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Printed on 7/20/2026
For informational purposes only. This is not medical advice.
DAST-10 is a brief self-report screening tool for problematic use of drugs other than alcohol and tobacco. It helps identify risk level and supports decisions for deeper substance-use assessment.
Formula: DAST-10 total = sum of 10 items (0-10), with item 3 reverse-scored.
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The patient self-reports on 10 questions about drug use (excluding alcohol and tobacco) in the past 12 months, covering use, loss of control, social/family consequences, illegal activity, withdrawal, and medical problems.
Count 'Yes' responses as 1 point each, except for item 3 ('Are you able to stop using drugs when you want to?') where 'No' = 1 point and 'Yes' = 0. Total score ranges 0-10.
0 = no problem; 1-2 = low (brief advice); 3-5 = moderate (brief treatment intervention); 6-8 = substantial (intensive outpatient intervention); 9-10 = severe (intensive residential or inpatient treatment referral).
Primary Care Physicians
DAST-10 provides validated, structured screening for drug use problems in primary care, enabling risk stratification from brief advice (low score) to specialist referral (high score).
Addiction Medicine Specialists
At addiction medicine intake, DAST-10 quantifies drug use problem severity across multiple domains, informing treatment intensity decisions and complementing clinical interviews.
Pain Management Physicians
In patients prescribed opioids or other controlled substances, DAST-10 monitors for emerging drug use problems over time, supporting safe prescribing and early intervention when scores rise.
Surgeons & Anesthesiologists
Identifying drug use disorders before surgery allows planning for opioid management, withdrawal prevention, and anesthesia considerations in patients with active substance use problems.
Occupational Health & HR
Employee assistance programs (EAPs) use DAST-10 to identify employees with drug use problems and match intervention intensity to score severity, from brief counseling to formal treatment referral.
Item 3 ('Are you able to stop using drugs when you want to?') is the only reverse-scored item. A 'No' response = 1 point; 'Yes' = 0. This is the most common scoring error with DAST-10 — always check item 3 direction before calculating total.
DAST-10 was designed for drug use assessment excluding alcohol and tobacco. Always use AUDIT or AUDIT-C for alcohol screening concurrently. Inform patients clearly: 'These questions are about drugs other than alcohol and tobacco.'
Any positive DAST-10 in patients who use illicit drugs should prompt discussion of fentanyl contamination risk and naloxone availability. Fentanyl is now detected in many non-opioid drug supplies, making naloxone relevant for stimulant and other drug users.
For DAST-10 scores of 3-5 (moderate), brief motivational interviewing (MI) exploring ambivalence and readiness to change often improves engagement with more intensive treatment. Direct referral without motivational support frequently fails at this stage.
For patients whose DAST-10 positive result involves opioid use, buprenorphine/naloxone (Suboxone) is first-line pharmacotherapy for opioid use disorder maintenance treatment and can be initiated in primary care settings by waiver-trained physicians.
DAST-10 identifies drug use problems but not specific substances. Treatment differs substantially: opioids → buprenorphine/methadone; stimulants → contingency management, CBT; cannabis → CBT, motivational enhancement therapy. Substance-specific follow-up is essential.
A positive DAST-10 should be confirmed with comprehensive substance history (drug, frequency, route, quantity, last use) and urine toxicology screening. Self-report may underestimate use, especially for stigmatized substances.
DAST-10 covers misuse of prescription medications (opioids, benzodiazepines, stimulants) as well as illicit drugs. Explicitly ask about prescription drug misuse when introducing DAST-10, as patients may not self-identify this as 'drug use.'
DAST-10 has been validated in primary care, addiction medicine, emergency medicine, and psychiatric populations with reasonable sensitivity (70-100%) and specificity (65-80%). Performance varies by population, so clinical judgment should always complement the score.
DAST-10 developed by Skinner (Addict Behav 1982). Sensitivity 70-100%, specificity 65-80% for drug use disorders depending on population and threshold. Validated in primary care, addiction medicine, and psychiatric settings. SAMHSA recommends DAST-10 as part of SBIRT. NIDA QuickPic test also available for rapid single-item screening. Skinner (1982) original 28-item DAST was shortened to 10 items without significant loss of discriminative ability.
Higher DAST-10 scores indicate greater likelihood of clinically significant drug-related problems and support escalating assessment/treatment planning.
Use for rapid non-alcohol drug-use risk screening in primary care, emergency, and mental-health intake workflows.
DAST-10 is self-reported and may underdetect use when disclosure is limited. It does not by itself provide diagnosis, substance specificity, or intoxication/withdrawal acuity.
Disclaimer: This tool is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about your health.
April 21, 2026 · trust-baseline
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OpenMental HealthScreen for hazardous and harmful alcohol use with the 10-question AUDIT. Scores range from 0 to 40 across four risk zones. For quick screening use [CAGE](/tools/cage).
OpenMental HealthRapid 3-question alcohol-use screen to identify hazardous drinking patterns.
OpenMental HealthScreen risk of opioid misuse with the Opioid Risk Tool before initiating long-term opioid therapy.
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