Understand your level of risk
A validated screening tool, scored by an ACI-accredited clinician, gives you clear, judgement-free language for where your use or behaviour sits and what it means.
A confidential 1-hour assessment with an ACI-accredited, addiction-informed clinician. Validated screening included.
Four clear stages. You'll know exactly what to expect at each one - no surprises, no hidden steps.
Choose your concern and book your 1-hour assessment with an ACI clinician (€140).
A validated tool matched to your concern - AUDIT, ASSIST, CUDIT-R, DUDIT or PGSI - completed before the call.
Your answers are scored into a secure PDF and shared with your ACI therapist ahead of the session.
Your therapist talks through your results and gives you a structured therapy plan, or a referral.
An addiction assessment is about understanding your level of risk, naming the pattern, and finding the right next step - whether that's structured therapy with Fettle or a referral to specialist support. Earlier help is linked to better outcomes.
A validated screening tool, scored by an ACI-accredited clinician, gives you clear, judgement-free language for where your use or behaviour sits and what it means.
Your assessment always ends with a clear recommendation: a structured therapy plan with Fettle, or a referral to GP, HSE or specialist services where that is the safer step.
You don't need a diagnosis or a rock-bottom moment to deserve support. Reaching out before dependence sets in is linked to stronger, faster recovery.
In 2024 the Health Research Board recorded 8,745 cases treated for problem alcohol use - the highest in over a decade - and the ESRI estimates around 1 in 30 adults live with problem gambling.
Health Research Board · ESRIWhatever you're facing, you'll be met with care, not judgement. Each assessment uses an internationally validated screening tool matched to your concern.
The most common reason people in Ireland reach out. We work with the patterns, triggers and feelings beneath the drinking.
Tool: AUDITCocaine use is rising fast, often hand-in-hand with alcohol. Support looks at the whole picture, not one substance alone.
Tool: WHO ASSISTYou don't need to have lost everything to deserve support. Gambling harm is common and very treatable.
Tool: PGSIDaily use can be hard to step back from, especially when it's helping you sleep or unwind. No judgement here.
Tool: CUDIT-RHeroin, opioids, benzodiazepines, ketamine and prescription-medication misuse, with the safest specialist or medical support.
Tool: DUDITSedatives and painkillers can create dependence over time. We help you work safely toward change, alongside your GP.
Tool: DUDITOne of Ireland's fastest-growing treatment trends. Counselling supports the psychological pull and practical steps to cut down or stop.
Tool: DUDIT / ASSISTNicotine vaping can be strongly habit-forming, and HHC is now the most commonly reported new psychoactive substance in Irish data.
Tool: ASSISTYou don't have to be the person using to need support. We work with partners, parents and family members.
Concierge call| Your concern | Screening tool |
|---|---|
| Alcohol | AUDIT |
| Cocaine / stimulants | WHO ASSIST |
| Cannabis | CUDIT-R |
| Opioids / prescription / other drugs | DUDIT |
| Gambling | PGSI |
Fettle uses internationally validated screening tools - AUDIT and ASSIST (World Health Organization), CUDIT-R, DUDIT and the PGSI.13
Signs it may be time to talk, the screening tool and risk-level bands, and the bigger picture for each area.
Your clinician uses AUDIT - the WHO's Alcohol Use Disorders Identification Test - to gauge your level of risk and the right next step. In 2024 the Health Research Board recorded 8,745 cases treated for problem alcohol use, the highest annual total in over a decade.1
Signs it may be time to talk:
| AUDIT score | What it suggests |
|---|---|
| 0–7 | Lower-risk alcohol use |
| 8–15 | Hazardous alcohol use; brief intervention recommended |
| 16–19 | Harmful alcohol use; structured support recommended |
| 20+ | Possible alcohol dependence; clinical review and possible GP/specialist referral recommended |
Red flags we take seriously: daily heavy drinking, morning drinking, shakes, seizures, hallucinations, blackouts, previous detox or suicidal thoughts. Where these are present, therapy alone is not enough - a GP or HSE addiction service review may be required before reducing or stopping alcohol.
The WHO ASSIST screening tool assesses cocaine alongside alcohol, cannabis, sedatives and opioids - which matters, since cocaine is so often mixed with alcohol. In 2025 there were 6,535 cocaine treatment cases, 42% of all drug treatment and the highest ever recorded.3
Signs it may be time to talk:
| ASSIST score (cocaine/stimulants) | What it suggests |
|---|---|
| 0–3 | Lower risk |
| 4–26 | Moderate risk; brief intervention or therapy support recommended |
| 27+ | High risk; specialist addiction support recommended |
Red flags we take seriously: chest pain, paranoia, psychosis, suicidal thoughts, aggression, severe sleep deprivation, or mixing cocaine with alcohol or benzodiazepines.
