Overview
A Screen Identifies Risk; It Does Not Make a Diagnosis
Screening estimates whether a patient’s substance use warrants a fuller conversation and clinical assessment.
Screening estimates whether a patient’s substance use warrants a fuller conversation and clinical assessment. It does not by itself diagnose a substance-use disorder, establish impairment, or determine whether the patient is intoxicated or withdrawing. Ask in private and use neutral language. “We ask these questions routinely because alcohol, prescription medications, cannabis, opioids, stimulants, and other substances can affect health and treatment” reduces the sense that the patient has been singled out. A nonjudgmental approach improves disclosure; a positive result should lead to curiosity, not confrontation. The nurse should interpret the result alongside the patient’s pattern of use, loss of control, consequences, current physical state, and goals. A patient can have a low questionnaire score and still require urgent care for respiratory depression or delirium. Conversely, a high score in a patient who is currently stable calls for further assessment and a planned intervention, not an automatic assumption about the immediate level of danger.