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The DAST-10 (Drug Abuse Screening Test) is a ten-item, yes-or-no self-report screen for problems related to drugs other than alcohol over the past 12 months, derived from Harvey Skinner's 1982 DAST and published by CAMH. Primary care, emergency, and behavioral health clinicians use it to decide who needs a substance use assessment; it never diagnoses. This page covers how to document and interpret DAST-10 results, with a fictional sample note.
Patient self-report on paper or a tablet, or asked by a clinician as an interview; scored and interpreted by the treating clinician under the qualified-professional oversight the CAMH guide asks for; no publisher qualification level applies
Primary care and emergency physicians, nurses, addiction and behavioral health clinicians, hospital and trauma-center SBIRT teams, corrections and workplace programs, payers and auditors reviewing screening and brief-intervention claims
3 to 6 chart lines (version and time frame, medication handling, total and topics endorsed, substances named, follow-up, intervention) · patient completion about 5 minutes
Brief case-finding screen (10 yes-or-no items about drugs other than alcohol, one point per answer in the problem direction, total 0 to 10, standard past-12-month window)
Primary care and wellness visits after a positive single-question screen, emergency and trauma-center screening, addiction and behavioral health intakes, treatment follow-up on a documented shorter window, workplace, corrections, and research settings
Skinner 1982 (Addictive Behaviors) with the CAMH Guide for Using the DAST (revised 2023); copyright Skinner and CAMH, free non-commercial reproduction with attribution and digital licensing through CAMH; USPSTF 2020 grade B lists the DAST among example tools and requires none; described here for documentation, no items reproduced
The Drug Abuse Screening Test was published by Harvey A. Skinner in Addictive Behaviors in 1982 as a 28-item self-report scale modeled on the Michigan Alcoholism Screening Test, and that paper also derived a 20-item form; the ten-item DAST-10 was built later from the items that discriminated best, and the author's guide reports it correlating .98 with the DAST-20. The instrument asks ten yes-or-no questions about involvement with drugs other than alcohol, and its standard instruction block sets the past 12 months as the window, defines drug use for scoring purposes as prescribed or over-the-counter medication taken beyond its directions plus any non-medical use of drugs, and lists cannabis, sedatives, stimulants, hallucinogens, solvents, and opioids as example classes. At the topic level the items cover non-medical use and using more than one drug at a time, control over use, memory and perceptual effects, guilt, complaints from family and neglect of responsibilities, illegal activity connected with obtaining drugs, withdrawal, and medical harm; one point is scored for each answer in the problem direction, one item is keyed in the opposite direction, and the total runs 0 to 10. It takes about five minutes, works as a self-report or a structured interview, is published and sold by the Centre for Addiction and Mental Health (CAMH) in Toronto in English and French, and carries LOINC panel 82666-9 with total score 82667-7. The DAST-20 remains available for fuller clinical assessment, the DAST-A (Martino, Grilo, and Fehon, 2000) is the adolescent adaptation, and a DAST-R with less stigmatizing wording was described as under development in the 2023 guide.
Three facts carry the documentation. First, the familiar severity bands are not in the 1982 paper: they come from Skinner's CAMH-published Guide for Using the DAST, which introduces them as tentative guidelines, and the author's suggested case-finding threshold is a total of 3 or more, offered in the same tentative spirit pending research on alternative cut points; a synthesis of 346 DAST studies published online in 2024 (Johnson and colleagues, Measurement and Evaluation in Counseling and Development) reported pooled internal consistency around .81 to .84 and an aggregated diagnostic optimum of 7 for the DAST-10, which is the clearest evidence that a positive screen is a case-finding result and not a diagnosis, and that DSM-5 criteria belong in a substance use assessment. Second, the time frame decides the meaning: the standard instruction is the past 12 months, the guide says a screen used that way should not simply be repeated for another 12 months, and a follow-up administration reworded to six months (which the guide permits) is a modified instrument that must be charted as such. Third, the score is silent about the drugs: CAMH's own description says the DAST obtains no information about the types of drugs used, their frequency, or the duration of use, and the prescription-medication rule lives in the instruction block that many EHR builds and web reproductions drop, so the note has to add the substances and say how prescribed medication was handled. The CAGE and its CAGE-AID variant are the four-item consequence screens, the AUDIT-C covers alcohol, which the DAST excludes, and the WHO ASSIST and the TAPS tool are the substance-specific alternatives when the clinician needs to know which drug drives the risk.
