To address the urgent need for brief screening tools in keeping with the national priority to improve screening and treatment for SUDs (SAMHSA, 2010a; Office of National Drug Control Policy, 2010), we evaluated item-level psychometric (IRT) and classification (ROC-AUC) information of substance-specific dependence questions for five SUDs in a large sample of treatment-seeking, opioid-dependent adults. Across five substances, withdrawal was among the least prevalent symptoms, while taking large amounts and inability to cut down were among the most prevalent symptoms. IRT analysis provided support for the concept that items closely related to the underlying latent trait of a SUD showed good-to-high ROC-AUC values in identifying cases of SUDs (taking large amounts, inability to cut down, tolerance, medical/psychological problems), and severe and less discriminative items exhibited low sensitivity and a fair ROC-AUC in identifying a SUD (withdrawal for all substances; time using for alcohol and sedatives; giving up activities for sedatives). These results demonstrate the feasibility of applying IRT and ROC-AUC procedures to select dependence symptom items to develop an efficient, reasonably sensitive, and simplified tool to screen for SUDs in
