Reviewing her scale scores reveals openness in disclosing her use of drugs… Read more

Enhancing Your Clients’ Insight and Motivation Using the SASSI

Through the years, we have had the opportunity to share inspirational stories with our colleagues about their experience using the SASSI. One such story came recently from a psychologist who uses the SASSI in his practice. This was a gratifying story for us to hear and we are pleased that he has allowed us to share it with you. The mother of a 22-year-old woman called me because she felt very strongly that her daughter… Read more

Defensiveness and Non-voluntary Clients

The Importance of Additional Assessment Data The client is a 38-year-old male named Jim (not his real name), who was referred for a substance use evaluation following a second arrest for domestic violence. The practitioner calling in the profile reported having collateral evidence substantiating a significant history of alcohol abuse for this client. The SASSI results indicate that Jim has a low probability of having a substance use disorder. He is not acknowledging any significant… Read more

SAM Contributes to SASSI-4 Accuracy

This SASSI-4 profile of a 37-year-old female was called in to our clinical support line. As we look at her results, it appears that she answered the items in a meaningful manner (RAP=0).  She is likely to have a high probability of a substance use disorder (SYM=6, SAM=8) based on decision rule 6. Notice that despite the relatively low DEF score and apparent lack of defensive responding, the SAM scale score, when combined with the… Read more

SYM Scale and Environmental Factors

We had the opportunity to consult with a treatment provider who had called in SASSI-4 scores for a Native American couple residing in Canada. Since both profiles nicely illustrate important clinical features of each client, we decided to present the interpretations in this sample. We are grateful to the treatment agency in Northern Canada that granted us permission to use the information included in this sample. To facilitate the presentation of the profiles in a… Read more