Screening Tools for Drug and Alcohol Use

Screening and Assessment Tools

Drug and Alcohol screening instruments question people about how much and how often they drink or do drugs,  and/or the consequences of their drinking and using.  Answers to ‘how much and how often’ questions indicate whether a person was, is, or may be at risk for developing a substance or alcohol use disorder.  A hallmark of alcoholism and drug addiction is continued use of a substance despite adverse consequences. Questionnaires focusing on consequences generally are quite successful in detecting dependent users; without quantity/frequency questions, however, these instruments tend to miss early stage problem drinkers and at-risk drinkers.

Because no single tool is absolute, or works with the same accuracy on each person, a variety of tools are available for use.  Adolescent tools are designed with this in mind; but in general, the tools used is based upon the preference of the assessing person.

AUDIT

The Alcohol Use Disorders Identification Test is a simple and effective method of screening for unhealthy alcohol use, defined as risky or hazardous consumption or any alcohol use disorder.

Based on the data from a multinational World Health Organization collaborative study, the AUDIT has become the world’s most widely used alcohol screening instrument since its publication in 1989. It is currently available in approximately 40 languages.

The AUDIT can also help identify alcohol dependence and specific consequences of harmful drinking. It is particularly designed for health care practitioners and a range of health settings, but with suitable instructions it can be self-administered or used by non-health professionals.

Scoring the AUDIT

The number in the column of each response checked should be entered in the extreme right-hand column. All the response
scores should then be added and recorded in the box labeled “Total”.

Total scores of 8 or more are recommended as indicators of hazardous and harmful alcohol use, as well as possible
alcohol dependence.

NMASSIST

The NIDA (National Institute on Drug Abuse) Modified Assist drug use test is a comprehensive test.  It is designed  to be given in a clinical or medical setting  by a clinicial practioner.  The NMASSIST is a series of questions to identify risky substance use in adult patients.

MAST

The Michigan Alcoholism Screening Test is one of the most widely used measures for assessing alcohol  abuse.  The measure is a 25-item questionnaire designed to provide a rapid and effective screening for lifetime alcohol-related problems and alcoholism.

The MAST has been productively used in a variety of settings with varied populations.
Several briefer versions of the MAST have been offered

Scoring the MAST Test

Score one point if you answered “no” to the following questions: 1 or 4. 

Score one point if you answered “yes” to the following questions: 2, 3, 5 through 22.

A total score of six or more indicates hazardous drinking or alcohol dependence and further evaluation by a healthcare professional is recommended

The DAST Test

The Drug Abuse Screening Test is a parallel of the MAST Test (Michigan Alcohol Screening Tool) for drugs specifically.  

DAST Test and Scoring

The Drug Abuse Screening Test (DAST) was developed in 1982 and is still an excellent screening tool. It is a 28-item self-report
scale that consists of items that parallel those of the Michigan Alcoholism Screening Test (MAST). The DAST has “exhibited valid
psychometric properties” and has been found to be “a sensitive screening instrument for the abuse of drugs other than alcohol.

CRAFFT

The CRAFFT Screening Test is a short assessment tool designed to screen for substance-related risks and problems in adolescents. CRAFFT stands for the key words of the 6 items in the second section of the assessment – Car, Relax, Alone, Forget, Friends, Trouble.

 The CRAFFT screening tool begins with past-12-month frequency items (Part A),questions for any use over the past year and the other six (Part B) ask about situations in which the respondent used drugs or alcohol and any consequences of usage.

The CRAFFT can function as a self-report questionnaire or an interview to be administered by a clinician.  Both employ a skip pattern: those whose Part A score is “0” (no use) answer the Car question only of Part B, while those who report any use in Part A also answer Part B’s five CRAFFT questions. Each “yes” answer is scored as “1” point and a CRAFFT total score of two or higher identifies “high risk” for a substance use disorder and warrants further assessment.

CRAFFT Questionnaire

Part A score is “0” (no use) answer the Car question only of Part B.

Part A with any use also answer Part B’s five CRAFFT questions.

Each “yes” answer is scored as “1” point and a CRAFFT total score of two or higher identifies “high risk” for a substance use disorder and warrants further assessment.

The CAGE Questionnaire

The CAGE questionnaire is a series of four questions to check for signs of possible alcohol dependency. The questions are designed to be less obtrusive than directly asking someone if they have a problem with alcohol.

 

Questions

CAGE is an acronym that makes the four questions easy to remember. Each letter represents a specific question:

  1. Have you ever felt you should cut down on your drinking?
  2. Have people annoyed you by criticizing your drinking?
  3. Have you ever felt bad or guilty about your drinking?
  4. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)?

Each question requires a simple yes or no answer. Each yes answer increases the chances that someone may have an alcohol dependency. Generally, two or three yes answers suggest heavy alcohol use or alcohol use disorder.

Screening to Brief Intervention (S2BI)

Screening to Brief Intervention Tool for teens.  The link is:  https://www.drugabuse.gov/ast/s2bi/#/

BSTAD

Brief Screener for Alcohol, Tobacco, and other Drugs consists of frequency of use questions to identify risky substance use by adolescent patients. 

The link is:  https://www.drugabuse.gov/ast/bstad/#/

TAPS

Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS), consists of a combined screening component (TAPS-1) followed by a brief assessment (TAPS-2) for those who screen positive.  This can be self-administered or by a professional, adults or teens.  You can follow the link here:  https://www.drugabuse.gov/taps/#/

Opioid Risk Tool

This tools may be used by a medical doctor to assess risks of abuse for people beginning an opioid pain management program.  If patients test at a high rate, they may be referred to a drug dependency program such as a Medical Assisted Treatment in addition to pain management.  You can follow the link here:  https://www.drugabuse.gov/sites/default/files/opioidrisktool.pdf

AUDIT Manual

The AUDIT Manual is a comprhensive tool used by clinicians in determining Substance or Alcohol Use Disorders.

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