HIV/AIDS Program
Substance abuse management: Guidelines for assessing options
Assessing the role and impact of drug/alcohol use
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- Ask the client:
- What are the good things about doing drug or drinking?
- What are some of the not-so-good things about doing drugs or drinking?
- How does doing drugs/drinking affect other aspects of your life?
- Examine the client-identified motivations for drug/alcohol use:
- Pleasure
- Escape
- Energy
- Sexual activity
- Relief from emotional or physical pain
- Helps being more social
- Ask whether there are any other pleasurable activities that do not relate to using drugs.
- Intake method:
- Is your method of intake causing you harm?
- Should you alternate with other methods of intake?
- How do injecting, snorting, smoking, oral, keistering affect you?
- What would you think about using the drug orally opposed to intravenously?
- What if you alternated between injecting and snorting?
- Frequency:
- How many times do you use/drink in a given day?
- How would it work for you if you reduced the number of times you shoot up each day from 6 to 3 times?
- How would it be for you to drink 3 drinks after dinner instead
of 5?
- Dosage:
- How much do your use/drink each time?
- What amount do you like to use (1/4 gram, 1 shot)?
- How much does it take to give you the pleasurable effects you like?
- How would it work for you if you injected an eight rather than a quarter?
- How would it be for you if you drank 2 shots in your drink instead of 3?
- Purity:
- How safe do you feel about "the cut" in the drugs you use?
- How would you feel about maintaining one or two regular, reputable dealers who do not cut the product with a lot of "bunk"
- Drug combinations:
- Do you experience any negative effects that might be caused through interaction with other drugs you are taking? (i.e. Methamphetamines and antidepressants or antiretroviral drugs; alcohol and antidepressants etc.)
- How does using effect the daily dosing regimen of protease inhibitors, other HIV medications or any other medications you need to take on a regular, consistent basis?
- What would you think about setting an alarm of some kind that could help you manage some of these issues?
- Environment:
- Are you in a safe physical environment when you use?
- Are you alone or with others?
- Do you feel safe one way more than another?
- Outside responsibilities:
- Have you reduced outside responsibilities?
- Have you coordinated responsibilities around your high?
- Adverse reactions:
- Have you prepared for adverse physical reactions?
- Have you prepared for adverse psychological reactions? (i.e. What if you get really paranoid? Do you have a plan for dealing with it?)
- Legal risk:
- What level of legal risk do you face in using?
- Do you have a relatively safe copping plan?
- Are you on probation, do you have warrants?
- Are you going to be in public?
- Financial risk:
- What effect does using have on your finances?
- Are you able to maintain basic survival needs such as food, housing, clothing and transportation?
- What effect does using have on your ability to maintain comfort needs such as health care, message, counseling, recreation?
- HIV and STD risks:
- Do you have all the drug injecting equipment you'll need for your drug using period? (Sterile syringes, cookers, cottons, bleach, water)
- Do you have all the right equipment for your sexual play? (Condoms, lubrication.)
- Before getting high:
- Have you had a nutritious meal?
- Have you had plenty of water or juice to drink?
- Have you taken multivitamins?
- How would it be for you to plan for these things before you use?
- What would you think about always having a healthy meal before you drink?
- During the night:
- Can you drink water, suck popsicles, ice cubes, or find some way to rehydrate your body?
- What do you think about planning to have these things available to you before you use?
- After the high:
- Have you stocked the refrigerator with appealing foods for when you come down?
- What is your plan to have these things ready?
- General eating plan:
- Do you know the foods that will contribute most to restoring depleted levels of dopamine and serotonin or to stabilize post-withdrawal mood swings?
- Your use and affects on relationships:
- How does use affect your family (parents, brothers, sisters and others)?
- How does it affect you lover, sexual partners?
- How does it affect your drug using friend?
- How does it affect your non-drug using friends?
- How does it affect your relationships with your employer, doctor, case manager?
- Your use and your work:
- How does getting high or drinking positively and negatively affect your job?
- How does your job effect getting high or drinking?
- Do you like or dislike your work?
- How are your job and using related?
- Your use and community involvement:
- How does getting high positively or negatively affect being involved in the community?
- Are there activities that bring you satisfaction that you would like to do more?
- Your use and enhancing pleasure:
- What are pleasurable things about getting high or drunk?
- What are the not-so-good things about getting high or drunk?
- Are there other sources of pleasure that are affected by getting high or drunk? If so, what are they?
- How could getting high/drunk be made less harmful yet more pleasurable?
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related links
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 Drug Abuse Trends in King County. Detailing local area drug trends based on treatment admissions, emergency department mentions and drug-caused deaths.
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 Trail to Treatment (Adobe PDF format)*
Trail to Treatment is a guidebook for outreach workers, case managers, counselors and other frontline staff who refer adults to drug and alcohol treatment. It contains information that will help you and your clients access treatment.
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 King County Needle Exchange Program
Needle exchange is designed to reduce the spread of HIV/AIDS and other blood-borne infections among injection drug users, their families and communities.
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 Alcohol prevention for gay, lesbian and bisexual youth Gay, lesbian and bisexual teens, especially who have grown up in cultures that disapprove and disrespect sexual minorities, may drink to make their feelings go away. Drinking is one response and unfortunately can make things worse. |
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