Learn / Substance Abuse Evaluations: Why They Matter and What to Expect

Substance Abuse Evaluations: Why They Matter and What to Expect

Kayla Gill
 May 31st, 2024|   Clinically Reviewed by 
Rajnandini Rathod

Key Points

  • A substance abuse evaluation is an assessment that helps your rehab get to know you.
  • They use the results to build an effective, personalized treatment plan.
  • Be prepared to answer questions honestly during this confidential process.

If you’re starting treatment for a substance use disorder, a substance abuse evaluation is a foundational first step. 

This confidential chat with a qualified professional—usually a therapist, psychologist, or social worker—dives deep into your relationship with substances. Through a series of questions and possibly some tests, they’ll determine if you have a substance use disorder (SUD) and how serious it is. They’ll also look at how substances affect your daily life, from your mental health to your job and relationships.

Why all the questions? This intel helps your treatment team build a treatment plan just for you, to set you up for success in recovery.

Here’s how it works.

What Is a Substance Abuse Evaluation?

In a rehab setting, this assessment is how a treatment center gets to know its patients. This process is important because it helps staff create an effective treatment plan. It’s one way to learn data that helps your treatment team determine the best course of action.


A diagnosis helps you and your treatment team get a clearer picture of what’s going on. 

To make a diagnosis, a qualified addiction treatment professional will talk to you in detail about your substance use. They’ll ask about what you’ve used, how often, and for how long. They’ll want to know if you’ve ever tried to quit before, and how your substance use affects your daily life.

Taken together, this information lets a clinician diagnose an SUD (or co-occurring mental health condition) and determine its severity.

Knowing exactly what you’re dealing with helps your treatment team create a recovery plan that’s right for you.

Treatment Planning for Addiction 

Your team will use the information they gathered from your evaluation to create a personalized treatment plan that fits your unique needs. This treatment plan is like a roadmap to your recovery. 

A thorough substance abuse assessment helps your therapists understand the biological, psychological, and social aspects of your addiction.1 Having a comprehensive picture lets your rehab tailor the treatment plan to address your addiction and any underlying issues that are causing it.

Legal Requirements

In some cases, substance abuse evaluations might be court-ordered. This happens in situations where the legal system needs a clearer picture of your substance use. For instance, if you’re arrested for driving under the influence (DUI), a judge might require an evaluation2 to assess the severity of your problem and decide if treatment is necessary. Substance abuse evaluations can also play a role in child custody disputes. A judge might order one to understand how substance use could affect your ability to care for a child.  

Defense attorney Allison Williams, Esq. explains how substance use evaluations are used in legal proceedings:3

The substance abuse evaluation looks into how your behavior is impacted by your use of substances. That could involve how it impacts your personal relationships, your work responsibilities, and your parenting.

In this case, the focus is on the behavior, on the substance used. “A substance abuse evaluation is a mental health assessment tool that looks into the issue of whether or not your use of substances, whether legal or illegal, has an adverse impact on your life,” says Williams. For example, “There are certain recreational drugs that…may constitute an illegal act, but they don’t necessarily mean that you committed child abuse and neglect.”

These evaluations are different than what you would experience in a voluntary addiction treatment program, and the outcome can have legal consequences. Most court-ordered substance abuse evaluations also include drug testing. 

Components of a Substance Abuse Evaluation

Clinical Interviews

The main part of a substance abuse evaluation is the clinical interview. This is a confidential conversation with a clinical professional like a therapist or social worker. They’ll ask questions about different aspects of your life to better understand your situation:

  • Substance use history: What substances you use, how often you use them, for how long, any attempts you’ve made to quit, and cravings
  • Health: Your physical and mental health history, including any underlying conditions that might be contributing to your substance use
  • Lifestyle: How substance use affects your work, relationships, finances, well-being, and daily life 

Questionnaires and Standardized Tests

Substance abuse evaluations often use questionnaires and standardized tests alongside clinical interviews. These provide additional data points to support the information gathered during your conversation. They might include: 

Your rehab might also administer a drug test (such as a urine test) upon arrival and potentially throughout your stay, depending on their policies. 

Medical Exam

While substance abuse evaluations mainly focus on your behavior and experiences, your assessment might also include a brief medical exam by a healthcare professional. This is to assess any physical health issues caused by or related to your substance use, and may include:

  • Vital signs: Fluctuations in vitals like blood pressure and breathing can sometimes signal withdrawal symptoms or underlying health conditions.
  • Checking for physical effects of substance use: This might involve checking your skin for infections or track marks, examining your eyes for abnormalities, and listening to your heart and lungs for any irregularities.
  • Neurological assessment: Simple tests may be used to evaluate your coordination, reflexes, and cognitive function. The doctor will be looking for any potential damage as substance use can impair these areas.

