There are a number of screening tools available that can be self-administered via pen and paper, computer and tablet, or conducted by an interviewer. Each screening tool has pros and cons and a program should decide which screening tool is best for their agency based on population served with consideration to which substances are being used as well as state/regional billable terms for utilization of specific screening forms. Adopt SBIRT offers training and technical assistance on the use of screening assessments.
OPIOID SPECIFIC SCREENING TOOLS
The Opioid Risk Tool (ORT) is a brief, self-report screening tool designed for use with adult patients in primary care settings to assess risk for opioid abuse among individuals prescribed opioids for treatment of chronic pain. Patients categorized as high-risk are at increased likelihood of future abusive drug-related behavior. The ORT can be administered and scored in less than 1 minute and has been validated in both male and female patients, but not in non-pain populations.
The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is a questionnaire that screens for all levels of problem or risky substance use in adults. The ASSIST consists of eight questions covering tobacco, alcohol, cannabis, cocaine, amphetamine-type stimulants (including ecstasy) inhalants, sedatives, hallucinogens, opioids and ‘other drugs’. The ASSIST is designed to be given by a health professional as part of a verbal interview with an adult patient. It can be self-administered electronically, applying automatic skip patterns based on patient answers. The ASSIST can be modified based on which substances are screened for and what language is used to describe these substances. The version provided here screens for non-medical drug use only, and uses language that defines misuse of three types of prescription drugs.
ALCOHOL and DRUG SCREENING TOOLS
The Brief Health Screen is administered to adults age 18 and older. One validated question for alcohol use, and one validated question for adult drug use. Positive responses warrant further screening.
The Alcohol Use Disorders Identification Test (AUDIT), developed in 1982 by the World Health Organization, is a simple way to screen and identify people at risk of alcohol problems. It is given to adults ages 18 and older when positive on the alcohol question on the Brief screen. A “Full screen” that assesses quantity of alcohol use and related consequences.
The Drug Abuse Screening Test (DAST) is given to adults ages 18 and older when positive on the drug question on the Brief screen. The DAST is a “Full screen” that assesses consequences related to recreational drug use and includes extra questions about types of drugs, injection of drugs, and drug treatment.
The Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) Tool consists of a combined screening component (TAPS-1) followed by a brief assessment (TAPS-2) for those who screen positive. This tool:
- Combines screening and brief assessment for commonly used substances, eliminating the need for multiple screening and lengthy assessment tool;
- Provides a two stage brief assessment adapted from the NIDA quick screen and brief assessment (adapted ASSIST-lite)
- May be either self-administered directly by the patient or as an interview by a health professional;
- Uses an electronic format (available here as an online tool);
- Uses a screening component to ask about frequency of substance use in the past 12 months; and
- Facilitates a brief assessment of past 3 months problem use to the patient. *Note: The NIDA Drug Use Screening Tool (NMASSIST) was discontinued in favor of the TAPS Tool.
PREGNANT AND POSTPARTUM WOMEN SCREENING TOOLS
The 5P’S was developed by the Institute for Health and Recovery to help identify alcohol and other drug use among pregnant and postpartum women. It is designed to ask a pregnant woman about the alcohol and drug use of her Parents and Partner, as well as her own use in the Past and Present and includes questions about Peers and Smoking. The 5P’S includes eight questions to screen for use of tobacco, alcohol, and drug use, as well as depression and intimate partner violence.
ADOLESCENT SCREENING TOOLS
Screening to Brief Intervention (S2BI) is a validated electronic screening tool for youth. S2BI begins with a single question assessing the frequency of past-year use in eight categories of substances, including alcohol, marijuana, cocaine and prescription drugs. The S2BI is given to adolescent patients ages 12-17, at least once a year, during any visit. This screener includes supplemental CRAFFT questions, the PHQ-2 and PHQ-9 Modified for Teens screening tools for adolescent depression. Free on-line training modules and S2BI information are available through www.teensubstancescreening.org.