Addiction assessment (Comprehensive substance use (addiction) assessment)

What is an addiction assessment?

An addiction assessment is a structured, confidential conversation with a clinician or trained drug and alcohol worker. They will ask about what you use (alcohol, drugs or both), how much, how often, and how it affects your body, mood, work, money and relationships. They may use simple questionnaires, such as the AUDIT for alcohol, and sometimes a urine or saliva test or blood tests.

The aim is not to judge you. Addiction is a health condition, not a moral failing, and the assessment exists to understand your needs and agree a plan with you. Many people feel relief once they have talked it through.

An assessment can tell whether your use is risky or dependent, whether stopping suddenly could be dangerous (this is very important with alcohol and some sedatives), and what support might help most. It cannot, on its own, fix the problem — but it is the doorway to treatment, and a good assessment leads to a clear, agreed next step.

You do not have to pay to get help. Free NHS and charity services are available across the UK, and you can usually refer yourself without seeing your GP first.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your test

• Think about what you use, roughly how much and how often — being honest helps you get the right help and keeps you safe.
• Bring a list of your medicines, including anything bought online, and any inhalers or prescriptions.
• Note any physical or mental health problems, and tell the assessor if you have ever had a withdrawal seizure, fit or 'the shakes'.
• Write down what you want from treatment, even if you are not sure yet — cutting down, stopping, or just feeling safer.
• You can usually self-refer to a local NHS or charity service; you do not always need a GP referral, and the conversation is confidential.
• If you are worried about confidentiality, ask at the start what is shared and with whom — staff can explain the limits clearly.
• Bring a trusted friend or family member if it helps; you can also ask for an interpreter.

What happens

You will meet a clinician or trained drug and alcohol worker, usually for around 45 to 90 minutes. They will ask about your alcohol or drug use — what, how much, how long, and how it affects your daily life, health and mood — and about your work, family and housing. They may use questionnaires and, for some substances, ask for a urine or saliva sample, or arrange blood tests.

They will ask about risk, including overdose, withdrawal, mental health and safety at home. This is routine and is there to protect you, not to catch you out.

Together you will agree a treatment plan and you will usually be given a named worker (sometimes called a keyworker) who supports you through treatment. You should leave knowing what happens next, who to contact, and what to do in an emergency.

Is this test right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The assessment itself is safe — the main 'risk' is that it can feel exposing to talk honestly. The bigger danger is not getting help, or stopping heavy alcohol or sedative use suddenly without advice, which can cause life-threatening withdrawal. Ask the assessor what is confidential, what the plan is, and exactly who to call if things get worse.

Published figures to discuss

An addiction assessment is a conversation and some questionnaires, so there are no meaningful procedural complication rates to quote. What varies is what the assessment finds and how accurately risk is judged. Screening tools like AUDIT are guides, not perfect tests, and a clinician's judgement of dependence and withdrawal risk matters more than any single score.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery from an assessment. 'Afterwards' means what happens once your plan is agreed and how your support begins.

• Feeling emotionally drained or relieved after the conversation.
• Mixed feelings about the plan — motivation and worry together.
• Waiting a short time for any blood test results.
• Needing a follow-up appointment to finalise details.
• No immediate change in how you feel physically — the assessment is the start, not the treatment.

Aftercare

• Keep the contact details of your named worker and the service's helpline somewhere safe.
• Follow the agreed plan, and go back sooner if things get worse or you feel unsafe.
• Do not stop heavy drinking or long-term sedatives suddenly without medical advice — withdrawal can be dangerous.
• If opioids (such as heroin) are part of the picture, ask about take-home naloxone, which can reverse an overdose.
• Tell the service if your circumstances change — housing, work, mental health or a relapse — so the plan can be adjusted.
• Use the free support offered, including help for family members affected by your use.
• Save crisis numbers: 999 for an emergency, Samaritans 116 123, and the FRANK drugs helpline 0300 123 6600.

