Scientific background: Substance Use (Teens)

About this test

The CRAFFT was developed by the Center for Adolescent Substance Use Research (CeASAR) at Boston Children's Hospital and is one of the best-validated brief screens for risky substance use in adolescence. In a re-evaluation against DSM-5 criteria (Mitchell et al., 2014), the proportion of people with a diagnosable substance use disorder rose sharply with the number of "yes" answers -- from 32% at one "yes" answer to over 90% at four or more. A score of 2 or more is considered a sign of a problem serious enough to warrant further evaluation.

In the original validation study by Knight and colleagues (2002), a threshold of 2 or more proved to be the optimal balance for detecting a diagnosable substance use disorder in 14- to 18-year-olds (sensitivity 80%, specificity 86%). For the more specific question of dependence on alcohol or other substances, the same threshold performed even better in follow-up studies (sensitivity 92%, specificity 80%) -- the CRAFFT is especially reliable at catching the more severe cases.

Dimensions

Sources & license

• Knight, J. R., Sherritt, L., Shrier, L. A., Harris, S. K., & Chang, G. (2002). Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Archives of Pediatrics & Adolescent Medicine, 156(6), 607-614.

  The CRAFFT is, per the official CeASAR (Boston Children's Hospital) policy, free to use, including digital/electronic integration. Copyright John R. Knight, MD, Boston Children's Hospital. Item wording verified against the original screening form.

  https://crafft.org/

• Mitchell, S. G., Kelly, S. M., Gryczynski, J., Myers, C. P., O'Grady, K. E., Kirk, A. S., & Schwartz, R. P. (2014). The CRAFFT cut-points and DSM-5 criteria for alcohol and other drugs: A reevaluation and reexamination. Substance Abuse, 35(4), 376-380.

  Scientific publication, cited as evidence for the score-to-diagnosis relationship.