Tobacco, Alcohol, Prescription medications, and other Substance use Tool (TAPS)
The TAPS Tool is a two-part screening and brief assessment instrument used to identify substance use and substance use disorders in adults. It covers tobacco, alcohol, prescription medications, and illicit drugs, and is designed for use in primary care and general medical settings. The TAPS tool assesses the use of tobacco, alcohol, prescription medications, and other substances. It's designed for healthcare providers to identify and address substance use in patients effectively.
About the TAPS Tool
Developed through a NIDA-supported research initiative, the TAPS Tool integrates a brief screener (TAPS-1) with a more detailed assessment (TAPS-2) if initial risk is identified. It assesses past-year and past-3-month use across a range of substances, including tobacco, alcohol, cannabis, cocaine, prescription stimulants, sedatives, and opioids. The tool supports SBIRT (Screening, Brief Intervention, and Referral to Treatment) workflows in busy clinical environments.
It is appropriate for use with adults aged 18 and older.
Psychometric Properties
The TAPS Tool has been validated in U.S. primary care populations and shows good sensitivity and specificity for detecting problem substance use and moderate-to-severe substance use disorders.
- TAPS-1: High sensitivity for any past-year use
- TAPS-2: Differentiates substance use risk by frequency and impact
- Good agreement with Composite International Diagnostic Interview (CIDI) as a reference standard
Source: McNeely et al., 2016; McNeely et al., 2017
The Scale
TAPS-1 includes 4 initial yes/no questions about past 12-month use of:
- Tobacco
- Alcohol
- Prescription medications (used non-medically)
- Other drugs
If any “yes” is endorsed, TAPS-2 follows with frequency-based questions for the past 3 months, asking how often each substance was used and whether use affected responsibilities or safety.
HiBoop implements TAPS as a two-stage experience:
- Stage 1 (TAPS-1): Rapid screen, 4–5 substance categories
- Stage 2 (TAPS-2): Auto-triggered for substances endorsed in TAPS-1, with brief follow-up questions on use severity and impact
Each substance category produces a risk score from 0 to 3.
HiBoop highlights risk levels per substance and supports clinician filtering (e.g., show all clients with opioid risk ≥2).
References
- 1.McNeely J, Wu LT, Subramaniam G, et al. Performance of the Tobacco, Alcohol, Prescription Medication, and Other Substance Use (TAPS) Tool for Substance Use Screening in Primary Care Patients. Ann Intern Med. 2016;165(10):690-699.View source
- 2.Gryczynski J, McNeely J, Wu LT, et al. Validation of the TAPS-1: A Four-Item Screening Tool to Identify Unhealthy Substance Use in Primary Care. J Gen Intern Med. 2017;32(9):990-996.View source
- 3.Adam A, Schwartz RP, Wu LT, et al. Electronic self-administered screening for substance use in adult primary care patients: feasibility and acceptability of the tobacco, alcohol, prescription medication, and other substance use (myTAPS) screening tool. Addict Sci Clin Pract. 2019;14(1):39.View source
Frequently Asked Questions
Is the TAPS Tool self-report or clinician-administered?
The TAPS Tool has been validated in both self-administered (tablet/electronic) and interviewer-administered formats. The self-administered format, known as myTAPS, showed high acceptability in primary care patients, though older adults and those with lower education may benefit from interviewer support. Both formats demonstrated comparable psychometric performance in the original NIDA Clinical Trials Network validation study.
What substances does the TAPS Tool screen for?
TAPS covers four substance categories: tobacco, alcohol, prescription medications used non-medically, and other drugs (including cannabis, cocaine, stimulants, sedatives, and opioids). The TAPS-1 first-stage screener asks about past 12-month use across these categories, and the TAPS-2 follow-up component gathers frequency and impact data for any endorsed substance.
Can the TAPS Tool diagnose a substance use disorder?
No. The TAPS Tool is a screening and brief assessment instrument; it is not designed to provide a diagnosis. A positive screen indicates a need for further clinical evaluation. Diagnosis of a substance use disorder requires a comprehensive clinical assessment by a qualified healthcare professional using recognized diagnostic criteria.
How is the TAPS Tool scored?
TAPS-1 captures frequency of use (never, less than monthly, monthly, weekly, daily or almost daily) for each of the four substance categories. TAPS-2 then generates a risk score of 0–3 per substance category based on frequency of use and reported impact on responsibilities or safety. Scores are interpreted per substance rather than as a single composite total, which supports identifying which substance(s) warrant clinical attention.
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