The DAST-10 sits wherever a positive first question about drug use needs a structured second step. In US primary care the USPSTF's 2020 recommendation to ask adults about unhealthy drug use (grade B, wherever assessment and treatment can be offered or referred) has put a single question or the NIDA Quick Screen at the front of the visit and the DAST-10 behind it, so family physicians, internists, nurse practitioners, and embedded behavioral health consultants chart it at wellness visits and after a positive quick screen; CMS's SBIRT guidance names the AUDIT and the DAST as example structured assessment tools, which is why the same entry often supports a claim. Emergency departments and trauma centers use it when a fast drug-problem index fits the bedside, with the caution that it is not valid in a patient who is intoxicated or withdrawing. Addiction and behavioral health programs record it at the intake beside the substance use assessment and biopsychosocial assessment, and repeat it during treatment on a documented shorter window as a monitoring measure. Workplace, corrections, and court-linked programs use it too, where self-report validity is the documentation problem and instruments built for defensive responding, such as the SASSI, or collateral and toxicology data carry more weight. In Canada CAMH publishes the instrument and asks clinicians to screen every patient aged 10 and over for substance use and record the result in the cumulative patient profile; in Australia the RACGP frames routine or opportunistic screening inside the 5As and points general practice to the ASSIST-Lite rather than the DAST. Neighbors win in three places: the AUDIT-C for alcohol, which the DAST-10 excludes; the CAGE-AID when a four-item conjoint alcohol-and-drug probe is all the encounter allows; and the COWS or CIWA-Ar when the question is withdrawal severity, which no DAST answer can grade.
No law, payer, or author prescribes a DAST-10 note format; what exists is an instruction block and a guide from the author, a copyright line that asks for attribution, and payer and accreditation rules that ask for a named structured tool, the result, the time spent, and an intervention. What survives review is an entry that names the version and the window actually used, says how prescribed medication and cannabis were handled, records the mode and the fitness to complete, charts the total with the topics endorsed, lists the substances in the patient's words, labels the result a screen with its band attributed and tentative, and documents the follow-up, the intervention with its minutes, and where the record lives. Each element below carries the pitfall that most often undermines it.
Version and time frame. Write DAST-10, DAST-20, or DAST-A, and the window the patient was told to consider: the standard past 12 months, or the modified window actually used and why (the guide permits a shorter window, six months for example, for follow-up after treatment). A lifetime or 30-day adaptation is a different instrument with no demonstrated equivalence to the 12-month reading, so its band language does not transfer. When the score is a repeat, name the prior date and window so the two totals are compared on the same terms or not compared at all. Pitfall: "DAST 4" with no version or window, or a six-month follow-up total trended against a 12-month intake baseline as if the two were the same measure.
Instruction block and prescribed medication. Record that the full instruction text was presented or read aloud, because it carries the definition that decides what counted: medication taken as prescribed, or as directed on the package, does not count; use beyond the directions, another person's prescription, a different route, and any non-medical use do. Cannabis counts whenever the use is non-medical, regardless of state or provincial law, and medically authorized cannabis is charted with how the patient interpreted it. When the instruction block was cut from the form or the EHR build, say so and say how the patient interpreted the items. Pitfall: Cannabis dropped because it is legal, or a prescribed opioid or stimulant counted (or excluded) with nothing in the note saying which and why.
Mode, language, completeness, and fitness. Chart self-report (paper, tablet, portal) or clinician interview, the language or translation used (CAMH sells English and French; other adaptations vary in validation and may not carry the English cut points), that all ten items were answered, and who computed the total. Add that the patient was not intoxicated or in withdrawal at the time, because the guide says the DAST should not be given in either state; an emergency-department result taken from an impaired patient is charted with that limitation. Pitfall: A score taken from an intoxicated patient after an injury charted like a routine screen, or a translation charted as plain DAST-10 with the English threshold applied.
Total, then the topics endorsed. Chart the total out of 10 and, in your own words, the topic areas the patient endorsed in the problem direction (a partner's complaints, control over use, withdrawal, medical harm, and so on), because the guide itself directs the reader to examine item responses for specific problem areas and the topics decide what the follow-up looks at. Score with the key on the licensed form: one item is keyed in the opposite direction, and reproductions circulate with reworded items and mismatched keys. Pitfall: A bare total, a key copied from an unlicensed PDF, or DAST-20 interpretation applied to a DAST-10 total.
