An evaluation of eight short versions of the Drug Use Disorder Identification Test (DUDIT). A prison population study

• Published in: Drug and alcohol dependence reports Vol. 3; p. 100043
• Main Authors: Pape, Hilde, Lobmaier, Philipp, Bukten, Anne
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2022; Elsevier
• Subjects: Drug problems; DUDIT; Full Length Report; Prison population; Screening; Short versions; Validation study; Screening; Drug problems; Prison population; DUDIT; Short versions; Validation study
• ISSN: 2772-7246; 2772-7246
• DOI: 10.1016/j.dadr.2022.100043

•Eight brief DUDIT screeners were evaluated in a national prison population sample.•DUDIT-C (four consumption items) effectively detected likely drug dependence.•DUDIT-C and one additional item performed better than DUDIT-C alone.•Cut-points with high sensitivity and specificity were identified. The eleven-item Drug Use Disorder Identification Test (DUDIT) is a recommended screening tool, but its length may impede its use in prison intake assessments. Hence, we examined the performance of eight brief DUDIT screeners against the full DUDIT, employing a sample of male inmates. Our study included male participants in the Norwegian Offender Mental Health and Addiction (NorMA) study who reported pre-prison drug use and who had been incarcerated three months or less (n = 251). We performed receiver operating characteristic curve (ROC) analyses and estimated the area under the curve (AUROC) to assess the performance of DUDIT-C (four drug consumption items) and five-item versions that consisted of DUDIT-C and one additional item. Almost all (95%) screened positive on the full DUDIT (scores ≥6) and 35% had scores that were indicative of drug dependence (scores ≥25). The DUDIT-C performed very well in detecting likely dependence (AUROC=0.950), but some of the five-item versions performed significantly better. Of these, the DUDIT-C + item 5 (craving) had the highest AUROC (0.097). A cut-point of ≥9 on the DUDIT-C and ≥11 on the DUDIT-C + item 5 identified virtually all (98% and 97%, respectively) cases of likely dependence, with a specificity of 73% and 83%, respectively. At these cut-points, the occurrence of false positives was modest (15% and 10%, respectively) and only 4–5% were false negatives. The DUDIT-C was highly effective in detecting likely drug dependence (according to the full DUDIT), but some combinations of DUDIT-C and one additional item performed better.