About the CRAFFT

The CRAFFT is a efficient and effective health screening tool designed to identify substance use, substance-related riding/driving risk, and substance use disorder among youth ages 12-21. It has been implemented as part of universal screening efforts in thousands of busy medical and community health settings, as it yields information that can serve as the basis for early intervention and patient-centered counseling.

The CRAFFT is the most well-studied adolescent substance use screener available and has been shown to be valid for adolescents from diverse socioeconomic and racial/ethnic backgrounds. It is recommended by the American Academy of Pediatrics’ Bright Futures Guidelines for preventive care screenings and well-visits, the Center for Medicaid and CHIP Services’ Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program, and the National Institute of Alcohol Abuse and Alcoholism (NIAAA) Youth Screening Guide.

The current version of the tool, the CRAFFT 2.1, includes evidence-based revisions to increase the sensitivity and specificity of the tool and includes vaping as a method of administration for marijuana use.


CeASAR Researchers


  1. Harris SK, Knight JR, Van Hook S, Sherritt L, Brooks T, Kulig JW, Nordt C, Saitz R. Adolescent substance use screening in primary care: validity of computer self-administered vs. clinician adminstered screening. Subst Abus March 2015; 1-7.
  2. Harris SK, Louis-Jacques J, Knight JR. Screening and brief intervention for alcohol and other abuse. Adolesc Med State Art Rev. 2014;25(1):126-156.
  3. Hassan A, Harris SK, Sherritt L, Van Hook S, Brooks T, Carey P, Kossack R, Kulig J, Knight JR. Primary care follow-up plans for adolescents with substance use problems. Pediatr 2009;124;144-150.
  4. Knight JR, Kuzubova K, Csemy L, Sherritt L, Copelas S, Harris SK. Computer-Facilitated Screening and Brief Advice to Reduce Adolescents’ Heavy Episodic Drinking: A Study in Two Countries. Journal of Adolescent Health.
  5. Knight JR, Shrier LA, Bravender TD, Farrell M, Vander Bilt J, Shaffer HJ. A new brief screen for adolescent substance abuse. Arch Pediatr Adolesc Med. 1999;153(6):591-596.
  6. Knight JR, Sherritt L, Shrier LA, Harris SK, Chang G. Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Arch Pediatr Adolesc Med. 2002;156(6):607-614.
  7. Knight JR, Sherritt L, Harris SK, Gates EC, Chang G. Validity of brief alcohol screening tests among adolescents: A comparison of the AUDIT, POSIT, CAGE and CRAFFT. Alcohol Clin Exp Res 2002;27:67-73.
  8. Knight JR, Harris SK, Sherritt L, Van Hook S, Lawrence N, Brooks T, Carey P, Kossack R, Kulig J. Prevalence of positive substance abuse screen results among adolescent primary care patients. Arch Pediatr Adolesc Med. Nov 2007;161(11):1035-1041.
  9. Levy S, Sherritt L, Gabrielli J, Shrier L, Knight JR. Screening adolescents for substance use-related high-risk sexual behaviors. J Adolesc Health 2009:45;473-7.
  10. Levy S, Sherritt L, Harris SK, et al. Test-retest reliability of adolescents’ self-report of substance use. Alcohol Clin Exp Res. 2004;28(8):1236-1241. .
  11. Rojas NL, Sherritt L, Harris SK, Knight JR. The role of parental consent in adolescent substance use research. J Adolesc Health 2008;42:192-7.

Posters and Presentations

  1. Flynn A, Knight JR, Sherrit L, Harris SK. Does Perceived Risk of harm Mediate the Effects of a Primary Care Alcohol Screening and Brief Advice Intervention for Adolescents?Association for Medical Education and Research in Substance Abuse annual conference, Washington D.C., 2017.
  2. Gibson EB, Knight JR, Finlayson J, Sherritt L, Harris SK. Clinician’s Responses to a Computer-Facilitated Substance Use Screening and Brief Advice System for Primary Care. Poster presented at Association for Medical Education and Research in Substance Abuse annual conference, Washington D.C., 2017.
  3. Harris SK, Sherritt L, Gibson EB, et al. Primary Care Testing of the National Institute for Alcohol Abuse and Alcoholism’s (NIAAA) Youth Screener for Identifying Underage Alcohol Use Severity. Association for Medical Education and Research in Substance Abuse annual conference, Washington D.C., 2017.
  4. Harris SK, Sherritt L, Copelas S, Knight JR, Research P for ASA. Reliability and Validity of Past-12-Month Frequency Items as Opening Questions for the Updated CRAFFT Adolescent Substance Use Screening System. Poster presented at Association for Medical Education and Research in Substance Abuse annual conference, Washington D.C., 2016.
  5. Showalter E, Knight JR, Sherritt L, Harris SK. Is screentime important?: Efficacy of a computer-facilitated brief intervention for reducing adolescent substance use is predicted by viewing time. Association for Medical Education and Research in Substance Abuse annual conference, Washington D.C., 2016.
  6. Harris SK, Sherrit L, Copelas S, Knight JR, Partnership for Adolescent Substance Abuse Research. Reliabilty and validity of past-12-month frequence items as opening questions for the updated CRAFFT adolescent substance use screening system. International Network for Brief Interventions for Alcohol and Other Drugs, Lausanne, Switzerland, 2016.

