Substance use assessment

The manuals converge on the need to assess substance use with structured, longitudinal methods rather than relying on a single snapshot. Across the extracts, they recommend collecting baseline and follow-up data, reviewing alcohol and other substance use patterns over time, and interpreting outcomes across related domains such as craving, abstinence, heavy drinking days, and broader addiction-related functioning. They also agree that substance use assessment is tied to safety and treatment decisions. The sources mention using standardised tools and clinical interview, checking withdrawal symptoms, and reviewing breathalyser and urine toxicology results before dosing decisions. Several manuals also link assessment to screening or monitoring for risk, including hazardous use, misuse, dependence, diversion, and exclusions related to recent substance use disorders. The manuals differ mainly in emphasis and substance focus. The ketamine protocol centres on daily alcohol and other substance use, craving measures, withdrawal, and toxicology. The psilocybin and ibogaine sources place more weight on alcohol outcomes and broader addiction severity, including family and social functioning problems. The MDMA source is more focused on risk awareness and exclusion criteria, while the ibogaine extract is broader in its use of the Addiction Severity Index-Lite or comparable structured assessments.