The UNCOPE: An Effective Brief Screen for DSM–5 Substance Use Disorders in Correctional Settings

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This study examines the clinical utility of the UNCOPE (Hoffmann, Hunt, Rhodes, & Riley, 2003), a brief 6-item screen that has been validated on a number of criminal justice involved populations (i.e., state prison and county jail inmates, recent arrestees, and juvenile offenders), in identifying risk for DSM–5 substance use disorders (SUDs) among a large sample of state prison inmates. Although the UNCOPE has demonstrated relatively good accuracy in identifying DSM–IV substance dependence, its utility for DSM–5 SUDs warrants investigation. The current study explored substance-specific UNCOPE screening for identifying DSM–5 diagnoses for alcohol, cocaine, and cannabis. Data for the present report were derived from routine consecutive clinical assessments of 6,871 male and 801 female inmates recently admitted to a state prison system. All inmates were administered the UNCOPE as part of a computer-prompted structured diagnostic interview conducted by certified addiction counselors during routine clinical assessments to identify SUDs. Results revealed that a cut-score of 3 positive responses yielded reasonable sensitivity estimates for a severe DSM–5 diagnosis ranging from 85% to 97%, depending on substance class and gender. Specificity findings for those without a severe diagnosis were very high and ranged from 97% to 99%. Cronbach’s alphas were .90 or greater, and the item intercorrelations were generally high. Observed findings suggest screening for specific substances using the UNCOPE is a potentially valid strategy for the identification of specific DSM–5 SUDs among inmates.

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