Who Should Be Screened for Problem Drug Use?

Substance abuse and illicit drug use are prevalent and costly in our society. But which patients in the emergency department (ED) merit a discussion designed to uncover problem drug use? Investigators performed a secondary analysis of screening data from a large randomized trial of a brief intervention for problematic drug use.

The analysis focused on the 3240 patients reporting drug use in the 30 days before the ED visit; 64% met criteria for problematic drug use. Of 1940 primary users of marijuana, 47% screened positive for problem drug use. Of 1300 users of other drugs (e.g., other illicit drugs, prescription drugs), 91% had problem drug use (odds ratio, 14.61). The two strongest predictors of problem drug use were use of any drug other t…