Drug use screening questions
At a checkup, drug use screening means your clinician asks questions about drug use. It is not a urine, saliva or blood test. (USPSTF, 2020)
Who is asked
- Adults 18 and older, including people who are pregnant or postpartum. The USPSTF recommends screening by asking questions (grade B), when services for accurate diagnosis, effective treatment and appropriate care can be offered or referred. (USPSTF, 2020)
- Adolescents 12 to 17. The USPSTF found the evidence insufficient to weigh benefits and harms (I statement), so clinicians use their judgment about asking. (USPSTF, 2020)
- Who the recommendation does not cover. People who already have a diagnosed drug use disorder or are in, or referred to, drug use treatment, and settings where treatment cannot be provided or the result of screening is punitive. (USPSTF, 2020)
In the USPSTF statement, unhealthy drug use means using illegal drugs, or using a prescription drug in ways a doctor did not recommend, such as to get high or to change your mood or way of thinking. Alcohol and tobacco are covered by separate recommendations. (USPSTF, 2020) Alcohol questions are on the AUDIT-C alcohol screening page.
What happens
The USPSTF says your clinician can ask the questions, or ask you to share your answers on a form, computer or tablet. Self-completed and interviewer-asked tools appear to have similar accuracy. (USPSTF, 2020) Your primary care provider or a mental health provider may do the screening. There is no special preparation, and MedlinePlus says there is no risk in taking a questionnaire. (MedlinePlus, screening tests)
Short question tools
The USPSTF identified 30 different screening tools that studies had evaluated. (USPSTF, 2020) The ones named by the sources are below, described in general terms.
| Tool | What it asks about | How it is used |
|---|---|---|
| Single question | How often you used drugs | One of the direct tools the USPSTF review looked at (single-item drug frequency) (USPSTF, 2020) |
| NIDA Quick Screen | Use of alcohol, tobacco, prescription drugs for nonmedical reasons and illegal drugs in the past year (4 questions) | A brief tool that may fit busy primary care (USPSTF, 2020) |
| TAPS | Part 1: tobacco, alcohol and other substance use in the past year. A yes leads to part 2 | Your score gives a risk level for each substance (MedlinePlus, screening tests) |
| ASSIST (8 items) | Drug use and the risks linked to it | A longer tool that may show a need for a prompt fuller assessment (USPSTF, 2020) |
| DAST-10 | 10 yes or no questions about how much and how often you take drugs, and whether drugs cause problems in your life and health | Answers are scored on a point system (MedlinePlus, screening tests) |
| CRAFFT | Use of alcohol, tobacco and nicotine, marijuana and other substances, including opioids | Recommended by AAP Bright Futures for the risk assessment from 11 through 21 years (AAP Bright Futures, 2025) |
| PRO (Prenatal Risk Overview) | Drug use questions in a prenatal risk assessment tool | Named by the USPSTF for pregnant people (USPSTF, 2020) |
How your answers are used
The USPSTF says screening tools are not meant to diagnose drug dependence, addiction or drug use disorders. People with a positive result may need to be offered or referred for a diagnostic assessment. (USPSTF, 2020) MedlinePlus says some tests can show whether you are at low, moderate or high risk of complications from drug use. (MedlinePlus, screening tests)
Privacy of your answers
The USPSTF names possible harms of asking about drug use and recording the answers, such as stigma, labeling and medical or legal consequences. To limit them, it says clinicians should know their state's requirements and best practices on informed consent for screening, mandatory screening, documenting results in medical records, reporting results to legal authorities, and confidentiality protections. (USPSTF, 2020)
How this differs from a workplace drug test
A drug test checks a sample for signs of drugs. Urine is the most common sample; blood, saliva, hair, fingernails or sweat can also be used. Employers may require a test before hiring, after an accident or to check for on-the-job drug use. It cannot diagnose a drug use disorder. (MedlinePlus, drug testing)
- Before the test. MedlinePlus says to tell the testing professional about any prescription drugs, over-the-counter medicines or supplements you take, because they may affect the result, to avoid foods with poppy seeds, and to make sure you know what you are being tested for, why, and how the results will be used. (MedlinePlus, drug testing)
- A positive result. One or more drugs were found in amounts that suggest use or misuse. You will usually have a follow-up confirmatory test, because the first type of urine test can give false positives. (MedlinePlus, drug testing)
- A negative result. The drugs tested for were not found, or the amount found was too small to count as positive. (MedlinePlus, drug testing)
When to contact a medical professional
The MedlinePlus Substance use disorder page says: (MedlinePlus, substance use disorder)
- Make an appointment with your provider if you or a family member is using a substance and wants to stop. Also contact your provider if you have been cut off from your drug supply and are at risk of withdrawal. Many employers offer referral services for their employees with substance use problems.
- If you or someone you know is thinking about suicide, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.
- You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.
- If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.
Where they differ:
- Teens. The USPSTF found the evidence insufficient for screening ages 12 to 17. (USPSTF, 2020) AAP Bright Futures marks a tobacco, alcohol or drug use risk assessment at every preventive visit from 11 through 21 years, and names CRAFFT as a recommended tool. (AAP Bright Futures, 2025)
- What a result shows. The USPSTF says screening tools are not meant to diagnose drug use disorders. (USPSTF, 2020) MedlinePlus says results may show whether you have a substance use disorder and how severe it is. (MedlinePlus, screening tests)
- Questions or a sample. In the USPSTF recommendation, screening never means testing urine, saliva or blood. (USPSTF, 2020) MedlinePlus describes cases where a provider orders a drug test, such as checking that an addictive prescription medicine is taken correctly, or signs of a possible overdose in an emergency room. (MedlinePlus, drug testing)
Your doctor decides what your result means for you.
Questions people ask
Is drug use screening a urine test?
No. In the USPSTF recommendation, screening means asking questions about drug use, face to face, on paper or on a screen. It does not mean testing urine, saliva, blood or other samples. (USPSTF, 2020)
Who should be asked about drug use?
The USPSTF recommends asking adults 18 and older, including people who are pregnant or postpartum (grade B), when diagnosis, treatment and care can be offered or referred. For ages 12 to 17 it found the evidence insufficient (I statement). AAP Bright Futures marks a tobacco, alcohol or drug use risk assessment at every visit from 11 through 21. (USPSTF, 2020) (AAP Bright Futures, 2025)
Does a positive screen mean I have an addiction?
No. The USPSTF says screening tools are not meant to diagnose drug use disorders, and people with a positive result may need to be offered or referred for a diagnostic assessment. (USPSTF, 2020)
Can I fill in the questions myself?
Yes, often. The USPSTF says a clinician can ask the questions or ask you to share your answers on a form, computer or tablet, and that self-completed and interviewer-asked tools appear to have similar accuracy. (USPSTF, 2020)
Is a job drug test the same thing?
No. A workplace drug test checks a sample, most often urine, for signs of drugs. A positive result is usually followed by a confirmatory test, because the first type of urine test can give false positives. (MedlinePlus, drug testing)