A substance abuse evaluation is one of the first steps to recovery from drug and alcohol addiction. If you have an appointment set for a substance abuse evaluation, you may be feeling a little anxious not knowing what to expect. This is completely natural, but please know that you are not alone in this process.
Here we will cover everything you need to know about substance abuse evaluations, including different types of evaluations, components of an evaluation, and the cost of a substance abuse evaluation, as well as practical tips to prepare yourself for the evaluation. It may feel overwhelming, but you are on the road to recovery from a life-changing experience.

What Is a Substance Abuse Evaluation?

A substance abuse evaluation is a thorough examination conducted by a licensed mental health or substance abuse counselor to gather information about a person’s current substance use. Key components of a substance abuse evaluation include screening tools and assessments, followed by treatment recommendations.

Substance Abuse Screening

Generally, a substance abuse evaluation begins with screening questions. This may be done in writing or over the phone prior to your appointment. Some of the important things asked during an intake screening include:
  • Which substances you use, including specific frequency and last use of each substance
  • Any withdrawal symptoms you are currently experiencing
  • Significant medical history
  • Occupation
  • Family dynamics, including who you live with and their ages
  • Mental health history
  • Legal history and current status
Some of the screening questions may be simple yes or no answers that the evaluator will use to ask more in-depth questions in the assessment interview.
Depending on your provider, specific screening tools, such as the CAGE Questionnaire for alcohol use, may be given.

Substance Abuse Assessment

The substance abuse assessment portion of a substance abuse evaluation is usually in person and will go more in-depth about the nature of your substance abuse. You can expect the assessment to last a few hours as the evaluator asks more specifics about your current substance use, treatment history, current and past withdrawal symptoms, medical history, mental health history including trauma, significant developmental milestones, family dynamics, past and current family substance abuse, and anything else the evaluator may find significant for the assessment.
Many substance abuse evaluators use a format developed by the American Society of Addiction Medicine (known as ASAM). ASAM uses six dimension categories to determine the severity of your use. These dimensions are:
1 – Acute Intoxication and/or Withdrawal Potential
2 – Biomedical Conditions and Complications
3 – Emotional/Behavioral/Cognitive Conditions and Complications
4 – Readiness to Change
5 – Relapse/Continued Use Potential
6 – Recovery Environment
A score is formulated based on your answers to the questions on each dimension, which helps the provider determine the appropriate level of care for your recovery.

Purpose of a Substance Abuse Evaluation

A substance abuse evaluation has three main purposes. The first is to formulate a potential substance use diagnosis using the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), which was developed by the American Psychiatric Association. Once a diagnosis has been made, it is easier for members of your treatment team to communicate about your substance abuse. Diagnoses are also important for insurance companies to potentially cover any costs of your recovery treatment.
Another purpose of a substance abuse evaluation is to determine general treatment recommendations, including the level of care. Levels of care include:
  • Inpatient medically managed detox
  • Subacute detox
  • Inpatient residential treatment
  • Partial hospitalization
  • Intensive outpatient
  • Traditional outpatient
For more information on higher levels of care for substance abuse, click here or call Transformations at Mending Fences at (888) 974-9098.
The third purpose of a substance abuse evaluation is to help to create a recovery treatment plan that is tailored to your specific needs. For example, if you have mental health issues such as depression or anxiety, some of the goals on your treatment plan will have interventions to address these problems. Every person’s recovery journey is unique, and the more information providers have about yours, the better the likelihood is for a positive outcome.
The results of your substance abuse evaluation can also help you and your treatment team start developing a comprehensive relapse prevention plan that will guide your recovery. A relapse prevention plan is a guide to help keep you from returning to substance abuse. It includes triggers like specific situations or places where you crave substances and specific interventions and coping skills for each trigger.

Different Types of Substance Abuse Evaluations

Basically, there are two types of substance abuse evaluations: voluntary and court-ordered evaluations. Voluntary evaluations take place when you suspect or know you have a problem with substance use and you are seeking treatment on your own accord.
Court-ordered substance abuse evaluations are ordered by a judge because you have committed a crime while under the influence of drugs or alcohol. A judge may also mandate a substance abuse evaluation for situations like child protection cases and custody determinations.
Some of the reasons a criminal court may order a substance abuse evaluation are if you get arrested for driving under the influence (DUI), possession of illegal substances, and public intoxication.
People often proactively seek a substance abuse evaluation and treatment before it is mandated by the legal system. In this case, your insurance may cover the treatment. It also may look good to the judge that you take your offense seriously, and you may receive a less harsh sentence.
In the case of court-ordered substance abuse evaluations, your sentencing may include following the treatment recommendations of the evaluator. Many insurance companies consider this a plan exclusion and will not cover the cost of treatment.

Cost of a Substance Abuse Evaluation

For voluntary evaluations when entering a treatment program, your insurance company should cover some if not all of the cost. Call the customer care number on the back of your insurance card and ask about behavioral health benefits. Some of the questions you will want to be answered are:
  • Does my plan cover substance abuse evaluations?
  • Is pre-certification required for a substance abuse evaluation?
  • What is the difference in coverage for in-network versus out-of-network providers?
  • What are my deductible and out-of-pocket max?
  • How much of my deductible has been met?
  • Do you have a list of in-network substance abuse providers?
If your substance abuse evaluation is court-ordered, you will most likely have to pay for it out of your own pocket. Depending on where you are in your court case, insurance may cover the cost of substance abuse treatment but not the evaluation. The cost of a substance abuse evaluation varies from state to state, but generally, the cost is anywhere from $100 to $150.

Preparing for a Substance Abuse Evaluation

When preparing for a substance abuse evaluation, it is natural to feel nervous and worry about being judged. For this reason, many people minimize or try to hide their use. However, you can save yourself and your family valuable time by being completely honest about your use. Remember the people who provide substance abuse evaluations are licensed professionals and have heard it all. Trust that they are there to help you come up with a plan for your recovery.
A substance abuse evaluation typically includes a urine drug screen (UDS) or a blood test. The purpose of these types of screenings isn’t to try to trick or shame you. Substance abuse evaluators need to get an accurate read on exactly what types of substances are in your body. Getting a baseline on the drugs will help with level of care recommendations, treatment planning, and possible medication-assisted therapy (MAT).
Finally, if you are preparing yourself for a substance abuse evaluation, show yourself some compassion and grace. Admitting you have a problem with substances may be one of the hardest things you ever do in your life, but it may also be one of the shining moments that you look back on and can be proud of.


If you or a loved one is suffering from substance abuse, there is help available. Your first step is to call a treatment provider to set up a substance abuse evaluation for a possible diagnosis and appropriate level of care recommendations. The sooner you call, the sooner you can start working on your recovery treatment plan.
For questions about substance abuse evaluations or any other mental health or addiction issues, call Transformations at Mending Fences at (888) 974-9098. Admission coordinators are available to answer any questions and find out more about your specific concerns. They can complete a short phone screening to see if they are able to meet your needs and, if not, work with you to find an appropriate referral.