Evaluating brief screeners to discriminate between drug use disorders in a sample of treatment-seeking adults.
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OBJECTIVE:The objective was to identify a potential core set of brief screeners for the detection of individuals with a substance use disorder (SUD) in medical settings. METHOD:Data were from two multisite studies that evaluated stimulant use outcomes of an abstinence-based contingency management intervention as an addition to usual care (National Drug Abuse Treatment Clinical Trials Network trials 006-007). The sample comprised 847 substance-using adults who were recruited from 12 outpatient substance abuse treatment settings across the United States. Alcohol and drug use disorders were assessed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Checklist. Data were analyzed by factor analysis, item response theory (IRT), sensitivity and specificity procedures. RESULTS:Comparatively prevalent symptoms of dependence, especially inability to cut down for all substances, showed high sensitivity for detecting an SUD (low rate of false negative). IRT-defined severe (infrequent) and low discriminative items, especially withdrawal for alcohol, cannabis and cocaine, had low sensitivity in identifying cases of an SUD. IRT-defined less severe (frequent) and high discriminative items, including inability to cut down or taking larger amounts than intended for all substances and withdrawal for amphetamines and opioids, showed good-to-high values of area under the receiver operating characteristic curve in classifying cases and noncases of an SUD. CONCLUSION:Findings suggest the feasibility of identifying psychometrically reliable substance dependence symptoms to develop a two-item screen for alcohol and drug disorders.
Substance Withdrawal Syndrome
Sensitivity and Specificity
Published Version (Please cite this version)10.1016/j.genhosppsych.2012.06.014
Publication InfoWu, Li-Tzy; Swartz, Marvin S; Pan, Jeng-Jong; Burchett, Bruce; Mannelli, Paolo; Yang, Chongming; & Blazer, Dan G (2013). Evaluating brief screeners to discriminate between drug use disorders in a sample of treatment-seeking adults. General hospital psychiatry, 35(1). pp. 74-82. 10.1016/j.genhosppsych.2012.06.014. Retrieved from https://hdl.handle.net/10161/19963.
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Professor of Psychiatry and Behavioral Sciences
I am currently semi-retired. Most of my recent work has been focused on roles with the National Academy of Medicine (former Institute of Medicine). I have chaired three committees during the past four years, one on the mental health and substance use workforce, one on cognitive aging, and one on hearing loss in adults. I currently also chair the Board on the Health of Select Populations for the National Academies. In the past I have been PI on a number of research
Assistant Professor in Psychiatry and Behavioral Sciences
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
Associate Professor of Psychiatry and Behavioral Sciences
Professor in Psychiatry and Behavioral Sciences
My major research interest is in examining the effectiveness of services for severely mentally ill individuals, including factors that improve or impede good outcomes. Current research includes: the effectiveness of involuntary outpatient commitment, psychiatric advance directives, criminal justice outcomes for persons with mental illnesses, violence and mental illness and antipsychotic medications. I also served as member of the MacArthur Foundation Research Network on Mandate
Professor in Psychiatry and Behavioral Sciences
Education/Training: Pre- and post-doctoral training in mental health service research, psychiatric epidemiology (NIMH T32), and addiction epidemiology (NIDA T32) from Johns Hopkins University School of Public Health (Maryland); Fellow of the NIH Summer Institute on the Design and Conduct of Randomized Clinical Trials.Director: Duke Community Based Substance Use Disorder Research Program.Research interests: COVID-19, Opioid misuse, Opioid overdose, Opioid use disorder
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How do prescription opioid users differ from users of heroin or other drugs in psychopathology: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Wu, Li-Tzy; Woody, George E; Yang, Chongming; Blazer, Dan G (Journal of addiction medicine, 2011-03)To study substance use and psychiatric disorders among prescription opioid users, heroin users, and non-opioid drug users in a national sample of adults.Analyses of data from the 2001-2002 National Epidemiologic Survey on ...
Differences in behavioral health disorders and unmet treatment needs between medical marijuana users and recreational marijuana users: Results from a national adult sample. Park, Ji-Yeun; Wu, Li-Tzy (Drug and alcohol dependence, 2017-11)BACKGROUND:Available data suggest that medical marijuana users may have more mental health problems than recreational marijuana users. There is limited information about differences in behavioral health disorders and unmet ...
Wu, Li-Tzy; McNeely, Jennifer; Subramaniam, Geetha A; Brady, Kathleen T; Sharma, Gaurav; VanVeldhuisen, Paul; Zhu, He; ... (8 authors) (Drug and alcohol dependence, 2017-10)BACKGROUND:There are limited data about the extent of DSM-5 substance use disorders (SUDs) among primary care patients. METHODS:This study analyzed data from a multisite validation study of a substance use screening instrument ...