DAST-10 is a 10-question yes/no screener for drug use (excluding alcohol and tobacco), developed by Dr. Harvey Skinner in 1982. Scoring: 0 = no problems, 1–2 = low, 3–5 = moderate, 6–8 = substantial, 9–10 = severe. It is a screening, not a diagnosis — only a licensed clinician can diagnose substance use disorder using DSM-5.
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What the DAST-10 measures and why NIDA and SAMHSA endorse it
The DAST-10 is a 10-question yes/no screener developed by Dr. Harvey Skinner at the Addiction Research Foundation in Toronto (now part of CAMH) in 1982. It identifies drug-use problems in the past 12 months, excluding alcohol and tobacco. Sensitivity 0.80–0.95, specificity 0.70–0.90 across primary-care and emergency-department populations. The US National Institute on Drug Abuse publishes it as a standard instrument, and SAMHSA includes it in the SBIRT workflow alongside AUDIT for alcohol.
The 10 questions cover three domains: patterns of use (Q1–3 — non-medical use, polysubstance, loss of control), consequences of use (Q4–7 — blackouts, guilt, family complaints, neglect), and escalation markers (Q8–10 — illegal activity, withdrawal, medical problems). Each question contributes 1 point for "yes," except Q3 is reverse-scored — "no" contributes 1 point because the question asks whether you are always able to stop (a "no" indicates loss of control).
The DAST is free and public-domain. It appears in NIDA CTN Common Data Elements, USPSTF evidence reviews, and most major EHR systems for primary-care substance-use screening.
What the 5 score bands mean
DAST-10 score interpretation comes directly from Skinner's 1982 publication: zero is "no problems reported," 1–2 is "low," 3–5 is "moderate," 6–8 is "substantial," and 9–10 is "severe." Skinner recommended further investigation at any score of 3 or higher and intensive assessment at 6 or higher. Each band below explains what the score reflects clinically, what guidance Skinner attached to it, and how the band typically maps to ASAM levels of care in current US practice.
A DAST-10 score of zero means none of the ten items flagged in the past 12 months. The result is consistent with no clinically significant drug-use problems by Skinner's threshold. The instrument has documented sensitivity 0.80–0.95 in primary-care populations, so a zero is a meaningful negative signal — but it is still a screener, not a diagnosis. Brief experimental use, prescription-medication-only patterns, and concerns specific to a single substance can sit below the DAST-10 threshold yet still warrant a conversation with a clinician. If a specific event prompted you to take this screener, consider mentioning it at your next primary-care visit even with a zero score.
A DAST-10 score of 1 or 2 flags some pattern of drug use but stays below Skinner's substantial-concern threshold of 3. At this band Skinner recommended monitoring and re-screening if use escalates rather than immediate intervention. SAMHSA's primary-care SBIRT workflow typically triggers a brief educational conversation here, sometimes called "advice" rather than full brief intervention. NIDA's Drugs, Brains, and Behavior is the standard plain-language reference at this stage, and SAMHSA's helpline at 1-800-662-4357 can answer follow-up questions confidentially. Consider re-taking DAST-10 in three to six months if drug use continues, especially if frequency, dose, or substance variety has increased since the last screening.
A DAST-10 score of 3 to 5 is consistent with harmful drug use by Skinner's framework. Skinner recommended further investigation with additional testing or clinical conversation, and SAMHSA's SBIRT workflow triggers full brief intervention at this band — a 5 to 15 minute structured conversation about the relationship between drug use and the consequences the screener captured. Treatment typically maps to ASAM Level 1.0 outpatient or Level 2.1 IOP (intensive outpatient) depending on substance and co-occurring conditions. A clinician will want to know which substances are involved, frequency, and whether withdrawal symptoms are present — bring the score and a substance list to that visit. SAMHSA 1-800-662-4357 can also place a referral.
