Underreporting of illicit drug use by patients at emergency departments as revealed by two-tiered urinalysis.
This study investigates the validity of questionnaire-based self-reports of illicit drug use by comparing with a two-tiered urinalysis among patients at emergency departments. Questions on the use of alcohol and drugs were administered to patients recruited on a continual basis for 2weeks at the emergency department of two hospitals in northern Taiwan. Positive tests of initial urinalysis using fluorescence polarization immunoassay were further confirmed by gas chromatography/mass spectrometry. In a total of 1502 patients interviewed, 632 (42%) also provided a urine sample. Among those with urine samples, the positive rate of urinalysis was 1.4% for amphetamine-type drugs and 1.6% for opiates. Among those with positive urinalysis, a false-negative rate ranged from 66.6% for amphetamines to 70.0% for opiates. Meanwhile, all the self-reported current uses of either amphetamines or opiates were confirmed by urinalysis. The results indicate that the false-negative rates of questionnaire-based, self-reported current use of illicit drug are around two thirds and the false-positive rates are negligible, which might be useful for the calibration of estimates from epidemiological surveys.
Institute of Epidemiology, College of Public Health, National Taiwan University, 1 Jen-Ai Road, Sec. 1, Taipei 100, Taiwan. weijen@ha.mc.ntu.edu.tw
Wei J
WJ
Chen
Cheng-Chung
CC
Fang
Ren-Shi
RS
Shyu
Kuo-Chien
KC
Lin
D000293:Adolescent; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000175:diagnosis / Q000523:psychology / Q000652:urine; D000662:Amphetamines / Q000652:urine; D000701:Analgesics, Opioid / Q000652:urine; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000523:psychology / Q000652:urine; D012647:Self-Assessment; D015813:Substance Abuse Detection / Q000379:methods* / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology / Q000652:urine*
D000662:Amphetamines; D000701:Analgesics, Opioid