Just say "I don't": lack of concordance between teen report and biological measures of drug use.
BACKGROUND
Prevalence estimates of illicit drug use by teens are typically generated from confidential or anonymous self-report. While data comparing teen self-report with biological measures are limited, adult studies identify varying degrees of under-reporting.


METHODS
Hair analyses for cocaine, opiates and marijuana were compared to confidential teen self- and parent-reported teen drug use in a longitudinal cohort of >400 high-risk urban teens and parents.


RESULTS
Both teens and parents substantially underreported recent teen cocaine and opiate use. However, compared with parents, teens were more likely to deny biomarker-verified cocaine use. Teen specimens (hair) were 52 times more likely to identify cocaine use compared with self-report. Parent hair analyses for cocaine and opiate use were 6.5 times and 5.5 times, respectively, more likely to indicate drug use than were parental self-report. The lack of concordance between self-report and bioassay occurred despite participant's knowledge that a "certificate of confidentiality" protected both teen and adult participants, and that the biological specimens would be tested for drugs.


CONCLUSIONS
These findings confirm prior reports of adult under-reporting of their own drug use while extending our understanding of teen's self-admitted drug use. The lack of concordance between teen self- or parent-reported teen drug use and biomarkers confirm our concerns that both teen- and parent-reported teen drug use is limited, at least for youth in high-risk urban settings. Methods of ascertainment other than self- or parent-report must be considered when health care providers, researchers and public health agencies attempt to estimate teen drug-use prevalence.
Carmen and Ann Adams Department of Pediatrics, Wayne State University, Children's Hospital of Michigan, 3901 Beaubien St, Detroit, MI 48201, USA. vdelaney@med.wayne.edu
Virginia
V
Delaney-Black
Lisa M
LM
Chiodo
John H
JH
Hannigan
Mark K
MK
Greenwald
James
J
Janisse
Grace
G
Patterson
Marilyn A
MA
Huestis
Joel
J
Ager
Robert J
RJ
Sokol
D000293:Adolescent; D015982:Bias; D002648:Child; D019970:Cocaine-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D008192:Deception; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000453:epidemiology; D008824:Michigan; D016017:Odds Ratio; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D015813:Substance Abuse Detection / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D014342:Truth Disclosure
D013287:Illicit Drugs