What does the USPSTF recommend?	For adults 18 years or older: Grade B
	Screen by asking questions about unhealthy drug use in adults 18 years or older. Screen when services for accurate diagnosis, effective treatment, and appropriate care can be offered or referred. Screening refers to asking questions about unhealthy drug use, not testing biological specimens. Unhealthy drug use includes using illegal drugs, such as heroin, or using a prescription drug in ways that are not recommended by a doctor, such as to “get high” or affect someone's mood or way of thinking. For adolescents: I statement The evidence is insufficient to assess the balance of benefits and harms of screening for unhealthy drug use.
To whom does this recommendation apply?	Adults 18 years or older and adolescents, including those who are pregnant and postpartum. Settings and people for which services for accurate diagnosis, effective treatment, and appropriate care can be offered or referred. Does not apply to:  Adolescents or adults who have a currently diagnosed drug use disorder or are currently undergoing or have been referred to drug use treatment.  Settings and people for which treatment cannot be provided or the result of screening is punitive.
What's new?	This recommendation to screen adults for unhealthy drug use is new and is based on new evidence. Previously in 2008, there was insufficient evidence to make a recommendation for adults. Evidence continues to be insufficient to assess the balance of benefits and harms of screening for drug use in adolescents.
How to implement this recommendation?	For adults: Ask adults about unhealthy drug use. Clinicians can ask the questions or ask their patient to share their answers on a form, computer, or tablet. There are a variety of screening tools available, such as:  Brief tools (e.g., NIDA [National Institute on Drug Abuse] Quick Screen, which asks 4 questions about use of alcohol, tobacco, nonmedical use of prescription drugs, and illegal drugs in the past year), which may be more feasible in busy primary care settings.  Longer tools (e.g., the 8-item ASSIST [Alcohol, Smoking and Substance Involvement Screening Test]) that assess risks associated with unhealthy drug use or comorbid conditions.  The PRO (Prenatal Risk Overview) for pregnant people. Providers should be aware of state requirements and best practices on informed consent for screening, documenting screening results in medical records, and confidentiality protections. For adolescents: Evidence is insufficient, so clinicians should use their judgment about screening by asking questions about drug use.
What are other relevant USPSTF recommendations?	The USPSTF has also issued other related recommendations on interventions to prevent drug use in children, adolescents, and young adults; screening and behavioral counseling interventions for reducing unhealthy alcohol use in adolescents and adults; interventions for tobacco smoking cessation in adults, including pregnant people; and primary care interventions to prevent tobacco use in children and adolescents. These recommendations are available at https://www.uspreventiveservicestaskforce.org.
Where to read the full recommendation statement?	Visit the USPSTF website (https://www.uspreventiveservicestaskforce.org) to read the full recommendation statement. This includes more details on the rationale of the recommendation, including benefits and harms; supporting evidence; and recommendations of others.