RT Journal Article
SR Electronic
T1 Identifying Problematic Substance Use in a National Sample of Adolescents Using Frequency Questions
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 550
OP 558
DO 10.3122/jabfm.2019.04.180284
VO 32
IS 4
A1 Laura J. Chavez
A1 Katharine A. Bradley
A1 Gwen T. Lapham
A1 Thomas M. Wickizer
A1 Deena J. Chisolm
YR 2019
UL http://www.jabfm.org/content/32/4/550.abstract
AB Background: Brief substance use screening questions for tobacco, alcohol, cannabis, and other drugs need further validation in adolescents. In particular, optimal age-specific screening cut-points are not known, and no study has been large enough to evaluate screening questions for noncannabis illicit drug use.Methods: Adolescent respondents to an annual national household survey were included (2008 to 2014; n = 169,986). Days of tobacco use in the past month, and days of alcohol, cannabis, other illicit drug use in the past year, were assessed as brief screens for tobacco dependence and DSM-IV alcohol (AUD), cannabis (CUD), and other illicit drug use disorders (DUD). Areas under receiver operating characteristics curves (AUCs), sensitivity and specificity were estimated separately by age group (12–15-, 16–17-, and 18–20-year-olds) and cut-points that maximized combined values of sensitivity and specificity were considered optimal.Results: The prevalence of tobacco dependence, AUD, CUD, and DUD was 5.8%, 7.1%, 4.5%, and 2.0%, respectively. AUCs ranged 0.84 to 0.99. The optimal cut-points for screening for tobacco dependence and DUDs was the same for all age groups: ≥1 day. The optimal cut-points for alcohol and cannabis varied by age: ≥3 days for 12–15-year-olds and ≥12 days for older adolescents.Conclusions: Brief measures of past-year use, or past-month use for tobacco, accurately identified adolescents with problematic substance use. However, health systems should use age-specific screening cut-points for alcohol and cannabis to optimize screening performance.