Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul-Aug;32(4):550-558.
doi: 10.3122/jabfm.2019.04.180284.

Identifying Problematic Substance Use in a National Sample of Adolescents Using Frequency Questions

Laura J Chavez  1 , Katharine A Bradley  2 , Gwen T Lapham  2 , Thomas M Wickizer  2 , Deena J Chisolm  2
Affiliations

Identifying Problematic Substance Use in a National Sample of Adolescents Using Frequency Questions

Laura J Chavez et al. J Am Board Fam Med. 2019 Jul-Aug.

Abstract

Background: Brief substance use screening questions for tobacco, alcohol, cannabis, and other drugs need further validation in adolescents. In particular, optimal age-specific screening cut-points are not known, and no study has been large enough to evaluate screening questions for noncannabis illicit drug use.

Methods: Adolescent respondents to an annual national household survey were included (2008 to 2014; n = 169,986). Days of tobacco use in the past month, and days of alcohol, cannabis, other illicit drug use in the past year, were assessed as brief screens for tobacco dependence and DSM-IV alcohol (AUD), cannabis (CUD), and other illicit drug use disorders (DUD). Areas under receiver operating characteristics curves (AUCs), sensitivity and specificity were estimated separately by age group (12-15-, 16-17-, and 18-20-year-olds) and cut-points that maximized combined values of sensitivity and specificity were considered optimal.

Results: The prevalence of tobacco dependence, AUD, CUD, and DUD was 5.8%, 7.1%, 4.5%, and 2.0%, respectively. AUCs ranged 0.84 to 0.99. The optimal cut-points for screening for tobacco dependence and DUDs was the same for all age groups: ≥1 day. The optimal cut-points for alcohol and cannabis varied by age: ≥3 days for 12-15-year-olds and ≥12 days for older adolescents.

Conclusions: Brief measures of past-year use, or past-month use for tobacco, accurately identified adolescents with problematic substance use. However, health systems should use age-specific screening cut-points for alcohol and cannabis to optimize screening performance.

Keywords: Adolescent; Cannabis; Street Drugs; Substance-Related Disorders; Surveys and Questionnaires; Tobacco.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: none declared.

Comment in

References

    1. Windle M. Drinking Over the Lifespan: Focus on Early Adolescents and Youth. Alcohol research : current reviews. 2016;38(1):95–101. - PMC - PubMed
    1. Dawson DA, Goldstein RB, Chou SP, Ruan WJ, Grant BF. Age at first drink and the first incidence of adult-onset DSM-IV alcohol use disorders. Alcoholism, clinical and experimental research. 2008;32(12):2149–2160. - PMC - PubMed
    1. Maggs JL, Staff J, Kloska DD, Patrick ME, O'Malley PM, Schulenberg J. Predicting Young Adult Degree Attainment by Late Adolescent Marijuana Use. The Journal of adolescent health : official publication of the Society for Adolescent Medicine. 2015;57(2):205–211. - PMC - PubMed
    1. Volkow ND, Compton WM, Weiss SR. Adverse health effects of marijuana use. The New England journal of medicine. 2014;371(9):879. - PubMed
    1. Murray CJ, Atkinson C, Bhalla K, et al. The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. Jama. 2013;310(6):591–608. - PMC - PubMed

Publication types