A single-question screening test for drug use in primary care

Area of Science:

• Primary Care Medicine
• Addiction Psychiatry
• Clinical Screening Tools

Background:

• Drug use, including illicit substances and nonmedical prescription drugs, is prevalent but often overlooked in primary care.
• Effective screening methods are needed to identify patients with drug use or drug use disorders in these settings.

Purpose of the Study:

• To validate a single-question screening test for drug use and drug use disorders within a primary care population.
• To assess the sensitivity and specificity of this brief screen compared to established measures.

Main Methods:

• Adult primary care patients were administered a single screening question about past-year drug use.
• The Drug Abuse Screening Test (DAST-10) and diagnostic interviews served as reference standards.
• Oral fluid testing was also employed to detect common drugs of abuse.

Main Results:

• The single screening question demonstrated 100% sensitivity for detecting drug use disorders.
• It showed 73.5% specificity for drug use disorders and high sensitivity for self-reported drug use (92.9%).
• Screening test characteristics were comparable to the DAST-10 and minimally impacted by demographics.

Conclusions:

• A single screening question effectively identifies drug use in primary care patients.
• This brief, validated tool supports the integration of drug use screening into routine primary care.