Section 2 Section 1 Section 3 Substance Social situation/behaviour General & use psychological health U12 12+ Drug Type U12 12+ Living situation U12 12+ General Health 5 2 Alcohol Problems with housing, Frequent reports of health 5 2 4 3 8 4 Amphetamine insecure or inadequate problems 6 3 Cannabis 4 4 Looked after by LA 2 1 Difficulty sleeping 5 Cocaine 6 Homeless 6 5 Chronic fatigue 1 5 Crack 6 5 Severe sleep problems 8 4 Ecstasy U12 12+ Adult Support 8 5 Neglect/self neglect 1 5 Heroin 3 2 Conflict at home 1 8 Extreme weight loss 8 4 LSD Has no supportive Blackouts and/or memory 7 4 9 7 4 Magic Mushrooms relationships with adults loss 8 5 Solvents/gas etc. Witnesses or has known 10 Pregnant 9 6 7 4 Ketamine abusive relationships 10 Fitting 6 2 Others (please list) Accidental/planned 10 U12 12+ Sexual behaviour overdose U12 12+ Contact with other users Inappropriate/unsafe 6 2 9 7 Lone use sexual behaviour U12 12+ General Health Some friends who use Abusive 6 2 Low self‐esteem 6 6 drugs/alcohol, some sexual 4 2 Inability to concentrate who Commercial sexual 3 2 Insecure sens eof identity 8 4 All don't friends use 8 relationships 4 3 Negative or low aspiration drugs/alcohol Eating disorder/marked 8 4 U12 12+ Smoking U12 12+ Criminal Involvement changes in eating patterns At risk of involvement Frequent bouts of 5 2 Tobacco 8 8 with 6 2 unhappiness/depression the criminal justice Involved with criminal U12 12+ Injecting 3 3 Memory loss system 8 Currently/recently 8 4 justice system 8 8 Self‐harm injecting 8 8 Severe anxiety/panic attacks U12 12+ Intoxication U12 12+ Education/employment Suicide attempts Truanting and/or erratic 4 Use with loss of Severe paranoia 4 2 attendance Hallucinations (when not U12 12+ Frequency 4 2 At risk of exclusion intoxicated) 5 Occasional drug/alcohol 6 4 Excluded/unemployed use 8 3 Regular drug/alcohol use 5 Daily use U12 12+ Family substance use Known drug/alcohol 4 4 misuse among close family/carers Signficantly affected bu 8 8 someone else's drug/alcohol misuse Section Section 2 Section 3 Total: Total: Total:
Section 1 Substance use Section 2 Social situation/behaviour Section 3 General & psychological health U12 12+ Drug Type U12 12+ Living situation U12 12+ General Health 5 2 Alcohol 5 2 Problems with housing, insecure or inadequate 4 3 Frequent reports of health problems 8 4 Amphetamine 6 3 Cannabis 4 4 Looked after by LA 2 1 Difficulty sleeping 5 Cocaine 6 Homeless 6 5 Chronic fatigue 5 Crack 6 5 Severe sleep problems 8 4 Ecstasy U12 12+ Adult Support 8 5 Neglect/self neglect 5 Heroin 3 2 Conflict at home 8 Extreme weight loss 8 4 LSD 7 4 Has no supportive relationships with adults 9 Blackouts and/or memory loss 7 4 Magic Mushrooms 8 5 Solvents/gas etc. 9 6 Witnesses or has known abusive relationships 10 Pregnant 7 4 Ketamine 10 Fitting 6 2 Others (please list) 10 Accidental/planned overdose U12 12+ Sexual behaviour U12 12+ Contact with other users 6 2 Inappropriate/unsafe sexual behaviour 9 7 Lone use U12 12+ General Health 6 1 Some friends who use drugs/alcohol, some who don't 6 Abusive sexual 6 2 Low self‐esteem 4 2 Inability to concentrate 8 Commercial sexual relationships 3 2 Insecure sens eof identity 8 4 All friends use drugs/alcohol 4 3 Negative or low aspiration 8 4 Eating disorder/marked changes in eating patterns U12 12+ Smoking U12 12+ Criminal Involvement 5 2 Tobacco 6 2 At risk of involvement with the criminal justice system 8 8 Frequent bouts of unhappiness/depression U12 12+ Injecting 8 4 Involved with criminal justice system 3 3 Memory loss 8 Currently/recently injecting 8 8 Self‐harm 8 8 Severe anxiety/panic attacks U12 12+ Intoxication U12 12+ Education/employment Suicide attempts 4 Use with loss of 4 2 Truanting and/or erratic attendance Severe paranoia Hallucinations (when not intoxicated) U12 12+ Frequency 4 2 At risk of exclusion 5 1 Occasional drug/alcohol use 6 4 Excluded/unemployed 8 3 Regular drug/alcohol use 5 Daily use U12 12+ Family substance use 4 4 Known drug/alcohol misuse among close family/carers 8 8 Signficantly affected bu someone else's drug/alcohol misuse Total: Section 1 Total: Section 2 Total: Section 3
substance-misuse-screening-tool-2018.docx