CISS is for evaluation / clinical audit purposes only and is a rough indicator of professional impression of recent drug / alcohol related problems in the past month. Specific situations / behaviours are listed only as guiding examples and may not reflect the exact situations / behaviours of the client.

• Have they been asked to leave a treatment in the last month, or left against staff advice?
• What has the referrer told you about client's reliability / compliance?
• What does client tell you about their ability to make appointments on time?
• How many cancelled appointments / phone calls did you have to make before finally getting to meet for the assessment?
• How difficult was it to get the client in for assessment?
• How late was client for the actual assessment interview?

• If there are a lot of other services involved e.g. child care issues or legal, the client will be time consuming in any case (e.g. writing reports / meetings with other agencies etc.)
• Otherwise, how difficult / draining was the assessment interview itself?

N.B. CISS targets the 30 days prior to assessment so if they are new prisoners then score CISS in usual way on basis of functioning before coming into prison, and other available history.

• There are certain groups of people in prison who use drugs, and some who dont, some prisons have drug free wings. If prisoner is associating with the resident drug users they score 1 for associating with drug users.
• If prisoner has short sentence, remand, and has unstable accommodation outside, or nowhere to go outside, or is being continually transferred then they also score 1 for unstable accommodation.  If they are in same cell for a good few few months that can be considered stable accommodation.

• Most prisoners do some type of work or study (usually part time) while they are in prison - they only score 1.
• If they are in full time work in laundry, library etc. - they score 0.
• If they are on short remand and are just waiting around without really engaging in prison activity - they score 2.

• Scored on frequency of contact with substance-misuse specific support, same as on the outside.
• E.g. some prisons have NA / AA meetings, drug free programmes, drugs counselling, perhaps from those workers that are doing the assessment.

• Does the prisoner abide by prison rules?
• Do they get into trouble?
• Do they turn up on time for assessments?
• Do they need to be chased up / reminded about appointments ?
• Do they follow staff recommendations?

• All injectors score at least 1 on ‘sexual / injecting risk’. Some alcohol users when disinhibited have been known to have unsafe sex with casual partners.
• Child care is an ‘occupation’ (you decide if full or part time).
• Irregular petty crime (e.g., shoplifting) scores 1 on 'criminal involvement' unless it occurs on a regular basis (e.g., 2+ times a week), in which case it scores 2. Any instance of a more serious crime (e.g., violence) scores 2 regardless.
• All methadone or benzodiazepine prescribed (scripted) clients score at least 1 on ‘drug use’, score 2 if using other drugs on top. Only drug free clients score 0.
• Alcohol users who regularly binge still score 2 on ‘drug use’ even if they do not drink daily.
• Prescribed medication drugs like SSRI’s or neuroleptics need not be classified as ‘drug use’. Prescribed abusable drugs like methodone, benzodiazepines or dexedrine are classified as drug use.
• Clinic attendance classifies as ‘ongoing support’. All clients should score 1 or less, unless they were assessed at intake for the month before coming to your clinic.
• ‘Working relationships’ for clients with a lot of external professional involvement or issues (e.g., lawyers or child care & Social Services, reports that need writing) are unusually time consuming. They score 2 even if the client is not stressful to see.

 Links within CISS site 

CISS home page and index.

CISS form

CISS general overview. Unedited version of an explanatory article about CISS which appeared in Addiction Today Magazine (Nov/Dec, 1999)

CISS comparison scores for harm minimisation oriented methadone prescribing outpatient services

CISS comparison scores for an outpatient alcohol service (item score comparisons with drug users)  

CISS comparison scores and cutoffs for abstinence oriented services

CISS technical information (reliability, validity, correlations with other scales)  

CISS detailed information. Validation of the Christo Inventory for Substance-misuse Services (CISS): a simple outcome evaluation tool (from Drug and Alcohol Dependence, 2000).

ã 1998 George Christo PhD, PsychD.