Screening Tests
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Drug Abuse Screening Test (DAST): The 28-item self-report Drug Abuse Screening Test (DAST) was created to screen for substance use in a clinical or treatment evaluation setting (Harvey Skinner, 1982). A short version of the original DAST, the DAST-10, is useful to screen for drug abuse in primary care.

1. Have you used drugs other than those required for medical reasons?
2. Do you abuse more than one drug at a time?
3. Are you always able to stop using drugs when you want to?
4. Have you ever had blackouts or flashbacks as a result of drug use?
5. Do you ever feel bad or guilty about your drug use?
6. Does your spouse ever complain about your involvement with drugs?
7. Have you ever neglected your family or missed work because of your use of drugs?
8. Have you ever engaged in illegal activities in order to obtain drugs?
9. Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs?
10. Have you had medical problems as a result of your drug use (e.g. memory loss, hepatitis, convulsions, bleeding)?

Scoring: Each positive response receives one point. 1-2 points = monitor patient and reassess later; 3-5 points = investigate substance use further; 6-8 points = address the problem immediately. If the screening is positive, additional questions should assess the following topic areas: history of drug use; tolerance, intoxication, and withdrawal; abstinence and relapse; consequences of use; craving and control; treatment history; psychiatric history; medical history; family history; and personal (social) history.

CAGE Screening Test for Alcohol Abuse: Cut down -- Have you ever felt you ought to cut down on your drinking or drug use? 2) Annoyed -- Have people annoyed you by criticizing your drinking or drug use? 3) Guilty -- Have you ever felt bad or guilty about your drinking or drug use? 4) Eye-opener -- Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover? 71% sensitivity and 76% specificity. Brown (1998).

Two-item Cojoint Screening (TICS) for Alcohol and Drug Abuse: The TICS consists of two questions about substance use: In the last year, have you ever drank or used drugs more than you meant to? Have you felt you wanted or needed to cut down on your drinking or drug use in the last year? One positive response indicates a 45% likelihood of having a substance use disorder; two positive responses indicates a 75% chance. Sensitivity and specificity are both around 81%. Brown R.L., Leonard T., Rounds L.A., Papasouliotis O. (1997). A two-item screening test for abuse of alcohol and other drug problems. Journal of Family Practice, 44:151-160.