What to Expect During the Evaluation

The entire evaluation process typically takes a few hours. Specifics might vary depending on your facility, but here’s what you can generally expect:

  • Intake: You’ll start by filling out paperwork with basic information about yourself, such as your contact information and medical history.
  • Clinical interview: You’ll have a private conversation with an addiction treatment professional where you discuss any topics relevant to the condition you’re seeking treatment for.
  • Questionnaires and tests: You might be asked to fill out questionnaires that assess the severity of your dependence, your mental health, and the impact of substance use on your life. Some programs might also test for the presence of substances in your system. 
  • Physical exam: While not always included, some evaluations include a physical exam by a healthcare professional. This is to assess any physical health problems potentially caused by substance use. The doctor will likely check your vital signs, look for signs of withdrawal, and examine your general physical health.
  • Review and recommendations: After the evaluation is complete, the evaluator will discuss the results with you, explain their findings, and recommend next steps.

Preparing for a Substance Abuse Evaluation

Coming prepared for your evaluation can save time, ease your stress, and ensure you provide your treatment team with complete, accurate information. 

Gathering Documentation

Check with your rehab’s admissions team about which documentation you need to bring:

  • Medical records: If you have any medical records related to your substance use, such as hospital visits or doctor’s notes, bring them along.
  • List of current medications: Make a list of all the prescription medications you’re currently taking.
  • Treatment history: If you’ve been treated for substance use in the past, information like discharge summaries or treatment center reports can help inform your current treatment experience.

Don’t worry if you can’t find everything—just bring what you have. What’s most important is to be open and honest during the evaluation process.

Mental and Emotional Preparation

Substance abuse evaluations can get into some pretty personal details about your past, so it helps to take a moment beforehand to mentally and emotionally prepare. Expect to answer open-ended questions that encourage you to share your experiences honestly.

There’s no shame in talking through your experiences. Doing so as candidly as possible helps your treatment team design an effective plan. Remember: they’re not doing this to judge you, but to give you the best help they can. 

Addiction treatment is confidential, and that includes your initial evaluation. The information you share will be kept private according to HIPAA regulations, with some exceptions like potential harm to yourself or others. If you have any concerns about confidentiality, don’t hesitate to ask the staff directly.

After the Evaluation

Receiving Results

Once the addiction evaluation process is complete, the evaluator will usually discuss their findings with you right away. They’ll explain the diagnosis, recommend the next steps, and address any questions or concerns.

Next Steps

The results of your evaluation will guide the path forward. Here are some potential next steps:

  • Addiction treatment: If you have a substance use disorder, the evaluator will likely recommend starting treatment. They can discuss various treatment options with you, such as inpatient or outpatient programs, and help you find a program that best suits your needs.
  • Additional testing: In some cases, the evaluator might recommend further testing. This could involve seeing a specialist for a mental health assessment or undergoing additional medical tests to rule out any underlying physical conditions that might prevent you from participating in an addiction treatment program.
  • Referral to specialists: If you have a special need, your treatment team might refer you to other specialists for additional support. This could include, for example, medically supervised detox at a recommended detox center or a psychiatrist for medication management.

Finding and Choosing an Addiction Treatment Provider

When you’re ready to start treatment, finding the right program can make a world of difference. Here are some tips to help you choose a rehab that’s the right fit:

  • Treatment focus: Are you looking for treatment for a specific condition, or a program with specific therapies? Consider what type of program best suits your needs.
  • Credentials and staff: Take a look at the staff’s certifications and specializations. Look for experienced professionals with expertise in the areas you need to focus on.
  • Insurance coverage: Verify if the program accepts your insurance and find out what your out-of-pocket costs will be.
  • Location and amenities: Consider factors like the facility’s location, amenities, and the overall treatment environment. Does it feel comfortable and conducive to your recovery?
  • Reviews and recommendations: Read online reviews from past clients and seek recommendations from trusted sources like your therapist or primary care doctor.

Finding Solutions Together

The purpose of a substance abuse evaluation is simple: it’s how rehabs gather information on their patients, so they can help them. Once this in-depth assessment is complete, you’ll have a much clearer picture of your problems related to substance abuse—which is the first step to identifying the most effective solutions.

A comprehensive addiction treatment program can help you treat the mental, emotional, and physical aspects of your addiction, as well as uncover what’s driving it. Let this pivotal experience be a turning point in your life that puts you on the path to healing. 

To find a program that meets your needs, search for rehabs by location, insurance accepted, and more, and reach out to a center directly today. 

Return to Resource Library

Our Promise

How Is Recovery.com Different?

We believe everyone deserves access to accurate, unbiased information about mental health and addiction. That’s why we have a comprehensive set of treatment providers and don't charge for inclusion. Any center that meets our criteria can list for free. We do not and have never accepted fees for referring someone to a particular center. Providers who advertise with us must be verified by our Research Team and we clearly mark their status as advertisers.

Our goal is to help you choose the best path for your recovery. That begins with information you can trust.