Tag: SUD

Substance Use Disorder


A frequent question we get is regarding the web-based version of the SASSI-4 and how to identify the SYM (Symptoms) scale items on a client’s completed questionnaire. Because the SYM items are face valid they can give you information concerning the client’s substance use and it may be worthwhile to do a content analysis of the SYM items as they directly relate to substance use.

While logged into your sassionline.com account, click on the tab ‘My Clients’ and then click on ‘Support Materials.’ On the Support Materials page click on ‘SASSI-4 User Guide.’ Go to page 19 for the information on SYM. There you will see the 20 SYM items listed. We suggest you print this page out to assist in identifying the SYM items on your clients’ completed questionnaires.

As always, we encourage you to call our free clinical help line for interpretation assistance at 800.726.0526 Option 2.

A Good Assessment is Key to a Good Use of the SASSI

This SASSI-4 profile is an excellent example of why the comprehensive assessment is a crucial part of the evaluation process.

This 33-year-old male completed the FVA/FVOD side of the questionnaire for his whole lifetime.

His RAP is 0 as is his Prescription Drug Scale.

His profile graphs most of his scores within the norm, between the 15th and 85th percentiles. The one standout is the SAT score of 0. That score indicates someone who is hypersensitive to what others think about him and may harbor feelings of resentment coming across as having a chip on his shoulder. Although the DEF score of 7 is not quite high enough to trigger looking at the possibility of SASSI missing individuals with a substance use disorder, it is significantly above average so there may be a “hint” of him exhibiting defensiveness.

Based on the face of it and on the SASSI alone, he comes up with a Low Probability of a Substance Disorder.

So, what is missing? The information gathered from the rest of his evaluation.

This individual has a history of 3 DUI’s – one in 2013, 2020 and the last in 2023.

As you can see, he does not indicate in his FVA or SYM any issues with alcohol or negative consequences of his usage. From his perspective, he has not had negative consequences. It could be that what he was required to do historically was minimal i.e. an alcohol education class. As these offenses are spread over 10 years, it may mean that he has a problem with drinking and driving. What is his current usage? Does he have a diagnosable disorder based on the DSM-5? Knowing about his extensive history requires the Clinician to dig deeper into this client’s use history and question his perspectives.

A useful tool we offer for both individual administration and for alcohol-related education and treatment interventions is the BADDS – Behaviors & Attitudes Drinking and Driving Scale.

It identifies drinking and driving and riding behaviors, history of impaired driving, the likelihood of riding or driving with an impaired driver, rationalizations for drinking and driving and intervention effectiveness.

The BADDS can be used in Driver’s education classes, Impaired driving prevention, DUI courts and DUI programs, Colleges and Universities and Counseling and treatment programs.

The BADDS can be used as a pre-test or be re-administered to measure behavioral and/or attitudinal change in multiple intervals. The post-test can also assess overall program effectiveness.

The BADDS is available in a paper and pencil version only for those 18 years or older with a third grade reading level and takes about 15 minutes to administer. We do offer on-demand webinar training. For more information go to www.thebadds.com.

PDF Version Available for Download

Across the Pond and Beyond

Did you know that SASSI screening tools are available for use and are obtainable through our international distributors? If you are in, or have friends/colleagues in the UK, Australia, or Greece, please take note of our licensed distributors there for affordable access to SASSI screening tools.

In the UK, the paper & pencil version of the adult SASSI-4 and adolescent SASSI-A3 is available through SASSI Direct Ltd. For ordering information please email sassi@sassidirect.co.uk.

In Australia, the paper & pencil version of the adult SASSI-4 and adolescent SASSI-A3 is available through The Help Now Group. Since purchasing the web-based version of the SASSI through SASSI Online can be challenging for our Australian colleagues due to issues with credit card processing, access and administrations of the web-based version can also be purchased through The Help Now Group. For ordering information please email rodney@thehelpnow.org.

In Greece, a reliable and validated version of the translated adult SASSI-3 in Greek is available through Panagiota Kontoleon. For ordering information please email panagiota@kontoleon.com.gr.

We are pleased that these distributors are working with us to promote screening for those individuals suffering from substance use-related issues and disorders.

SASSI Online Tips and Tricks: Volume 8 | Viewing Report Results

SASSI Online is our web-based platform that supports the digital administration of the Adult SASSI-4, Adolescent SASSI-A3, and Spanish SASSI.

In this edition of SASSI Online Tips and Tricks we highlight the steps to view a client’s completed SASSI questionnaire results.  When a client completes the questionnaire, responses are sent to the scoring server for immediate results. You will receive an email notification that the questionnaire is complete, with instructions on how to view the report from the Account Dashboard. For security reasons, report results are not sent via email. 

To view the report and questionnaire responses you must be logged in to your dashboard, and locate the client on your My Clients tab. To view the report or questionnaire responses for your client, click on their Client ID. In the window, select what you would like to view from the following options: View Report or View Questionnaire.

