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McLellan, A.T., Luborski, L., Woody, G.E., & O’Brian, C.P. (original); McLellan, A.T., Kushner, H., Metzger, D., Peters, R., Smith, I., Grissom,G., Pettinati, H., & Argeriou, M. (5th edition)
Free
Measure is in the public domain and may be used free of charge. Scoring software is available at a cost. Please see 'Online Resources' for more details.
Treatment Research Institute 600 Public Ledger Building S. Independence Mall West. Philadelphia, PA 19106 Tel: 1-215-399-0980 Fax: 1-215-399-0987
No copy available from the Knowledge Institute. Contact author or publisher.
Measure is in the public domain and may be used free of charge. Scoring software is available at a cost. Please see 'Online Resources' for more details.
1980, 1992
Original (ASI; 1980). Fifth edition (1992). Several versions: native version, ASI-Lite (149 instead of 163 questions), teen version (T-ASI), gambling version, and European version (EuropASI)
Drug/alcohol use, psychiatric/psychological status
Assesses type and severity of addictions/substance use disorders in 7 different areas of an individual’s life. It is NOT a diagnostic tool.
Can be used as a pre-treatment assessment to determine appropriate interventions and treatment programs, or as an indication of progress during and following completion of such programs.
The ASI was designed for use with adults, but has been used with adolescents as well. The teen version of the ASI (T-ASI) was designed specifically for use with adolescents.
Additional information to inform measure use
A sixth version of the measure is reported in the literature, the publisher still seems to be making the 5th version widely available and the sixth version has been hard to come across in a usable form.
Varies by version. The ASI has 161 items (plus 28 general information/demographic items); the ASI-Lite has 131 (plus 18 general/demographic) items; the Native version has 201 (plus 19 general/demographic) items; the T-ASI has 154 (plus 18 general/demographic) items.
The ASI has 6 subscales: Medical Status, Employment/Support Status, Drug/Alcohol Use, Legal Status, Family/Social Relationships, and Psychiatric Status. The Native version has an additional Spiritual and Ceremonial Practices scale (as well as a detailed family history form). The T-ASI has an additional School Status scale, and separates Family/Social Relationships into two different scales (i.e. a Family Relationships and a Social/Peer Relationships scale), but omits the Medical Status scale.
Most questions are a simple recording of patients answer. Most are yes/no or open-ended questions. Questions where patients are required to give a rating on a scale go from 0 (Not at all) to 4 (Extremely). Questions requiring the interviewer to give a severity rating go from 0 (no treatment necessary) to 9 (treatment needed to intervene in life-threatening situation).
Estimates range from 30-60 minutes.
Training is required to administer the ASI, but no specific educational or professional qualifications are listed. The training can be obtained either through a self-training package that is available, or by on-site instruction at the Training Research Institute.
It can be manually scored by a technician or scoring can be done with a computer program. Training is required to interpret results.
The norms, reliability and validity statistics included in each measure profile are those reported by the author(s) of the measure. It is important to note that altering, adding or removing questions from a measure voids these reported statistics, possibly making the revised tool unreliable and invalid.
The normative sample was drawn from a number of treatment programs in the Philadelphia area, including private and public facilities, and inpatient, outpatient, and partial hospital programs. There were also pregnant substance abusers drawn from a treatment program for mothers in Atlanta, Georgia. Incarcerated subjects were drawn from the Hillsborough County Sheriff’s Office Substance Abuse Treatment Program in Florida. Homeless subjects were drawn from a seven public detoxification centers in Boston, Massachusetts. All were adults and represented a wide range of socioeconomic and marital statuses, living situations, ethnicities, and substances of primary uses. There is some evidence to suggest that there may be unique ASI profiles for different ethnic/racial groups and genders (Brown, 1993).
The authors report excellent inter-rater reliabilities ranging from 0.84-0.95. Further investigation by other researchers has resulted in a wide range of reported inter-rater reliabilities, ranging from a low of 0.30 (Hodgins, 1992) to 1.00 (Alterman, 1994; Stoffelmayer, 1994). Many studies reported separate reliability data for the composite scores the interviewer severity ratings. Generally, inter-rater reliabilities tended to be lower for severity ratings than composite scores. Internal consistency was generally very good across studies, ranging from a low of 0.44 (Luo, 1997) to 0.89 (Leonhard, 2000). It has been noted that the psychiatric status, medical status, and drug/alcohol use subscales generally have greater internal consistency than the other scales (Makela, 2004). The same author also notes that many of the lower internal consistencies came from studies with special populations (e.g., the homeless or mental patients) or from European studies using translated versions of the ASI. The authors reported initial 3-day test-retest reliabilities all above 0.92. However, further studies have resulted in a much greater range, going from 0.03 to 0.97 (Makela, 2004). Makela (2004) noted that many of the lower test-retest reliabilities came from studies of special populations.
The authors report that concurrent and discriminative validities were demonstrated with respect to a number of other measures for both composite scores and severity ratings. A number of studies by other authors have also demonstrated moderate to extensive concurrent validity. One study demonstrated poor concurrent validity with other measures of drug/alcohol abuse (Kosten, 1983). A number of studies have also demonstrated predictive validity with respect to a variety of different outcome variables. The ASI also demonstrates good specificity and sensitivity.
No copy available from the Knowledge Institute. Contact author or publisher.
Measure is in the public domain and may be used free of charge. Scoring software is available at a cost. Please see 'Online Resources' for more details.
Treatment Research Institute 600 Public Ledger Building S. Independence Mall West. Philadelphia, PA 19106 Tel: 1-215-399-0980 Fax: 1-215-399-0987
Alterman, A.I., Brown, L.S., Zaballero, A., & McKay, J.R. (1994). Interviewer severity ratings and composite scores of the ASI: A further look. Drug and Alcohol Dependence, 34, 201-209.
