Registered Nurses' Association of Ontario

Universal Screening Questions

  • The purpose of universal screening is to identify whether a clients substance use is placing them at risk for various problems and may warrant further screening with an appropriate focused tool (Health Canada, 2002; SAMHSA, 2005).
  • Universal screening requires minimal time and effort on the part of the nurse, and can take place either during initial contact or as part of ongoing assessment with the client.
  • It is recommended that nurses ask the following three universal questions to screen all clients for substance use on initial contact across all settings (Health Canada, 2002, p. 32):

Have you ever had any problems related to your use of alcohol or other drugs?


Has a relative, friend, doctor or other health-care provider been concerned about your drinking or other drug use or suggested cutting down?


Have you ever said to another person “No, I don’t have [an alcohol or drug] problem,” when around the same time, you questioned yourself and felt, “Maybe I do have a problem”?



  • A positive response (i.e., when a client answers “yes” to any of the above questions) indicates the need for further investigation (Health Canada, 2002).
  • If there are no positive responses to any of the universal screening questions, the expert panel recommends that the nurse provide health education teaching using brief intervention and positive validation for healthy behaviours and continue to screen for substance use periodically, using the screening and assessment algorithm.


Addiction and Mental Health
Engaging Clients who Use Substances
Sample Tools