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Arch Intern Med. 2010 Jul 12;170(13):1155-60. doi: 10.1001/archinternmed.2010.140.

A single-question screening test for drug use in primary care.

Author information

1
Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts 02118, USA. peter.smith@bmc.org

Abstract

BACKGROUND:

Drug use (illicit drug use and nonmedical use of prescription drugs) is common but underrecognized in primary care settings. We validated a single-question screening test for drug use and drug use disorders in primary care.

METHODS:

Adult patients recruited from primary care waiting rooms were asked the single screening question, "How many times in the past year have you used an illegal drug or used a prescription medication for nonmedical reasons?" A response of at least 1 time was considered positive for drug use. They were also asked the 10-item Drug Abuse Screening Test (DAST-10). The reference standard was the presence or absence of current (past year) drug use or a drug use disorder (abuse or dependence) as determined by a standardized diagnostic interview. Drug use was also determined by oral fluid testing for common drugs of abuse.

RESULTS:

Of 394 eligible primary care patients, 286 (73%) completed the interview. The single screening question was 100% sensitive (95% confidence interval [CI], 90.6%-100%) and 73.5% specific (95% CI, 67.7%-78.6%) for the detection of a drug use disorder. It was less sensitive for the detection of self-reported current drug use (92.9%; 95% CI, 86.1%-96.5%) and drug use detected by oral fluid testing or self-report (81.8%; 95% CI, 72.5%-88.5%). Test characteristics were similar to those of the DAST-10 and were affected very little by participant demographic characteristics.

CONCLUSION:

The single screening question accurately identified drug use in this sample of primary care patients, supporting the usefulness of this brief screen in primary care.

PMID:
20625025
PMCID:
PMC2911954
DOI:
10.1001/archinternmed.2010.140
[Indexed for MEDLINE]
Free PMC Article

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