Screening in primary care settings for illicit drug use: assessment of screening instruments - a supplemental evidence update for the U.S. Preventive Services Task Force

Lanier D, Ko S
Record ID 32011001412
English
Authors' objectives:

The goals of this review were (1) to identify standardized instruments described in the medical literature that have been designed for detecting use/abuse of illicit drugs; (2) to select those instruments reasonably short enough to have the potential for routine use in a busy primary care practice setting; (3) to determine the extent of published evidence about the accuracy (sensitivity and specificity) and the reliability of potentially useful instruments, and rate the quality of that evidence; and (4) to determine the extent to which validated instruments have been assessed for feasibility and utility when applied in primary care practice settings and among various patient populations.

Authors' recommendations: There is fair evidence that standardized questionnaires considered short enough to be potentially useful in the practice setting have acceptable accuracy and reliability in screening for drug use/misuse. One instrument (the CRAFFT) has been adequately validated for screening adolescents for drug use/misuse. Three instruments of various lengths (ASSIST, CAGE-AID, and DAST-20) have been validated for screening adults. The evidence is not sufficient, however, to establish the positive predictive value of these tests when used in a general medical patient population with a predictably lower prevalence of drug use/misuse. The available evidence does not permit one to determine the overall clinical utility of these instruments when applied in a busy primary care practice setting, and especially in screening pregnant women for drug use.
Details
Project Status: Completed
Year Published: 2008
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: United States
MeSH Terms
  • Drug Misuse
  • Substance Abuse Detection
  • Adolescent
  • Adult
  • Pregnant Women
  • Drug Users
  • Substance-Related Disorders
Contact
Organisation Name: Agency for Healthcare Research and Quality
Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
Contact Name: martin.erlichman@ahrq.hhs.gov
Contact Email: martin.erlichman@ahrq.hhs.gov
Copyright: Agency for Healthcare Research and Quality (AHRQ)
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