DAST-10: Scoring and Interpretation Guide
A clinician's guide to scoring and interpreting the Drug Abuse Screening Test (DAST-10), Harvey Skinner's ten-item yes/no screen for problems related to drug use other than alcohol. Covers the reverse-scored item, the severity bands, psychometrics, and how to feed the result back in a motivational interviewing style.
About this resource
The Drug Abuse Screening Test was developed by Harvey Skinner at the Addiction Research Foundation in Toronto (now part of the Centre for Addiction and Mental Health) and published in 1982 as a 28-item questionnaire modelled on the Michigan Alcoholism Screening Test. The DAST-10 is the shortened version now used in most settings. Its ten yes/no questions ask about drug use over the past twelve months: whether the person has used drugs other than those required for medical reasons, whether they can stop when they want to, and whether use has led to blackouts, guilt, relationship problems, illegal activity, withdrawal symptoms or medical problems. 'Drugs' is defined broadly to include prescription medication used beyond its prescription, cannabis, stimulants, opioids, sedatives and hallucinogens; it deliberately excludes alcohol, which the AUDIT covers.
This resource is a scoring and interpretation guide. The DAST is copyrighted by Dr. Skinner and is free for non-commercial clinical and research use with acknowledgement, but we do not reproduce the items; obtain the official version. The guide covers the response format, the one reverse-scored item that catches out the unwary, the score bands from none to severe with the level of response each suggests, and the psychometric evidence summarised in Yudko and colleagues' 2007 review. A score of 3 or more is the usual point at which further assessment is recommended.
For counsellors, the DAST-10 is a quick, non-threatening way to open a conversation about drug use in a client who has come for something else. The professional version adds guidance on using the answers, rather than the total, to explore what the drug use does for the person and where they see it fitting in their life, which is the conversation that motivational interviewing builds on.
How to use it
- Obtain the official DAST-10. Give it at assessment, or when drug use comes up, framed as a routine set of questions about the past year. Explain what counts as a drug, and that alcohol is asked about separately.
- Score each answer as 1 for a yes that indicates a problem and 0 otherwise. Note that one item is worded so that 'no' is the problem answer and 'yes' scores 0. The official scoring sheet marks it. Add the ten scores for a total of 0 to 10.
- Place the total in the severity band. A score of 3 or more suggests a level of problem that warrants further assessment; 6 or more suggests a substantial problem and specialist involvement.
- Feed the result back neutrally and ask for the client's reaction before offering any view. Then go through the yes answers one by one: what happened, how the client felt about it, and whether it is something they would want to be different.
- Repeat the DAST-10 at review points as one marker of change, remembering that it asks about the past twelve months and so lags behind current use. A drug use diary or a shorter reference period tracks change better.
References
- Skinner, H. A. (1982). The Drug Abuse Screening Test. Addictive Behaviors, 7(4), 363-371.
- Yudko, E., Lozhkina, O., & Fouts, A. (2007). A comprehensive review of the psychometric properties of the Drug Abuse Screening Test. Journal of Substance Abuse Treatment, 32(2), 189-198.
- Miller, W. R., & Rollnick, S. (2023). Motivational interviewing: Helping people change and grow (4th ed.). Guilford Press.