External Researchers

  1. Abbott PJ. Screening American Indian/Alaska natives for alcohol abuse and dependence in medical settings. Curr Drug Abuse Rev. 2011;4(4):210-214. http://www.ncbi.nlm.nih.gov/pubmed/21999696.
  2. Agley J, Gassman RA, Jun M, Nowicke C, Samuel S. Statewide Administration of the CRAFFT Screening Tool: Highlighting the Spectrum of Substance Use. Subst Use Misuse. 2015;50(13):1668-1677.
  3. Alayan N, Shell L. Screening adolescents for substance use: The role of NPs in school settings. Nurse Pract. 2016;41(5):1-6.
  4. Alderson H, McGovern R, Brown R, et al. Supporting Looked After Children and Care Leavers In Decreasing Drugs, and alcohol (SOLID): protocol for a pilot feasibility randomised controlled trial of interventions to decrease risky substance use (drugs and alcohol) and improve mental health of look. 2017;3(1):25.
  5. Araújo P, Carvalho MGN, van Weelden M, Lourenço B, Queiroz LB, Silva CA. Substance misuse and sexual function in adolescents with chronic diseases. Rev Paul Pediatr. 2016;34(3):323-329.
  6. Arnaud N, Baldus C, Elgán TH, et al. Effectiveness of a Web-Based Screening and Fully Automated Brief Motivational Intervention for Adolescent Substance Use: A Randomized Controlled Trial. J Med Internet Res. 2016;18(5):e103.
  7. Amaud N, Bröning S, Drechsel M, Thomasius R, Baldus C. Web-based screening and brief intervention for poly-drug use among teenagers: study protocol of a multicentre two-arm randomized controlled trial. BMC Public Health. 2012;12(1):826.
  8. Atilola O, Ayinde O, Adeitan O. Beyond prevalence and pattern: problematic extent of alcohol and substance use among adolescents in Ibadan South-west Nigeria. Afr Health Sci. 2013;13(3):777-784.
  9. Atilola O, Ola B, Abiri G, et al. Status of mental-health services for adolescents with psychiatric morbidity in youth correctional institutions in Lagos. 2017;29(1):63-83. doi:10.2989/17280583.2017.1321550.
  10. Atilola O, Stevanovic D, Balhara YPS, et al. Role of personal and family factors in alcohol and substance use among adolescents: an international study with focus on developing countries. J Psychiatr Ment Health Nurs. 2014;21(7):609-617.
  11. Bagley SM, Anderson BJ, Stein MD. Usefulness of the CRAFFT to Diagnose Alcohol or Cannabis Use Disorders in a Sample of Emerging Adults with Past-Month Alcohol or Cannabis Use. J Child Adolesc Subst Abuse. 2017;26(1):18-23.
  12. Beeley P, Scriba CJ. [In search of new paths. The self image of the Leopoldina and the Royal Society in London in its correspondence 1670-1677]. Acta Hist Leopoldina. 2008;(49):305-326. http://www.ncbi.nlm.nih.gov/pubmed/20617620.
  13. Bertini MC, Busaniche J, Baquero F, et al. Transcultural adaptation and validation of the CRAFFT as a screening test for problematic alcohol and substance use, abuse and dependence in a group of Argentine adolescents. Arch Argent Pediatr. 2015;113(2):114-118.
  14. Braaten K, Briegleb C, Hauke S, Niamkey N, Chang G. Screening pregnant young adults for alcohol and drug use: a pilot study. J Addict Med. 2008;2(2):74-78.
  15. Burke PJ, O’Sullivan J, Vaughan BL. Adolescent substance use: brief interventions by emergency care providers. Pediatr Emerg Care. 2005;21(11):770-776. http://www.ncbi.nlm.nih.gov/pubmed/16280955.
  16. Chang G, Orav EJ, Jones JA, Buynitsky T, Gonzalez S, Wilkins-Haug L. Self-reported alcohol and drug use in pregnant young women: a pilot study of associated factors and identification. J Addict Med. 2011;5(3):221-226.
  17. Christie G, Marsh R, Sheridan J, et al. The substances and choices scale (SACS)–the development and testing of a new alcohol and other drug screening and outcome measurement instrument for young people. Addiction. 2007;102(9):1390-1398.