The SASSI report includes a graph of the client’s scale scores, the outcome of the decision rules based on the client’s responses, and a narrative report on the client’s profile. The completed questionnaire contains all questions asked, the client’s responses, and the scale scores.

Sample SASSI Online Reports are available here:

If you are not currently using SASSI Online and would like to experience the features of the digital platform, create an account at www.sassionline.com.  If you already have an account, let us know if you have any suggestions for our next edition of SASSI Online Tips and Tricks.  As a bonus for reading this blog post to the end, reach out to us at blog@sassi.com, with the code phrase: Report Results, to request two free SASSI Online administrations!

Last Clinical Q&A Until Summer | Register Now!

We wanted to welcome you to join us for a free one-hour online SASSI Q&A session hosted by our Clinical Director, Kristin Kimmell, LCSW, LCAC. This will be our last free Q&A session until Summer.

The Q&A is scheduled from Noon-1pm ET on: April 16th. You can save your spot by clicking here. We welcome you to share profiles to discuss with the group by sending them (de-identified) via email any time prior to the session to scarlett@sassi.com. These profiles will help others learn about the SASSI and offer insight into the various profile configurations.

Note: Q&A sessions do not provide CEUs and are not a substitute for SASSI Training.

In-Person SASSI Trainings

Happy Spring! Our certified SASSI trainers have been busy doing live in-person training this year and would like to hear from you about the need in your local area for this service. Please visit the training page on our website to view a list of currently scheduled workshops at www.sassi.com/sassi-training. If nothing is scheduled in your area, please reach out directly to the trainer so they know there is interest in their area, and they can plan accordingly. They are also happy to schedule private in-person training for your agency/organization.

Reminder: Our clinical team is available M-F to answer questions about the administration, scoring, and interpretation of our instruments at 800.726.0526 option 2. This is a free service, and we encourage you to call often.

Adolescent SASSI-A3 Review: High Probability Result with a VAL of 6

This adolescent male profile presents some initial complications for the reviewer in regards to the clinical interpretation as seen on the graph. The face valid scales fall either within the norm or below the norm. One of the subtle scales is above the 85th percentile so is clinically significant, and another is below the norm. An examination of the scales produces useful information to guide the discussion of the results with the client and directing appropriate treatment considerations.

This 17-year-old male completed the FVA/FVOD side of the questionnaire for his whole lifetime.

The VAL is 6.

Rx Scale is 0.

High Probability of a Substance Use Disorder is based on Rule 6.

Rule 6: a. FVOD 7 or more. (8)

            b. FRISK or ATT or SYM is 3 or more. (SYM – 3).

            c. OAT 5 or more (7).

Clinical Discussion

The FVOD of 8 is above average and should be noted. Examining those particular questions, he endorsed will provide the groundwork for how and under what circumstance he is using drugs. With the FRISK (0) and ATT (1) scores so low, his use is not necessarily tied to his peers, nor does he have a belief or value system that supports the idea that everyone uses substances. Looking at his one ATT score will help to evaluate any beliefs he may hold around substances.

The SYM (3) score is above average and again, because it is a face valid scale, content analysis will provide information regarding the consequences that he does acknowledge.

The OAT (7) scale is significant because it is elevated above the 85th percentile. This is the subtle scale that you want elevated as it indicates someone who can acknowledge limitations and shortcomings. He can probably identify with other substance users and those behaviors represented in that population such as impatience, resentment, self-pity, or impulsiveness. This, of course, does not mean he wants to or believes that he can change. But this information can be used as a positive to recognize the insights he may have around his use.

The low SAT (1) score (below the 15th percentile) gives some clues on how best to approach this client. This score indicates he is very hypersensitive to what others think about him. He may come across as having a chip on his shoulder so tread lightly!

The DEF (8) score, though above average, is still within the norm so does not indicate significant defensiveness on the client’s part.

The SAM (3) and COR (3) have no clinical significance.

Does the VAL score of 6 impact the results? Given the outcome was High Probability based on Rule 6, the impact is nil. The VAL is significant only if the outcome was Low Probability. However, with that score, the evaluator may hypothesize that perhaps the client was trying to skew the results but failed.

Questions remain regarding the current use of substances by the client. Is he minimizing his use or is he presenting an accurate picture? He was not defensive so perhaps his overriding concern was how he was viewed by the evaluator.

Treatment Considerations

Recommendations for the level of treatment need to be considered if he does have a diagnosable disorder based on the DSM-5. Actual current use also needs to be established. The elevated OAT score does indicate he will not feel out of place in a group setting. Prior history of substance use issues also need to be considered. It would appear, however, that outpatient treatment would be a consideration with the level of intervention to be determined by the overall assessment.

