Screening mothers of young children for substance abuse

Pediatricians have been urged to screen for parental substance abuse, but few screening instruments have been tested for mothers. We compared six screening questions for maternal alcohol and drug abuse with the Michigan Alcoholism Screening Test (MAST) and the Drug Abuse Screening Test (DAST). Questionnaires were completed by 507 mothers; most were Caucasian (78%) and married (75%). Eighteen percent were positive on the MAST, and 3% were positive on the DAST. The screening questions for drinking had a 90% sensitivity compared with the MAST; the questions about drug use had a sensitivity of 88% compared with the DAST. The MAST detected only 25% of mothers who reported physiologic tolerance to alcohol and 32% of those who reported binge drinking; the DAST failed to detect any mothers who reported using drugs in the previous 24 hours. The six screening questions about alcohol and drug use had good sensitivity, detected potential drinking problems and drug abuse missed by the MAST and DAST, and can be incorporated easily into a comprehensive psychosocial questionnaire.