The CRAFFT Screening Test is a brief, evidence-based questionnaire used to detect possible alcohol alcohol and drug drug problems in adolescents and young adults. It is intended as a rapid screening instrument that helps clinicians, school health staff, and counselors identify youth who may benefit from additional evaluation, brief intervention, or referral for treatment. The test is widely used because it is simple, age-appropriate, and practical in many settings.

Structure and content

The test has two parts. The first part asks about recent use (typically within the past 12 months) of alcohol, cannabis, prescription medications, or other substances. If the young person reports any use, the second part asks six questions that form the CRAFFT items. The letters of the name form an acronym that corresponds to domains of risky behavior or consequences:

  • C — riding in a Car driven by someone (or oneself) who was using substances;
  • R — using substances to Relax or feel better;
  • A — using substances while Alone;
  • F — Forgetting things while using;
  • F — Friends or family telling the adolescent to cut down;
  • T — getting into Trouble because of substance use.

Scoring and interpretation

Each of the six CRAFFT items is scored as present or absent. Scores range from 0 to 6. A higher score indicates a greater likelihood of a substance use disorder or problems related to use. Common practice is to consider a score of 2 or greater as a threshold for further assessment or intervention; however, interpretation should account for context, age, and clinical judgment. The CRAFFT is a screening—not a diagnostic—tool: positive results should prompt more detailed evaluation.

Administration and typical settings

The instrument can be administered by a clinician, nurse, counselor, or via self-report, and it fits into routine visits in primary care, school-based health centers, emergency departments, and mental health clinics. Because it is brief and conversational in tone, many providers use it as part of preventive care for adolescents. A trained professional or clinician can follow up positive screens with motivational interviewing, safety planning, or referral to specialized services.

History, validation, and adaptations

Developed specifically for adolescents, the CRAFFT has been validated in multiple studies and populations and is recommended by professional bodies as an efficient adolescent screening tool. It has been translated into several languages and adapted for diverse cultural settings, with ongoing research into age-appropriate wording and cutoffs. Its brevity and focus on risky situations rather than heavy clinical terminology contribute to its acceptability among youth.

Uses, benefits, and limitations

The main benefit of CRAFFT is early identification of risky substance use so that timely brief interventions or referrals can occur. It is useful in preventive care, injury prevention (e.g., identifying riding with impaired drivers), and behavioral health screening. Limitations include possible underreporting by youth, cultural differences in interpretation of questions, and the fact that it cannot determine severity or diagnose a substance use disorder on its own. Positive screens should be followed by a more detailed assessment, consideration of co-occurring mental health conditions, and appropriate follow-up care.

For clinical protocols, training materials, or scoring guides, providers commonly consult professional resources or local adolescent health services to ensure consistent application and to link screening results to appropriate next steps.