We recommend administrators of the SASSI have access to The Adolescent SASSI-A3 User Guide and Manual. It contains information on scoring, interpreting profiles and includes examples of profiles. It defines all the scales, what they represent, clinical considerations and giving feedback. The Manual also contains the research and validation information. Please call our Customer Service number for more information on how to order – 800-726-0526.

PDF Version Available for Download

Another Public Health Threat: The Extensive Use of Bromazolam

We recently published a commentary in Public Health Open Journal regarding Bromazolam (fake Xanax) use. It is increasingly being found in the illicit drug supply, mixed with other drugs like fentanyl and heroin, among others. Within the commentary, we examine the current state of the science as it pertains to the public health dangers of Bromazolam and its various illicit distribution networks, not only in North America but across the world. We also examine possible directions the substance use disorder (SUD) field may undertake to address the proliferation and abuse of this substance along with overdose prevention efforts that include the public health dangers of Bromazolam use. 

We invite you to download this free commentary to read and share with your friends, family, and colleagues. 

Yet Another Public Health Threat: A Commentary and Examination of the Extensive Use of Bromazolam  

Upcoming Clinical Q&A and Live Online SASSI Training | Register Now!

We wanted to remind you about our free one-hour online SASSI Q&A sessions hosted by our Clinical Director, Kristin Kimmell, LCSW, LCAC.

We love hearing about how you are using the SASSI and answering your questions about our screening tools. We currently have three more FREE Q&As scheduled from Noon-1pm ET on: February 13th, March 12th, & April 16th. You can save your spot by clicking here. We welcome you to share profiles to discuss with the group, please send them (de-identified) via email any time prior to the session to scarlett@sassi.com. These profiles help others learn about the SASSI and offer insight into the various profile configurations. If you are a SASSI Online (www.sassionline.com) user, we have a LIVE certified SASSI training webinar for Session 1: Administration & Scoring of the web-based version of the SASSI scheduled for February 6th and Session 2: Clinical Interpretation on February 20th. Each session is 9am-1:30pm ET and costs only $60 USD per session. You can register by clicking here.

Note that the Q&A sessions do not provide CEUs and are not a substitute for SASSI Training. SASSI training provides 3.5 NAADAC CEUs per session or you can choose 3.5 TCBAP (for Texas professionals) or CACCF (for Canada professionals) CEUs.

Adult SASSI-4 Review: Does the SASSI evaluate for Video Gaming?

This is an interesting profile on a 23-year-old male as it brought up the question, we get on the helpline regarding video gaming. “Does the SASSI evaluate for video gaming addiction?”, especially if the administrator believes the client was possibly including video gaming as well as substance use in his answers. The simple answer is no, it does not, so please clarify with your client not to include video gaming.  A drug that is often associated with video gaming is Adderall so the follow-up question to a client who admits to excessive video gaming is to question what drugs are they using to maintain that level of energy and concentration.

This individual was instructed to complete the FVA/FVOD side of the questionnaire for the last 12 months.

RAP was 0.

High Probability of a Substance Use Disorder.

Prescription Drug Scale result was 3 so meets the cutoff for High Probability of Prescription Drug Abuse.

He met Rule 1 with a FVOD score of 21.

             Rule 2 with a SYM score of 7.

             Rule 4 with a SYM score of 5 (7) or more and a SAT score of 4 (7) or more.

Looking at the graph on the Profile sheet, you will see a significant elevation on the FVOD scale score – above the 98th% so he is openly acknowledging use of drugs. By analyzing his responses, you will gain insight into what circumstances he is using, including dealing with emotional or stressful issues. And remember, he is answering the FVOD questions based on the last 12 months.

The SYM elevation is above the 85th percentile – enough to meet Rule 2. Because SYM is a face valid scale, you can do content analysis on those questions to look at the symptoms and consequences of his substance use.

The OAT score is within the norm. It would probably be the case that he does not identify with other substance abusers. This may be related to his very low-DEF score.

The SAT score is within the norm but high. The administrator may pick up some denial or lack of insight on the part of the client. And again, it may be related to the DEF score.

The DEF score is very significant because it is so low, below the 15th percentile. This individual may be in emotional distress and may be suffering from depressive symptoms. He should be evaluated for depression as he may be using substances to self-medicate. He may also believe that if he wasn’t depressed, he would not be abusing substances thus the OAT and SAT scores may reflect this perception.

The Rx score is also very significant and warrants further investigation as to what prescription drugs he may be abusing and if, in fact, are related to video gaming.

The rest of the scores are within the norm, so not clinically significant.

In summary, these clinical results are hypotheses to explore with the client to determine the depth and scope of the client’s use in order to recommend a treatment plan which fits his particular needs.

We hope this is helpful to you.

The clinical helpline line is open for your inquiries, M-F, 12- 5 (EST) at 888-297-2774 and you will be directed to a clinical consultant. If we are not available, please leave a message and we will return your call.

And as always, Thank you for your interest in the SASSI.

PDF Version Available for Download