A new brief screen for adolescent substance abuse

Area of Science:

• Adolescent Medicine
• Psychiatry
• Public Health

Background:

• Adolescent substance use poses significant health risks.
• Brief screening tools are needed for early identification of alcohol and other drug (AOD) use in clinical settings.
• Existing screening methods may be time-consuming or less suitable for routine adolescent care.

Purpose of the Study:

• To develop and validate a brief screening instrument for alcohol and other drug (AOD) use among adolescents.
• To create a user-friendly tool for identifying adolescents at risk for substance use disorders.

Main Methods:

• A 9-item screening test was created by adapting items from existing AOD assessments.
• The new test was administered to 99 adolescents (aged 14-18) attending a hospital-based clinic, concurrently with the Personal Involvement With Chemicals Scale (PICS) as the criterion standard.
• Psychometric properties, including internal consistency (Cronbach alpha) and correlation with PICS scores, were analyzed using regression and sensitivity/specificity calculations.

Main Results:

• The 9-item test demonstrated good internal consistency (Cronbach alpha = .79).
• A 6-item version, forming the CRAFFT mnemonic, showed a strong correlation with PICS scores (Pearson r = 0.84, P<.01) and correctly classified 86% of subjects.
• The CRAFFT screen achieved 92.3% sensitivity and 82.1% specificity for identifying the need for intensive AOD treatment.

Conclusions:

• The 6-item CRAFFT mnemonic appears to be a promising brief screening tool for alcohol and other drug use in adolescents.
• Further validation in general adolescent clinic populations is recommended to confirm its psychometric properties.
• CRAFFT offers a potentially effective method for early detection of substance use issues in young people.