A New Brief Screen for Adolescent Substance Abuse

Abstract

Objective To develop a brief alcohol and other drug (AOD) screening test for adolescents. Methods A 9-item test was constructed by combining and modifying items from several AOD assessments, and administered concurrently with the Personal Involvement With Chemicals Scale (PICS), the criterion standard. Setting A hospital-based adolescent clinic. Subjects Fourteen- to 18-year-old patients consecutively arriving for routine medical care who were known to have used AOD. Measures Internal consistency of the 9 items was calculated using the Cronbach α. The relationship between the brief screen and PICS raw score was determined by stepwise linear regression analysis. The PICS T score has been shown to correctly classify substance abuse treatment need as no treatment (Tr=0.84,P<.01). This model correctly classified 86% of subjects according to the PICS criteria. Two or more yes answers had a sensitivity of 92.3% and specificity of 82.1% for intensive AOD treatment need. The 6 items were arranged into a mnemonic (CRAFFT). Conclusions Further research must confirm the test's psychometric properties in a general clinic population. However, CRAFFT seems promising as a brief AOD screening test.