  18. Connery HS, Albright BB, Rodolico JM. Adolescent substance use and unplanned pregnancy: strategies for risk reduction. Obstet Gynecol Clin North Am. 2014;41(2):191-203.
  19. Cook RL, Chung T, Kelly TM, Clark DB. Alcohol screening in young persons attending a sexually transmitted disease clinic. Comparison of AUDIT, CRAFFT, and CAGE instruments. J Gen Intern Med. 2005;20(1):1-6.
  20. Cote-Menendez, M., Uribe-Isaza, M., & Prieto-Suárez, E. (2013). Validación para Colombia de la escala Crafft para tamización de consumo de sustancias psicoactivas en adolescentes. Revista de Salud Pública, 15(2), 220–232.
  21. Cummins LH, Chan KK, Burns KM, Blume AW, Larimer M, Marlatt GA. Validity of the CRAFFT in American-Indian and Alaska-Native adolescents: screening for drug and alcohol risk. J Stud Alcohol. 2003;64(5):727-732. http://www.ncbi.nlm.nih.gov/pubmed/14572196.
  22. D’Amico EJ, Parast L, Meredith LS, Ewing BA, Shadel WG, Stein BD. Screening in Primary Care: What Is the Best Way to Identify At-Risk Youth for Substance Use? Pediatrics. 2016;138(6).
  23. Dhalla S, Zumbo BD, Poole G. A review of the psychometric properties of the CRAFFT instrument: 1999-2010. Curr Drug Abuse Rev. 2011;4(1):57-64. http://www.ncbi.nlm.nih.gov/pubmed/21466499.
  24. Dieppe C, Stanhope B, Rakhra K. Children who harm themselves: development of a paediatric emergency department triage tool. Emerg Med J. 2009;26(6):418-420.
  25. Diestelkamp S, Kriston L, Arnaud N, et al. Drinking patterns of alcohol intoxicated adolescents in the emergency department: A latent class analysis. Addict Behav. 2015;50:51-59.
  26. Falck RS, Nahhas RW, Li L, Carlson RG. Surveying teens in school to assess the prevalence of problematic drug use. J Sch Health. 2012;82(5):217-224.
  27. Gabrielli J, Jackson Y, Brown S. Associations Between Maltreatment History and Severity of Substance Use Behavior in Youth in Foster Care. Child Maltreat. September 2016.
  28. Gamarel KE, Nelson KM, Brown L, Fernandez MI, Nichols S, Adolescent Medicine Trials Network for HIV/AIDS Intervention. The Usefulness of the CRAFFT in Screening for Problematic Drug and Alcohol Use Among Youth Living with HIV. AIDS Behav. 2017;21(7):1868-1877.
  29. Golpe S, Gómez P, Braña T, Varela J, Rial A. The relationship between consumption of alcohol and other drugs and problematic Internet use among adolescents. Adicciones. 2017;0(0):959.
  30. Griswold KS, Aronoff H, Kernan JB, Kahn LS. Adolescent substance use and abuse: recognition and management. Am Fam Physician. 2008;77(3):331-336. http://www.ncbi.nlm.nih.gov/pubmed/18297958.
  31. Gryczynski J, Kelly SM, Mitchell SG, Kirk A, O’Grady KE, Schwartz RP. Validation and performance of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) among adolescent primary care patients. Addiction. 2015;110(2):240-247.
  32. Ha C, Balderas JC, Zanarini MC, Oldham J, Sharp C. Psychiatric comorbidity in hospitalized adolescents with borderline personality disorder. J Clin Psychiatry. 2014;75(5):e457-64.
  33. Harris SK, Knight JR, Van Hook S, et al. Adolescent substance use screening in primary care: Validity of computer self-administered versus clinician-administered screening. Subst Abus. 2016;37(1):197-203.
  34. Johnson KN, Raetz A, Harte M, et al. Pediatric trauma patient alcohol screening: a 3 year review of screening at a Level I pediatric trauma center using the CRAFFT tool. J Pediatr Surg. 2014;49(2):330-332.
  35. Jull A. The CRAFFT test was accurate for screening for substance abuse among adolescent clinic patients. Evid Based Nurs. 2003;6(1):23. http://www.ncbi.nlm.nih.gov/pubmed/12546041.
  36. Kandemir H, Aydemir Ö, Ekinci S, Selek S, Kandemir SB, Bayazit H. Validity and reliability of the Turkish version of CRAFFT Substance Abuse Screening Test among adolescents. Neuropsychiatr Dis Treat. 2015;11:1505-1509.
  37. Karila L, Legleye S, Beck F, Corruble E, Falissard B, Reynaud M. [Validation of a questionnaire to screen for harmful use of alcohol and cannabis in the general population: CRAFFT-ADOSPA]. Presse Med. 2007;36(4 Pt 1):582-590.
  38. Kelly TM, Donovan JE, Chung T, Bukstein OG, Cornelius JR. Brief screens for detecting alcohol use disorder among 18-20 year old young adults in emergency departments: Comparing AUDIT-C, CRAFFT, RAPS4-QF, FAST, RUFT-Cut, and DSM-IV 2-Item Scale. Addict Behav. 2009;34(8):668-674.
  39. Kelly TM, Donovan JE, Chung T, Cook RL, Delbridge TR. Alcohol use disorders among emergency department-treated older adolescents: a new brief screen (RUFT-Cut) using the AUDIT, CAGE, CRAFFT, and RAPS-QF. Alcohol Clin Exp Res. 2004;28(5):746-753. http://www.ncbi.nlm.nih.gov/pubmed/15166649.
  40. Knight JR, Harris SK, Sherritt L, et al. Adolescents’ preference for substance abuse screening in primary care practice. Subst Abus. 2007;28(4):107-117.
  41. Levy S, Sherritt L, Gabrielli J, Shrier LA, Knight JR. Screening adolescents for substance use-related high-risk sexual behaviors. J Adolesc Health. 2009;45(5):473-477.
  42. Levy S, Sherritt L, Harris SK, et al. Test-retest reliability of adolescents’ self-report of substance use. Alcohol Clin Exp Res. 2004;28(8):1236-1241. http://www.ncbi.nlm.nih.gov/pubmed/15318123.
  43. Lippard ETCC, Mazure CM, Johnston JAYY, et al. Brain circuitry associated with the development of substance use in bipolar disorder and preliminary evidence for sexual dimorphism in adolescents. 2017;95(1-2):777-791.
  44. McCabe SE, West BT, Teter CJ, Cranford JA, Ross-Durow PL, Boyd CJ. Adolescent nonmedical users of prescription opioids: brief screening and substance use disorders. Addict Behav. 2012;37(5):651-656.
  45. Mitchell SG, Kelly SM, Gryczynski J, et al. The CRAFFT cut-points and DSM-5 criteria for alcohol and other drugs: a reevaluation and reexamination. Subst Abus. 2014;35(4):376-380.
  46. Moreno MA, Briner LR, Williams A, Brockman L, Walker L, Christakis DA. A content analysis of displayed alcohol references on a social networking web site. J Adolesc Health. 2010;47(2):168-175.
  47. Nazerfard E, Cook DJ. CRAFFT: An Activity Prediction Model based on Bayesian Networks. J Ambient Intell Humaniz Comput. 2015;6(2):193-205.
  48. Nevitt JR, Lundak J, Galardi G. A profile of adolescent alcohol offenders in two rural Midwestern counties. Psychol Rep. 2006;98(2):379-384.
  49. Ng JWL, Kwan R, Cheok CCS. Clinical and Functional Outcomes in Young Adult Males With ADHD. 2017;21(6):465-474.
  50. Oesterle TS, Hitschfeld MJ, Lineberry TW, Schneekloth TD. CRAFFT as a Substance Use Screening Instrument for Adolescent Psychiatry Admissions. J Psychiatr Pract. 2015;21(4):259-266.
  51. Patton R, Deluca P, Kaner E, Newbury-Birch D, Phillips T, Drummond C. Alcohol screening and brief intervention for adolescents: the how, what and where of reducing alcohol consumption and related harm among young people. Alcohol Alcohol. 2014;49(2):207-212.
  52. Pereira BA de AX, Schram PFC, Azevedo RCS de. Avaliação da versão brasileira da escala CRAFFT/CESARE para uso de drogas por adolescentes. Cien Saude Colet. 2016;21(1):91-99.
  53. Pilowsky DJ, Wu L-T. Screening instruments for substance use and brief interventions targeting adolescents in primary care: a literature review. Addict Behav. 2013;38(5):2146-2153.
  54. Ramos MM, Warner T, Rosero D, Condon TP. A Clinical Instrument to Guide Brief Interventions for Adolescents with Substance Use Concerns. Subst Abus. August 2017:0.
  55. Rojas NL, Sherrit L, Harris S, Knight JR. The role of parental consent in adolescent substance use research. J Adolesc Health. 2008;42(2):192-197.
