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The Addiction Severity Index at 25: Origins, contributions, and transitions
Abstract
The Addiction Severity Index (ASI) is a multi-dimensional interview used to measure the substance use, health, and social problems of those with alcohol and other drug problems, both at admission to treatment and subsequently at follow-up contacts. This article first discusses the conceptual and practical importance of the ASI's multi-dimensional approach to measuring addiction severity, as illustrated by two case presentations. The second section of the paper reviews how this measurement approach has led to some important findings regarding the prediction and measurement of addiction treatment effectiveness. The third section describes the historical and practical considerations that have changed the instrument over time, details the problems with the instrument, and describes our efforts to correct those problems with the ASI-6. Finally, some recent ASI data collected from over 8,400 patients admitted to a nationally representative sample of U.S. addiction treatment programs are presented.
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Metadata
- Authors
- McLellan, A. T., Cacciola, J. C., Alterman, A. I., Rikoon, S. H., & Carise, C.
- Affiliations
- Treatment Research Institute (US)
- DeltaMetrics (United States) (US)
- University of Pennsylvania (US)
- Corresponding author
- McLellan, A. Thomas
- ORCID
- Rikoon, Samuel H.
- Venue
- The American Journal on Addictions
- Publisher
- Wiley
- Published
- 2006-03-04
- Volume
- 15
- Issue
- 2
- Pages
- 113-124
- ISSN
- 1055-0496 (ISSN-L)
- 1521-0391
- OpenAlex
- W2026646521
- Cited by
- 450
- References
- 78
- Citations by year
- 2026: 17 · 2025: 15 · 2024: 14 · 2023: 24 · 2022: 19 · 2021: 19 · 2020: 21 · 2019: 27 · 2018: 24 · 2017: 28 · 2016: 18 · 2015: 42 · 2014: 27 · 2013: 34 · 2012: 45
- FWCI
- 7.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal on Addictions (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Sociology and Political Science › Homelessness and Social Issues
- Keywords
- Addiction Severity Index, alcohol and drug problems, addiction treatment effectiveness, substance use, treatment admissions, follow-up evaluation
- MeSH terms
- Adult, Alcoholism, Anxiety Disorders, Depressive Disorder, Female, Health Status, Humans, Interview, Psychological, Male, Opioid-Related Disorders, Pregnancy, Prognosis, Severity of Illness Index, Social Problems, Comorbidity, Crack Cocaine, Treatment Outcome, Diagnosis, Dual (Psychiatry), Substance-Related Disorders, Cocaine-Related Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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