This TIP, titled Simple Screening Instruments for Outreach for Alcohol and Other Drug Abuse and Infectious Diseases, addresses the twin epidemics of substance abuse and infectious diseases. Service providers from many disciplines and across many systems and agencies are increasingly encountering individuals with AOD abuse problems, which place them at higher risk for acquiring infectious diseases. The TIP presents two screening instruments - one for AOD abuse and one for infectious diseases - that were designed to be able to be rapidly administered by a wide range of providers and relatively simple to score and interpret. The instruments are flexible and applicable to diverse populations. The TIP describes considerations in the development of these instruments and offers guidelines for their use in field tests. Guidelines for training staff in the use of these instruments are also presented, and legal and ethical concerns, especially in the area of confidentiality, are discussed.

Contents

• What Is a TIP?
• Consensus Panel
• Foreword
• Chapter 1 - Introduction
  • Rationale for Concomitant Screening
  • Scope of the Twin Epidemics
  • The Screening Process
  • The Development Process
  • Epidemiologic Criteria
  • Organization of This TIP
• Chapter 2 - Development of the Simple Screening Instrument For AOD Abuse
  • Domains Measured by the Instrument
  • Administration of the AOD Screening Instrument
  • Referral Issues
  • Glossary for AOD Abuse Screening
  • Sources for the AOD Screening Questions
• Chapter 3 - Development of the Simple Screening Instrument for Infectious Diseases
  • Purpose and Scope
  • Administration of the Infectious-Disease Screening Instrument
  • Linkages and Service Integration Models
  • Training Resources
  • Glossary for Infectious-Disease Screening
  • Notes on the Screening Questions
• Chapter 4 - Training and Implementation
  • Understanding the Rationale
  • Potential Barriers to Screening
  • Training for Administration Of the Screening Instruments
  • Implementation of Simple Screening Programs
  • Model Programs
• Chapter 5 - Legal Issues Surrounding Client Confidentiality
  • Perceived Obstacles to Maintaining Confidentiality
  • Federal and State Confidentiality Laws
  • Sharing Confidential AOD Information
  • Communication With Others
  • Other Exceptions to the General Rule
  • Other Rules About Confidentiality
  • A Final Note
• Appendix A - References
• Appendix B - Sample Curriculum for Outreach Workers
• Appendix C - Cultural Competence
• Appendix D - Federal Resource Panel
• Appendix E - Field Reviewers

This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. This publication was written under contract number ADM 270-91-0007 from the Center for Substance Abuse Treatment of the Substance Abuse and Mental Health Services Administration (SAMHSA). Anna Marsh, PhD, and Sandra Clunies, MS, served as the CSAT Government project officers. Duiona Baker, MPH, served as the Government content advisor. Randi Henderson, Mim Landry, and Deborah Shuman served as writers.

The opinions expressed herein are the views of the consensus panel members and do not reflect the official position of CSAT or any other part of the U.S. Department of Health and Human Services (DHHS). No official support or endorsement of CSAT or DHHS is intended or should be inferred. The guidelines proffered in this document should not be considered as substitutes for individualized patient care and treatment decisions.