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Abstract
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BACKGROUND: Emerging adults between the ages of 18 and 25 have the highest rates of illicit drug use and heavy alcohol use. The purpose of this study was to determine the performance of the Relax, Alone, Forget, Family/Friends, Trouble (CRAFFT) screening to identify alcohol and cannabis use disorders using Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria in a sample of emerging adults who use alcohol or cannabis or both.
METHODS: Study participants were recruited as part of a larger intervention study of health behaviors among emerging adults between the ages of 18 and 25 reporting alcohol and/or cannabis use. As part of baseline data collection, responses to the CRAFFT (score range: 0-6) and the Structured Clinical Interview for DSM-IV (SCID) were recorded. Additional questions about craving permitted approximation with DSM-5 diagnoses of alcohol and cannabis use disorders.
RESULTS: Participants (N = 382) averaged 21 (±2.1) years of age, 47% were male, 65% were non-Latino Caucasian, and using the SCID 42% met criteria for an alcohol use disorder and 45% met criteria for cannabis use disorder. When evaluating for any alcohol use disorder alone, using a cutoff score of 4, the sensitivity was 81.4% but the specificity was only 45.3%. At a cutoff score of 4, sensitivity for identifying any cannabis use disorder alone was 83.7% and specificity was 48.6%.
CONCLUSIONS: In emerging adults who report using alcohol or cannabis, the CRAFFT had low specificity for predicting alcohol or cannabis use disorder, despite using higher cut scores than previously published. The CRAFFT's utility in determining clinical substance use disorders in this population may be limited. |