September 2019 65 The Validity of TCU Drug Screen 5 for Identifying Substance Use Disorders among Justice-Involved Youth Amanda L. Wiese Thomas R. Blue Danica Kalling Knight Kevin Knight Texas Christian University THE RATE OF SUBSTANCE 1 use (SU) among individuals involved in the juvenile justice (JJ) system is high. JJ-involved youth are nine times more likely to develop a sub- stance use disorder (SUD) when compared with youth who do not come into contact with the JJ system (Substance Abuse and Mental Health Services Administration, 2015). In fact, nationwide, 78 percent of JJ-involved youth report alcohol use, 85 percent report marijuana use, and 7 percent report opioid use (Zhang, 2004; Mulvey, Schubert, & Chassin, 2010; CASA, 2004; McClelland, Elkington, Teplin, & Abram, 2004). SU among this vul- nerable JJ population is related to increased risk of delinquent behavior as well as future recidivism (Aalsma et al., 2015; Schubert, Mulvey, & Glasheen, 2011). Identifying youth at risk of SUD as they enter the JJ system is an essential component of any approach designed to address SU and reducing recidivism risk (Farabee, Shen, Hser, Grella, & Anglin, 2001). As specified in the 1 Funding for this study was provided by the National Institute on Drug Abuse, National Institutes of Health (NIDA/NIH) through a grant to Texas Christian University (U01DA036224; Danica K. Knight, Principal Investigator). Interpretations and conclusions in this paper are entirely those of the authors and do not necessarily reflect the posi- tion of NIDA/NIH or the Department of Health and Human Services. risk-need-responsivity (RNR) model, three principles should guide assessment and treat- ment for persons involved in the justice system (Andrews, Bonta, & Hoge, 1990; Andrews, Bonta, & Wormith, 2011). The risk principle highlights the importance of first identifying an individual’s level of risk of future offending in order to determine the necessary level of program intensity. The need principle states that rehabilitation programs should place emphasis on targeting the needs of the indi- vidual that are directly related to his or her criminal behaviors. The responsivity principle underscores the importance of choosing an intervention that aligns with the individual’s learning style and capabilities. Increasingly, the RNR framework has been used to guide JJ system reforms and has resulted in systematic efforts to identify the unique needs of youth as agencies work toward lowering recidi- vism rates and increasing public safety (e.g., Schwartz, Barton, & Orlando, 1991; Seigle, Walsh, & Weber, 2014). According to the Juvenile Justice Behavioral Health Services Cascade (Belenko et al., 2017), the first step in a best-practice approach to addressing SU needs among youth is through universal and evidence-based screening. This means that all youth should be screened upon entry into the JJ system using a brief tool that has been validated through systematic research and that maps to clinically meaningful indica- tors of SU problems. Screening results above a given threshold should be used to trigger a comprehensive assessment, and information from both screening and assessment should inform the frequency, intensity, and content of recommended treatment services (Belenko et al., 2017). JJ agencies, however, often fall short of screening 100 percent of youth. Indeed, only 78 percent of youth who enter the JJ sys- tem ever receive a screening instrument, and only 52 percent ever receive a full assessment (Dennis et al., 2018). As a result, only 65 per- cent of youth entering the JJ system have their needs identified (Dennis et al., 2018). Furthermore, many existing SU screen- ers in use with JJ-involved youth are not validated and/or do not map directly onto state-of-the-art clinical diagnostic tools such as the Diagnostic and Statistical Manual of Mental Disorders V-R (DSM-5; American Psychiatric Association, 2013). While com- monly used within JJ setting, risk assessment tools that include SU items are not designed to diagnose SU or mental health problems (Vincent, Guy, & Grisso, 2012); yet many JJ agencies rely solely on risk and need assessments when making SU referral deci- sions. Identifying SU treatment needs also can be hindered by limited staff resources (e.g., lack of training on how to administer