The Drug Abuse Screening Test (DAST-10) is a 10-item self-report screen for problematic drug use - excluding alcohol and tobacco - over the past 12 months. Each yes/no item scores 0 or 1, giving a total of 0-10 that reflects the degree of drug-related consequences: inability to stop, blackouts or flashbacks, family concern, neglect of responsibilities, withdrawal symptoms and medical problems.
It deliberately measures consequences rather than quantity or frequency of use, and it does not distinguish between substances. A positive screen says "drug use is causing problems worth assessing", not which drug, how much, or whether a use disorder is present - that requires a fuller clinical assessment.
02 - Origin & purpose
Where it comes from.
The DAST was developed by Harvey A. Skinner at the Addiction Research Foundation in Toronto and published in 1982 as a 28-item parallel to the Michigan Alcoholism Screening Test (MAST), giving clinicians a brief, quantifiable index of drug-related problems at a time when structured drug screening barely existed 1. Shorter 20- and 10-item versions followed, with the DAST-10 becoming the standard in routine care because it screens in under two minutes with little loss of accuracy 2.
Its intended role is first-line case finding in general medical, psychiatric and addiction settings, feeding a positive result into a more thorough assessment and brief intervention. Four decades on, it remains one of the most widely used drug screens in both research and practice.
03 - Scoring & cutoffs
How scoring works.
One point per "yes" (one item is reverse-scored), giving 0-10 for the past 12 months. A score of 3 or more is the most commonly used threshold for a positive screen. Conventional interpretation bands: 0 no reported problems; 1-2 low level - monitor and reassess; 3-5 moderate level - further assessment and brief intervention; 6-8 substantial level - intensive assessment, treatment referral recommended; 9-10 severe level - intensive assessment and treatment. Some settings use a lower threshold (2 or more) where sensitivity matters more than false positives, such as high-prevalence populations.
Score
Severity
Interpretation
0–0
No problems
No problems reported.
1–2
Low level
Low level of problems related to drug use.
3–5
Moderate level
Moderate level of problems. Further investigation warranted.
6–8
Substantial level
Substantial level of problems. Assessment and intervention recommended.
9–10
Severe level
Severe level of problems. Intensive assessment and treatment recommended.
04 - Validation evidence
How well it performs.
A comprehensive psychometric review of the DAST family (Yudko, Lozhkina & Fouts, 2007), covering studies from 1982 to 2005, found moderate to high reliability and validity across versions and settings 2. Diagnostic accuracy for the DAST-10 varies with the cutoff and the population: lower cutoffs trade specificity for sensitivity. Validation spans psychiatric outpatients, primary care, and international samples including pregnant women and adolescents 34.
α 0.86-0.94
Internal consistency
Cronbach alpha for the DAST-10 across studies (Yudko et al., 2007).
r ≈ 0.71
Test-retest reliability
For the DAST-10 (Cocco & Carey, 1998).
41-95%
Sensitivity
Depending on cutoff (1/2 up to 3/4) and population (Carey, Carey & Chandra, 2003).
68-99%
Specificity
Across the same cutoff range and populations (Carey, Carey & Chandra, 2003).
Free. The alcohol instrument the DAST was modelled on.
DAST-10
10
<2 min
Free for non-commercial use with attribution. Reach for it as the default all-drugs consequence screen in adults.
06 - When to use it
Right tool, wrong tool.
The DAST-10 is a first-line case-finding instrument for adults: it tells you whether drug use is producing consequences that merit a fuller assessment, and grades that signal enough to choose between monitoring, brief intervention and referral.
Reach for it when
-First-line drug screening in adult psychiatric, primary care and general medical settings
-Quantifying drug-related consequences to grade the response (monitor, brief intervention, referral)
-Populations where any non-prescribed drug use matters
-Pairing with the AUDIT for full substance coverage
Reach for something else when
-Alcohol or nicotine problems - both are explicitly excluded
-Identifying which substance is involved
-Measuring change over short periods (the 12-month window barely moves)
-Adolescents, where the CRAFFT is validated and preferred
-Diagnosis of a substance use disorder - a positive screen starts, not ends, assessment
07 - Confidence & precision
Reading the score with care.
Internal consistency is strong (α ≈ 0.86-0.94) but test-retest of about 0.71 means single-point changes should not be over-read. No standard error of measurement or minimal clinically important difference is established for the DAST-10, and its 12-month reporting window makes it structurally insensitive to short-term change - it is a case-finding tool, not a progress measure. Face-valid yes/no items also make deliberate underreporting easy where disclosure feels risky, so a low score in a high-suspicion context should not close the question.
08 - Limitations
What it cannot tell you.
Excludes alcohol and tobacco; must be paired with an alcohol screen for full coverage.
Face-valid items are susceptible to underreporting, especially where disclosure has consequences.
Does not identify which substance, quantity or frequency - consequences only.
The 12-month window is insensitive to recent change, making it unsuitable for monitoring.
Optimal cutoffs vary by population; the standard threshold of 3 or more loses sensitivity in some groups.
[3]Cocco KM, Carey KB. Psychometric properties of the Drug Abuse Screening Test in psychiatric outpatients. Psychol Assess. 1998;10(4):408-414. (1998) ↩
[4]Carey KB, Carey MP, Chandra PS. Psychometric evaluation of the Alcohol Use Disorders Identification Test and Short Drug Abuse Screening Test with psychiatric patients in India. J Clin Psychiatry. 2003;64(7):767-774. (2003) ↩
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