Substance use prevalence and screening instrument comparisons in urban primary care

Joshua D. Lee, Benjamin Delbanco, Edward Wu, Marc N. Gourevitch

Research output: Contribution to journalArticlepeer-review


Substance use screening in a primary care setting compared the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST version 3.0), Two-Item Conjoint Screen (TICS), National Institute on Alcohol Abuse and Alcoholism (NIAAA) daily limit single item, and electronic medical record (EMR). Among 236 consecutive adults, ASSIST moderate- to high-risk substance use prevalence was tobacco, 15.3%; alcohol, 8.5%; cannabis, 5.1%; cocaine, 2.5%; and opioids, 2.5%. Compared to ASSIST, a positive TICS was 45% (95% confidence interval [CI], 27-64%) sensitive, 99% (95-100%) specific; the NIAAA single-item screen was 80% (56-94%) sensitive, 87% (82-91%) specific. The NIAAA single item correlated closely with alcohol ASSIST. TICS and EMR were less sensitive for any nontobacco substance use.

Original languageEnglish (US)
Pages (from-to)128-134
Number of pages7
JournalSubstance Abuse
Issue number3
StatePublished - Jul 2011


  • Addiction screening
  • prevalence
  • primary care
  • substance use disorders

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health


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