Addiction Severity Index data from general membership and treatment samples of HMO members - One case of norming the ASI

The Addiction Severity Index (ASI) is a widely used interview among substan ce-dependent populations in treatment. Its value as a treatment planning an d evaluation tool has been diminished by the lack of comparative data from nonclinical samples. The present study included four scales from the ASI co llected on samples of adult subscribers to a large health maintenance organ ization (HMO) in northern California, as well as an adult clinical sample f rom the same geographic region with the same HMO insurance, thereby offerin g informative contrasts. Interviews (N = 9,398) of non-alcohol-dependent or abuse adults from a random sample of members of a large HMO were analyzed. We collected complete ASI data on the alcohol, drug, medical, and psychiat ric composite scales and partial data on the employment scale. A sample of 327 adult members of the same HMO from one of the counties included in the survey, who were admitted to treatment for alcohol and/or drug addiction, w as administered the same ASI items at treatment admission. Analyses compare problem severities in the two samples by age and gender. The general membe rship reported some problems in most of the ASI problem areas, although at levels of severity that were typically far below those seen in the clinical sample. General membership and clinical samples were somewhat similar in m edical status and in employment. As expected, alcohol, drug, and psychiatri c status were much more severe in the clinical sample. The data from the HM O general membership sample provide one potential comparison group against which to judge the severity of problems presented by drug- and alcohol-depe ndent patients at treatment admission and at posttreatment follow-up. The a uthors discuss the implications for treatment planning and the evaluation o f treatment outcome. (C) 2000 Elsevier Science Inc. All rights reserved.