title: Comparison of patient self-reports and urinalysis results obtained under naturalistic methadone treatment conditions.
abstract: This study examined under naturalistic assessment conditions the validity of self-reported opiate and cocaine use among 175 veterans enrolled in methadone treatment, and factors related to self-report validity, such as stage in treatment and drug of abuse. Veterans were interviewed by clinical staff about past 30-day drug use with the addiction severity index (ASI), and urinalysis results were obtained for the same 30-day interval assessed with the ASI. Analysis revealed that urinalysis generally produced higher rates of substance use than patient self-report, and with the exception of reported opiate use among new patients presenting for treatment, validity of patient self-reported drug use generally was poor with patients under-reporting both opiate and cocaine use. The findings are in marked contrast to those obtained in other studies in which participants are ensured confidentiality regarding their self-reports. Further, the results raise questions about the utility of self-report measures of substance use to assess patient progress or methadone program performance.
authors.affiliation: John D. Dingell VA Medical Center, Department of Psychiatry (116A), 4646 John R. Street, Detroit, MI 48201-1932, USA. chermack.stephen@med.va.gov
authors.forename: S T
authors.initials: ST
authors.lastname: Chermack
authors.forename: J
authors.initials: J
authors.lastname: Roll
authors.forename: M
authors.initials: M
authors.lastname: Reilly
authors.forename: L
authors.initials: L
authors.lastname: Davis
authors.forename: U
authors.initials: U
authors.lastname: Kilaru
authors.forename: J
authors.initials: J
authors.lastname: Grabowski
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D010349:Patient Compliance / Q000523:psychology*; D015203:Reproducibility of Results; D015813:Substance Abuse Detection / Q000523:psychology*; D014342:Truth Disclosure; D014728:Veterans / Q000523:psychology*
chemical_list: D008691:Methadone