Researchers have long recognised that epidemiology constitutes, as much as it measures, the diseases it tracks. In the field of substance use and addiction, a range of screening and diagnostic tools have been developed (eg the four-item CAGE or the eight-item ASSIST). Typically designed to identify problem drinking or drug use, these tools are often linked directly with addiction diagnostic categories derived from the DSM or the International Classification of Diseases. These screening and diagnostic tools are used for a variety of purposes (eg identification of substance use, diagnosis of dependence or addiction), in a range of settings (eg primary health care, welfare, criminal justice, AOD treatment and epidemiological research) and their use is widespread in Anglo-European countries.
This project will collect and examine substance use and addiction screening and diagnostic tools currently being used in two countries: Canada and Australia. The analysis will focus on the relationships between the tools, their specific items, the core concepts in 'addictions' theory they rely upon and how they are situated in current practice. The cross-national applicability of tools will also be examined given the widespread use of these tools, developed and tested largely in the USA, in Australia and Canada.
In undertaking this collection and analysis the project asks, how do the addiction screening and diagnostic tools define and shape the phenomenon they purport to track? What are the material effects of defining addiction in certain ways, measuring it in certain communities and contexts, and through certain methods, and designing responses based on these strategies?