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The DAST-10 Drug Abuse Screening form implements the abbreviated 10-item version of the Drug Abuse Screening Test, a validated self-report instrument designed to identify patients who may be misusing prescription medications, over-the-counter drugs, or illicit substances. Unlike alcohol-specific tools such as the CAGE or AUDIT, the DAST-10 focuses exclusively on drug use other than alcohol, making it an essential complement in comprehensive substance use screening protocols. Each of the ten questions addresses a different dimension of problematic drug use over the past 12 months, including inability to stop using, withdrawal symptoms, blackouts, drug-related medical problems, and neglect of responsibilities.
The digital version uses simple yes/no response options and automatically calculates the total score from 0 to 10. Scoring zones categorize patients as no problems reported (0), low level (1-2), moderate level (3-5), substantial level (6-8), or severe level (9-10). Each zone is linked to clinical action recommendations ranging from monitoring and brief intervention for low-level scores to intensive assessment and referral to specialized substance use treatment programs for substantial and severe scores. The scoring aligns with SAMHSA SBIRT protocols and ASAM criteria for level-of-care determination.
This template is widely used in primary care offices, behavioral health clinics, emergency departments, pain management practices, and criminal justice health programs. The DAST-10 is particularly valuable in settings where prescription opioid and benzodiazepine misuse screening is a priority. It supports compliance with state prescription drug monitoring program (PDMP) requirements and is recommended by NIDA and the World Health Organization as part of routine screening. The form uses non-stigmatizing language and includes confidentiality assurances consistent with 42 CFR Part 2 protections for substance use records.
What's included
- All ten validated DAST-10 screening questions
- Automatic score calculation with five severity zones
- SBIRT-aligned clinical action recommendations per score level
- Non-stigmatizing language with confidentiality assurances
- 42 CFR Part 2 substance use record protections notice
- Referral documentation and follow-up action planning
Who uses this template
- Primary care routine drug use screening alongside alcohol assessments
- Behavioral health intake and substance use disorder evaluation
- Pain management clinics monitoring prescription opioid misuse risk
- Emergency department SBIRT programs and crisis intervention screening
All form fields
12 fields across 1 page. Customize any field after signing up.
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