Making addiction in screening and diagnostic tools used in AOD and other health settings

Project Team

Dr Robyn Dwyer, National Drug Research Institute, Curtin University

Professor Suzanne Fraser, National Drug Research Institute, Curtin University


Researchers have long recognised that epidemiology constitutes, as much as it measures, the diseases it tracks. In the field of substance use and addiction, a range of screening and diagnostic tools have been developed (e.g., the four-item CAGE or the eight-item ASSIST). Typically designed to identify problem drinking or drug use, these tools are often linked directly with addiction diagnostic categories derived from the DSM or the International Classification of Diseases. These screening and diagnostic tools are used for a variety of purposes (e.g., identification of substance use, diagnosis of dependence or addiction), in a range of settings (e.g., primary health care, welfare, criminal justice, AOD treatment and epidemiological research) and their use is widespread in Anglo-European countries.

This project collected and examined substance use and addiction screening and diagnostic tools currently being used in two countries: Canada and Australia. The analysis focused on the relationships between the tools, their specific items, the core concepts in ‘addictions’ theory they rely on and how they are situated in current practice.

In undertaking this collection and analysis the project asked, how do addiction screening and diagnostic tools define and shape the phenomena they merely purport to track? What are the material effects of defining addiction in certain ways, measuring it in certain communities and contexts, and through certain methods, and designing responses based on these strategies?


Dwyer, R. and Fraser, S. (2017). Engendering drug problems: Materialising gender in the DUDIT and other screening and diagnostic ‘apparatuses’. International Journal of Drug Policy, 44, pp. 135-144. DOI: 10.1016/j.drugpo.2017.05.049 [RJ1345]

Dwyer, R. and Fraser, S. (2016). Making addictions in standardised screening and diagnostic tools. Health Sociology Review, 25, (3), pp. 223-239. DOI: 10.1080/14461242.2016.1184581 [RJ1053]

Dwyer, R. and Fraser, S. (2015). Addiction screening and diagnostic tools: ‘Refuting’ and ‘unmasking’ claims to legitimacyInternational Journal of Drug Policy, 26, (12), pp. 1189-1197.