Abstract
Methods We developed a four-item screener called the Substance Use Brief Screen (SUBS), and a brief assessment that is an audio computer-assisted self-interview version of the Alcohol, Smoking, and Substance Involvement Screening Test (ACASI ASSIST). Adult patients were recruited consecutively from a safety net primary care clinic. Participants completed the SUBS and ACASI ASSIST in English using a touchscreen tablet computer, followed by interviewer-administered reference standard measures. We evaluated the sensitivity and specificity of the SUBS for detecting past-year unhealthy substance use, and the concordance of ACASI ASSIST responses with the previously validated interviewer-administered ASSIST.
Highlights
Substance use frequently goes undetected in medical settings, in part due to lack of an efficient approach to screening and assessment
Sensitivity was lower for prescription drugs (56%) than for illicit drugs (80%)
The ACASI ASSIST demonstrated excellent concordance (92–99%) with the ASSIST in identifying moderate to high-risk substance use, though illicit drug use was more frequently reported on the ACASI ASSIST
Summary
Substance use frequently goes undetected in medical settings, in part due to lack of an efficient approach to screening and assessment.
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