DUST Pre/Post intervention (circle appro.)
Date Score Note:
Please complete sections 1, 2 & 3 Complete section 1 for the the young person's substance use to the best of your knowledge. Tick the most appropriate response. If you are unsure, do not tick.
Name DOB SECTION 1 Substance Use
'Past use' is for reference only Please tick appropriate boxes but do not score this. The score for each of the three sections should be added up. Once completed please refer to the scoring table below. If you are concerned that the young person does not meet the threshold for referral, please contact in2change on 01978 295629 for advice.
Sec. 1 Score 0-4 Score 5-6. Score 7+ Sec. 2 Score 0-1 Score 2-5. Score 6+
Scoring Table Drug/Alcohol Use Consider giving drugs information/ advice Consider seeking advice from in2change, Wrexham's young person's drug and alcohol team Refer to in2change, Wrexham young person'sdrug alcohol team
Within last 3 months 2
Alcohol
2
Amphetamine
2
Cannabis Cocaine
4
Crack
4
Ecstasy
7
Heroin
4
Ketamine
4
LSD
4 7
2 2 2 2
Magic Mushroom Solvents/Gas/Aerosols Other's, please list (include misuse of prescribed drugs): Other 1… Other 2… Other 3… Other 4…
1 2
Drug. Alcohol Use - Frequency Occasional drug. alcohol use Regular drug/alcohol use
0 5
Injecting Not injecting Currently/recently injecting
0 2
substance misuse problems Sec. 3 Score 0-4. Score
MEDIUM RISK
5-9.
Consider seeking advice from in2change
Score
Consider seeking advice from
10 +
in2change or other relevant agency.
Drug/Alcohol use - Intoxication Drug/alcohol use without loss of consciousness or aggression Drug/alcohol use with loss of consciousness or aggression
General and Psychological Health LOW RISK
Use
4
Social Situation/Behaviour LOW RISK MEDIUM RISK Consider seeking advice from in2change Consider seeking advice from in2change or other relevant agency. * A high score means the young person is vulnerable to developing
Past Drug Type
Contact with Other Drug/Alcohol Users 0
No drug/alcohol using friends
1
Some friends who use drugs/alcohol
2
All friends use drugs/alcohol
and some who don't
Total Section 1
* A high score means the young person is vulnerable to developing substance misuse problems
NOTE Past Use For information only - Please tick but do not score
SECTION 2 Social Situation/Behaviour
0 1 2 6
0 1 2 2
0 1
2
0 1 2
Living Situation No Problems with accommodation Problems with accommodation, insecure or inadequate housing Looked after by local authority Homeless Adult Support Has supportive relationships with more than one adult Has supportive relationship with one adult Has no supportive relationships with adults Problematic relationships (e.g. domestic violence at home). Occupation In education/employment/training Truanting from school/at risk of school exclusion/drug or alcohol related absences from work School excluded/unemployed Criminal Involvement No criminal involvement At risk of involvement in the Criminal Justice System Involved in Criminal Justice System or committing more serious crimes
0 2 6
Sexual Behaviour Age appropriate/safe sexual behaviour Inappropriate/unsafe sexual behaviour Commercial sex/abusive sexual relations
2
Other Drug related debt
0 2 5
Family Drug/Alcohol Use No know family drug/alcohol use Known drug/alcohol misuse among close family members/carers Significantly affected by someone else's drug/alcohol misuse Total Section 2
SECTION 3 General and Psychological Health
0 1 1 1 1 5 5 5 10 10 10 10 10
General Health Young person reports no significant health problems Teeth problems Stomach problems Regular headaches Difficulty sleeping Chronic fatigue Severe sleep problems Self neglect Extreme weight loss Blackouts and/or memory loss Pregnant Fitting Accidental/planned overdose
Psychological Health Young person reports no significant psychological problems 1 Low self-esteem 1 Mild anxiety 1 Shyness 5 Eating disorder/marked change in eating pattern (e.g. loss of appetite/bingeing) 5 Frequent bouts of unhappiness/ depression 5 Self-harm 5 Severe anxiety/panic attacks 10 Suicide attempts 10 Severe paranoia 10 Hallucinations (when not under the influence of substances 0
Total Section 3
Section 1 + Section 2 + Section 3 Total