Screening for current drug use disorders in alcoholics: an application of receiver operating characteristic analysis

The major objectives of the present study were 2-fold: (1) to demonstrate the superiority of receiver operating characteristic (ROC) methodology in the comparison of screening tests that yield continuous values; and (2) to identify the best screening indicator of current drug use disorders in alcoholics. We evaluated the ability of the screening tests to detect drug use disorder (DUD) according to the research diagnostic criteria. Results showed that the language of addiction - drug version and the reasons for drug use (RDU) screening tests offered excellent detectability for current DUD. The accuracy of both tests was reduced as the result of broadening the clinical spectrum in the comparative group. Implications of these findings to the neglected topic of clinical and co-morbid spectrums in screening test evaluation is presented. Issues surrounding the use of psychiatric diagnoses as standards, assessment of efficacy, the role of screening in defining subthreshold disorder, and the use of biochemical screening as an adjunct to the questionnaire approach are also discussed.