A DAST-10 score of 6 to 8 indicates a substantial drug-use problem. Skinner's original guidance at this band calls for intensive assessment and treatment. A clinician will want full history plus DSM-5 substance-use-disorder evaluation (the diagnostic standard, eleven criteria graded mild / moderate / severe). Treatment typically starts at ASAM Level 2.1 IOP (nine to nineteen hours of structured programming per week) or Level 3.1 clinically managed low-intensity residential, depending on substance, withdrawal risk, and home stability. For opioids, FDA-approved medications for opioid use disorder — buprenorphine, methadone, naltrexone — cut overdose mortality by more than half versus abstinence-only. Stimulant use disorder has no FDA-approved medication yet but responds to contingency management plus CBT.
A DAST-10 score of 9 or 10 indicates a severe drug-use problem and triggers Skinner's most urgent guidance. Intensive assessment and, depending on substance and daily intake, medically supervised detox may be indicated before any structured treatment can begin. Opioid, benzodiazepine, and severe stimulant withdrawal each carry distinct medical risks. Benzodiazepine withdrawal in particular can be life-threatening — seizures and delirium are documented after abrupt cessation in heavy daily users, and clinicians taper rather than stop. Opioid withdrawal is rarely fatal alone but post-abstinence overdose risk rises sharply due to lost tolerance, which is why buprenorphine or methadone induction at ASAM Level 3.7-WM medically managed inpatient detox dramatically reduces relapse mortality. Call SAMHSA 1-800-662-4357 and describe substances honestly — they route to the appropriate detox level. Immediate medical distress: 911.
From a DAST-10 score to a real next step: SAMHSA helpline, ASAM levels, and MAT
If your DAST score is 3 or higher, Skinner's guidance recommends clinician follow-up; 6 or higher recommends intensive assessment and treatment. A DAST score alone is not a treatment plan but a structured, evidence-based starting point. Here is how the instrument's recommendations translate to concrete actions in the United States today.
If you scored 3 or higher
- Call SAMHSA's free 24/7 helpline at 1-800-662-4357. Counsellors provide information, insurance-navigation, and warm transfers to local treatment. Free, confidential, English and Spanish.
- Talk to a primary-care clinician and bring your DAST-10 score. DAST-10 appears in SBIRT screening as the standard drug-use instrument that clinicians administer routinely; a 3+ is a direct reason for longer conversation about drug use and treatment options including medications (buprenorphine, methadone, naltrexone for opioid use disorder; no FDA-approved medication yet for stimulant use disorder).
- Search SAMHSA's treatment locator by ZIP or browse our directory by state.
If you scored 9 or 10 — read this first
Withdrawal danger depends on substance and daily intake. Some specifics:
- Opioids (heroin, fentanyl, oxycodone, hydrocodone): withdrawal is extremely uncomfortable but rarely life-threatening on its own. Primary danger is post-abstinence overdose from lost tolerance. Medically supervised detox (ASAM Level 3.7-WM) + buprenorphine or methadone dramatically reduces relapse and overdose mortality.
- Benzodiazepines (alprazolam, clonazepam, diazepam): withdrawal CAN be life-threatening. Seizures and delirium are documented. Never stop abruptly after heavy daily use. Clinicians taper over weeks to months. Hospital or medically monitored inpatient detox is often indicated (ASAM 3.7-WM or 4.0).
- Stimulants (cocaine, methamphetamine, amphetamines): physical withdrawal is not dangerous but post-acute withdrawal produces severe depression and suicidality for weeks. Monitored setting recommended during early abstinence.
Call SAMHSA 1-800-662-4357 and describe your substance(s) honestly — they route you to the appropriate detox level. Immediate medical distress: 911.
If DAST-10 is not the right fit: AUDIT-10, PHQ-9, CAGE-4, and WHO ASSIST
DAST-10 screens for drug use excluding alcohol and tobacco. If alcohol is your main concern, or if depression or anxiety co-occurs (which is the case in 30–60% of substance-use disorder), the screeners below cover those distinct questions.
AUDIT-10 (Alcohol Use Disorders Identification Test)
10-question WHO-validated alcohol screener. Pair with PHQ-9 for a full alcohol-plus-depression picture — the combination is the standard primary-care SBIRT workflow.
