Researchers Validate Single-Question Screening Test for Drug Use in Primary Care

Drug use and drug use disorders are common but often under-recognized in primary care settings. Given the effectiveness of early recognition and brief intervention, BUSM researchers investigated a single-question screening test for drug use and drug use disorders that could be easily incorporated into routine primary care.

The single-question test asked patients to report the number of times they had used drugs in the past year. Any answer of one or more was considered positive for drug use and followed up with a diagnostic interview and oral test for validation. Analysis of results from 286 subjects validated the test was 92.9% sensitive and 94.1% specific for the detection of past year drug use and 100% sensitive and 73.5% specific for the detection of a drug use disorder; comparable to results from longer screenings. These results debunk popular arguments that all effective drug screenings are too long and involved for primary care settings and open an opportunity to include them in PCP routines for millions of patients.

“To our knowledge, no other single-question screening test for drug use has been validated in any setting,” said lead author Peter C. Smith, MD, MSc, from the Section of General Internal Medicine, Department of Medicine at BUSM. “Such a screening test could facilitate early identification and brief intervention, as well as the avoidance of prescription errors and associated risks.” These findings appear on-line in the July 12 issue of the Archives of Internal Medicine.