This assessment uses the standard PGSI (Problem Gambling Severity Index) risk bands used in Irish gambling-harm screening. A 2023 ESRI study estimated that 1 in 30 adults - around 130,000 people - live with problem gambling.5
Signs it may be time to talk:
| PGSI score | What it suggests |
|---|---|
| 0–2 | Low-risk gambling |
| 3–7 | Moderate-risk gambling |
| 8+ | High-risk gambling; support recommended |
CUDIT-R looks at cannabis use over the past six months, including frequency, control, motivation and impact on daily life. Cannabis is consistently the third most commonly treated drug in Ireland, and the main problem drug for the youngest people entering treatment.3
Signs it may be time to talk:
| CUDIT-R score | What it suggests |
|---|---|
| 0–7 | Lower-risk cannabis use |
| 8–11 | Hazardous cannabis use |
| 12+ | Possible cannabis use disorder; further clinical support recommended |
For heroin, opioids, benzodiazepines, ketamine and prescription-medication misuse, your clinician uses DUDIT (the Drug Use Disorders Identification Test). In 2025, 15,422 cases were treated for problem drug use in Ireland - the highest on record - and almost two-thirds involve more than one substance.3
The different drugs we support: heroin and opioids (the second most commonly treated drug, an ageing cohort), prescription medication, benzodiazepines (reported in around 30% of polydrug cases in 2024),4 ketamine (334 treatment cases in 2025, a twelve-fold increase since 2017),3 polydrug use, and new and emerging drugs including HHC.
| DUDIT score | What it suggests |
|---|---|
| Men 6+ / Women 2+ | Possible drug-related problem |
| 25+ | Possible heavy dependence; specialist review recommended |
Important: for opioids and benzodiazepines, ACI therapists can assess and support, but do not manage detox or advise stopping suddenly - stopping these can be dangerous and needs medical supervision.
Not every addiction involves a substance. These assessments use recognised, ICD-11-aligned screening tools to understand whether a behaviour has become difficult to control - and to build a confidential support plan. They are for screening, triage and treatment planning, not formal diagnosis, and follow the same structure as our other assessments.
Understand whether screen, phone or gaming use is affecting your wellbeing - and leave with a support plan. Gaming disorder is recognised by the WHO in ICD-11;6 problematic smartphone use is not a formal diagnosis, so we screen for it as problematic screen/phone use.
“This assessment helps identify whether screen, phone or gaming use has become difficult to control and whether it is affecting sleep, mood, relationships, work, school or daily life.”
A short, 4-item Gaming Disorder Test aligned with the WHO's ICD-11 criteria: impaired control, gaming taking priority over other activities, and continuing despite harm.14
A 10-item validated screen (Smartphone Addiction Scale – Short Version) for problematic smartphone/screen use, using gender-based cut-off values.14
Understand whether sexual behaviour or pornography use has become difficult to control - and get a confidential support plan. The clinically accurate term is Compulsive Sexual Behaviour Disorder (CSBD), recognised in ICD-11 as an impulse-control disorder, not a substance addiction.7
“This assessment explores whether sexual behaviour or pornography use has become difficult to control and whether it is affecting relationships, wellbeing, work, daily functioning or safety.”
A 19-item screen developed around the ICD-11 CSBD criteria; a score of 50 or more indicates a higher likelihood of compulsive sexual behaviour.14
A short 6-item screen for problematic pornography use; a score of 20 or more (out of 42) is commonly used as a possible indicator.14
Whatever the focus, your assessment includes a careful check for anything that needs more than therapy alone:
Many people find it reassuring to know what to expect. Fettle therapists often draw on solution-focused therapy - a warm, practical, future-focused approach that builds on your existing strengths rather than dwelling on the problem. Here's a soft outline of a typical eight-session journey. It's a guide, not a script: your therapist will always shape it around you, your pace and your goals.
A relaxed assessment. You share what's brought you here, what matters to you, and what you'd like to be different. No pressure, no judgement - just a first conversation.
Using gentle questions (like the “miracle question”), you explore what life would look like once things improve - giving you a clear, hopeful direction to aim for.
With simple scaling questions (“where are you today, 0 to 10?”), you and your therapist map where you are now and what even one small step forward would look like.
You look for “exceptions” - the times things were a little better. These moments reveal strengths and strategies you can lean on more deliberately.
You notice and grow the changes already underway, turning one-off successes into steadier habits, and troubleshooting what gets in the way.
You widen the circle - coping tools, routines, relationships and resources - so progress doesn't rest on willpower alone.