PHQ-9 (Patient Health Questionnaire-9)
9-question Kroenke-2001 depression severity screener. Depression co-occurs with substance use disorder in 30–40% of cases — integrated treatment is best evidence.
GAD-7 (Generalized Anxiety Disorder)
7-question anxiety severity screener (Spitzer 2006 — same author family as PHQ-9). Anxiety co-occurs with depression in roughly 50% of cases. At cutoff ≥10: 89% sensitivity, 82% specificity for GAD.
CAGE-4
4-question alcohol screener (Ewing JAMA 1984). Faster than AUDIT-10 but less sensitive. Public-domain. Cutoff ≥2 has 71% sensitivity / 90% specificity for AUD.
PHQ-2
2-item subset of PHQ-9 (anhedonia + depressed mood). Faster pre-screen used in primary care before triggering full PHQ-9.
ACE (Adverse Childhood Experiences)
10-question retrospective measure of childhood adversity (Felitti / CDC 1998). Public-domain. ACE ≥4 increases adult substance use disorder risk by 7×. Trauma-informed counterpart to current-symptom screeners.
PCL-5 (PTSD Checklist for DSM-5)
20-question current-symptom screener developed by VA National Center for PTSD (Weathers 2013). Public-domain. DSM-5-aligned with 4 cluster sub-scores. Pairs with ACE (past exposure + current symptoms = standard trauma workup). Cutoff ≥31 for probable PTSD.
WHO ASSIST
Longer 8-item WHO instrument covering alcohol, tobacco, cannabis, cocaine, stimulants, inhalants, sedatives, hallucinogens, opioids. For one-shot multi-substance screening. WHO ASSIST manual.
DAST-10 terms: ASAM, MOUD, DSM-5, SBIRT, withdrawal management
Six terms appear repeatedly across this page — the instrument itself (DAST-10), the medications used in opioid use disorder (MOUD), the level-of-care framework that maps DAST scores to treatment intensity (ASAM), the diagnostic standard a clinician uses after the screen (DSM-5), the public-health workflow DAST-10 fits inside (SBIRT), and the medical process behind detox (withdrawal management). Plain definitions follow.
- DAST-10
- Drug Abuse Screening Test, 10-question version. Developed by Dr. Harvey Skinner at CAMH in 1982. Scores 0–10 across 5 risk bands.
- MOUD · Medications for opioid use disorder
- FDA-approved medications for opioid dependence: buprenorphine (partial agonist, office-based), methadone (full agonist, OTP only), and naltrexone (antagonist). With counselling, MOUD cuts overdose mortality by more than half. See our MAT treatment page.
- ASAM level of care
- The American Society of Addiction Medicine framework classifying treatment intensity from Level 0.5 through Level 4. DAST scores 6+ typically map to Level 2.1 or higher. See our treatment types index.
- DSM-5 substance use disorder
- 11 clinical criteria from the American Psychiatric Association. 2–3 criteria = mild SUD, 4–5 = moderate, 6+ = severe. DAST screens; DSM-5 diagnoses in interview.
- SBIRT
- Screening, Brief Intervention, and Referral to Treatment — SAMHSA public-health workflow. DAST-10 is the "S" for drug use (AUDIT-10 for alcohol). Brief intervention is a 5–15 minute conversation.
- Withdrawal management (detox)
- Medically supervised process stabilising a patient through acute withdrawal. ASAM identifies 5 levels, ambulatory (1-WM) through medically managed inpatient (4-WM). Critical for benzodiazepines and heavy alcohol use — withdrawal can be life-threatening.
DAST-10 FAQ: anonymity, scoring, alternatives, withdrawal safety
Ten common questions about DAST-10 — whether the quiz is truly anonymous, what specific scores mean clinically, how DAST-10 differs from DSM-5 diagnosis, when to use a different screener (AUDIT-10 for alcohol, PHQ-9 for depression), and the substance-specific withdrawal safety facts that matter most at high scores.
