title: Statewide Administration of the CRAFFT Screening Tool: Highlighting the Spectrum of Substance Use.
abstract: BACKGROUND
  Adolescent alcohol and drug use in the United States are associated with negative consequences spanning multiple domains. Much of the public health surveillance of these behaviors relies on self-report survey data. These data frequently takes the form of frequency or prevalence data for specific substances, which may not provide a complete picture of use.
  
  
  OBJECTIVE
  This study analyzes a state-level survey that includes the CRAFFT screening tool. The study's goal is to elucidate the spectrum of substance use severity across a large segment of substance-using adolescents attending schools in the state of Indiana and to assess the contribution of a variety of predictor variables to the variance between users falling into each category of use severity.
  
  
  METHODS
  Data were collected in 2011 from 168,801 adolescents, of whom 25,204 met the inclusion criteria for this study. The authors utilize multinomial logit analyses to highlight variables, including sociodemographic data, poly-drug use, and risk/protective behavior scales, associated with each category of use.
  
  
  RESULTS
  Seriousness of use is not uniform across substance-using adolescents; 49% were categorized as nonproblem users, 33% as problem users, and 18% as dependent users. Risk and protective factors predict adolescents' severity of substance use, but do not do so uniformly. Poly-drug use is a significant predictor of problem use and dependent use as well.
  
  
  CONCLUSIONS
  The CRAFFT may provide a more nuanced perspective of adolescent substance use than frequency/prevalence data alone; the authors describe the implications derived from these data and analyses to the adolescent prevention and treatment systems.
authors.affiliation: a School of Public Health , Indiana University , Bloomington , Indiana , USA.
authors.forename: Jon
authors.initials: J
authors.lastname: Agley
authors.affiliation: a School of Public Health , Indiana University , Bloomington , Indiana , USA.
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Gassman
authors.affiliation: a School of Public Health , Indiana University , Bloomington , Indiana , USA.
authors.forename: Mikyoung
authors.initials: M
authors.lastname: Jun
authors.affiliation: a School of Public Health , Indiana University , Bloomington , Indiana , USA.
authors.forename: Carole
authors.initials: C
authors.lastname: Nowicke
authors.affiliation: a School of Public Health , Indiana University , Bloomington , Indiana , USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Samuel
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D005260:Female; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D009042:Motivation; D015999:Multivariate Analysis; D015995:Prevalence; D065840:Protective Factors; D012307:Risk Factors; D012309:Risk-Taking; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D000066608:Underage Drinking / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
keywords: CRAFFT; Keywords screening; adolescent; data collection; prevention; treatment