About the CRAFFT

The CRAFFT is an 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. The CRAFFT 2.1+N contains additional questions about tobacco and nicotine use.



CABHRe Researchers


  1. 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.
  2. 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.
  3. 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.
  4. 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. .
  5. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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.
  10. Harris SK, Knight JR. Putting the screen in screening: technology-based alcohol screening and brief interventions in medical settings. Alcohol Research: Current Reviews. 2014;36(1):63-79
  11. Hadland SE, Harris SK. Youth marijuana use: state of the science for the practicing clinician. Current Opinions in Pediatrics. 2014 Aug;26(4):420-7.
  12. 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.
  13. Hadland SE, Knight JR, Harris SK. Medical marijuana: review of the science and implications for developmental behavioral pediatric practice. Journal of Developmental Behavioral Pediatrics. 2015 Feb-Mar;36(2):115-23.
  14. D’Souza-Li L, Harris SK. The future of Screening, Brief Intervention, and Referral to Treatment in adolescent primary care: research directions and dissemination challenges. Current Opinions in Pediatrics. 2016 Aug;28(4):434-40.
  15. Johnson JK, Johnson RM, Hodgkin D, Jones AA, Matteucci AM & Harris SK. Heterogeneity of state medical marijuana laws and adolescent recent use of alcohol and marijuana: Analysis of 45 states, 1991-2011. Subst Use. 2017; 39.
  16. Hadland SE, Copelas SH, Harris SK. Trajectories of substance use frequency among adolescents seen in primary care: implications for screening. Journal of Pediatrics. 2017 May;184:178-185.
  17. Harris SK, Aalsma MC, Weitzman ER, Garcia-Huidobro D, Wong C, Hadland SE, Santelli J, Park MJ, Ozer EM. Research on clinical preventive services for adolescents and young adults: where are we and where do we need to go? Journal of Adolescent Health, 2017 Mar;60(3):249-260. PMCID: PMC5549464.
  18. Gómez P, Harris SK, Barreiro C, Isorna M, Rial A. Profiles of Internet use and parental involvement, and rates of online risks and problematic Internet use among Spanish adolescents. Computers in Human Behavior. 2017;75:826-833.
  19. Golpe S, Gómez P, Harris SK, Braña T, Rial A. Gender differences in the use of the Internet among Spanish adolescents. Behavioral Psychology / Psicología Conductual: Revista Internacional Clínica y de la Salud. 2017;25(1):129-146.
  20. Levy S, Ziemnik RE, Harris SK, Rabinow L, Breen L, Fluet C, Strother H, Straus JH. Screening adolescents for alcohol use: tracking practice trends of Massachusetts pediatricians. Journal of Addiction Medicine. 2017 Nov/Dec;11(6):427-434.
  21. O’Brien KHM, Knight JR, Harris SK. A Call for Social Responsibility and Suicide Risk Screening, Prevention and Early Intervention Following the Release of the Netflix Streaming Series, 13 Reasons Why. JAMA Internal Medicine. 2017 Oct 1;177(10):1418-1419. PubMed PMID: 28759674.
  22. Shrier LA, Sarda V, Jonestrask C, Harris SK. Momentary factors during marijuana use as predictors of lapse during attempted abstinence in young adults. Addictive Behaviors. 2018. 83:167-174. doi: 10.1016/j.addbeh.2017.12.032.
  23. Sneider JT, Cohen-Gilbert JE, Hamilton DE, Stein ER, Golan N, Oot EN, Seraikas AM, Rohan ML,Harris SK, Nickerson LD, Silveri MM. Adolescent hippocampal and prefrontal brain activation during performance of the virtual Morris Water Task. Frontiers in Human Neuroscience. 2018; Volume 12; Article 238. doi: 10.3389/fnhum.2018.00238.
  24. Rial A, Harris SK, Knight JR, Araujo M, Gómez  P**, Braña T, Varela J, Golpe  Empirical validation of the CRAFFT abuse screening test in a Spanish sample: Psychometric properties and recommendations. Adicciones. 2018 Jan 15;0(0):1105. doi: 10.20882/adicciones.1105.
  25. Harris SK, Johnson J, Knight JR. Governmental Policy on Cannabis Legalization and Cannabis as Medicine: Impact on Youth. In The ASAM Principles of Addiction Medicine, Sixth Edition, ed. by SC Miller, DA Fiellin, RN Rosenthal, R Saitz. Philadelphia, PA: Lippincott Williams & Wilkins. 2018.
  26. Brooks TL, Knight JR, Harris SK. Screening and brief intervention for adolescents. In The ASAM Principles of Addiction Medicine, Sixth Edition, ed. by SC Miller, DA Fiellin, RN Rosenthal, R Saitz. Philadelphia, PA: Lippincott Williams & Wilkins. 2018.
  27. 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. 2018 Jan;62(1):118-120. doi: 10.1016
  28. Knight JR, Csemy L, Sherritt L, et al. Screening and brief advice to reduce adolescents’ risk of riding with substance-using drivers. J Stud Alcohol Drugs. 2018; 79(4): 611-616. 
