CADS: Two Short Screeners for Cocaine and Heroin Dependence among Arrestees

In view of the prevalence of drug use among criminals, the assessment of drug dependence is a valuable responsibility of the criminal justice system. Obtaining accurate and expeditious assessments, however, has traditionally been a difficult goal to achieve because of limited time and resources. While several scales have been developed to screen for drug dependence, none have been developed for specific drugs of abuse within criminal populations. We used data from the Substance Abuse Need for Treatment among Arrestees (SANTA) study in Baltimore to develop screening instruments for cocaine and heroin dependence. The SANTA interview is a module of questions that diagnoses alcohol and other drug (AOD) abuse and dependence according to the Diagnostic and Statistical Manual of Mental Disorders, third edition-revised (DSM-III-R) criteria. Extensive inquiries about AOD-using behaviors are made using a computer-assisted module of the Diagnostic Interview Schedule, Version III-Revised (DIS-III-R), a structured interview that operationalizes the nine DSM-III criteria to diagnose substance abuse and dependence and estimate treatment need based on interview responses. The Center for Substance Abuse Research (CESAR) Arrestee Drug Screener (CADS) developed in the current study utilizes two sets of three questions each from the DIS-III-R for the purpose of identifying cocaine and heroin dependence among arrestees. The high sensitivities and negative predictive values of the CADS make them especially useful for identifying those arrestees most likely to be diagnosed dependent on the respective drug. Implications for using the screeners with criminal populations are discussed.