Discussion
SUDs
DISORDERS
In this cross-sectional study, we observed that the S2BI, BSTAD, and TAPS screening tools all had adequate psychometric properties for identifying tobacco/nicotine, alcohol, and cannabis use disorders among adolescents at the recommended cut points. Point estimates of sensitivity and specificity were generally high, and there were no notable differences in performance across the 3 tools for any measure or any substance. Our findings confirm that brief screening tools that ask about the past-year frequency of use are useful for identifying adolescents with SUDs.The TAPS, which comprises past-use frequency questions combined with questions about problems, contains more questions and takes longer to administer than either the S2BI or BSTAD, yet the results of this study suggest that the psychometric properties were similar. Because our findings suggest that the extra questions did not appear to improve performance, we recommend the shorter tools for widespread implementation in pediatric care settings. However, our findings also suggest that the TAPS may be useful in settings that provide care for patients in both pediatric and adult age ranges in which a single tool may simplify clinical protocols.Rates of substance use disclosure and prescription medication use were higher among participants screened with the S2BI compared with the other tools. This finding may be of importance because previous studies have found lower rates of substance use disclosure in clinical samples compared with research trials.