For your discussion this week, provide a 1-2 paragraph summary of a hypothetical

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For your discussion this week, provide a 1-2 paragraph summary of a hypothetical case vignette (not a real case) that includes the following:
Presenting Problem/Challenge
Environmental Context
Risk/Protective Factors
Noted Strengths
Provide a summary of what screening or assessment tools might be useful in this case to direct your work.
The screening tool I would like to use is the
Tobacco, Alcohol, Prescription medication, and other Substance use Tool
The Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) Tool consists of a combined screening component (TAPS-1) followed by a brief assessment (TAPS-2) for those who screen positive.
This tool:
Combines screening and brief assessment for commonly used substances, eliminating the need for multiple screening and lengthy assessment tools
Provides a two stage brief assessment adapted from the NIDA quick screen and brief assessment (adapted ASSIST-lite)
May be either self-administered directly by the patient or as an interview by a health professional
Uses an electronic format (available here as an online tool)
Uses a screening component to ask about frequency of substance use in the past 12 months
Facilitates a brief assessment of past 3 months problem use to the patient
The TAPS Tool has two components. The first component (TAPS-1) is a 4-item screen for tobacco, alcohol, illicit drugs, and non-medical use of prescription drugs. If an individual screens positive on TAPS-1 (i.e., reports other than “never“), the tool will automatically begin the second component (TAPS-2), which consists of brief substance-specific assessment questions (TAPS-2) to arrive at a risk level for that substance. Clinicians are encouraged to provide positive feedback to patients who screen negative and support their choice to abstain from substances. For patients who have a positive screen on the TAPS-1, a brief assessment (TAPS-2) identifies the specific substance(s) use and risk level, ranging in severity from “problem use” to the more severe substance use disorder (SUD).
Instructions:
These tools can be used by the patient (self-administered) online or administered as an interview by a health professional. Upon completion, the tool will automatically generate a risk level for each substance class. Implications of the score, along with suggested clinician actions and additional resources, will be provided.
Screening Tool Cutoffs and Scoring Thresholds:
The TAPS tool starts with questions about the frequency of use of tobacco, alcohol, and other substances in the past 12 months. Endorsement of any substance use during the initial screening phase (TAPS-1) prompts few additional questions regarding use-related behaviors through a brief assessment (TAPS-2). Scores on these questions generate a risk level per substance endorsed, based on a range of possible scores per substance.
TAPS Score Risk Category
0 No Use in Past 3 Months
1 Problem Use
2+ Higher Risk
For identifying DSM-5 SUD at the recommended cutoff of 2+, the TAPS Tool has adequate sensitivity (>70%) only for tobacco, alcohol, and marijuana. Further assessment should be conducted for patients with a score of 1+ for other substances. This assessment is a high priority for patients with a TAPS score of 2+, given its high positive predictive value for most substance classes.
Tool Development and Validation:
The above text has extra references in it (the WHO CIDI SAM). The TAPS Tool was compared to a reference standard measure in adult primary care patients and demonstrated adequate psychometric properties.
McNeely J, Wu L, Subramaniam G, Sharma G, Cathers LA, Svikis D, et al. Performance of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) Tool for Substance Use Screening in Primary Care Patients. Ann Intern Med. 2016;165:690-699. doi: 10.7326/M16-0317

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