title: The substance abuse subtle screening inventory minimizes the need for toxicology screening of prenatal patients.
abstract: Multiple authors have reported attempts to effectively address the discovery of substance abuse in pregnancy using various mechanisms to encourage positive self-reports and urine toxicology to augment identification. In this study, we evaluated 1,251 patients with (a) self-report, (b) the Substance Abuse Subtle Screening Inventory (SASSI), and (c) urine toxicology screening to determine which modality or combination would yield the most cost-effective discovery. Combining the SASSI with the self-report was the most clinically effective and cost effective mode of discovery. This led to the development of a clinical protocol using the SASSI and self-report with limited use of urine toxicology for specific patient subgroups. Alcohol abuse, which is missed by toxicology and self-report, is detected by the SASSI.
authors.affiliation: Department of Obstetrics and Gynecology, Medical College of Ohio, Toledo 43614-5809, USA. thorrigan@mco.edu
authors.forename: T J
authors.initials: TJ
authors.lastname: Horrigan
authors.forename: N
authors.initials: N
authors.lastname: Piazza
mesh_terms: D000328:Adult; D000465:Algorithms; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D009820:Ohio; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000191:economics / Q000517:prevention & control / Q000652:urine; D011295:Prenatal Care / Q000191:economics / Q000379:methods*; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D012650:Self Disclosure; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000191:economics / Q000517:prevention & control / Q000652:urine