  29. Shrier LA, Burke PJ, Kells M, Scherer EA, Sarda V, Jonestrask CJ, Xuan Z, Harris SK. Pilot randomized trial of MOMENT, a motivational counseling-plus-Ecological Momentary Intervention to reduce marijuana use in youth. mHealth. 2018 Jul 30;4:29. doi: 10.21037/mhealth.2018.07.04. eCollection 2018.
  30. McCarty C, Levy, S, Harris SK. Alcohol Use Screening and Behavioral Counseling with Adolescents in Primary Care: A Call to Action. JAMA Pediatrics. 2019 Jan 1;173(1):12-14. doi: 10.1001/jamapediatrics.2018.4171.
  31. Chadi N, Hadland SE, Harris SK. Understanding the implications of the “vaping epidemic” among adolescents and young adults: A call to action. Subst Abus. 2019;18:1-4.
  32. Hadland SE, Knight JR, Harris SK. Alcohol use disorder: A pediatric-onset condition needing early detection and intervention. Pediatrics. 2019;143(3). 
  33. Knight JR, Sherritt L, Gibson EB, Levinson J, Grubb LK, Samuels RC, Silva T, Vernacchio L, Wornham W, Harris SK. Effect of computer-based substance use screening and brief behavioral counseling vs. usual care for adolescents in pediatric primary care: a pilot randomized clinical trial. JAMA Network Open. 2019 Jun 5;2(6):e196258. doi: 10.1001/jamanetworkopen.2019.6258.
  34. Levy S, Wiseblatt A, Straus JH, Strother H, Fluet C,Harris SK.Adolescent SBIRT practices among pediatricians in Massachusetts. Journal of Addiction Medicine. June 5, 2019 – Volume Publish Ahead of Print – Issue – p doi: 10.1097/ADM.0000000000000551
  35. Chen Y, Harris SK, Worthington EL, VanderWeele TJ. Religiously or spiritually-motivated forgiveness and subsequent health and well-being among young adults: an outcome-wide analysis. Journal of Positive Psychology. 2019;14(5):649-658. doi: 10.1080/17439760.2018.1519591.
  36. Ganapathi L, McFall AL, Srikrishnan AL, Kumar MS, Anand S, Lucas GM, Mehta S, Harris SK, Solomon S. Young people who inject drugs in India have high HIV incidence and behavioural risk: a cross-sectional study. Journal of the International AIDS Society. 2019 May, 22:e25287. doi: 10.1002/jia2.25287.
  37. Knight JR, Sherritt L, Gibson EB, Levinson J, Grubb LK, Samuels RC, Silva T, Vernacchio L, Wornham W, Harris SK. Effect of computer-based substance use screening and brief behavioral counseling vs. usual care for adolescents in pediatric primary care: a pilot randomized clinical trial. JAMA Network Open. 2019 Jun 5;2(6):e196258. doi: 10.1001/jamanetworkopen.2019.6258.
  38. Maksimovskiy A, Oot E, Seraikas A, Rieselbach M, Caine C, Sneider J, Cohen-Gilbert J, Harris SK, Nickerson L, Rohan M, Silveri M. Morphometric biomarkers of adolescents with familial risk for alcohol use disorder. Alcoholism: Clinical and Experimental Research. 2019 Nov;43(11):2354-2366. doi: 10.1111/acer.14201.
  39. Hassan A, Harris SK, Knight JR. Screening, Brief Intervention and Referral to Treatment (SBIRT) in a Primary Care and Pediatric Setting. Clinical Manual of Youth Addictive Disorders. Ed. by Y Kaminer, K Winters. Washington, D.C.: American Psychiatry Association Publishing. 2019.
  40. Shrier LA, Xuan Z, Harris SK. Changes in cannabis use-related factors prior to a self-quit attempt in young adults. Cannabis. 2020; 3(1):31-40.
  41. Gibson EB, Knight JR, Levinson J, Sherritt L, Harris SK. Pediatric primary care provider perspectives on a computer-facilitated screening and brief intervention system for adolescent substance use. Journal of Adolescent Health. Nov 1;S1054-139X(20)30590-5. doi: 10.1016/j.jadohealth.2020.09.037. Online ahead of print.
  42. Liu J, Halpern-Felsher B, Harris SK. Does tobacco screening in youth primary care identify youth vaping? Journal of Adolescent Health. 2021 Feb 17:S1054-139X(21)00045-8. doi: 10.1016/j.jadohealth.2021.01.017. Online ahead of print. PMID: 33610402
  43. Johnson JK., Johnson RM., Hodgkin D., Jones AA., Kritikos A, Doonan SM., Harris SK. Medical marijuana laws (MMLs) and dispensary provisions not associated with higher odds of adolescent marijuana or heavy marijuana use: a 46 state analysis, 1991-2015. Substance Abuse. 2021 Mar 22:1-5. doi: 10.1080/08897077.2021.1900986. Online ahead of print. PMID: 33750275
  44. Lin JA, Harris SK, Shrier LA. Trait mindfulness and cannabis use-related factors in adolescents and young adults with frequent use. Substance Abuse. 2021 Apr 2:1-6. doi: 10.1080/08897077.2021.1901179. Online ahead of print. PMID: 33798028
  45. Kuzubova K, Knight JR, Harris SK. Adolescent gender and age differences in religiously and spiritually-motivated types of forgiveness and their relationship to depressive symptoms. Journal of Religion and Health. 2021 Mar 6. doi: 10.1007/s10943-021-01217-6. Online ahead of print. PMID: 33677784

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. 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.
  6. 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.

External Researchers

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