Review of Ibogaine Treatment Assessment and Screening Practices
Assessment vs Screening
If somebody you love needs help to overcome substance abuse or addiction, how do you determine the extent of the problem and what kind of help is needed? And how do you decide whether rehabilitation is appropriate?
Most experts agree that successful treatment of substance abuse starts with—and depends on—thorough and accurate assessment of the individual.
An important distinction is that assessment is not the same as screening. Screening relies on questionnaires, which are scored, and if the score suggests the individual has a problem, then the next step would be to conduct an in-depth assessment.
The purpose of a professional assessment is to determine whether a person has a real substance abuse disorder and, if so, how severe it is. The assessment will also determine whether any additional psychiatric and/or medical problems need to be addressed.
Most traditional residential rehabs do not conduct proper assessment of their clients, relying instead on the ASAM Criteria.
The “ASAM Criteria” refers to the American Society of Addiction Medicine’s Patient Placement Criteria, which outlines six treatment-planning dimensions addressing areas such as: readiness for change, relapse potential and medical needs. These guidelines were created to provide a common language for mental health professionals to describe the severity of a patient’s substance abuse problems, and to help guide proper placement.
In reality, the ASAM Criteria are complicated and difficult to implement. What usually happens is that the provider interviews the patient, looks broadly at the ASAM assessment dimensions, and says the patient is appropriate for whatever level of care the provider wants, whether needed or not.
Very few rehabs use reliable, validated assessment tools that have been developed by researchers to assess a client’s multiple needs and help the treatment team design appropriate interventions.
The “gold standard” in assessment tools are the Addiction Severity Index (ASI) and the Global Appraisal of Individual Needs (GAIN).
What does a proper assessment look like?
An ideal assessment takes into consideration the following:
• Age, gender and marital or partner status
• Educational status
• Substance use history (Such as: date of last use, how much is regularly used and whether the problem is occurring now or in the recent or distant past. This part of the assessment helps determine whether the patient is currently intoxicated, in withdrawal or abstinent.)
• Culture and ethnicity
• Treatment history
• Information on previous treatment experiences
• Medical history (For example, at Crossroads Ibogaine Treatment Center we include laboratory tests, EKG and a physical exam conducted by an internal medicine specialist to make sure patients are healthy before we begin Ibogaine detox therapy.)
• Psychological/ psychiatric history
• Occupation and financial status
• Religious affiliation
• Readiness and motivation to change
• Level of insight that the patient has into his/her problem drug use
• Identification of strengths, resources and sources of support.
• Determination of need for various kinds of support, including: medical, legal, housing, marital, financial, etc.
Finally, the process of conducting an assessment and offering a recommendation should end in a way that feels collaborative, useful and informative.
For more information on the “gold standard” assessment tools, visit: Addiction Severity Index (ASI) and Global Appraisal of Individual Needs (GAIN).