You prepare for triggers and tough days, with a calm, practical plan so a slip becomes a setback you recover from, not a reason to give up.
You celebrate how far you've come, capture what helped most, and set out how you'll keep your momentum - with the door open to return any time.
Solution-focused therapy is a recognised, strengths-based approach. The number and content of sessions is always tailored to you.
Choose a convenient time that fits your schedule. Evening and weekend appointments available.
Intake Form
Start with a free concierge call or go straight to your assessment. Ongoing therapy is optional and only recommended where clinically appropriate.
Spread the cost interest-free: pay in 3 equal instalments at no extra cost. Available at checkout, subject to Klarna eligibility checks.
A focused 1-hour, one-to-one assessment with an ACI-accredited, addiction-informed therapist, including a validated pre-screening tool matched to your concern.
Covered by leading Irish health insurers
Receipts for your addiction assessment and ongoing therapy can be submitted to major Irish health insurers - VHI, Laya, or Irish Life Health - as an outpatient counselling or psychology benefit, depending on your plan, and you may be able to claim tax relief on therapy costs through Revenue. Check your Table of Benefits or call your insurer before booking to confirm your per-session benefit amount.
Addiction counselling is confidential talking therapy that helps you understand and change a harmful relationship with a substance or behaviour - such as alcohol, cocaine, gambling, cannabis or other drugs. At Fettle it's delivered online, one-to-one, by clinicians accredited by the Addiction Counsellors of Ireland (ACI) and therapists accredited by IACP, ICP or PSI.
Your clinician uses an internationally validated screening tool matched to your concern: AUDIT for alcohol, WHO ASSIST for cocaine/stimulants, CUDIT-R for cannabis, DUDIT for opioids/prescription/other drugs, and the PGSI for gambling. Your scored results are shared with your ACI therapist as a secure PDF before your 1-hour assessment. A Fettle assessment provides addiction screening, support planning and a therapy pathway recommendation - and, where needed, a referral to GP, HSE or specialist services. It is not a medical diagnosis, detox planning or addiction medicine assessment, and is not a substitute for emergency care, GP care, detox services or psychiatric assessment.
No. You don't need a diagnosis, a rock-bottom moment, or a certain level of use to deserve support. Many people reach out simply because something doesn't feel right - and earlier help is linked to better outcomes. A free 20-minute concierge call is a no-pressure way to talk it through.
First you complete a short, validated screening tool matched to your concern (for example, CUDIT-R for cannabis). Your answers are compiled into a secure PDF and shared with your ACI therapist, who talks through the results with you on a 1-hour assessment (€140) and agrees a personalised next-step recommendation. Where ongoing support is right for you, your therapist builds a structured therapy plan you can begin afterwards. Prefer to talk first? A 20-minute concierge call is free.
Yes. Online therapy lets you get support from a private, familiar space, with no waiting room and no waiting list. Sessions are confidential, within the normal professional and legal limits your therapist will explain at the outset.
The addiction assessment is €140 for a 1-hour session with an ACI therapist, including your screening, a secure results review and a personalised next-step recommendation. Where ongoing support is recommended, your therapist agrees a therapy plan you can begin afterwards. A 20-minute concierge call is free. Receipts can be submitted to major Irish health insurers, and you may be able to claim tax relief through Revenue. Please confirm current prices on the Fettle pricing page.
Therapists tailor their approach to you and often draw on solution-focused therapy - a warm, practical, future-focused method that builds on your existing strengths. A typical journey runs around eight sessions, but is always shaped around your goals and pace.
Yes. We offer a Screen & Gaming Use Assessment (using the GDT for gaming and the SAS-SV for problematic phone/screen use) and a Compulsive Sexual Behaviour & Porn Use Assessment (using the CSBD-19 and PPCS-6). Both are for screening and support planning rather than formal diagnosis, and include a clinical risk and safeguarding check, with escalation to specialist, safeguarding or emergency services where needed.
Yes. You don't have to be the person using to need support. We work with partners, parents and family members on how to cope, set healthy boundaries and help without losing themselves.
Counselling isn't an emergency service. If you or someone else is in immediate danger, call 112 or 999. For free, confidential support you can also call the HSE Drugs & Alcohol Helpline on 1800 459 459 (Mon–Fri, 9.30am–5.30pm) or the Samaritans on 116 123, any time.
Counselling is a powerful step, but it isn't an emergency service. If you or someone else is in immediate danger - or someone has overdosed - please use these free, confidential supports.
Every statistic on this page is drawn from a named, reputable source - primarily Ireland's Health Research Board (HRB), the ESRI, the HSE and the World Health Organization. Figures reflect the most recent reports available at the time of writing (June 2026).
