MDCalc

The Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) Questionnaire

Screens for substance use risk in adolescents.

This tool reflects CRAFFT 2.1.

Part A
Please ask your patient the following questions: During the past 12 months, how many days did you...

Drink more than a few sips of beer, wine, or any drink containing alcohol?

Use any marijuana (cannabis, weed, oil, wax, or hash, by smoking, vaping, dabbing, or in edibles) or "synthetic marijuana" (like "K2," "Spice")?

Use anything else to get high (like other illegal drugs, pills, prescription or over-the-counter medications, and things that you sniff, huff, vape, or inject)?

Part B
Please ask your patient the following question(s):

Have you ever ridden in a CAR driven by someone (including yourself) who was "high" or had been using alcohol or drugs?

Result:

Please fill out required fields.
Advice

  • Adolescents who screen positive (score ≥ 2) should undergo further evaluation to formally diagnose a substance use disorder.

  • Additional questions and discussions should follow any “yes” answer. This will guide management plans, counseling, and support measures.

  • The “CAR” question is considered especially important, as young patients are at risk even if they do not use alcohol or drugs themselves. This warrants further information gathering, advice, action plans, and follow-up.

  • ”Red flag” behaviors (e.g., using substances alone, episodes of amnesia due to substance use) may necessitate a referral to a treatment specialist.

  • For more guidance, refer to the American Academy of Pediatrics’ clinical report.
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