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Single-Item Screening for Substance Use in Primary Care: An Investigation
Conference poster

Single-Item Screening for Substance Use in Primary Care: An Investigation

Robert C. Sterling, Lauren Kairys, William Leach, Anna Flattau, Jessica L Chou, Rikki A Patton and Margaret Dickinson
Annals of behavioral medicine, v 60(Supplement_1), pp S313-S313
01 Apr 2026
DOI: https://doi.org/10.1093/abm/kaag012#page=S313
url
https://doi.org/10.1093/abm/kaag012#page=S313View
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Abstract

Screening Substance Abuse
Efforts to promote widespread implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) have been hampered by a lack of training and available resources, including personnel and time. As a result, recently considerable attention has been paid to developing screening tools that, while brief, maintain their level of sensitivity. One such example is the recently developed NIDA single-item screen. Validation of this “instrument” has provided clinicians with another tool however concerns about sensitivity continue. As part of a large SAMHSA-funded project, universal screening featuring the NIDA single item screen was introduced into a large, urban primary care setting in late fall of 2024. In this session, we will describe the findings from this project. Through the first eight months of implementation, 7.1% of the over 3,500 primary care patients screened responded positively. Interestingly, that number does appears to fall below previously observed rates of positivity observed across a variety of primary care settings (15-25%), supporting earlier findings about sensitivity of the single item. This finding led us to examine whether we could identify descriptive factors that might be predictive of the probability of a positive screen. To address this question, age, sex, social determinants of health (SDOH), and a geo-coded deprivation index (ADI) were introduced into a multiple logistic regression. Results indicated that age in years (b= -.03, p < 0.001, OR=0.98), sex (b=-.78, p < 0.001, OR=0.46), and social determinants of health (b= 1.41,p < 0.001, OR=3.05) were significant predictors of a positive screen. Individuals were more likely to screen positive if they were younger, male, or flagged for SDOH. While the use of the NIDA single item screen did not yield the number of positive findings that a more time intensive screening process might have, the fact that a number of individuals at risk were identified and offered services should not be overlooked. Implications of these findings as they relate to widescale SBIRT implementation and the need for continued education on responding to the needs of individuals misusing substances will be considered.

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