An evaluation of eight short versions of the Drug Use Disorder Identification Test (DUDIT)

Hilde Pape, Philipp Lobmaier, Anne Bukten. An evaluation of eight short versions of the Drug Use Disorder Identification Test (DUDIT). A prison population study. Drug and Alcohol Dependence Reports, Volume 3, 2022. https://doi.org/10.1016/j.dadr.2022.100043

Background

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.

Methods

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.

Results

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.

Conclusions

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.