Development and validation of a Korean screening tool to identify individuals at high risk of drug use

Objectives: To develop and validate a culturally adapted Korean screening tool for identifying adults at high risk of substance use disorders. Methods: A cross-sectional survey was conducted involving 207 adults (age: 19–59 years) who had used drugs in the preceding two years. The DAST11-K, denoting an 11-item cultural adaptation of the DAST-10 with the addition of a prescription narcotic misuse item, was evaluated against a DSM-5-based reference standard and compared with CRAFFT in a 2023 subsample. Exploratory K-PDAS was built around psychotropic medications identified in a preliminary survey, including study drugs, weight-loss medications, and propofol. Results: DAST11-K demonstrated good reliability (Cronbach’s α=0.81) and discrimination against the DSM-5-based criterion (AUC=.83; 95% CI: 0.77–0.90). At the optimal cut-off (criterion value 5.5), sensitivity and specificity were 68% and 89%, respectively, correlating strongly with the CRAFFT ( r=0.78) and predicting DSM-5 substance use disorders across drug classes and overall (adjusted OR=2.00; 95% CI: 1.59–2.52). Moreover, although K-PDAS displayed comparable specificity, its sensitivity remains low and requires further validation. Conclusion: DAST11-K represents a practical, culturally grounded tool for the early identification of adults at high risk of drug use in Korea, while K-PDAS might serve as an exploratory supplement reflecting Korea-specific patterns.