Substances named, in the patient's words. The instrument yields no drug type, frequency, or duration, so add them: each substance, route, typical amount and frequency, last use, and source (own prescription, someone else's, illicit supply), plus injection use, overdose history, and current medications. Screen alcohol separately (the AUDIT-C or the full AUDIT) and say so, since the DAST excludes it; the substance line is what the assessment, the intervention, and any later comparison rest on. Pitfall: A positive screen with no substance named, so the next reader cannot tell weekend cannabis from daily non-prescribed fentanyl.
Interpretation: a screen, with a tentative band. Write the conclusion as a screening result (positive screen for further assessment; substance use disorder not established) and, when you use a band, attribute it: totals of 1 to 2 are described in the CAMH guide as a low level of problems, 3 to 5 as intermediate (moderate on older reprints), 6 to 8 as substantial, and 9 to 10 as severe, with 3 or more the author's suggested case-finding threshold, all labeled tentative by the author. Name the population caveat when it changes the reading: psychiatric populations have validated lower cut points, pregnancy studies show low sensitivity above the lowest cut point, adolescents have their own version and an insufficient-evidence rating from the USPSTF, and self-report can be shaped by legal, employment, or custody stakes. Pitfall: "DAST-10 = 7, substance use disorder" with no criteria assessed, or a zero in a court-referred patient charted as no problem.
Follow-up, intervention, minutes, and record. Name what the result triggered and when: a full substance use assessment with DSM-5 criteria, a withdrawal assessment when current heavy use raises that risk, toxicology only if it changes management (screening means asking questions, not testing specimens). Document the brief intervention (feedback, the patient's goal, options offered), the referral made or declined, and the face-to-face minutes for any time-based code. State the rescreen plan and where the result lives: a primary-care DAST-10 is a HIPAA record; the same result created by a federally assisted Part 2 program carries Part 2 consent and redisclosure rules. A refusal is charted as a refusal, never as a zero. Pitfall: "Counseled on drug use" with no content, goal, or minutes, or a refused screen entered as 0 of 10.
DAST-10 DOCUMENTATION BLOCK Date: [ ] Setting: [ ] Clinician: [ ] Encounter: [wellness / intake / ED or trauma / treatment follow-up / other] Version: [DAST-10 / DAST-20 / DAST-A] Prompted by: [single-question screen / routine / referral] Time frame: [standard past 12 months / modified: state the window and why] Instruction block: [full text presented / read aloud / omitted: state how items were interpreted] Prescribed medication as directed: [excluded; named] Cannabis: [non-medical, counted / medically authorized, how interpreted] Mode: [self-report: paper, tablet, portal / interview] Language: [ ] Completeness: [all 10 answered / missing: state] Total computed by: [ ] Fitness: [not intoxicated or in withdrawal at completion / limitation noted] Total: [ ] of 10 Topics endorsed (own words): [ ] Substances (patient's words): [substance, route, amount, frequency, last use, source; injection use; overdose history] Alcohol screened by: [AUDIT-C / AUDIT; result] Interpretation: [positive / negative screen for further assessment; band per the CAMH guide, tentative; disorder not established; population or self-report caveat, or none] Follow-up triggered: [substance use assessment with DSM-5 criteria / withdrawal assessment / toxicology if it changes management; date] Intervention: [feedback given; patient's goal; referral made, declined, or not indicated; face-to-face minutes] Plan: [rescreen window and date; treatment or counseling; next visit] Record: [code claimed (bare number); storage location; Part 2 status if created by a Part 2 program; consent on file] Clinician signature / credentials: Date:
Free to use and share, no signup. The PDF includes a one-page cheat sheet with element-by-element pitfalls and a pre-sign checklist; the DOCX is the blank documentation block, ready to adapt. Neither reproduces the questionnaire items.
Scenario: a US family medicine visit in a clinic with an embedded behavioral health consultant, where a yes to the practice's single-question drug screen leads to a DAST-10 on the clinic tablet; the physician records the window and the medication rule, names the substances, keeps the result a screen, delivers a brief intervention, books the full assessment, and records the claim and the record status. All details are fictional.