• Notes on what you use, how much and how often
• Up-to-date list of all medicines
• Any past withdrawal problems written down (fits, shakes, hallucinations)
• Photo ID or details for self-referral if asked
• Questions you want to ask the assessor
• Crisis numbers saved (999, Samaritans 116 123, FRANK 0300 123 6600)

⚠ Get urgent help if…

• Thoughts of harming yourself or ending your life — contact your GP or Samaritans, free on 116 123. For urgent non-life-threatening advice, use NHS 111 in England, Scotland or Wales; in Northern Ireland contact your GP out-of-hours service or your HSC Trust's Phone First service. Call 999 if you are in immediate danger.
• Signs of severe alcohol withdrawal: shaking, sweating, confusion, hallucinations or a fit (seizure) — this is a medical emergency, call 999.
• Signs of overdose in yourself or someone else: very drowsy, unresponsive, slow or stopped breathing, blue lips — call 999 immediately.
• Severe chest pain, breathing difficulty or collapse.
• Feeling unable to keep yourself or someone in your care safe.
• Rapidly worsening mental health, including hearing or seeing things that are not there.

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your psychiatrist gives you.

Results & realistic expectations

A good assessment results in a clear, shared understanding of your situation and an agreed plan that you have helped shape. It should explain whether your use is harmful or dependent, whether a medically supervised detox is needed, and what support will help most.

An assessment cannot guarantee an outcome and is not a one-off fix. It is the first step, and the plan it produces is meant to be reviewed and changed as you progress. A result that says your use is more serious than you hoped is still useful — it means you are getting the right level of help.

An assessment reflects your situation at one moment. As your use, health or circumstances change, the picture changes too, so reassessment is a normal part of treatment rather than a sign of failure. Plans are routinely reviewed and updated, and you can ask for a fresh assessment if your needs change.

Related tests, treatments or support

An addiction assessment often goes hand in hand with a mental health review, because substance use and conditions like anxiety, depression or trauma frequently occur together. It may also include physical health checks, blood-borne virus testing and, for opioids, an offer of take-home naloxone.

Follow-up & long-term care

You should leave with a named worker and a clear plan for the next contact, whether that is a keyworker session, therapy, a prescription review or a detox plan. Any blood test results are usually discussed at a follow-up. Your plan is reviewed regularly, and you can get back in touch sooner if things change.

• Keep regular contact with your named worker as agreed.
• Attend review appointments so your plan stays right for you.
• Ask for reassessment if your use or circumstances change.
• Keep crisis and helpline numbers to hand.

Repeat, follow-on and what comes next

• Reassessment is normal and expected as your use and circumstances change.
• An early plan is often refined after the first weeks of contact or once test results are back.
• A goal of cutting down may later change to abstinence, or vice versa, and the plan should adapt.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• A clear written plan and a named worker (keyworker) with contact details.
• Explicit emergency advice, including 999 for overdose or seizure and crisis lines.
• An offer of take-home naloxone and training where opioids are involved.
• A safe plan for any detox, never advising sudden stopping of alcohol or sedatives without supervision.
• Arranged follow-up and a route back if things get worse, plus support for affected family members.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Length and depth of the assessment (brief screen versus full comprehensive assessment).
• Whether questionnaires, urine or saliva tests and blood tests are included.
• Seniority of the clinician (for example a consultant addiction psychiatrist versus a drug and alcohol worker).
• Whether a written report, letter or onward referral is provided.
• Whether mental health assessment is included alongside the substance use assessment.
• Number of follow-up appointments built in.

• The clinician's or service's fee and how long the appointment lasts.
• Whether any tests (urine, saliva, blood) are included or charged separately.
• Whether a written plan, report or GP letter is included.
• What follow-up or onward support is offered, and at what cost.
• What happens, and what it costs, if further assessment is needed.
• Cancellation and rescheduling policy.
• Confirmation that free NHS and charity routes have been explained as an option.

On the NHS? Free NHS and charity drug and alcohol assessment is available across the UK, often by self-referral; private assessment may be used for speed, choice or privacy, but you do not need to pay to get help.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the psychiatrist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good psychiatrist will welcome every one of these.

• Based on this, is my use harmful, or am I dependent — and what does that mean?
• Would it be dangerous for me to cut down or stop on my own?
• What treatment options do you recommend, and what are the alternatives?
• Who will be my named worker, and how do I contact them or get help in a crisis?
• What is confidential, and in what situations would anything be shared?
• If I use opioids, can I have take-home naloxone and training to use it?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the psychiatrist who carries out my test, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this test not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified psychiatrist for addiction assessment

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Drug addiction: getting help NICE CG115 — Alcohol-use disorders: diagnosis, assessment and management Drinkaware — Understanding the AUDIT alcohol screening test Royal College of Psychiatrists — Addictions faculty resources We Are With You — free, confidential drug and alcohol support FRANK — find drug treatment support near you nidirect — urgent and emergency care services (Northern Ireland) nidirect — GP out-of-hours service (Northern Ireland)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.