Cross sectional studies (Mordal et al) tell us that around a third of patients admitted to acute psychiatric wards have illicit drugs detected in their system on admission. A third of patients also report a need for professional help in relation to their substance use.
This new systematic review from researchers at York University (Mdege and Lang) aimed to identify the best screening instrument to detect illicit drug use in the general hospital setting.
They conducted a systematic search and found 13 instruments to include in their analysis:
Unfortunately when they assessed the instruments for reliability, validity, feasibility and acceptability, they found that none of them had been tested sufficiently in general hospital wards. They were therefore unable to recommend any of them for this purpose.
The reviewers concluded:
The review identified and described 13 instruments that could be useful in general hospital wards. There is however lack of evaluation of illicit drug use screening instruments in general hospital wards. Currently clinicians or researchers searching for a simple, reliable, general screening instrument for current drug use to guide practice or research in general hospital wards do not have enough comparative evidence to choose between the available measures.
Mdege ND, Lang J. Screening instruments for detecting illicit drug use/abuse that could be useful in general hospital wards: a systematic review. Addict Behav. 2011 Dec;36(12):1111-9. Epub 2011 Jul 23. [PubMed abstract]
Mordal J, Holm B, Gossop M, Romøren M, Mørland J, Bramness JG. Psychoactive substance use among patients admitted to an acute psychiatric ward: laboratory findings and associations with clinical characteristics. Nord J Psychiatry. 2011 Jun;65(3):208-15. [PubMed abstract]