A clinician's guide to the DAST-10, including how to score it, choose a defensible cutoff, and document the screen so it supports medical necessity.
October 16, 2026
By Ryan DeCook, LCSW • Clinically reviewed by Bettina D'Andrea, MSN PMHNP-BC
12 min read
By Ryan DeCook, LCSW • Clinically reviewed by Bettina D'Andrea, MSN PMHNP-BC
What to know
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As a therapist, if you want a quick, validated read on drug use at intake, the DAST-10 is a great option. It’s only 10 yes or no questions, completed in about five minutes. The challenge is in the details: variable cutoff guidelines, one reverse-scored item that can trip people up, and notes that have to hold up under payer review.
The Drug Abuse Screening Test (DAST-10) is a 10-item, yes-or-no screening tool that measures drug-related problems over the past 12 months. It excludes alcohol and tobacco, takes about five minutes, and is the short form of the 28-item DAST Harvey Skinner published in 1982.
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The DAST-10 questionnaire opens with a lengthy preamble. Two parts matter most: Alcohol and tobacco are excluded, and "drug abuse" includes prescription or OTC medication used beyond directions, not only illicit drugs. You can find the 10 yes-or-no questions via the National Library of Medicine.
Clients may minimize or skip items. Note any skipped items, since a partial screen can't be interpreted the same way.
The following scoring ranges follow Skinner's five severity bands.
Skinner framed these bands as tentative guidelines. Read them alongside your clinical interview, observed impairment, and history.
| Score range | Degree of problems | Suggested action |
|---|---|---|
| 0 | No problems reported | None |
| 1–2 | Low level | Monitor or reassess later |
| 3–5 | Moderate level | Further assessment |
| 6–8 | Substantial level | Intensive assessment |
| 9–10 | Severe level | Intensive assessment |
There's no single right cutoff. The most commonly used is ≥3, where the moderate band starts, but published thresholds vary by setting and population. ≥3 performed best as a cutoff in a clinical validation study. Choose based on what a positive screen triggers in your practice.
The DAST-10 derives from the Drug Abuse Screening Test developed by Harvey A. Skinner, PhD, at the Addiction Research Foundation in Toronto, now the Centre for Addiction and Mental Health. The original DAST was published in 1982.
The DAST is copyrighted by Harvey Skinner and CAMH. The form allows reproduction for non-commercial clinical use with attribution. Commercial, digital-product, or modified use requires permission from CAMH.
About five minutes, whether the client self-reports or you administer it as an interview.
No. The DAST-10 excludes alcohol and tobacco. Pair it with an alcohol-specific instrument, such as the AUDIT or shorter AUDIT-C, when alcohol screening is also needed.
According to the original severity bands, 6–8 indicates a substantial problem and 9–10 a severe problem. Both call for intensive assessment. Level of care, including whether specialty treatment is needed, comes out of that assessment, not the score alone.
Yes. Send it through a secure client portal or administer it by telehealth interview, and confirm the client has privacy before reviewing answers.
No. It shows whether drug-related problems are likely and whether further assessment is needed. Diagnosis requires a clinical assessment against DSM-5-TR criteria.
Yes. A meta-analysis found strong sensitivity (0.90) and good specificity (0.82), meaning it catches most true drug problems while flagging some false positives that need confirmation. Various studies, including this one, confirm that internal consistency and test-retest reliability is good indicating that the instrument measures what it intends to and repeated tests over time measure successfully.
Screening is part of measurement-based care, and it adds admin work. Headway takes much of it off your plate.
This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
© 2026 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.
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