  56. Rumpf H-J, Wohlert T, Freyer-Adam J, Grothues J, Bischof G. Screening questionnaires for problem drinking in adolescents: performance of AUDIT, AUDIT-C, CRAFFT and POSIT. Eur Addict Res. 2013;19(3):121-127.
  57. Sarkar M, Burnett M, Carrière S, et al. Screening and recording of alcohol use among women of child-bearing age and pregnant women. Can J Clin Pharmacol. 2009;16(1):e242-63. http://www.ncbi.nlm.nih.gov/pubmed/19372602.
  58. Sivertsen B, Skogen JC, Jakobsen R, Hysing M. Sleep and use of alcohol and drug in adolescence. A large population-based study of Norwegian adolescents aged 16 to 19 years. Drug Alcohol Depend. 2015;149:180-186.
  59. Skogen JC, Bøe T, Knudsen AK, Hysing M. Psychometric properties and concurrent validity of the CRAFFT among Norwegian adolescents. Ung@hordaland, a population-based study. Addict Behav. 2013;38(10):2500-2505.
  60. Skogen JC, Sivertsen B, Lundervold AJ, Stormark KM, Jakobsen R, Hysing M. Alcohol and drug use among adolescents: and the co-occurrence of mental health problems. Ung@hordaland, a population-based study. BMJ Open. 2014;4(9):e005357.
  61. STEMBRIDGE VA, CRAFFT WM, TOWNSEND FM. Medical investigation of aircraft accidents with multiple casualties. J Aviat Med. 1958;29(9):668-675. http://www.ncbi.nlm.nih.gov/pubmed/13575373
  62. Subramaniam M, Cheok C, Verma S, Wong J, Chong SA. Validity of a brief screening instrument-CRAFFT in a multiethnic Asian population. Addict Behav. 2010;35(12):1102-1104.
  63. Subramaniam M, Verma S, Cheok C, Lee I-M, Wong J, Chong SA. Prevalence and correlates of psychotic symptoms among Asian males. Soc Psychiatry Psychiatr Epidemiol. 2012;47(1):137-144.
  64. Suwała M. [Alcohol and other psychoactive substances addiction risk assessment among chosen high school students test group]. Przegl Lek. 2014;71(11):620-623. http://www.ncbi.nlm.nih.gov/pubmed/25799857.
  65. Tanney MR, Naar-King S, MacDonnel K, Adolescent Trials Network for HIV/AIDS Interventions 004 Protocol Team. Depression and stigma in high-risk youth living with HIV: a multi-site study. 2012;26(4).
  66. Tanney MR, Naar-King S, Murphy DA, Parsons JT, Janisse H, ATN 004 Protocol Team. Multiple risk behaviors among youth living with human immunodeficiency virus in five U.S. cities. J Adolesc Health. 2010;46(1):11-16.
  67. Tossmann P, Kasten L, Lang P, Strüber E. [Determination of the concurrent validity of the CRAFT-d – a screening instrument for problematic alcohol consumption]. Z Kinder Jugendpsychiatr Psychother. 2009;37(5):451-459.
  68. van Weelden M, Lourenço B, Viola GR, Aikawa NE, Queiroz LB, Silva CA. Substance use and sexual function in juvenile idiopathic arthritis. Rev Bras Reumatol. 2016;56(4):323-329. http://www.ncbi.nlm.nih.gov/pubmed/26924004.
  69. van Weelden M, Queiroz LB, Lourenço DMR, Kozu K, Lourenço B, Silva CA. Alcohol, smoking and illicit drug use in pediatric systemic lupus erythematosus patients. Rev Bras Reumatol. 2016;56(3):228-234.
  70. Wartberg L, Diestelkamp S, Arnaud N, Thomasius R. [Psychosocial Characteristics of Adolescents Treated for Alcohol Intoxication in Emergency Departments]. Prax Kinderpsychol Kinderpsychiatr. 2016;65(7):516-533.
  71. Wartberg L, Kriston L, Diestelkamp S, Arnaud N, Thomasius R. Psychometric properties of the German version of the CRAFFT. Addict Behav. 2016;59:42-47.
  72. Wilson CR, Sherritt L, Gates E, Knight JR. Are clinical impressions of adolescent substance use accurate? Pediatrics. 2004;114(5):e536-40.
  73. Young A, Grey M, Abbey A, Boyd CJ, McCabe SE. Alcohol-Related Sexual Assault Victimization Among Adolescents: Prevalence, Characteristics, and Correlates. J Stud Alcohol Drugs. 2008;69(1):39-48.