title: Substance use prevalence and screening instrument comparisons in urban primary care.
abstract: Substance use screening in a primary care setting compared the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST version 3.0), Two-Item Conjoint Screen (TICS), National Institute on Alcohol Abuse and Alcoholism (NIAAA) daily limit single item, and electronic medical record (EMR). Among 236 consecutive adults, ASSIST moderate- to high-risk substance use prevalence was tobacco, 15.3%; alcohol, 8.5%; cannabis, 5.1%; cocaine, 2.5%; and opioids, 2.5%. Compared to ASSIST, a positive TICS was 45% (95% confidence interval [CI], 27-64%) sensitive, 99% (95-100%) specific; the NIAAA single-item screen was 80% (56-94%) sensitive, 87% (82-91%) specific. The NIAAA single item correlated closely with alcohol ASSIST. TICS and EMR were less sensitive for any nontobacco substance use.
authors.affiliation: Division of General Internal Medicine, New York University School of Medicine, New York, New York 10010, USA. joshua.lee@med.nyu.edu
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Lee
authors.forename: Benjamin
authors.initials: B
authors.lastname: Delbanco
authors.forename: Edward
authors.initials: E
authors.lastname: Wu
authors.forename: Marc N
authors.initials: MN
authors.lastname: Gourevitch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection / Q000295:instrumentation*; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*