Detecting DSM-5 Opioid and Methamphetamine Use Disorders With the UNCOPE Screen

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.