Screen of drug use: Diagnostic accuracy for cannabis use disorder

As cannabis has been legalized for medicinal and recreational use, rates of cannabis misuse and cannabis use disorder (CUD) have increased. However, only a small percentage of individuals with CUD seek treatment. A practical screening instrument is needed to detect CUD in primary care (PC) to address the needs of individuals with CUD. This study seeks to validate the 2-item Screen of Drug Use (SoDU) to help detect CUD in the PC setting.

We used archival data from 1283 patients recruited in the Department of Veterans Affairs (VA) PC clinics. A total of 51 individuals (4%) met DSM-IV criteria for CUD (abuse or dependence; with or without other drug use disorders). A diagnosis of CUD based on the Mini International Diagnostic Interview (MINI) was used as the criterion. Concurrent diagnostic properties of the SoDU were examined against the MINI.

The SoDU was 100% sensitive (95% confidence interval [CI], 93.00% - 100%), and 87.50% specific (95% CI, 85.53% - 89.23%). When tested in subgroups of patients varying in age, gender, race/ethnicity, marital status, educational level, and PTSD status, the SoDU maintained 100% sensitivity in all subgroups; specificity ranged from 76.26% to 94.34%.

The SoDU is an appropriate instrument to help identify CUD in primary care. It is brief, easy to use, and has good concurrent diagnostic validity for diverse groups of patients.