The DAST is a screening tool used to help identify drug use issues that can be administered by clinicians or by self-reporting. Different versions of the DAST can be used, which include a varying number of questions. The DAST can help inform diagnosis and treatment but is not a diagnostic tool.
- DAST is a questionnaire that is used to screen for drug use issues.
- DAST can be used in any clinical setting or answered at home and can help determine if a substance use issue is present and to what degree.
- DAST is simple to administer and is reliable and accurate in finding risky drug use behaviors.
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DAST questionnaire and screening for substance abuse risk
The Drug Abuse Screening Test (DAST) was designed by H.A. Skinner in 1982 and published by the Center for Addiction and Mental Health, Toronto, Canada. The original test consists of 28 items that are answered yes or no to help determine whether a drug abuse issue is present and to what severity. [1][2]
The test includes questions about the use of drugs not including alcohol within the last year. This refers to the use of any illicit drugs or prescription and over-the-counter drugs in ways not directed. The questions involve drug use behaviors and consequences and the views of the individual and others about their drug use. [2]
The original DAST consists of 28 items. Skinner and the Center for Addiction and Mental Health have also adapted and published shorter versions. The DAST-10 and DAST-20 consist of 10 and 20 items respectively, that are included in the original DAST. [2] In 2000, Martino et al developed the DAST-A, which is the adolescent version with slightly different language. [3]
How to administer the DAST
The DAST can be administered in a clinical setting by a healthcare professional in interview form or as a self-report by people at home. It can be used to identify drug use issues in psychiatric patients, people attending hospitals or primary care, or any other individuals with suspected substance use issues. [4]
The DAST is quick to administer and is a simple test to use for individuals answering at home without a professional.
Limitations and considerations
Some of the limitations and considerations of the versions of DAST include: [2][5]
- The tests don’t take into account cultural or social differences that may impact the results
- People could give a fake answer to impact their results
- Scores do not give a clear picture of the individual’s well-being or functioning and may be misinterpreted
- Low threshold scores, particularly for the DAST-10, might over-identify drug use issues, although additional assessments can provide further confirmation
DAST vs. Other screening tools
DAST is one of the most widely used and most reliable screening tools for drug use problems. Different versions can be used, all of which are quick and simple to administer. [5] Other accurate and easy-to-use screening tools, including CAGE, SBIRT, and AUDIT, can also be used.
The number of items in each test can impact not only how quickly the test is administered but also the accuracy of the results. Also, some tests, such as the AUDIT, screen only for alcohol use issues, and the DAST only screens for drug use issues.
DAST-10: Self-test option
The DAST-10 is the quickest and easiest version of DAST to use at home. People can complete the DAST-10 themselves to help determine the degree of their substance use issues. The following 10 items should be answered with yes or no:
- Have you used drugs other than those required for medical reasons?
- Do you abuse more than one drug at a time?
- Are you unable to stop abusing drugs when you want to?
- Have you ever had blackouts or flashbacks as a result of drug use?
- Do you ever feel bad or guilty about your drug use?
- Does your spouse (or parents) ever complain about your involvement with drugs?
- Have you neglected your family because of your use of drugs?
- Have you engaged in illegal activities in order to obtain drugs?
- Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs?
- Have you had medical problems as a result of your drug use (e.g. memory loss, hepatitis, convulsions, bleeding)?
Scoring and interpretation
Each question should be answered yes or no. If people are unsure about an answer, the response that is mostly correct should be chosen. Each question that is answered yes scores one point, apart from question 3 in the DAST-10, which score one point for no and 0 points for yes.
These points are then added together and interpreted as the following: [2][6]
- 0: No problems
- 1-2: Low level of issue
- 3-5: Moderate level of issue
- 6-8: Substantial level of issue
- 9-10: Severe level of issue
What to do if you score high on the DAST
A low degree of substance use issues should be monitored and re-assessed at a later date. Moderate to severe degrees of substance use issues should be further investigated, with higher-scoring people being recommended to receive intensive assessments and treatment. [7]
If a healthcare professional administers the DAST, they will likely make an appropriate referral for those with higher scores. People answering the DAST-10 questions at home may wish to consult with a medical professional about their score, particularly if it is 3 or above, to receive advice on available treatment or intervention options.
People who score 0 do not need to take any action. If people taking the test at home score 1-2, they may wish to retake the test after a period of time, or make changes to their lifestyle or behavior to improve their score.
Treatment options for substance abuse
People with substance use issues can utilize professional treatment to reduce or stop drug use. This can include:
