BACKGROUND: Psychoactive drug use is an important public health issue in Sri Lanka as it causes substantial health, social and economic burden to the country. Screening for substance use disorders in people who use drugs is vital in preventive health care, as it can help to identify problematic use early. Screening can aid in referring those in need, for the most appropriate treatment and care. Thus, preventing them from developing severe substance use disorders with complications. The Drug Abuse Screening Test (DAST-10) is an evidence-based tool widely used to assess the severity of psychoactive drug use. This study aimed to culturally adapt and evaluate the validity and reliability of the Drug Abuse Screening Test (DAST-10) in Sri Lanka.
METHODS: The DAST-10 was culturally adapted, and the nine-item Sinhala version (DAST-SL) was validated using exploratory and confirmatory factor analysis. The validation study was conducted in the Kandy district among people who use drugs, recruited using respondent-driven sampling. Criterion validity of the questionnaire was assessed by taking the diagnosis by a psychiatrist as the gold standard. Cut-off values for the modified questionnaire were developed by constructing Receiver Operating Characteristic (ROC) curves. The reliability of the DAST-SL was assessed by measuring its internal consistency and test re-test reliability.
RESULTS: The validated DAST-SL demonstrated a one-factor model. A cut-off value of ≥ 2 demonstrated the presence of substance use disorder and had a sensitivity of 98.7%, specificity of 91.7%, a positive predictive value of 98.8% and a negative predictive value of 91.3%. The area under the curve of the ROC curve was 0.98. A cut-off score of ≤ 1 was considered a low level of problems associated with drug use. The DAST-SL score of 2-3 demonstrated a moderate level of problem severity, a score of 4-6 demonstrated a substantial level of problems, and a score of ≥ 7 demonstrated a severe level of drug-related problems. The questionnaire demonstrated high reliability with an internal consistency of 0.80 determined by Kuder-Richardson Formula-20 and an inter-class correlation coefficient of 0.97 for test re-test reliability.
CONCLUSIONS: The DAST-SL questionnaire is a valid and reliable tool to screen for drug use problem severity in people who use drugs in Sri Lanka.

This study investigated the applicability of the Chinese versions of Drug Abuse Screening Test (DAST) to detect illicit substance use in college students.
The data arising from a campus prevention program, Screening for Illicit Substance Use in College (SISUC), were utilized to explore the psychometrics of 26 items (DAST-26) and 10 items (DAST-10) versions of DAST in college students (CS group). A group of youth with illicit substance use were enrolled as the Illicit Substance Use group (IS group). A set of self-report questionnaires, including the Chinese version of DAST, were administered.
A total of 1214 participants were recruited as the CS group and 208 as the IS group. The Cronbach\'s alpha of DAST-26 was 0.74 in CS and 0.90 in IS; while 0.59 in CS and 0.78 in IS for the DAST-10. At a cut-off of 4 for DAST-26, the sensitivity was 87 % and specificity 97 %. As to DAST-10, a cut-off of 2 produced the sensitivity of 86 % and specificity of 96 %. The area under the curve was 0.943 for DAST-26 and 0.940 for DAST-10. The confirmatory factor analyses found a single-factor solution for the DAST-26 and DAST-10.
With comparison to the DAST-26, the shorter version, DAST-10, may offer promise for detecting illicit substance use in college students.

Mitragyna speciosa (\'kratom\') contains mu opioid partial agonists. It is widely available, and occasionally used as a home remedy for opioid use disorder. The Drug Enforcement Agency considers kratom a drug of concern; however, prevalence of use and role in drug misuse are unknown. This study aimed to characterize kratom use in the United States.
Cross-sectional Survey of Non-Medical Use of Prescription Drugs (NMURx) Program, 2018 third quarter and 2019 first quarter.
A validated non-probability online survey in the United States.
A total of 59 714 respondents aged 18 years or older, weighted to represent the adult US population (n = 252 063 800).
In addition to prevalence of past-year kratom and other drug use, behavior proportions were estimated. The Drug Abuse Screening Test (DAST-10) estimated consequences of drug abuse.
The estimated prevalence of past-year kratom use in the adult US population was 0.8% [95% confidence interval (CI) = 0.7-0.9], representing 2 031 803 adults. Life-time prevalence was 1.3% (95% CI = 1.2-1.4), representing 3 353 624 adults. Kratom users were younger (mean 35 years, P < 0.001), with higher proportions of males (61.0 versus 48.6%, P < 0.001), students (14.1 versus 7.5%, P < 0.001) and health-care professionals (9.7 versus 4.5%, P < 0.001) and fewer bachelor\'s/advanced degree graduates (33.4 versus 42.6%, P < 0.001) compared with non-users. Results were inconclusive on whether there was a difference in kratom use by race, household income or employment status. Among those with past-year kratom use, 36.7% (95% CI = 32.1-41.3) non-medically used prescription opioids, 21.7% (95% CI = 18.0-25.5) used illicit opioids, 54.4% (95% CI = 49.5-59.3) used another illicit drug and 67.1% (95% CI = 62.5-71.8) used cannabis. The DAST-10 profile was more often substantial/severe in kratom users (21 versus 1%, P < 0.001) compared with non-users.
Estimated United States past-year prevalence of kratom use is 0.8%, and kratom users tend to have more serious substance abuse profiles than non-users or users of cannabis, alcohol or cigarettes. To our knowledge, this is the first description of kratom use at the national level.

This study aimed to investigate the validity and reliability of the Mandarin Chinese version of the Drug Abuse Screening Test (DAST-20) among adolescents, as well as examining the test\'s predictability with regard to the actual level of drug abuse.
A total of 100 adolescent participants were recruited with their consent, in which 49 were current drug users and 51 were non-users. Based on the frequency of their drug use, participants who had used drugs at least once every week during the past year were classified as regular users (34 participants); participants who had not reached the regular use frequency of once every week during the past year were classified as occasional users (15 participants). All of the participants were required to answer a sociodemographic questionnaire, and undergo a DAST-20 (Mandarin Chinese version).
The DAST-20, which has a high reliability with a Cronbach\'s alpha of 0.88, and a construct validity accounting for 61.87% of the variance. The area under the receiver operating characteristics (ROC) curve was 0.96 between the users and nonusers, and 0.93 between the occasional users and non-occasional users. A cut-off of three points could identify 93.5% of the drug users and 88.9% of nonusers, whereas a cut-off of six points could identify 85.3% of the regular users and 92.4% of non-regular users.
The DAST-20 was the strongest predictor of adolescents who were regular users, occasional users, and non-users after controlling for other potential covariates. The Mandarin Chinese version of the DAST is simple to use and has a satisfactory validity and reliability. It is an effective screening tool for drug users among adolescents.

Substance use disorders (SUDs) are significant risk factors for psychiatric relapses and hospitalizations in psychiatric populations. Unfortunately, no instrument has been validated for the screening of SUDs in psychiatric emergency settings. The Drug Abuse Screening Test (DAST) is widely used in the addiction field, but is has not been validated in that particular context. The objective of the current study is to examine the psychometric properties of the DAST administered to psychiatric populations evaluated in an emergency setting.
The DAST was administered to 912 psychiatric patients in an emergency setting, of which 119 had a SUD (excluding those misusing alcohol only). The internal consistency, the construct validity, the test-retest reliability and the predictive validity (using SUD diagnoses) of the DAST were examined. The convergent validity was also examined, using a validated impulsivity scale.
Regarding the internal consistency of the DAST, the Cronbach\'s alpha was 0.88. The confirmatory factor analysis showed that the DAST has one underlying factor. The test-retest reliability analysis produced a correlation coefficient of 0.86. ROC curve analyses produced an area under the curve of 0.799. Interestingly, a sex effect was observed. Finally, the convergent validity analysis showed that the DAST total score is specifically correlated with the sensation seeking dimension of impulsivity.
The results of this validation study shows that the DAST preserves its excellent psychometric properties in psychiatric populations evaluated in an emergency setting. These results should encourage the use of the DAST in this unstable clinical situation.