An electronic screen for triaging adolescent substance use by risk levels

Area of Science:

• Adolescent medicine
• Psychiatry
• Public health

Background:

• Early screening and intervention for adolescent substance use are crucial for reducing addiction and related health issues.
• Existing screening tools lack calibration for triaging adolescents into clinically relevant risk categories to guide interventions.

Purpose of the Study:

• To evaluate the psychometric properties of an electronic screening and brief assessment tool designed to categorize adolescent nontobacco substance use into four actionable risk levels.
• To determine the tool's effectiveness in identifying adolescents with varying degrees of substance use and related disorders.

Main Methods:

• Adolescents aged 12-17 years at primary care and substance use treatment centers completed an electronic screening tool assessing past-year frequency of 8 drug types.
• A structured diagnostic interview (Composite International Diagnostic Interview-Substance Abuse Module) was used as the criterion standard for diagnosing substance use disorders (DSM-5).
• Sensitivity and specificity were calculated for the screening tool in identifying nontobacco substance use, substance use disorders, severe substance use disorders, and nicotine dependence.

Main Results:

• The electronic screen demonstrated high sensitivity and specificity for identifying nontobacco substance use (100% and 84%), substance use disorders (90% and 94%), and severe substance use disorders (100% and 94%).
• The tool also showed good performance for nicotine dependence (75% and 98%).
• No significant differences in accuracy were found between the full tool and a brief version (Screening to Brief Intervention).

Conclusions:

• A single screening question on past-year substance use frequency effectively discriminates between clinically relevant risk categories in adolescents.
• This brief screening method is a valid approach for identifying adolescents needing intervention for substance use.
• The tool supports timely and targeted interventions, potentially reducing the long-term burden of addiction.