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Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
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Updated: Jun 29, 2025

High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry
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Detecting DSM-5 Opioid and Methamphetamine Use Disorders With the UNCOPE Screen.

Albert M Kopak1, Sierra D Thomas1, Norman G Hoffmann2,3

  • 1Department of Research, UNC Health Sciences, The Mountain Area Health Education Center, Asheville, NC, USA.

Substance Use & Addiction Journal
|April 3, 2024
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Summary

The UNCOPE screen accurately identifies opioid and methamphetamine use disorders in jail populations. A brief, 2-item version can efficiently detect these substance use disorders upon admission.

Keywords:
DSM-5jailmethamphetamineopioidscreen

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Area of Science:

  • Addiction Medicine
  • Criminal Justice Health
  • Psychiatry

Background:

  • The opioid epidemic causes record drug overdoses, particularly among criminal justice populations.
  • Opioid and methamphetamine use disorders are prevalent in detention centers.
  • Many correctional facilities lack routine screening for these substance use disorders.

Purpose of the Study:

  • To evaluate the UNCOPE, a 6-item screen, for detecting probable DSM-5 opioid and methamphetamine use disorders.
  • To identify key indicators for these specific substance use disorders.

Main Methods:

  • Comprehensive substance use assessments were conducted with 717 adults admitted to 4 county jails.
  • The UNCOPE screen's utility was examined against DSM-5 diagnoses.

Main Results:

  • Three positive UNCOPE responses detected 99.8% of opioid use disorder and 98.7% of methamphetamine use disorder diagnoses.
  • Receiver operating characteristic curves showed high accuracy (AUC 0.99 for opioid, 0.98 for methamphetamine).
  • Two UNCOPE items identified 100% of opioid use disorder and 99.6% of methamphetamine use disorder cases.

Conclusions:

  • The UNCOPE is a practical and efficient tool for identifying opioid and methamphetamine use disorders.
  • A 2-item UNCOPE screen can serve as an ultra-brief method for detection upon jail admission.