Is this DAST quiz anonymous?
Yes. Answers and scores are computed entirely in your browser. Nothing is sent to our servers. No email required. No account. No tracking of individual responses.
Is the DAST-10 a diagnosis?
No. The DAST-10 is a screening tool, not a diagnosis. A score of 3 or higher indicates drug-use patterns worth discussing with a clinician. Only a licensed healthcare professional can diagnose substance use disorder using DSM-5 criteria and a full clinical interview.
Who developed the DAST-10?
Dr. Harvey A. Skinner developed the DAST in 1982 at the Addiction Research Foundation (now Centre for Addiction and Mental Health, Toronto). It is recommended by NIDA and SAMHSA for routine primary-care substance-use screening.
What should I do if I score 6 or higher?
A score of 6–8 indicates substantial drug-use; 9–10 indicates severe. Speak with a clinician or call the SAMHSA National Helpline at 1-800-662-4357 (free, confidential, 24/7). Some drug withdrawals (opioids, benzodiazepines, severe stimulant crashes) can be medically dangerous and should be supervised.
Does DAST-10 include alcohol or tobacco?
No. DAST-10 asks about drug use excluding alcohol and tobacco. For alcohol screening use AUDIT-10. For tobacco, the Fagerström Test. For multi-substance screening, WHO ASSIST.
Can this quiz replace a clinical assessment?
No. A clinician will use DAST results alongside a full clinical interview, medical history, and DSM-5 criteria. This screener is a useful starting point, not a substitute.
Is my data saved anywhere?
No. The quiz uses client-side JavaScript only. Questions and answers never leave the page. You can take a screenshot or print the page to share with a clinician, but nothing is stored on our servers.
How is DAST-10 different from the DSM-5 criteria?
DAST-10 is a brief screener designed for fast identification. DSM-5 is the clinical diagnostic standard — 11 criteria evaluated in interview, classifying severity as mild, moderate, or severe. DAST flags; DSM-5 diagnoses.
What about withdrawal if I score high and want to stop?
Withdrawal danger depends on substance. Opioid withdrawal is uncomfortable but rarely life-threatening alone — primary risk is post-abstinence overdose. Benzodiazepine withdrawal CAN be life-threatening — seizures and death are documented. Never stop abruptly after heavy daily use. Stimulant withdrawal produces severe depression and suicidality. SAMHSA 1-800-662-4357 can advise.
Is this the same DAST my primary-care doctor might use?
Yes, the same 10 items with the same scoring. DAST-10 lives inside the NIDA Common Data Elements set, the SAMHSA SBIRT toolkit, and most major EHR substance-use screening workflows.
DAST-10 primary sources: Skinner 1982, NIDA CDE, SAMHSA, USPSTF, WHO
Every fact and threshold on this page traces to one of the 10 sources below: Skinner's original 1982 publication, the NIDA Common Data Elements record, SAMHSA's helpline and SBIRT workflow, the USPSTF DAST evidence review, ASAM's national practice guideline, and the WHO ASSIST manual for the multi-substance alternative.
- NIDA CDE — Drug Abuse Screening Test (DAST-10) instrument record.
- SAMHSA National Helpline (1-800-662-4357).
- SAMHSA — Screening, Brief Intervention, and Referral to Treatment.
- NIDA — Drugs, Brains, and Behavior: The Science of Addiction.
- USPSTF — The Drug Abuse Screening Test evidence review.
- Centre for Addiction and Mental Health (CAMH).
- SAMHSA treatment locator.
- 988 Suicide & Crisis Lifeline.
- ASAM National Practice Guideline for OUD.
- WHO ASSIST manual (multi-substance alternative).
reviewedBy schema appears in the structured data, and this notice stays visible. We do not provide medical advice and we do not replace evaluation by a licensed clinician. Medical emergency: 911. Crisis: call or text 988. Free, confidential substance-use guidance 24/7: SAMHSA 1-800-662-4357. Substance-use-disorder treatment records are protected under 42 CFR Part 2.
