A Single-Question Screening Test for Drug Use in Primary Care

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Abstract
Illicit drug use and nonmedical use of prescription drugs are common in the primary care setting and are underrecognized.1,2 Screening for drug use allows clinicians to counsel patients and, when indicated, refer them to treatment. Because of this, the Substance Abuse and Mental Health Services Administration has promoted the integration of screening and brief intervention for substance use disorders into the primary care setting.3 Screening for drug use is also useful as part of routine clinical care, for instance to aid in diagnosis and to avoid medication interactions. Few screening instruments for drug use or drug disorders have been validated, however, for use in primary care settings. Time is also limited during the primary care office visit, and commonly recommended drug screening instruments are composed of multiple questions, can be time consuming to administer, and may require scoring.4,5 Practice guidelines currently recommend the use of a single screening question for the detection of unhealthy alcohol use in primary care settings.6 Analogous single screening questions may also improve screening for drug use. We therefore set out to validate such a screening question in a sample of primary care patients.

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