Common screening tool accurately identified moderate-to-severe cannabis use disorder in teens
The S2BI screening tool showed excellent sensitivity (90%) and specificity (89%) for identifying moderate-to-severe cannabis use disorder among adolescents in primary care, but was less accurate for mild cases.
Quick Facts
What This Study Found
Using monthly or more frequent use as the threshold, S2BI had 90% sensitivity and 89% specificity for moderate-to-severe CUD, and 100% sensitivity and 93.6% specificity for moderate-to-severe AUD. Sensitivity dropped to 81.4% for any CUD and 53.3% for any AUD.
Key Numbers
517 adolescents aged 14-18; CUD prevalence 8.3%; AUD prevalence 2.9%; moderate/severe CUD sensitivity 90.0%, specificity 89.0%; any CUD sensitivity 81.4%, specificity 92.0%
How They Did This
Researchers administered the S2BI screening tool and the gold-standard Composite International Diagnostic Interview (CIDI) to 517 adolescents aged 14-18 presenting for primary care, then calculated sensitivity, specificity, and predictive values.
Why This Research Matters
Primary care visits represent a key opportunity to identify adolescents with substance use disorders. Validating a brief, practical screening tool against the diagnostic gold standard helps clinicians know how much to trust the results.
The Bigger Picture
Brief screening tools that can be integrated into routine primary care visits are essential for early identification of substance use disorders. This validation study suggests S2BI works well for the cases clinicians most need to catch: moderate and severe disorders.
What This Study Doesn't Tell Us
Single-site study. Low prevalence of AUD limited statistical power for alcohol-specific analyses. Cross-sectional design cannot assess how screening performance changes over time.
Questions This Raises
- ?Could modifications to S2BI improve detection of mild use disorders?
- ?How does screening performance differ across racial and socioeconomic groups?
- ?What percentage of positively screened adolescents actually receive follow-up care?
Trust & Context
- Key Stat:
- 90% sensitivity for moderate-to-severe cannabis use disorder
- Evidence Grade:
- Well-designed diagnostic validation study with gold-standard comparator, though single-site and relatively low disorder prevalence.
- Study Age:
- Published in 2021.
- Original Title:
- Sensitivity and specificity of S2BI for identifying alcohol and cannabis use disorders among adolescents presenting for primary care.
- Published In:
- Substance abuse, 42(3), 388-395 (2021)
- Authors:
- Levy, Sharon(9), Weitzman, Elissa R(5), Marin, Alexandra C, Magane, Kara M, Wisk, Lauren E, Shrier, Lydia A
- Database ID:
- RTHC-03290
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
What is the S2BI?
The Screening to Brief Intervention (S2BI) is a brief screening tool designed to identify substance use disorders in adolescents during primary care visits.
Was it better at detecting cannabis or alcohol problems?
It performed well for both at moderate-to-severe levels (100% sensitive for moderate/severe AUD, 90% for moderate/severe CUD), but was notably less sensitive for any AUD (53.3%) compared to any CUD (81.4%).
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-03290APA
Levy, Sharon; Weitzman, Elissa R; Marin, Alexandra C; Magane, Kara M; Wisk, Lauren E; Shrier, Lydia A. (2021). Sensitivity and specificity of S2BI for identifying alcohol and cannabis use disorders among adolescents presenting for primary care.. Substance abuse, 42(3), 388-395. https://doi.org/10.1080/08897077.2020.1803180
MLA
Levy, Sharon, et al. "Sensitivity and specificity of S2BI for identifying alcohol and cannabis use disorders among adolescents presenting for primary care.." Substance abuse, 2021. https://doi.org/10.1080/08897077.2020.1803180
RethinkTHC
RethinkTHC Research Database. "Sensitivity and specificity of S2BI for identifying alcohol ..." RTHC-03290. Retrieved from https://rethinkthc.com/research/levy-2021-sensitivity-and-specificity-of
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.