- Do you ever Forget things you did while
using alcohol or drugs? - Do your Family or Friends ever tell you that
you should cut down on your drinking or
drug use? - Have you ever gotten into Trouble while
you were using alcohol or drugs?
An affirmative answer to each question is worth
one point. A cut-off score of two is
recommended for identifying risky alcohol and
other drug use or the risk of addiction.^55 A
positive test is a good indicator that respondents
are in need of further assessment.
The CRAFFT is widely available free of
charge.^56
Populations and Settings Served. The
CRAFFT has been validated among adolescent
primary care clinic patients^57 and there is some
evidence that it is effective in identifying risky
substance use among pregnant women as well.^58
Clinical Utility. The CRAFFT has been found
to be a valid indicator of substance involvement.
A cut-off score of two accurately recognized 76
percent of adolescent risky users, 80 percent of
adolescents with addiction* and 92 percent of
adolescents who met diagnostic criteria
specifically for substance dependence.^59 The
CRAFFT has adequate internal and test-retest
reliability as well.^60 It has demonstrated a 92.3
percent sensitivity rate and an 82.1 percent
specificity rate among adolescents with a history
of alcohol and other drug use,^61 and an 86
percent sensitivity rate and a 76 percent
specificity rate in American Indian and Alaska
Native adolescents with regard to alcohol and
other drug use.† 62
- Including both substance abuse and substance
dependence, as identified by the Adolescent
Diagnostic Interview.
† Including over-the-counter drugs, marijuana,
cocaine, amphetamines, barbiturates/sedatives,
inhalants, hallucinogens, opioids and other drugs
(excluding nicotine).
Substance Abuse Subtle Screening
Inventory (SASSI)
Developed in 1988, the Substance Abuse Subtle
Screening Inventory can help practitioners
identify individuals who are likely to have
addiction involving alcohol or other drugs.^63
The instrument is available in separate versions
for adults (SASSI-3) and adolescents (SASSI-
A); only the adolescent version includes items
related to smoking.^64 To measure substance
involvement, the SASSI also contains some
indirect, “subtle” true-false items to help
practitioners identify respondents who may have
misrepresented the extent of their substance
use.‡ 65 The inclusion of these subtle items may
decrease erroneous assessments by as much as
76 percent.^66Both instruments can be self-, computer- or
staff-administered and generally take 10 to 15
minutes to complete and 10 minutes for
practitioners to score and interpret.^67Neither instrument requires extensive training to
administer.^68 A user’s guide and manual are
provided with the test.^69 Both versions of the
SASSI tools are copyrighted and available for
purchase only.^70Populations and Settings Served. SASSI may
be useful in inpatient and outpatient mental
health and medical settings, as well as criminal
justice, employee assistance and education
settings.^71 It has been used with inmates, college
students, pregnant women, brain injury patients
and psychiatric inpatients.^72‡ Examples include: I have never done anything
dangerous just for fun; There have been times when I
have done things I didn’t remember later; People who
use drugs have more fun; In school I have often been
in trouble for misbehaving; I can be depended on to
do the things I’m supposed to.