A national multi-site monitoring system for determining prevalence of alcohol and drug involvement in arrestees sought to refine the screening for substance dependence among persons arrested and incarcerated in local jails. Fifteen items were selected from the content of existing alcohol and drug abuse screens. These items were evaluated against a detailed diagnostic interview covering criteria of the DSM-IV. A total of 310 prisoners incarcerated within the previous 48 hours were recruited as subjects. Almost 65% of the subjects had a positive diagnosis of dependence for one or more substances. A six-item screen identified by the acronym UNCOPE emerged as the best set of screening items for identifying dependence on alcohol and/or drugs. The UNCOPE had sensitivity of 88% and specificity of 83% for the sample as a whole. It performed similarly irrespective of gender or ethnicity and appears to have potential utility in a wide range of populations.
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