Implementation of the National Drug Control Strategy and current health care reform necessitates the expansion of screening for drug use problems to promote treatment of SUDs. To address this need, we examined substance dependence criteria as brief screeners for SUDs among 920 opioid-dependent adults. The data are drawn from an 11-site, randomized treatment trial for opioid dependence within the National Drug Abuse Treatment Clinical Trials Network (CTN). Data from this study include a geographically diverse sample of drug users with sufficient prevalences of substance-related problems that were assessed by the same diagnostic instrument so as to provide useful data about the relative values of screening items for alcohol and multiple drug use disorders commonly seen in clinical settings. In this study, we apply two-parameter item response theory (IRT), sensitivity, and specificity analyses to examine substance dependence criteria as potential screeners for SUDs. This IRT approach assumes that a latent severity trait underlies response patterns of SUDs measured by DSM-IV criteria, and recognizes item-level (criterion) variability in the discrimination and severity of the SUD severity continuum (Saha et al., 2006; Wu
