Chemical Health Assessment | Hues Hope

Minnesota Chemical Health Assessment

Chemical Health Self-Assessment

Based on the ASAM Criteria (formerly Minnesota Rule 25). This confidential self-screening helps identify your needs across 6 clinical dimensions and recommends the right level of care.

⚠️ Important: This tool is for informational purposes only and does not replace a clinical assessment by a licensed professional. If you are in crisis, call 988 or 211 immediately.

Dimension 1 of 6 — Withdrawal & Intoxication 0% Complete

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Dimension 1: Acute Intoxication & Withdrawal Potential

Current substance use, withdrawal risk, and detox needs

1. How often do you currently use alcohol, drugs, or other substances?

Never or rarely (less than once a month) Monthly or a few times a month Weekly (several times per week) Daily or almost every day

2. When you stop or significantly reduce your substance use, do you experience withdrawal symptoms?

Examples: shaking, sweating, nausea, anxiety, seizures, hallucinations

No, I do not experience withdrawal symptoms Mild discomfort (anxiety, irritability, trouble sleeping) Moderate symptoms (shaking, sweating, nausea, strong cravings) Severe symptoms (seizures, hallucinations, delirium, or I’ve been hospitalized for withdrawal)

3. Are you currently using multiple substances (e.g., alcohol AND opioids, or alcohol AND benzodiazepines)?

No, I use only one substance or none Occasionally use a second substance Regularly use two or more substances together Daily use of multiple substances, including alcohol and/or opioids/benzodiazepines

4. Have you ever had a seizure, passed out, or required emergency care due to substance use or withdrawal?

No Once, but it was minor Yes, more than once Yes, I have had seizures or been hospitalized multiple times

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Dimension 2: Biomedical Conditions & Complications

Physical health issues that may affect or be affected by substance use

5. Do you have any chronic or serious physical health conditions?

Examples: liver disease, heart disease, HIV/AIDS, diabetes, chronic pain, pregnancy

No known physical health conditions Minor conditions that are well-managed Moderate conditions that may be worsened by substance use Serious conditions (liver failure, active infection, pregnancy complications) requiring medical care

6. Has your substance use caused or worsened any physical health problems?

No Possibly — I’ve noticed some changes but haven’t seen a doctor Yes — I have a diagnosed condition related to my use (e.g., liver damage, malnutrition) Yes — I have serious, ongoing medical complications requiring regular treatment

7. Do you have any medical needs that could interfere with your ability to participate in treatment?

Examples: need for dialysis, chemotherapy, chronic pain management, mobility issues

No medical needs that would interfere Minor needs that can be managed alongside treatment Moderate needs that require scheduling accommodations Significant medical needs requiring intensive medical supervision during treatment

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Dimension 3: Emotional, Behavioral & Cognitive Conditions

Mental health, psychiatric conditions, and co-occurring disorders

8. Do you currently experience symptoms of depression, anxiety, trauma, or other mental health conditions?

No significant mental health symptoms Mild symptoms that don’t significantly affect daily life Moderate symptoms that affect my daily functioning Severe symptoms — I have a diagnosed psychiatric condition or have been hospitalized for mental health

9. Have you had thoughts of harming yourself or others in the past 30 days?

No Occasional passive thoughts (e.g., “I wish I wasn’t here”) but no plan Active thoughts with some intent but no specific plan Active thoughts with a plan or recent attempt — Please call 988 now

10. Are you currently taking prescribed psychiatric medications (antidepressants, mood stabilizers, antipsychotics)?

No psychiatric medications Yes, and I take them consistently as prescribed Yes, but I sometimes miss doses or don’t take them as prescribed I need psychiatric medications but am not currently receiving them

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Dimension 4: Readiness to Change

Your motivation, willingness, and readiness to address substance use

11. How would you describe your readiness to change your substance use?

I don’t believe I have a problem and am not interested in changing I’m thinking about it but not ready to commit to change I’m ready to make changes and am starting to take steps I am fully committed to recovery and actively working on it

12. Are you seeking help voluntarily, or are you required to by a court, employer, or family pressure?

Completely voluntary — I want help for myself Mostly voluntary, with some external encouragement Primarily due to external pressure (family, employer) but I see the need Court-ordered or required — I strongly disagree I have a problem

13. How confident are you that you can make changes to your substance use?

Very confident — I have a plan and support Somewhat confident — I think I can do it with help Not very confident — I’ve tried before and relapsed Not confident at all — I don’t think I can change

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Dimension 5: Relapse & Continued Use Potential

Risk of returning to use and ability to maintain recovery

14. Have you previously attempted to stop or reduce your substance use?

I’ve never needed to — my use has not been a problem Yes, and I was successful for a significant period of time Yes, but I relapsed within a few weeks or months Yes, multiple times — I have not been able to stay sober for more than a few weeks

15. How strong are your cravings or urges to use substances right now?

No cravings Mild cravings that I can manage Moderate cravings that are difficult to resist Severe, overwhelming cravings that I cannot control

16. Do you know your personal triggers for substance use (people, places, emotions, situations)?

Yes, I know my triggers and have effective coping strategies I know some of my triggers but need help developing coping skills I have limited awareness of my triggers I have no awareness of triggers and no coping strategies

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Dimension 6: Recovery Environment

Your living situation, social supports, and barriers to treatment

17. How would you describe your current living situation?

Stable housing with supportive, sober household members Stable housing, but household members use substances or are unsupportive Unstable housing (couch surfing, staying with others temporarily) Homeless or in a shelter, or in a living situation that actively endangers my recovery

18. Do you have family, friends, or a support network who support your recovery?

Strong support network — family and friends actively support my recovery Some support — a few people in my life are supportive Limited support — most people in my life use substances or are indifferent No support — I am isolated or surrounded by people who actively encourage my use

19. Do you face any significant barriers to accessing treatment?

Examples: transportation, childcare, work schedule, language, immigration status, cost

No significant barriers Minor barriers I can work around Moderate barriers (e.g., no transportation, childcare needs) Severe barriers that make it very difficult to access or complete treatment

20. Do you have any legal issues related to your substance use (DWI, criminal charges, probation)?

No legal issues Minor past issues, fully resolved Active legal case or currently on probation/parole Facing serious charges or incarceration related to substance use

All responses are confidential. This tool does not collect or store personal information.

Chemical Health Self-Assessment

📊 Your Dimension Scores

🏥 Recommended Level of Care

✅ Recommended Next Steps

📍 Minnesota Treatment & Support Resources