Patient: D.K., 31 · Setting: Family medicine, integrated behavioral health clinic · Clinician: P. Nakamura, DO · Note date: 09/15/2026
Screen: DAST-10, adult self-report version with the full instruction block (drugs other than alcohol; standard past-12-month frame; prescribed and over-the-counter medication counted only when taken beyond its directions or non-medically), completed in English on the clinic tablet on 09/15/2026 after D.K. answered yes to the practice's single-question drug screen at today's visit; all ten items answered; total computed by the EHR and confirmed by hand. Total 4 of 10. The topics endorsed in the problem direction (using more than one drug at a time, guilt, a partner's complaints, and control over use) were reviewed with D.K. and match the history below. No prior DAST on file. Alert and oriented, speech and gait normal; not intoxicated or in withdrawal at completion.
Substances, in his words: Cannabis, smoked most evenings for about a year, one or two bowls, bought from a licensed dispensary and used to unwind, no medical authorization; alprazolam from a friend, about six times in the past three months, one tablet at a time to sleep after late shifts, last taken about ten days ago; no opioids, stimulants, or hallucinogens; never injected; no overdose history. Takes sertraline 50 mg daily as prescribed for two years, which was excluded from scoring under the instrument's definition when D.K. asked whether it counted. Alcohol screened separately today with the AUDIT-C: 2 of 12, negative under the practice convention. Tobacco: none.
Interpretation: Positive screen for further assessment. On the standard past-12-month frame, a total of 4 sits in the range the CAMH guide's tentative interpretation guidelines label intermediate (moderate on older reprints) and meets the author's suggested case-finding threshold of 3 or more; the guide calls both tentative, and neither is a diagnosis. DSM-5 substance use disorder criteria were not formally assessed today. The instrument collects no drug type, frequency, or duration, which is why the substances above are recorded in D.K.'s words. The non-prescribed alprazolam is the clinical priority (unknown supply, sedative use alongside nightly cannabis); cannabis is counted because the use is non-medical, and its legal status does not change the screen. No population caveat applies (31-year-old man, English, original wording, full instructions).
Follow-up assessment: Full substance use assessment booked with the clinic's behavioral health consultant for 09/22/2026 to review DSM-5 criteria for cannabis and sedative use, pattern and consequences, sleep, and D.K.'s goals. Withdrawal risk judged low today (intermittent benzodiazepine use, no daily use, no prior withdrawal); CIWA-Ar and COWS not indicated. Urine toxicology not ordered because it would not change today's management.
Brief intervention: Delivered by the physician: feedback on what the screen does and does not show, the risk of counterfeit tablets and of combining a sedative with nightly cannabis, and a menu of options. D.K. chose a goal of no alprazolam from any source starting today and agreed to bring the sleep problem to the assessment visit; referral accepted. Face-to-face time for the structured screen and brief intervention: 20 minutes.
Plan and record: Assessment visit 09/22/2026; physician follow-up in four weeks to review the goal, sleep, and the assessment findings, with the sertraline dose reviewed then. Rescreen with the DAST-10 on the standard frame no sooner than 12 months, or on a documented shorter window if the consultant uses it to monitor treatment. Screening and brief intervention claimed under 99408 (commercial plan), supported by the named tool, result, intervention content, and time above. Result recorded in the general medical record; this clinic is not a Part 2 program, so 42 CFR Part 2 does not attach to this entry and the internal referral needs no Part 2 consent. D.K. was told the screen is not a diagnosis and agreed with the plan.
This sample is fictional and for educational purposes. It does not describe a real patient or record; the scores, dates, and details are invented to show documentation structure and are not clinical guidance.
Writing these after every session? BastionGPT drafts complete notes from bullets, dictation, or a transcript.
Generate a note from bulletsUnited States: the instrument is a convention; the rules around it are real. No federal or state LAW names the DAST-10 or prescribes a screening note format. The USPSTF recommendation of June 2020 (grade B; CONVENTION, with payer and accreditation teeth) covers screening adults 18 and older, including pregnant and postpartum persons, by asking questions about unhealthy drug use wherever accurate diagnosis, effective treatment, and appropriate care can be offered or referred; it gives adolescents 12 to 17 an insufficient-evidence statement, defines screening as asking questions rather than testing urine, saliva, or blood, states that screening tools are not meant to diagnose drug use disorders, and lists the DAST among several example tools (single questions, the NIDA Quick Screen, the ASSIST, the TAPS) without requiring any of them; a note on the USPSTF site says both recommendations are being updated, with no final statement published as of September 2026. Under PAYER POLICY the SBIRT codes are time-based: Medicare pays G2011 for 5 to 14 minutes, G0396 for 15 to 30 minutes, and G0397 for more than 30 minutes of structured assessment and brief intervention, commercial plans use 99408 and 99409, and state Medicaid programs may use H0049 and H0050 under their own documentation policies; the CMS SBIRT fact sheet (May 2025) names the AUDIT and the DAST as example structured assessment tools and states that the medical record must support the claim, so a bare "DAST-10 = 4" supports none of these codes and a documented tool, result, intervention, and time supports all of them. No MIPS or Joint Commission measure names the DAST-10; measure 431 and the hospital SUB measure set concern alcohol, and the American College of Surgeons trauma verification standards (2022) require alcohol screening with a documented brief intervention while treating drug screening as encouraged practice, so a hospital's drug-screening workflow is CONVENTION or local policy rather than an accreditation mandate. Under LAW, 42 CFR Part 2 as amended by the February 2024 final rule (effective April 16, 2024; compliance date February 16, 2026, now passed) attaches to records created or received by a federally assisted Part 2 program, not to the word drug: a DAST-10 charted by a primary care or emergency clinician outside a Part 2 program is a HIPAA record, the same result recorded at intake in a Part 2 program is a substance use disorder record with its own consent and redisclosure rules, and the question to ask is where the record originated and under what program and consent, not whether it mentions drugs; the Part 2 consent page covers the mechanics.
Canada and Australia: no requirement, and the home institution's own documentation rule. In Canada, no federal or provincial LAW or payer names the DAST-10. CAMH, which publishes and sells the DAST-10 and DAST-20 in English and French, advises in its clinical guidance that every patient aged 10 and over be screened for substance use with the result recorded in the cumulative patient profile, that all use of cannabis and illegal drugs be followed by a brief assessment, and that daily and weekly use be documented for positive responses (CONVENTION); its instrument page states that the DAST collects no information on drug type, frequency, or duration. In Australia, the RACGP's alcohol and other drug guidance (updated June 2026; CONVENTION) frames routine or opportunistic screening inside the 5As, names the AUDIT-C for alcohol and the ASSIST-Lite and its online version for other drugs, and does not name the DAST-10; no MBS item names it either, and screening sits inside attendance and health-assessment items. In every jurisdiction the boundary is oversight rather than a qualification level: the CAMH guide says administration, scoring, and interpretation need oversight by a qualified professional and that the DAST is not designed for self-screening by the general public, so a patient-portal or EHR administration is fine when a clinician scores and interprets it, and a public self-scoring web tool is not. The validity limits are population-specific and belong in the note: a cut point of 2 was identified in 162 psychiatric outpatients with severe mental illness (Maisto and colleagues, 2000); among 1,349 psychiatric inpatients in India, 59 percent of those above the DAST-10 cut point had no substance use disorder at discharge (Carey, Carey, and Chandra, 2003); in 1,085 pregnant women sensitivity fell from 79 to 33 percent as the cut point rose from 1 to 3 (Lam and colleagues, 2015), which is why pregnancy-specific approaches are preferred in prenatal care; the adolescent DAST-A has its own validation and cut point (Martino, Grilo, and Fehon, 2000); and the guide's own limitations section notes that the item content is transparent enough for a respondent to fake, which is the reason a low score from a court-referred, employment-referred, or custody-involved patient is charted as a screen under those conditions, with collateral history, toxicology where clinically indicated, or an instrument built for defensive responding such as the SASSI considered rather than a clean bill written from the total. A translated DAST-10 is charted with its language, because the guide asks adapters to develop local cut points rather than import the English ones.
The DAST-10 is copyrighted by Harvey A. Skinner and the Centre for Addiction and Mental Health, Toronto, and made available under a permission line that allows reproduction free of charge for non-commercial clinical, research, and training use with credit to the author; the 2023 guide asks users to contact the author or CAMH about permission, CAMH sells the printed forms and routes digital and EHR licensing through its publications office, and no current source grants blanket commercial or public-web rights, so an EHR vendor build, a paid app, or a public self-scoring tool should clear rights with CAMH first. The correct citation is Skinner HA, Addictive Behaviors, 1982, volume 7, pages 363 to 371, with credit to Dr. Harvey A. Skinner, York University, and CAMH. BastionGPT is not affiliated with, or endorsed by, the publisher. This page reproduces no test items, stimuli, norms, or scoring materials.
