Underreporting of cocaine use at posttreatment follow-up and the measurement of treatment effectiveness.
Substance abusers, especially cocaine abusers, may underreport their substance use in outcome interviews. Follow-up interviews were conducted and urine specimens were obtained on 633 persons 9 months after admission to a 3-month cocaine treatment program. Although 422 (67%) reported no use of cocaine in the past 30 days, 134 of these (32%) had cocaine-positive urines. This group did not differ on most characteristics at intake or follow-up from the 288 with cocaine-negative urines. The amount of treatment received did affect willingness to admit drug use. Of 132 treatment completers who reported no cocaine use at follow-up, 21 (16%) had positive urines. Of 91 early dropouts who also reported no cocaine use, 36 (40%) had positive urines. This differential rate of underreporting had the effect of seriously underrepresenting the effectiveness of treatment completion as compared with little or no treatment.
Lundy
A
A
Department of Psychiatry, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19146, USA.
Gottheil
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E
McLellan
A T
AT
Weinstein
S P
SP
Sterling
R C
RC
Serota
R D
RD
D000328:Adult; D003042:Cocaine / Q000652:urine; D017248:Enzyme Multiplied Immunoassay Technique; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000534:rehabilitation / Q000628:therapy* / Q000652:urine; D010352:Patient Dropouts; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D015813:Substance Abuse Detection / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014342:Truth Disclosure
D003042:Cocaine