Substance use measures

Why substance use?

Substance use is classed as a ‘dimension’ outcome measure; it is the most direct measure of outcome, 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, which all contribute to the effects of a drug. 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. Substance Use is, therefore, suggested as one of the four key measures of addiction outcomes. The recommended scales, built into Take-a-Test, are the AUDIT and DUDIT.

Alcohol Use Disorder Identification Test - AUDIT

The AUDIT was designed by the World Health Organisation. Because it was designed as a screening test, its sensitivity is geared to low levels of consumption and so it is not ideal as an outcome measure. It is widely used and brief versions are available. The user guide is comprehensive. AUDIT is a composite measure tapping into drinking, dependence and problems: the first three questions, known as AUDIT-C, are about consumption and can be used on their own.

  • Timeframe :: The timeframe is not specified for the substance use items (current use implied) and is the last year for other items

  • Completion time :: <2minute

  • 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

  • Cut-off score :: The first eight 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 40, with higher scores suggestive of a more severe alcohol problem

  • Licence: free to use

References

Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. (1998) The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Archives of Internal Medicine 158: 1789 Journal article not found

Durbeej N, Berman AH, Gumpert CH, Palmstierna T, Kristiansson M, Alm C, et al. (2010) Validation of the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test in a Swedish sample of suspected offenders with signs of mental health problems: Results from the Mental Disorder, Substance Abuse and Crime study. Journal of Substance Abuse Treatment 39(4):364-77 Journal article not found

Barry AE, Chaney BH, Stellefson ML, Dodd V. (2015) Evaluating the psychometric properties of the AUDIT-C among college students. Journal of Substance Use 20:1-5 Journal article not found

Drug Use Disorder Identification Test - DUDIT

The DUDIT follows the same format as the AUDIT. Because it was designed as a screening test, its sensitivity is geared to low levels of consumption and so it is not ideal as an outcome measure. The user guide is comprehensive. DUDIT is a composite measure tapping into drinking, dependence and problems: the first four questions are about consumption and can be used on their own.

  • Timeframe :: The timeframe is not specified for the substance use items (current use implied) and is the last year for other items

  • Completion time :: Not specified - brief

  • 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

  • Cut-off scores :: 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

  • Licence: copyright

References

Berman AH, Bergman H, Palmstierna T, Schlyter F. (2005) Evaluation of the Drug Use Disorders Identification Test (DUDIT) in criminal justice and detoxification settings and in a Swedish population sample. European Addiction Research 11: 22-31

Durbeej N, Berman AH, Gumpert CH, Palmstierna T, Kristiansson M, Alm C, et al. (2010) Validation of the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test in a Swedish sample of suspected offenders with signs of mental health problems: Results from the Mental Disorder, Substance Abuse and Crime study. Journal of Substance Abuse Treatment 39: 364-77 Journal article not found

Hildebrand M. (2015) The Psychometric Properties of the Drug Use Disorders Identification Test (DUDIT): A Review of Recent Research. Journal of Substance Abuse Treatment 53:52

Berman AH, Palmstierna T, Källmén H, Bergman H. (2007) The self-report Drug Use Disorders Identification Test—Extended (DUDIT-E): Reliability, validity, and motivational index. Journal of Substance Abuse Treatment 32: 357-369

Other substance use measures

Prescription Drug Use Questionnaire - PDUQ

Time Line Follow Back - TLFB

Alcohol, Smoking and Substance Involvement Screening Test - ASSIST

Composite scales that include substance use

Treatment Outcome Profile - TOP

Maudsley Addiction Profile - MAP

Addiction Severity Index - ASI

More pages about outcomes measurement…

Check out these measures of: dependence, recovery, wellbeing, mental health and governance