The Cannabis Use Problems Identification Test (CUPIT) is a 16-item self-report screening questionnaire that identifies people whose cannabis use is currently problematic or at risk of becoming so. Developed by Bashford, Flett, and Copeland, it works across adolescents and adults, measuring impaired control over cannabis use alongside the problems that use can create.
Why healthcare providers use the CUPIT
- Early identification. It detects problematic cannabis use before it fully meets diagnostic criteria, supporting a timely clinical conversation.
- Validated cut-off. In the validation study a score of 12 or more reached 98% sensitivity for current or emerging cannabis use disorder.
- Broad age range. It was validated for both adolescents and adults, so a single tool can cover mixed caseloads.
- Two-dimensional view. It separates impaired control from cannabis-related problems, giving a fuller picture than a single global question.
- Self-report and brief. Patients complete the items themselves, keeping clinician time focused on interpretation and next steps.
Which settings use the CUPIT?
- Substance use services. Drug and alcohol clinicians use it to screen new referrals and gauge the severity of cannabis-related concerns.
- Primary care. General practices use it to open a structured discussion when cannabis use is raised or suspected.
- Mental health clinics. Teams use it to screen for co-occurring cannabis problems alongside mood or anxiety presentations.
- Youth and adolescent services. Its validation in younger populations makes it suitable for school-linked and youth health programs.
What does the CUPIT measure?
The CUPIT measures the extent and consequences of cannabis use across two subscales identified during its development. Together they capture both how much control a person has over their use and how much that use is affecting daily life. The item content is copyrighted by the authors, so the domains are summarized here rather than reproduced verbatim.
- Impaired control. Ten items covering difficulty limiting, cutting down, or stopping cannabis use.
- Cannabis-related problems. Six items covering the problems and harms that arise from continued use.
Scoring the CUPIT
- Number of items: 16 scored items across two subscales (10 impaired control, 6 problems).
- Per-item scale: predominantly five-point response categories reflecting frequency, intensity, or degree.
- Total score range: 0 to 82.
- Score direction: higher total scores indicate greater risk of cannabis-related harm.
Total scores support screening, not diagnosis. The cut-offs below come from the validation study and are intended to guide clinical decision-making and flag when further assessment may be warranted, rather than to confirm a cannabis use disorder on their own.
| Score | Interpretation | Suggested next step |
|---|---|---|
| 0 to 11 | Below the validated screening cut-off | Monitor |
| 12 to 19 | At or above the recommended cut-off; possible risk of cannabis-related harm | Consider further assessment |
| 20 or higher | Meets a higher-specificity threshold for likely cannabis use disorder | Consider further assessment |
Best practices for administration
- Explain the purpose. Tell patients the questionnaire helps understand cannabis use so they answer openly and honestly.
- Confirm the reference period. Make sure the person answers about their recent use as instructed on the form.
- Offer privacy. Let patients complete it in a private setting to reduce social pressure and improve accuracy.
- Review every item. Check for skipped questions before scoring, since missing responses distort the total.
- Interpret in context. Combine the score with clinical history and the presenting concern rather than reading it in isolation.
- Repeat over time. Re-administer at intervals to track whether cannabis use and related risk are changing.
How Zentake helps with the CUPIT
- Automatic scoring. Zentake totals the CUPIT on submit, so there is no hand-tallying and no arithmetic errors.
- Longitudinal tracking. Re-send the questionnaire on a schedule and view change over time to see whether risk is rising or falling.
- Before the visit. Patients complete it from home on any device, so results are ready before the appointment for mental health practices.
- HIPAA compliant. Responses are encrypted, with a signed BAA on every plan.
References
Bashford, J., Flett, R., and Copeland, J. (2010). The Cannabis Use Problems Identification Test (CUPIT): development, reliability, concurrent and predictive validity among adolescents and adults. Addiction, 105(4), 615-625. This validation study reports the 16-item structure, the 0 to 82 score range, and the recommended cut-off of 12, with a higher-specificity threshold near 20.
Last updated: August 2026