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

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.