title: A validation of self-reported substance use with biochemical testing among patients presenting to the emergency department seeking treatment for backache, headache, and toothache.
abstract: OBJECTIVE
  This study tests the validity of self-reported illicit substance use against biochemical testing among Emergency Department (ED) patients seeking treatment with narcotics for backache, headache, and toothache and to characterize patients who provide false reports.
  
  
  METHODS
  Retrospective chart review comparing the self-reported drug use history obtained during an ED visit during a six-year period (1995-2001) with the results of a biochemical drug screen obtained the same day.
  
  
  RESULTS
  248 patients met screening criteria, 79 (32%) of whom tested positive for unclaimed "drugs of abuse." Patients with a history of "drug abuse" and chronic pain were significantly more likely to test positive for unclaimed drugs than were their counterparts (p=.05 and p<.0001, respectively). No significant difference was found in comparing those with and without multiple ED visits or those requesting a specific narcotic.
  
  
  CONCLUSIONS
  Self-reported drug use is unreliable in this ED subpopulation. When this knowledge is critical for patient care, biochemical testing may be indicated.
authors.affiliation: Summa Health System, Akron, Ohio 44304, USA. schuckmh@summa-health.org
authors.forename: Hugh
authors.initials: H
authors.lastname: Schuckman
authors.forename: Susan
authors.initials: S
authors.lastname: Hazelett
authors.forename: Carol
authors.initials: C
authors.lastname: Powell
authors.forename: Sheila
authors.initials: S
authors.lastname: Steer
mesh_terms: D001416:Back Pain / Q000188:drug therapy / Q000652:urine; D002908:Chronic Disease; D015897:Comorbidity; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006261:Headache / Q000188:drug therapy / Q000652:urine; D006304:Health Status; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects / Q000652:urine; D008297:Male; D009294:Narcotics / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy* / Q000523:psychology / Q000652:urine*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012189:Retrospective Studies; D012737:Sex Factors; D015813:Substance Abuse Detection / Q000379:methods / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D014098:Toothache / Q000188:drug therapy / Q000652:urine; D014342:Truth Disclosure
chemical_list: D013287:Illicit Drugs; D009294:Narcotics