First Steps

Here's where to start if you're worried about drug or alcohol addiction.

In most cases, initially what happens is that the person suffering - or, more likely, a family member - recognizes that there is a problem and takes steps to begin the process of getting help. After that, often one of the first things that will happen is getting an assessment.


An assessment, usually conducted by a qualified chemical dependency counselor, will identify your history of substance use, the severity of your condition and any other health problems and personal circumstances that may affect your treatment. The assessment also helps ensure you get an accurate medical diagnosis of the disease.

It’s important to get an assessment completed so a professional can make a recommendation on the level of care needed.  The assessment is typically referred to as a “chemical dependency assessment” by treatment providers. 

The point of the assessment is for a credentialed professional to gauge the severity of the problem by asking questions regarding use and symptoms.  Be honest and open with the assessment professional, including the reasons for seeking services.

The assessment will provide the information needed to identify your diagnosis and determine your treatment needs and your long-term addiction management plan.


The assessment should help lead to an accurate diagnosis of the disease. Some physicians will diagnose the disease, but in reality, very few are trained in addiction medicine so they rely on chemical dependency counselors to determine the diagnosis based on the assessment. 

To be diagnosed with addiction, you must meet criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and used by doctors and other health providers to diagnose mental health conditions.

For each disorder included in DSM, a set of diagnostic criteria indicate what symptoms must be present (and for how long) as well as symptoms, disorders, and conditions that must not be present in order to qualify for a particular diagnosis. 

The current version of the manual, referred to as the DSM-5, refers to addiction as a “substance use disorder.” The illness is defined on a continuum from mild to severe based on the criteria. Each specific substance is addressed as a separate use disorder but nearly all substances are diagnosed based on the same overarching criteria. Mild substance use disorder requires two to three symptoms from a list of 11.

Contact Us for Help

If you need help getting an assessment, or have questions about what to do first, make an appointment with a trained recovery coach.

Or you can search online for providers that do assessments. In South Dakota, the Helpline Center’s 211 Resource Database is a great place to start.  

Tip: The search is case sensitive, for example, search “Chemical Dependency Assessment” in for a listing of qualified providers in your area. 

Source: Adapted from