A two-item conjoint screen for alcohol and other drug problems.
BACKGROUND
Although nonmedical use of illicit and prescription drugs is not uncommon among American adults, the currently recommended screens for substance use disorders focus only on alcohol. This study reports on the criterion validity of a two-item conjoint screen (TICS) for alcohol and other drug abuse or dependence for a split sample of primary care patients.


METHODS
Two random samples of primary care patients aged 18 to 59 years responded to several screening items that emanated from a focus group process. The DSM-III-R criteria for substance use disorders, as codified by the Composite International Diagnostic Interview-Substance Abuse Module, served as the criterion standard.


RESULTS
At least one positive response to the TICS (In the last year, have you ever drunk or used drugs more than you meant to? and Have you felt you wanted or needed to cut down on your drinking or drug use in the last year?) detected current substance use disorders with nearly 80% sensitivity and specificity. The TICS was particularly sensitive to polysubstance use disorders. Respondents who gave 0, 1, and 2 positive responses had a 7.3%, 36.5%, and 72.4% chance of a current substance use disorder, respectively; likelihood ratios were 0.27, 1.93, and 8.77. The results were consistent across split samples of 434 and 702 participants.


CONCLUSIONS
Current alcohol or other drug problems can be detected in nearly 80% of young and middle-aged patients by asking two questions that are easily integrated into a clinical interview.
Brown
R L
RL
Department of Family Medicine, University of Wisconsin-Madsion Medical School, 53715, USA.
Leonard
T
T
Saunders
L A
LA
Papasouliotis
O
O
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000175:diagnosis*; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011897:Random Allocation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis*; D014922:Wisconsin
D013287:Illicit Drugs