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Cognitive impairments are common among individuals with substance use disorders (SUD) and can significantly affect treatment outcomes, including retention and abstinence rates. Traditional neuropsychological assessments are often impractical for routine clinical use due to time and resource limitations, underscoring the need for brief, reliable cognitive screening tools. This study aims to evaluate two such tools, the Montreal Cognitive Assessment (MoCA) and the Brief Cognitive Status Examination (BCSE), in comparison to the Neuropsychological Battery of Fundació ACE (NBACE), considered the gold standard. A total of 258 SUD patients aged 45 and older were recruited from 12 outpatient centers across Catalonia, Spain. The findings revealed that 41.5% of participants exhibited impairments in more than three of six cognitive domains. The MoCA, using a cutoff score of 23, demonstrated a sensitivity of 79% and a specificity of 71%. In contrast, the BCSE showed a higher specificity (86%) and a slightly lower sensitivity (72%), resulting in fewer false positives. Additionally, the BCSE achieved a higher positive predictive value (PPV) than the MoCA (79% vs. 66%). Given its ease of administration, time efficiency, and superior accuracy, the BCSE emerges as a promising tool for routine cognitive screening in older adults with SUD. These findings highlight the importance of incorporating cognitive assessments into standard clinical practice to better identify cognitive deficits and guide personalized treatment strategies.