An Addiction Assessment in Switzerland: Records, Questions, and Next Steps

An addiction assessment should explain what is happening, what needs attention first, and which treatment options fit the person. In Switzerland, that may begin with a family doctor, a specialist addiction service, or a psychiatric team. The assessment is more than a questionnaire and does not automatically lead to residential rehab. Bring a clear account of substance use, health, earlier treatment, and current circumstances so the clinician can make a useful recommendation.

This guide explains how to prepare and how to evaluate the resulting plan. It applies to people seeking an initial assessment and to those returning after treatment has stopped helping. It is not a method for diagnosing yourself or deciding that withdrawal can be managed without medical supervision.

Clarify which kind of assessment you are booking

A screening conversation identifies issues that need closer attention. A diagnostic assessment considers whether the pattern meets criteria for a disorder and what else may explain the symptoms. A treatment assessment asks what help is appropriate now. These tasks overlap, but a short screening score should not be treated as a complete explanation of the person’s needs.

NIDA’s screening resources distinguish tools by substance, age, and method of administration. That matters when comparing online questionnaires: a tool developed for one purpose does not automatically answer another question. Ask which instrument is being used, what its result suggests, and what further discussion is needed before a diagnosis or treatment decision.

If an insurer, employer, court, or licensing authority has requested a report, identify that purpose before the appointment. Ask whether the service conducts that type of assessment and who will receive the report. An ordinary treatment consultation and a formal third-party evaluation may have different requirements. Do not assume that a routine clinic letter will satisfy a separate administrative process.

Describe the pattern, not only the amount

The NIAAA explanation of alcohol use disorder describes diagnosis through a pattern of symptoms and impairment, rather than consumption alone. Relevant features include loss of control, unsuccessful efforts to change, craving, consequences, tolerance, and withdrawal. Similar-looking amounts of use can therefore require different clinical discussions.

Write down a typical week and any recent period that was very different. Include what is used, when, how, and whether different substances or medications are combined. For alcohol, describe the actual drink, container size, and strength if known. For an unfamiliar substance, say what you believe it was and how uncertain you are; guessing confidently can obscure information the clinician needs.

Explain what happens before and after use. Does it follow a particular social situation, pain episode, work shift, or period of insomnia? Has it begun to occur earlier in the day? What has become harder to do? These details give the assessor something more specific to work with than a general statement that things are “out of control.”

Put withdrawal and immediate health questions first

NICE’s alcohol assessment guidance includes dependence severity, associated health and social problems, risk, and the possible need for assisted withdrawal. These are clinical questions. A reassuring appearance during an appointment does not establish that stopping a substance at home will be safe.

Tell the clinician about previous withdrawal, seizures, emergency visits, or admissions, and about any current change in use. Include prescribed sedatives and opioid medicines even if they are taken according to a prescription. Bring the medication containers or an accurate list when possible. Do not stop or alter treatment simply to arrive at the assessment “clean.” Ask the service for medical guidance if a change is already underway.

Alcohol withdrawal can be dangerous in someone who is dependent, as the NIAAA source explains. A planned assessment should therefore produce an explicit answer about whether withdrawal care is needed and who will arrange it. For immediate medical danger, call 144, listed in Swiss emergency guidance. Our detox assessment guide explains how the care setting is considered.

Build a timeline of mental and physical health

Substance use and mental health symptoms may overlap in ways that require careful assessment. NIAAA’s guidance on co-occurring conditions emphasizes the relationship between alcohol use, the timing of symptoms, and other mental health disorders. A diagnosis should not be settled solely by how someone feels during one difficult week.

Use a simple chronological account: symptoms before the current use pattern, symptoms during it, and experiences during earlier periods of reduced use or abstinence. Include sleep changes, mood episodes, panic, unusual perceptions, concentration problems, and physical symptoms that have concerned you. You do not need to decide which caused which. Clearly separating observation from interpretation helps the clinician investigate.

Bring records of relevant diagnoses and tests, but distinguish a confirmed conclusion from a possibility mentioned in passing. If pain, pregnancy, liver disease, breathing problems, or another medical condition affects the treatment discussion, identify the clinician already managing it. Ask whether the assessment team needs to coordinate directly rather than asking you to carry conflicting instructions between appointments.

Use Swiss services that match the question

The FOPH addiction support information links to national service-finding resources. Local eligibility and referral requirements still need to be checked. A municipal counseling office, medical addiction clinic, and hospital psychiatric service may each contribute different parts of an assessment.

For example, Integrierte Suchthilfe Winterthur publishes addiction medicine assessment, psychiatric examination, psychological testing, and ADHD assessment within its diagnostic work. The CHUV addiction outpatient service in Lausanne describes an initial assessment process leading to a treatment proposal. These are examples of documented assessment pathways, not guarantees that every requested test is needed or that every person is eligible.

When contacting a service, describe the main question and any existing care. Ask whether it can assess the whole situation or whether another professional should be involved. A useful response identifies the next clinical step, rather than simply directing you toward whichever program has accommodation available.

Bring records that can change the recommendation

Ask the service which documents are essential before sending a large file. A complete archive may contain useful information, but an organized summary helps the assessor find it. If records are missing, explain where they may be held and ask how the team would like to obtain them.

Explain earlier attempts in enough detail to learn from them

A statement that treatment “did not work” leaves several different possibilities unresolved. Perhaps the intended treatment never started, appointments were difficult to attend, side effects became unacceptable, or an improvement ended after circumstances changed. Describe the sequence so the assessor can distinguish a problem with the approach from a problem with access or continuity.

Include periods when things went better. What support was available then, and what was different about daily life? If a program ended successfully but follow-up never began, say so. If the proposed goal did not match what you were willing to attempt, explain that too. These details can help make the next recommendation more realistic without treating a past setback as a verdict on future treatment.

You can also identify a decision you are not ready to make. For example, you may be willing to discuss health risks and attend follow-up while still uncertain about a residential stay. Ask what useful care can begin now and what further information would help with the unresolved choice.

Discuss confidentiality before involving other people

The FOPH patient rights overview explains rights to information, access to the patient record, and medical confidentiality. Ask how those principles apply to the proposed assessment, including what will be documented and when information may be shared.

A relative may contribute observations that are difficult to remember, but agree on their role. You might want help describing changes at home while reserving time to speak with the clinician privately. If someone else is paying, clarify the difference between financial administration and access to clinical information. Do not assume that paying for an appointment gives another person the same role as the patient.

Expect a reasoned recommendation, with room for uncertainty

The result should explain the main findings, remaining uncertainties, and immediate priorities. If the assessor recommends therapy, medication, withdrawal care, or a more intensive setting, ask what each element is intended to address. If more information is needed, ask what it is and how it could change the plan.

Use concrete comparisons. If outpatient treatment is recommended, ask why it is sufficient at this stage and what would trigger reconsideration. If residential treatment is advised, ask which need requires living at the facility. Our comparison of inpatient psychiatry and residential rehab can help you follow that discussion without assuming the two are interchangeable.

Finally, record one accountable next step: who will make the referral, who will handle medication until then, and when the findings will be reviewed. If mental health and substance use both require care, our integrated treatment guide explains how those responsibilities can be connected. The value of an assessment is the informed, workable plan that follows it.