Addiction Awareness OSCA 11-036 response - REDACTED.pdf

02/28/2011 ENTER SITE NAME HERE
Page 1 of 10
ADDICTION SEVERITY INDEX NARRATIVE REPORT
DAVID WADE CHASE
Date of Birth:
Social Security Number:
Date of Interview:
Type of Interview:
Interviewer Name:
ID#
10730814694CH
Device ID#
XX-0000000-00-01
Time Int. Began:
Time Int. Ended:
Interviewer Id #: 001
GENERAL INFORMATION SECTION
The following is a clinical summary based on an in-person interview with David Chase, on
02/28/2011. This summary is based on the client's self report regarding lifetime and recent Medical,
Employment, Alcohol, Drug, Legal, Family/Social and Psychiatric involvement and/or problems.
Included in each of these sections is the interviewer's severity rating, suggesting the client's need
for treatment (or additional treatment beyond what he's already receiving). This is based on the
information provided by the client.
David is a 29 year old, White (Not Hispanic or Latino) male. He states that he does have a
religious/spiritual belief system. He has lived at his current address for approximately 5 months.
Neither the client nor his family owns this residence. David reports spending 30 of the past 30 days
in a Jail or Prison facility in which his freedom was restricted and/or prohibited. This could have
limited his ability to use alcohol or drugs, as well as his interactions with family and others.
ALCOHOL & DRUG SECTION
Lifetime and Recent Alcohol Use:
David appears to have no lifelong problems with alcohol, he has never drank either heavily
(generally defined as 5 or more drinks in one day) or regularly (approximately 3 or more days per
week), for even 6 months. I don't drink. He has not consumed any alcohol in the past 30 days. In the
past 30 days, he did not spend any money on alcohol. He has never experienced alcohol delirium
tremens.
Lifetime and Recent Drug Use: