Comparison of Self-Report and Hair Analysis in Detecting Cocaine Use in a Homeless/Transient Sample

Abstract

Detection of current (past 30 days) drug use by analysis of hair was examined along with self-reports of current use in a 1994 treatment needs assessment survey; the sample was 179 homeless/transient adults in New York state. Results of radioimmunoassay of hair (RIAH) were used to evaluate the veracity of self-reports of current cocaine use. Only 26% of those persons whose hair tested positive for cocaine (n=115) admitted to having used cocaine in the past 30 days. Subjects eligible for treatment, as indicated by a DSM-III-R diagnosis of cocaine dependency, were nearly four times as likely to admit current cocaine use than those who were not dependent. These results are consistent with other studies of populations at high risk for substance use.

Results of hair analyses for drugs of abuse and comparison with self-reports and urine tests

“…According to Magura and Kang [13] the under-reporting of cocaine abuse might be attributable to several factors: patients might have been suspicious or fearful of the research interviewers; cocaine use is stigmatized; cocaine use is rather infrequent and, consequently, patients do not define themselves as using the substance at all. Yet, self-report and urine test alone miss most drugs, and especially cocaine users in different risk populations [11,[16][17][18][19][20][21]. Hair tests improve detection significantly and thus can enhance various evaluations; for example the effects of prenatal cocaine use on fetal and child development [22][23][24].…”

Inconsistencies in self-reported drug use by adolescents in substance abuse treatment: Implications for outcome and performance measurements

“…By contrast, the accuracy of selfreported substance use and its effect on prevalence and age at first use estimates has been widely studied by epidemiologists and prevention researchers using both community and school-based samples (Appel et al 2001;Colon et al 2001;2002;Fendrich 2005;Fendrich et al 1999;Fendrich & Rosenbaum 2003;Fendrich & Vaughn 1994;Johnson & Mott 2001;Johnston & O'Malley 1997;Morral et al 2000;Percy et al 2005;Shillington & Clapp 2000;Tassiopoulos et al 2006). In general, the literature on the reliability and validity of substance use reports is derived from research studies with uncertain relevance to treatment populations.…”

Reply: Do Self-Reports Reliably Assess Abstinence in Cocaine-Dependent Patients?

“…Cocaine-dependent patients might under-report cocaine use due to forgetfulness, denial, or force of habit, and sometimes to please providers or avoid treatment consequences. Regardless of why under-reporting occurs, it is too prevalent for self-reports to constitute an acceptable primary outcome measure in cocaine clinical trials sponsored by the National Institute of Drug Abuse (NIDA) (Ehrman et al, 1997;Hser et al, 1999;Morral et al, 2000;Appel et al, 2001). Simply stated, urinary BE testing is currently the scientific standard.…”