COMPARISON ::: Substance Use Scales
scale characteristics and quality framework scores

Substance use is the most direct measure of outcome and most other outcome measures are related to it, however, there is no very satisfactory way of summarising and presenting substance use data.

There are three important elements: the frequency, the quantity and the route of use. Frequency can be recorded with greatest reliability; quantity is much more difficult and especially so for illicit drugs whose purity is usually unknown so that quantity consumed is also uncertain.

Composite measures, Such as the Addiction Severity Index or Maudsley Addiction Profile, always include some measure of use subscale which can be applied as a stand alone scale.

SUSS :: Substance Use in Specialist Services  designed for routine clinical practice and research

The Substance Use in Specialist Services (SUSS) measure was created as an alternative to use measures embedded in composite assessment tools and an alternative to popular screening tools. SUSS asks about frequency of use for tobacco, alcohol, cannabis, opioids, cocaine, stimulants, inhalants, sedatives, hallucinogens, injecting and amount used for tobacco and alcohol. Additional drugs can simply be added if there is local interest or a reporting requirement. SUSS also asks about prescribed medications. It is designed for routine assessment and outcome evaluation and can be packaged with other stand alone scales. Timeframe :: The last 28 days. Scoring :: There are no scores other than the absolute measures of quantity and frequency; prescribed medications are indicated by tick box format.Completion time :: Not specified but brief. Cut-off score :: The scale developers recommend using the scale as continuous data and so no cut-off scores have been designated. The higher the score the greater the satisfaction.


AUDIT-C :: Alcohol Use Disorders Identification Test (consumption) designed as screening tool

The Alcohol UseDisorders Identification Test (AUDIT) was a six country WHO collaborative project to develop a screening instrument for hazardous and harmful alcohol consumption. It is a 10 item questionnaire: questions 1-3 measure alcohol consumption, 4-6 drinking behaviour, 7-8 adverse reactions and 9-10 alcohol-related problems. . Among those diagnosed as having hazardous or harmful alcohol use, 92% had an AUDIT score of 8 or more, and 94% of those with non-hazardous consumption had a score of less than 8. Short versions have been developed. The Fast Alcohol Screening Test, FAST, takes the best performing items Q3, Q8, Q5, Q10 and is designed for use in busy medical services. The AUDIT-C takes the first three items only and is, therefore, a measure of consumption. The original wording has been modified in different versions causing some inconsistencies in responses. Timeframe :: The timeframe is not specified for the substance use items (current use implied) and is the last year for other items. Scoring :: Each question is scored 0= "never", 1= "monthly or less", 2= "2-4 times per month", 3= "2-3 times per week", 4= "4+ times per week"; the range of possible scores is 0 to 12. Completion time :: <2minutes. Cut-off score :: A score ≥5 is a positive AUDIT-C. It is important not to over interpret screening tests and take account of the whole picture. Typically a positive would lead on to completing the full AUDIT


DUDIT :: Drug Use Disorders Identification Test  designed for screening and research

The Drug Use Disorders Identification Test, DUDIT, is an 11-item screening instrument developed to identify non-alcohol drug use patterns and various drug-related problems in the general public as well as in individuals in clinical settings who are likely to meet criteria for a substance dependence diagnosis. DUDIT is designed to screen out those who do not have drug problems. The item structure follows on very similar lines as the AUDIT. Q1-4 are about drug use, Q5-8 are about dependence, and Q9-11 are about problems. Currently there are no shortened, substance use only, versions but there is an extended version the DUDIT-E. In addition to items covering amount and frequency of use and signs of hazardous use or dependence, the participant is asked about which drugs he or she is using, including illicit drugs and prescription drugs of abuse and lists are provided on the reverse of the questionnaire. Timeframe :: The timeframe is not specified for the substance use items (current use implied) and is the last year for other items. Scoring :: The first nine items are scored on a 5-point scale ranging from 0 to 4, and the last two are scored on a 3-point scale with values 0, 2, and 4. Thus, total scores range from 0 to 44, with higher scores suggestive of a more severe drug problem. Completion time :: Not specified but brief. Cut-off score :: The DUDIT cutoff score for any type of problematic use (harmful use, substance abuse, or dependence) is ≥6 for men and ≥2 for women, with different scores considered optimal depending on the population studied. The following risk levels are suggested for the DUDIT scores: no drug related problems ≤5; heavily dependent on drugs ≥25