The numbers behind these errors are specific. Across the studies reviewed by Yudko, Lozhkina, and Fouts (2007), DAST-10 sensitivity ranged from 41 to 95 percent and specificity from 68 to 99 percent depending on the cut point and the population, with the 41 percent coming from 1,349 psychiatric inpatients in India (Carey, Carey, and Chandra, 2003); a single question about past-year drug use was 100 percent sensitive and 73.5 percent specific for a current drug use disorder in 286 primary care patients and performed similarly to the DAST-10 (Smith and colleagues, 2010); a cut point of 2 fit 162 outpatients with severe mental illness (Maisto and colleagues, 2000); in 1,085 pregnant women sensitivity ran from 79 to 33 percent across cut points of 1 to 3 (Lam and colleagues, 2015); and a synthesis of 346 DAST articles reported pooled internal consistency of about .81 to .84 and an aggregated diagnostic optimum of 7 for the DAST-10 (Johnson and colleagues, 2024), against the author's tentative case-finding cut of 3. No published audit counts how often the version, the window, or the medication rule is missing from DAST-10 chart entries; the SBIRT and Part 2 rules described under compliance considerations are what turn those omissions into a claim or disclosure problem. The BastionGPT Clinical Advisory Board sees the same errors most often in DAST-10 documentation reviews:
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Each of the ten items is answered yes or no and one point is scored for each answer in the problem direction, with one item keyed in the opposite direction, so the total runs 0 to 10. There is no positive threshold inside the instrument. The CAMH-published Guide for Using the DAST suggests a total of 3 or more for case finding on the DAST-10 and describes its severity bands (0 none reported, 1 to 2 low, 3 to 5 intermediate or moderate, 6 to 8 substantial, 9 to 10 severe) as tentative guidelines pending further research on diagnostic validity; other cut points have been validated in particular populations (2 in outpatients with severe mental illness, 1 in a pregnancy study), and a 2024 synthesis of 346 DAST studies reported an aggregated diagnostic optimum of 7 for the DAST-10. Chart the total, the topics endorsed in your own words, the convention you applied with its source, and the conclusion as a screening result; never chart a band as a diagnosis, and never apply DAST-20 numbers to a DAST-10 total.
The DAST-10 is the brief case-finding form for primary care, emergency, workplace, and corrections settings; the DAST-20 keeps ten more items for fuller clinical assessment and research and is read on its own bands, which do not transfer to the ten-item total; the DAST-A (Martino, Grilo, and Fehon, 2000) is the adolescent adaptation with its own validation and cut point, and the USPSTF still rates the evidence for screening adolescents as insufficient. Reach past the DAST family when the encounter needs something else: the AUDIT-C or full AUDIT for alcohol, which every DAST excludes; the CAGE-AID when a four-item conjoint alcohol-and-drug probe is all the bedside allows; the WHO ASSIST or the TAPS tool when substance-specific risk (tobacco, alcohol, cannabis, stimulants, opioids) matters more than one aggregate problem score, which is also why Australian general practice guidance names the ASSIST-Lite; and the SASSI in court or employment contexts where defensive responding is expected. Whichever you use, the chart names it, its window, and its convention.
Prescribed medication taken as directed does not count; use beyond the directions, larger amounts, a different route, someone else's prescription, and any non-medical use do. That definition sits in the instrument's instruction block, not in the ten items, and the longer DAST's separate prescription-misuse item is absent from the DAST-10, which is why a form or EHR build that shows only the ten questions leaves the patient to guess whether a prescribed opioid or stimulant counts. Cannabis counts whenever the use is non-medical, regardless of state or provincial law, because it is a named example class in the instructions; medically authorized cannabis is the one case the legacy wording does not cleanly resolve, so chart how the patient interpreted it. Write the handling into the note whenever it affected an answer: "prescribed lisdexamfetamine as directed excluded; extra evening doses counted" is the shape of the sentence.
No. It is a positive case-finding screen that raises the probability of a drug use problem and says nothing about which drug, how often, or whether DSM-5 criteria are met; the USPSTF states that screening tools are not meant to diagnose drug use disorders, and the CAMH guide warns that a numerical score invites misinterpretation. The defensible chain in the chart is: the screen result under a named, attributed convention; the substances in the patient's words; a criteria-based substance use assessment; a withdrawal assessment (COWS or CIWA-Ar) when current heavy use raises that risk; toxicology only when it changes management, because screening means asking questions rather than testing specimens; and then the diagnosis, if any, in its own line. Some state forms label high totals "probable substance use disorder"; chart the screen result and the assessment separately rather than importing that label.
