New APF Study Introduces Tools to Measure Substance Use Disorder Knowledge

A study published in Drug and Alcohol Dependence introduces two new validated tools designed to measure substance use disorder (SUD) knowledge across prevention, treatment, and recovery.

In response to the lack of validated tools to measure general knowledge about SUD, the Addiction Policy Forum and researchers from the University of Delaware developed and tested two scales to assess knowledge about addiction, including risk factors, treatment options, and medications used to treat SUDs.

“Misinformation fuels stigma, which in turn discourages individuals from seeking assessments, treatment, and support,” explains Jessica Hulsey, one of the authors of the study and Executive Director of the Addiction Policy Forum. “New tools to measure knowledge about addiction—risk factors, the effectiveness of treatment, and recovery support — can help us break down harmful barriers, reduce stigma, and improve access to care. While many chronic health conditions have dozens of knowledge scales for patients, caregivers, and the community, the SUD space has had relatively few, so we are excited to share these new resources with the field.”

Research shows that individuals with greater knowledge about substances tend to engage in less substance use, including alcohol, marijuana, and opioids.¹-⁴ Individuals receiving substance use disorder (SUD) treatment who participate in educational interventions also demonstrate reduced substance use and improved recovery-related outcomes.⁵˒⁶ In addition, parents and caregivers, family and friends, and treatment providers with greater knowledge are better able to support individuals at risk of or experiencing SUD.⁷–¹⁰

“These scales expand the toolkit for measuring substance use disorder knowledge. They are unique in that they assess what people know about preventing and treating a broad range of substance use disorders,” said Dr. Valerie Earnshaw, the study’s lead author. “By improving how we measure knowledge, researchers can better understand how knowledge relates to substance use behaviors and evaluate the impact of education-based interventions.”

The study included two components. In the first phase, experts confirmed that the scale items were accurate and important to know. In the second phase, more than 5,400 community members from across the U.S. completed the scales, and their responses were used to test the validity and reliability of the scales.

The two scales include:

• SUD Prevention Knowledge Scale, which measures knowledge related to risk factors and protective factors for substance use disorder

• SUD Knowledge Scale, which measures knowledge about addiction characteristics, treatment and recovery, and medications used to treat SUD

These new tools provide an important resource for researchers, educators, and community organizations. By helping identify knowledge gaps and evaluate the impact of education and prevention programs, the scales can support efforts to improve public understanding of substance use disorders and reduce stigma.

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Reference: Earnshaw, V. A., Mousavi, M., Kelly, B., Zawislak, K., Fox, A. B., & Hulsey, J. (2026). Development and psychometric evaluation of two substance use disorder knowledge scales. Drug and Alcohol Dependence, 282, 113095. https://doi.org/10.1016/j.drugalcdep.2026.113095

Citations:

1. Scheier, L. M., & Botvin, G. J. (1997). Expectancies as mediators of the effects of social influences and alcohol knowledge on adolescent alcohol use: A prospective analysis. Psychology of Addictive Behaviors, 11(1), 48–64. https://doi.org/10.1037/0893-164X.11.1.48

2. Park, S. Y., Ryu, S. Y., Constantino, N., Yun, G. W., Jennings, E., & Fred, D. (2022). Marijuana knowledge, confidence in knowledge, and information efficacy as the protective and risk factors of marijuana use among college students. Journal of American College Health, 70(2), 363–370. https://doi.org/10.1080/07448481.2020.1751171

   
   

3. Farley, K. X., Anastasio, A. T., Kumar, A., Premkumar, A., Gottschalk, M. B., & Xerogeanes, J. (2019). Association between quantity of opioids prescribed after surgery or preoperative opioid use education with opioid consumption. JAMA, 321(24), 2465–2467. https://doi.org/10.1001/jama.2019.6125
   

4. Hua-Nguyen, C., Harris, A., Herrera, M. E., Falk, J., Le, M.-L., & Mital, S. (2025). Effectiveness of educational interventions in United States schools to prevent opioid-related harms: A systematic review. Addictive Behaviors, 163, 108268. https://doi.org/10.1016/j.addbeh.2025.108268
   

5. Ekhtiari, H., Rezapour, T., Aupperle, R. L., & Paulus, M. P. (2017). Neuroscience-informed psychoeducation for addiction medicine: A neurocognitive perspective. In T. Calvey & W. M. U. Daniels (Eds.), Progress in Brain Research (Vol. 235, pp. 239–264). Elsevier. https://doi.org/10.1016/bs.pbr.2017.08.013
   

6. Kargin, M., & Hicdurmaz, D. (2020). Psychoeducation program for substance use disorder: Effect on relapse rate, social functioning, perceived wellness, and coping. Journal of Psychosocial Nursing and Mental Health Services, 58(8), 39–47. https://doi.org/10.3928/02793695-20200624-03
   

7. Allen, M. L., Garcia-Huidobro, D., Porta, C., Curran, D., Patel, R., Miller, J., & Borowsky, I. (2016). Effective parenting interventions to reduce youth substance use: A systematic review. Pediatrics, 138(2), e20154425. https://doi.org/10.1542/peds.2015-4425
   

8. Calihan, J. B., Ventura, A. S., Wang, J., Puppala, R., Wiggins, M., Renehan, C., Garrity, B., & Bagley, S. M. (2025). Engaging affected family members in substance use disorder care: Knowledge, attitudes, and behaviors of addiction care teams. Substance Use & Addiction Journal, 47(1), 200–208. https://doi.org/10.1177/29767342251355135
   

9. Kumpfer, K. L., Alvarado, R., & Whiteside, H. O. (2003). Family-based interventions for substance use and misuse prevention. Substance Use & Misuse, 38(11–13), 1759–1787. https://doi.org/10.1081/JA-120024240
   

10. Wood, E., Samet, J. H., & Volkow, N. D. (2013). Physician education in addiction medicine. JAMA, 310(16), 1673–1674. https://doi.org/10.1001/jama.2013.280377

For more detailed information, refer to the full study: Development and psychometric evaluation of two substance use disorder knowledge scales