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Clinical screening tools for substance use disorders during pregnancy

Clinical screening tools for substance use disorders during pregnancy
4 Ps[1]
Parents: Did any of your parents have a problem with alcohol or other drug use?
Partner: Does your partner have a problem with alcohol or drug use?
Past: In the past, have you had difficulties in your life because of alcohol or other drugs, including prescription medications?
Present: In the past month, have you drunk any alcohol or used other drugs?
Scoring: Any "yes" should trigger further questions.
NIDA Quick Screen[2]
Screen your patients
Step 1. Use the NIDA Quick Screen to ask the patient about past-year drug use
Step 2. Ask the patient about lifetime drug use
Step 3. Determine risk level
Step 4. Depending on risk level: Advise, Assess, Assist, and Arrange
CRAFFT – Substance Abuse Screen for Adolescents and Young Adults[3]
C Have you ever ridden in a CAR driven by someone (including yourself) who was high or had been using alcohol or drugs?
R Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in?
A Do you ever use alcohol or drugs while you are by yourself or ALONE?
F Do you ever FORGET things you did while using alcohol or drugs?
F Do your FAMILY or friends ever tell you that you should cut down on your drinking or drug use?
T Have you ever gotten in TROUBLE while you were using alcohol or drugs?
Scoring: Two or more positive items indicate the need for further assessment.
Confidentiality statement: NOTICE TO CLINIC STAFF AND MEDICAL RECORDS: The information on this page is protected by special federal confidentiality rules (42 CFR Part 2), which prohibit disclosure of this information unless authorized by specific written consent. A general authorization for release of medical information is NOT sufficient.[3]
Reproduced from:
  1. Ewing H. A practical guide to intervention in health and social services with pregnant and postpartum addicts and alcoholics: theoretical framework, brief screening tool, key interview questions, and strategies for referral to recovery resources. Martinez (CA): The Born Free Project, Contra Costa County Department of Health Services; 1990.
  2. Screening for Drug Use in General Medical Settings: Quick Reference Guide, Version 2. National Institute on Drug Abuse. https://nida.nih.gov/sites/default/files/pdf/screening_qr.pdf (Accessed on October 31, 2023).
  3. Center for Adolescent Behavioral Health Research, Children's Hospital Boston. The CRAFFT screening interview. Boston (MA): CABHRe; 2009. © John R. Knight, MD, Boston Children's Hospital, 2018. All rights reserved. Reproduced with permission. For more information, contact [email protected].
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