DAST Screening Tool: Score and Next Step

DAST screening tool score bands

Use the NIDA Clinical Trials Network DAST-10 form for the items, then use this table to chart the score, band, and next step without pasting the questions into the note.

Score	Level	Next step
0	No problems reported	None at this time
1-2	Low	Monitor; reassess at a named date
3-5	Moderate	Further investigation
6-8	Substantial	Intensive assessment
9-10	Severe	Intensive assessment

• The DAST-10 does not cover alcohol, so ask about alcoholic beverages separately when that is a concern.
• A score is not a diagnosis; document the band and clinical follow-up rather than diagnosing from the total alone.
• Scores of 6-8 and 9-10 carry the same suggested action: intensive assessment.
• The form contains no detox order or prescribed level of care.

Educational resource for licensed clinicians. A total is not a diagnosis. The form’s action is the next step, not a level of care you invent to match the number.

You already have the number. The work is the band, the step, and a note the next clinician can follow without the ten questions.

Score it without pasting the items

The Drug Abuse Screening Test, 10-item form, is the DAST screening tool you are holding. On the form, drug use means prescribed or over-the-counter drugs taken beyond the directions, and any nonmedical use. The questions refer to the past 12 months. Alcoholic beverages are not in them.

Scoring is on the form, under the items. One point for each yes. Question 3 is the miss. A no on that item receives the point. A yes receives none. If you score every yes as a point, question 3 is scored backward, and the band drops under the line you meant to use.

The total runs from 0 to 10. NIDA Data Share says it takes about 2 minutes to score the DAST-10. That is scoring time, not a reason to skip the band.

NIDA’s screening tools chart, dated January 6, 2023, lists this tool for drugs, for adults, and as both self-administered and clinician-administered. The same row tells you to contact Dr. Harvey Skinner for use of the tool, and the chart marks it with the asterisk it uses for tools with associated fees.

Pick this screen, not the other one

A DAST assessment gives you one drug-problem total. That is what the DAST screening tool is for. It does not tell you which class carried the score, and it does not ask about alcoholic beverages.

When the next step depends on the class, including alcohol or tobacco, use the TAPS screening tool. TAPS returns a risk level by substance class. This total does not. Do not add the two numbers, and do not treat a DAST-10 zero as a clean alcohol screen.

If you have not chosen the instrument yet, stop and use the scales for mental health matrix. Scoring starts after the form is the one in front of you.

NIDA’s chart does not mark this tool for adolescents. It lists a separate adolescent version and tells you to contact Skinner for that one too. If the person in the chair is under 18, do not read this adult band table onto their answers.

Write the band, not a diagnosis

The form pairs each band with one suggested action. Zero: none at this time. One to two: monitor, reassess at a later date. Three to five: further investigation. Six to eight, and nine to ten: intensive assessment. Those words are the action. A severity adjective you prefer is not.

Further investigation is a short list. Which drugs. How often. Whether the use is already inside the workday. Whether alcohol needs its own question, because this form skipped it. Whether you need the class lines from TAPS before you name a plan. Write what you asked and what you heard. Do not write “moderate substance use” and stop.

Intensive assessment is the suggested action for both 6 to 8 and 9 to 10. Arrange it consistent with your clinical judgment, local protocol, and the person’s immediate safety needs. A 7 and a 10 share that action line. Do not add a detox order, a level of care, or a diagnosis the form does not state.

The chart line that survives a coverage day is the total, the band, and the step, in one sentence. “Drug screen completed” loses the 4, and it loses the next visit.

Once the band says investigate or assess, the hour shifts from scoring to counseling. The substance use counseling techniques guide is the work after you have the DAST screening tool total. It is not a substitute for the band.

If a tool drafts the note, you still choose the two facts that stay: the score, and the step. The documentation workflow can hold the line. It does not pick the band, and it should not paste the items because they were said aloud.

For the habits that keep a short screen from disappearing into a vague note, the progress notes best practices piece is the longer bench. The next reader still needs the total, the band, and the date of the step.

Copy a blank line

The filled note above is L.P. These fields are empty so you can write them during the hour, one line each. Fill them only after you have scored the form. An empty bracket is not a score.

Download the session map

The substance use counseling session map is the one-page sheet for the hour after the score: stage of change, an MI reflection, trigger and craving, a coping step, a harm-reduction goal in the client’s words, and a next-session line. If the band is 1 to 2, put the reassess date on that next-session line. If the band is 3 or higher, the further investigation or the intensive assessment needs a place to land. Use the sheet for that. Do not read it aloud as a script.

References

• National Institute on Drug Abuse Clinical Trials Network. (2014). Drug Abuse Screening Test (DAST-10) [Form].
• National Institute on Drug Abuse. (2023, January 6). Screening and assessment tools chart.
• National Institute on Drug Abuse. (n.d.). Drug Abuse Screening Test. NIDA Data Share.