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SBIRT DAST-10 Forms (English and Spanish)

SBIRT DAST-10 Forms (English and Spanish) 2025

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The Drug Screening Questionnaire (DAST) is a tool designed to assess an individual's drug use and its impact on health. It includes questions about the types of recreational drugs used, frequency of use, and related behaviors or consequences. Based on responses, a scoring system categorizes users into risk zones ranging from low risk to severe, guiding healthcare providers in offering appropriate interventions and referrals for treatment.

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Click ‘Get Form’ to open the SBIRT DAST-10 Form in the editor.
Begin by entering the patient’s name and date of birth at the top of the form. This information is crucial for identifying the individual being assessed.
In the section regarding recreational drug use, check all applicable boxes for drugs used in the past year. This helps in understanding the patient's history.
Indicate how often these drugs have been used by selecting one of the frequency options provided.
Answer each of the ten questions regarding drug use behavior by selecting 'Yes' or 'No'. Each response will contribute to scoring and interpretation later.
For providers, ensure to score responses accurately based on guidelines provided at the bottom of the form, correlating scores with risk zones.

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What is the DAST 10 questionnaire?

Definition: The Drug Abuse Screen Test (DAST-10) was designed to provide a brief, self-report instrument for population screening, clinical case finding and treatment evaluation research. It can be used with adults and older youth.

Who can administer a DAST 10?

While it can be self-administered, the presence of a clinician is recommended to help clarify questions and encourage honest responses. The DAST-10 is a streamlined version of the original 28-item tool (DAST-28), first published in 1982 as a rapid screener for drug-related concerns.

How do you interpret the SBIRT score?

Interpretation: For items 1 and 2, multiply the responses to compute the average number of standard drinks per week. A number greater than 14 suggests risky drinking on a weekly basis for men. A number greater than 7 suggests risky drinking on a weekly basis for women.

What is an SBIRT form?

Screening, Brief Intervention and Referral to Treatment (SBIRT) is an evidence-based approach to identify individuals who use alcohol and other drugs (substances) at risky levels.

What is a SBIRT score?

Screening, Brief Intervention, and Referral for Treatment (SBIRT) is an evidence-based approach for identifying patients who use alcohol and other substances at increased levels of risk to reduce and prevent related health consequences, diseases, accidents, and injuries.

What is the primary goal of the B component in SBIRT?

The result of the DAST-10 is a score ranging from 0 to 10, where a score of 0 means the client reported no drug problems, and a score of 10 equates to severe or multiple drug-related problems. A score from 6-8 indicates a substantial problem that requires intensive assessment and treatment.

SBIRT DAST-10 Forms (English and Spanish) 2025

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