Screening check
Should I be screened for drug use?
Unhealthy drug use means using illegal drugs, or using a prescription medicine other than as prescribed. The US Preventive Services Task Force recommends that clinicians ask adults about it. Check where you fall.
About you
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What you will see
Whether the USPSTF recommends drug use screening for you, and what a positive answer means.
Educational only, not medical advice. Talk to a clinician.
Source
US Preventive Services Task Force, June 2020 recommendation on screening for unhealthy drug use.
Validated in
Adults 18 or older and teens 12 to 17, including pregnant and postpartum people.
Limits
It is not a screening questionnaire or a diagnosis. It does not apply to people with a diagnosed drug use disorder or in treatment. Alcohol and tobacco have their own recommendations.
What the USPSTF recommends
| Who | Recommendation | Grade |
|---|---|---|
| Adults 18 or older | Screen by asking questions about unhealthy drug use, when accurate diagnosis, effective treatment and care can be offered or referred | B |
| Teens 12 to 17 | Evidence insufficient to weigh benefits and harms | I |
Screening means asking questions, not testing urine, blood or other samples (USPSTF 2020). The recommendation covers pregnant and postpartum people. It does not apply to people who already have a diagnosed drug use disorder or are in or referred to treatment, or to settings where treatment cannot be provided or where the result of screening is punitive (USPSTF 2020).
Why it matters
In 2018 about 12% of US adults reported current unhealthy drug use: 24% of young adults aged 18 to 25 and 10% of older adults. About 5.4% of pregnant people aged 15 to 44 reported use in the past month (USPSTF 2020). Unhealthy drug use is one of the most common causes of preventable death, injury and disability, and in 2017 it caused more than 70,000 fatal overdoses (USPSTF 2020).
How the questions are asked
A clinician can ask the questions, or you can answer them on a form, computer or tablet; both work about equally well (USPSTF 2020). The USPSTF gives examples of tools:
- Brief tools such as the NIDA Quick Screen, which asks 4 questions about alcohol, tobacco, nonmedical use of prescription drugs and illegal drugs in the past year.
- Longer tools such as the 8-item ASSIST, which also look at risks and related conditions.
- Tools with questions about prescription misuse, such as TAPS, and the PRO (Prenatal Risk Overview) in pregnancy (USPSTF 2020).
These tools do not diagnose a drug use disorder. A positive screen means a clinician may offer or refer for a fuller assessment (USPSTF 2020). There is little evidence on when to start or how often to ask (USPSTF 2020).
Who is more likely to use drugs
Everyone 18 or older should be asked, whatever their risk. Use is more common in people aged 18 to 25, men, people with a mental health condition or nicotine or alcohol dependence, people who were abused or neglected as children, and people with a parent, sibling or child who has a drug or alcohol addiction (USPSTF 2020).
Does treatment help?
No studies looked directly at whether screening itself reduces drug use. The USPSTF based its advice on treatment: FDA-approved medicines (naltrexone, buprenorphine, methadone) lowered relapse and kept more people in treatment in adults with opioid use disorder, and counseling had moderate benefits for stopping or cutting down (USPSTF 2020). Many drug use disorders are long-term conditions that can come back, so treatment often has to be repeated (USPSTF 2020).
Common questions
Why no advice for teens?
The USPSTF found too little evidence that screening tools detect most types of drug use in teens, or that treatment works for them (USPSTF 2020). Clinicians use their own judgement about asking.
Is this the same as a drug test?
No. The recommendation is about asking questions, not testing samples (USPSTF 2020).
Also see the alcohol screening (AUDIT-C), the depression screening (PHQ-9), the hepatitis C screening check, the HIV screening check and all screening tests by age.
Sources
- US Preventive Services Task Force. Screening for Unhealthy Drug Use: US Preventive Services Task Force Recommendation Statement. JAMA. 2020;323(22):2301. www.uspreventiveservicestaskforce.org/uspstf/recommendation/drug-use-illicit-screening
- Substance Abuse and Mental Health Services Administration. SAMHSA's National Helpline. www.samhsa.gov/find-help/helplines/national-helpline
- 988 Suicide and Crisis Lifeline. Call, text or chat 988; available 24/7, free and confidential. 988lifeline.org/
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-10-29. Spotted an error? See About.