CRAFFT Screening Test: Questions, Scoring, Age Range, and Limits

The CRAFFT 2.1 is a brief substance-use screener for adolescents and young adults, usually used with people ages 12 to 21. It asks about past-year alcohol and drug use, riding or driving risk, and related experiences; it does not replace a diagnostic assessment.

CRAFFT includes age-specific riding, driving, and social-risk questions for adolescents and young adults. ASSIST instead assigns substance-specific risk scores across alcohol, tobacco, and multiple drug categories for a broader clinical population.

Who is the CRAFFT designed for?

CRAFFT is designed for adolescents and young adults, with validation strongest in youth ages 12 to 18 and broader use commonly extending through age 21. The clinician should confirm that the version, language, and setting fit the person being screened.

CRAFFT is not a universal adult screen. A positive result in a young person should be interpreted with developmental stage, confidentiality rules, family context, safety, and access to age-appropriate services in mind.

What questions are included in CRAFFT 2.1?

CRAFFT 2.1 begins with past-12-month frequency questions about alcohol, marijuana, and other substances. If all opening answers are zero, the CAR question is asked; if any relevant use is reported, the remaining CRAFFT questions address riding or driving, using to relax or fit in, using alone, forgetting events, concern from friends or family, and trouble related to use.

The 2.1+N version adds the Hooked on Nicotine Checklist for tobacco or nicotine use. That extension should not be confused with the core six-question CRAFFT substance-use screen.

How is CRAFFT administered?

CRAFFT can be completed as a self-administered questionnaire or a clinician interview in a confidential healthcare setting. The official program recommends protecting privacy so that parents or other observers cannot see the young person’s answers.

Administration may occur in primary care, adolescent medicine, school-based health, or another qualified setting. Local law and clinical policy determine how confidentiality, parental involvement, and follow-up are handled.

How is the CRAFFT scored?

Each yes answer to the CRAFFT questions contributes one point, and the total is used with the provider manual and clinical context. A score of 2 or more commonly prompts further assessment, while the official score chart relates totals to the probability of meeting DSM-5 substance use disorder criteria.

Result	What it means	What should follow
0–1	Lower observed risk on the screener	Provide prevention, clarify use, and reassess when indicated
2 or higher	Positive screen	Complete clinical assessment and safety counseling
Any score with immediate danger	Safety concern overrides the score	Address intoxication, riding or driving, overdose, or crisis risk immediately

The CRAFFT score estimates screening risk. It does not prove a substance use disorder, establish impairment, or determine treatment without an assessment by a qualified professional.

What happens after a positive CRAFFT?

A positive CRAFFT leads to a private conversation about substance use, safety, motivation, mental health, and the need for further assessment. Brief motivational counseling and referral may follow, depending on the young person’s needs and the services available.

When a program uses the SBIRT pathway, CRAFFT can supply the screening step while brief intervention and referral remain separate clinical steps.

How does CRAFFT differ from adult screening tools?

CRAFFT is age- and development-specific, DAST-10 focuses on past-year drug-related problems, and ASSIST assigns substance-specific risk across a broad set of substances. A clinician should not swap one tool for another merely because all three produce a score.

Breath alcohol testing answers a different question: it estimates alcohol concentration at collection. It does not validate, invalidate, or replace the CRAFFT conversation.

What are the limits of CRAFFT?

CRAFFT is limited by self-report, privacy and disclosure barriers, developmental and cultural context, language, and the need for follow-up after a positive screen. It does not measure drug concentration, withdrawal severity, or current impairment.

A negative CRAFFT does not rule out risk when a young person is intoxicated, unsafe, unable to disclose privately, or experiencing symptoms that require immediate care. A positive result calls for support and assessment rather than automatic diagnosis.