Alterman, A.I., Bovasso, G.B., Cacciola, J.S., & McDermott, P.A. (2001). A comparison of the predictive validity of four sets of baseline ASI summary indices. Psychology of Addictive Behaviors, 15(2), 159-162.
Amoureus, M.P.S.R., van den Hurk, A.A., Breteler, M.H.M., & Schippers, G.M. (1994). The Addiction Severity Index in penitentiaries. International Journal of Offender Therapy and Comparative Criminology, 38(4), 309-318.
Appleby, L., Dyson, V., Altman, E., & Luchins, D. (1997). Assessing substance use in multiproblem patients: Reliability and validity of the Addiction Severity Index in a mental hospital population, Journal of Nervous and Mental Disease, 185(3), 159-165.
Bovasso, G.B., Alterman, A.I., Cacciola, J.S., & Cook, T.G. (2001). Predictive validity of the Addiction Severity Index’s composite scores in the assessment of 2-year outcomes in a methadone maintenance population. Psychology of Addictive Behaviors, 15(3), 171-176.
Brown, L.S., Jr., Alterman, A.I., Rutherford, M.J., Cacciola, J.S., & Zaballero, A.R. (1993). Addiction Severity Index scores of four racial/ethnic and gender groups of methadone maintenance patients. Journal of Substance Abuse, 5, 269-279.
Gerevich, J., Bacskai, E., Ko, J., & Rozsa, S. (2005). Reliability and validity of the Hungarian version of the European Addiction Severity Index. Psychopathology, 38(6), 301-309.
Haraguchi, A., Ogai, Y., Senoo, E., Saito, S., Suzuki, Y., Yoshino, A., ... Ikeda, K. (2009). Verification of the Addiction Severity Index Japanese version (ASI-J) as a treatment-customization, prediction, and comparison tool for alcohol-dependent individuals. International Journal of Environmental Research and Public Health, 6, 2205-2225.
Hendriks, V.M., Kaplan, C.D., van Limbeek, J., & Geerlings, P. (1989). The Addiction Severity Index: Reliability and validity in a Dutch addict population. Journal of Substance Abuse Treatment, 6(2), 133-141.
Hodgins, D.C., & El-Guebaly, N. (1992). More data on the Addiction Severity Index: Reliability and validity with the mentally ill substance abuser. Journal of Nervous and Mental Disease, 180(3), 197-201.
Kosten, T.R., Rounsaville, B.J., & Kleber, H.D. (1983). Concurrent validity of the Addiction Severity Index. Journal of Nervous and Mental Disease, 171(10), 606-610.
Krenz, S., Diecmann, S., Favrat, B., Spagnoli, J., Leutwyler, J., Schnyder, C., ... Besson, J. (2004). French version of the Addiction Severity Index (5th edition): Validity and reliability among Swiss opiate-dependent patients. European Addiction Research, 10(4), 173-179.
Larimer, M. E., Malone, D. K., Garner, M. D., Atkins, D. C., Burlingham, B., Lonczak, H. S., ...& Marlatt, G. A. (2009). Health care and public service use and costs before and after provision of housing for chronically homeless persons with severe alcohol problems. JAMA: the journal of the American Medical Association, 301(13), 1349-1357.
Leonhard, C., Mulvey, K., Gastfriend, D.R., & Shwartz, M. (2000). The Addiction Severity Index: A field study of internal consistency and validity. Journal of Substance Abuse Treatment, 18, 129-135.
Luo, W., Wu, Z., & Wei, X. (2010). Reliability and validity of the Chinese version of the Addiction Severity Index. Journal of Acquired Immune Deficiency Syndromes, 53(Supp. 1), S121-S125.
Mäkelä, K. (2004). Studies of the reliability and validity of the Addiction Severity Index. Addiction, 99, 398-410.
McCusker, J., Bigelow, C., Servignon, C., & Zorn, M. (1994). Test-retest reliability of the Addiction Severity Index composite scores among clients in residential treatment. The American Journal on Addictions, 3(3), 254-262.
McLellan, A.T., Luborski, L., Woody, G.E., & O’Brien, C.P. (1980). An improved diagnostic evaluation instrument for substance abuse patients: The Addiction Severity Index. Journal of Nervous and Mental Disease, 168(1), 26-33.
McLellan, A.T., Luborski, L., Cacciola, J., Griffith, J., Evans, F., Barr, H.L., & O’Brian, C.P. (1985). New data from the Addiction Severity Index: Reliability and validity in three centers. Journal of Nervous and Mental Disease, 173(7), 412-423.
McLellan, A.T., Kushner, H., Metzger, D., Peters, R., Smith, I., Grissom, G., Pettinati, H., Argeriou, M. (1992). The fifth edition of the Addiction Severity Index. Journal of Substance Abuse Treatment, 9, 199-213.
Meyers, K., McLellan, A.T., Jaeger, J.L., & Pettinati, H.M. (1995). The development of the comprehensive Addiction Severity Index for Adolescents (CASI-A): An interview for assessing multiple problems of adolescents. Journal of Substance Abuse Treatment, 12(3), 181-193.
Scheurich, A., Muller, M.J., Wetzel, H., Anghelescu, I., Klawe, C., Ruppe, A., ... Szegedi, A. (2000). Reliability and validity of the German version of the European Addiction Severity Index (EuropASI). Journal of Studies on Alcohol, 61(6), 916-919.
Stöffelmayr, B.E., Mavis, B.E., & Kasim, R.M. (1994). The longitudinal stability of the Addiction Severity Index. Journal of Substance Abuse Treatment, 11(4), 373-378.
