Comparison of self-reports and biological measures for alcohol, tobacco, and illicit drugs consumption in psychiatric inpatients

Abstract

This study is the first to compare self-reports and biological measures of alcohol, tobacco and illicit drug uses in a large sample of inpatients suffering from various categories of psychiatric illnesses, allowing for cross-diagnosis comparisons.

Drugs of abuse among acute psychiatric and medical admissions: laboratory based identification of prevalence and drug influence

“…On the basis of urine drug findings, stimulant drug use has been associated with schizophrenia (81) and illegal drug use has been associated with men, younger age and precarious housing (116). In three other studies, drug users could not be differentiated from non-users on the basis of urine drug findings (69,76,86).…”

“…Second, our definition of nonprescribed use of medicinal drugs may be questioned, and we could rather have included validated instruments such as the Benzodiazepine Dependence Questionnaire (168). Third, alcohol is rapidly removed from the body, and additional biomarkers with longer detection times, such as ethyl glucoronide (169) or carbohydrate deficient transferrin (116), could have added valuable information and increased the estimates of recent alcohol users. Fourth, with regard to the characteristics of the participating physicians, we only obtained data on name and gender.…”

“…Many studies lacked detailed information on recent substance intake and polydrug use, and substance specific detection rates were reported in about half of the studies (Table A2). Urine samples were obtained within 2, 24 or 48 hours after admission, if information about this was reported, and blood samples were used in three studies only (87,116,142). At the time of admission, clinical drug intoxication due to cocaine was reported among 50% of the patients in one study (70), and clinical drug influence among one-third of the patients in another (87), but these results were not compared with blood drug findings.…”

“…Studies comparing urine analysis to routine clinical practice, structured interviews and patient self-reports have reported under-detection of recent substance intake (65,66,81,116,117).…”

“…Many studies have therefore included self-made questions addressing recent intake as part of questionnaires or interviews in emergency departments (113), acute medical settings (114), drug treatment settings (115) and acute psychiatric settings (69,81,116,117).…”