NIDA Releases New Online Screening Tool for Substance Abuse

Megan Brooks

July 02, 2018

The National Institute on Drug Abuse (NIDA) has unveiled a new scientifically validated online screening tool that can help providers uncover patients' problem substance use.

The Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) Tool was developed within the clinical trials network. It consists of a comprehensive screening component and a brief assessment for those who screen positive. Unlike other screening tools, the TAPS Tool combines screening and brief assessment for multiple substances, eliminating the need for multiple screening and lengthy assessment tools.

The TAPS Tool may either be self-administered or administered in conjunction with an interview by a healthcare provider. It is not intended for self-assessment or to take the place of a healthcare provider's clinical judgment, NIDA says.

The TAPS Tool has two components. The first component (TAPS-1) is a four-item screen for tobacco, alcohol, illicit drugs, and the nonmedical use of prescription drugs. If an individual screens positive on TAPS-1 (ie, gives a response other than "never"), the tool proceeds to the second component (TAPS-2), which consists of brief substance-specific assessment questions through which the patient is assigned a risk level for that substance. Risk levels range in severity from "problem use" to substance use disorder.

One of the problems with other brief screens is that they only ask about drug use as a single category, Jennifer McNeely, MD, an assistant professor at New York University School of Medicine in New York City and a general internist specializing in addiction medicine, told Medscape Medical News.

"For me, as a primary care provider, if I get a positive screen saying my patient has risky drug use, I then have to ask a lot more questions to figure out, is that risky marijuana use or is that risky heroin use, which makes a big difference for my management. The TAPS is brief, but it also gives a drug-specific risk level," said McNeely.

In a validation study, which McNeely led, the TAPS Tool detected clinically relevant problem use in a diverse population of 2000 adult patients from five primary care centers in New York City; Baltimore, Maryland; and Richmond, Virginia.

The validation study also showed that the majority of patients were "comfortable" with the TAPS screening tool.

"When you talk to patients about screening for alcohol and drugs in general, patients actually consider it a marker of good care and think it should be asked, but there are caveats about how they want to be asked," McNeely said.

"Other research has shown that patients want their doctor to have the information, but it's a stigmatized behavior, and they don't want to just report it to anybody," she noted, "so self-administered tools work best in that case. The patients are generally more comfortable filling it out themselves, knowing that their doctor will see it, but not having the concern that the front desk or medical assistant is going to see it," she added.

The TAPS Tool is one of several tools on NIDA's NIDAMED Web portal that can help providers introduce brief, evidence-based substance use screenings into their clinical practices. Clinicians can survey the tools available to determine which one best fits their practice.

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