The Substance Use Brief Screen: A Comprehensive Tool for Unhealthy Tobacco, Alcohol, and Other Drug Use in Primary Care

Despite nationwide efforts to increase screening, brief intervention, and referral to treatment (SBIRT) delivery in primary care settings, reliable and feasible screening tools for alcohol and other drug use are lacking. This report described the results of a single site test-retest reliability study and a 2-site validation study of the 4-item Substance Use Brief Screen (SUBS), which evaluates unhealthy use and use disorders for alcohol, tobacco, and illicit drugs (including harmful use of prescription medications). The single site test-retest reliability study administered the SUBS to 54 participants twice in a 2-week period using tablet computers. The 2-site validation study compared the results of SUBS to reference standards (including self-report and saliva testing) among 586 participants:

• Analyses of area under the receiver operating curve indicated good discrimination (0.74–0.97) for all substance classes.

Comments:

The SUBS had good test-retest reliability, sensitivity, and specificity for detection of past-year unhealthy use of tobacco, alcohol, and other drugs in a large safety-net primary care population with a high prevalence of alcohol and illicit substance use, though harmful prescription drug use was relatively low. It was feasible for self-administration and generated valid results. This study addresses an important need for a brief screen with good performance characteristics.



Jeanette M. Tetrault, MD

Reference:

McNeely J, Strauss SM, Saitz R, et al. A brief patient self-administered substance use screening tool for primary care: two-site validation study of the Substance Use Brief Screen (SUBS). Am J Med. 2015 [Epub ahead of print]. doi: 10.1016/j.amjmed.2015.02.007.