Not on the score alone. The SBIRT codes are PAYER POLICY and time-based: Medicare pays G2011 for 5 to 14 minutes, G0396 for 15 to 30 minutes, and G0397 for more than 30 minutes of structured assessment and brief intervention; commercial plans use 99408 (15 to 30 minutes) and 99409 (more than 30); state Medicaid programs may adopt H0049 and H0050 under their own documentation rules. The CMS SBIRT fact sheet (May 2025) names the AUDIT and the DAST as example structured assessment tools, so the DAST-10 qualifies as the tool; the record still has to show the result, the intervention with its content, and the face-to-face time, and the fact sheet states that the medical record must support the claim. Medicare's annual alcohol screen (G0442) and its counseling code (G0443) are alcohol benefits and do not apply to a drug screen. Minutes are the minutes actually spent face to face: a DAST-10 completed on a tablet in the waiting room supports the tool and the result, not the time.
Only when the record is created or received by a federally assisted Part 2 program. Part 2 follows the source of the record, not the subject: a DAST-10 charted by a primary care or emergency clinician outside a Part 2 program is a HIPAA record and nothing more, while the same result recorded at intake in a Part 2 program is a substance use disorder record with Part 2 consent and redisclosure rules, and a copy received from the program carries the protection with it. The February 2024 final rule (effective April 16, 2024; compliance date February 16, 2026, now passed) aligned Part 2 with HIPAA on breach notification and enforcement, allowed a single consent for treatment, payment, and health care operations, and kept special protection against use of records in legal proceedings; it does not require a drug-screen result to be walled off in a separate part of the chart. Document where the result lives and, in a Part 2 program, which consent is on file; the Part 2 consent page covers the forms and the workflow.
As reliable as the respondent's reason to answer honestly, which is the guide's own caveat: the item content is transparent, so results can be faked, and a numerical score can be given too much weight. In a court-referred, employment-referred, or custody-involved patient a total of 0 documents that no problem was reported under those conditions, not that none exists, so write the conditions into the interpretation and add collateral history, prior records, toxicology where clinically indicated, or an instrument designed for defensive responding such as the SASSI. In pregnancy the direction of error reverses: sensitivity fell from 79 to 33 percent as the cut point rose from 1 to 3 in 1,085 pregnant women (Lam and colleagues, 2015), and the USPSTF discusses pregnancy-specific instruments, so prenatal services usually document a pregnancy-oriented screen instead and say why. Psychiatric populations validate lower cut points, adolescents have their own version, and a translated DAST-10 does not inherit the English threshold; the note names the population and the convention in every one of these cases.
The standard instruction covers the past 12 months, and the CAMH guide says a screen used that way should wait at least another 12 months before it is repeated; the USPSTF sets no interval, so an annual DAST-10 is a workflow convention rather than an evidence-based interval. For treatment follow-up the guide permits altering the instructions to a shorter window, six months after discharge for example, and that is a modified administration: chart the window, record the current substances beside the total, and compare only totals taken on the same window, because a 12-month intake score and a six-month follow-up score are different measures. Trending is legitimate as a description ("7 of 10 at intake on the 12-month frame; 3 of 10 at six months on a six-month frame, not directly comparable"), never as a change score, since no validated change threshold exists. Serial results follow the conventions of the outcome measure note.
Yes. Give it the facts (version and window, whether the full instruction text was presented and how prescribed medication and cannabis were handled, mode and language, the total and topics endorsed, the substances in the patient's words, any assessment or withdrawal check and its date, the intervention and its minutes, and where the result is stored) and it drafts the full entry: the screen result with the band attributed as tentative, the substance line, a screening-level interpretation with the population caveat, the follow-up, the intervention, the plan, and the record placement, ready for your review. It can also check a finished note for a missing version or window, unstated medication or cannabis handling, a total with no substances, a band charted as a diagnosis, a refusal entered as zero, or an intervention with no content or minutes. BastionGPT is HIPAA-compliant with a signed BAA on every plan, and your data is never used to train models.
The instrument facts and compliance claims on this page trace to these sources, last verified September 2026:
Educational content, not legal or billing advice. Sample notes are fictional. Follow your organization's policies and your board, payer, and jurisdiction requirements.