title: Denial of urinalysis-confirmed opioid use in prescription opioid dependence.
abstract: Although research has generally supported the validity of substance use self-reports, some patients deny urine-verified substance use. We examined the prevalence and patterns of denying urinalysis-confirmed opioid use in a sample of prescription opioid dependent patients. We also identified characteristics associated with denial in this population of increasing public health concern. Opioid use self-reports were compared with weekly urinalysis results in a 12-week multi-site treatment study for prescription opioid dependence. Among those who used opioids during the trial (n=246/360), 44.3% (n=109) denied urinalysis-confirmed opioid use, although usually only once (78%). Overall, 22.9% of opioid-positive urine tests (149/650) were denied on self-report. Multivariable analysis found that initially using opioids to relieve pain was associated with denying opioid use. These findings support the use of both self-reports and urine testing in treating prescription opioid dependence.
authors.affiliation: Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA 02478, USA.
authors.forename: E Yvette
authors.initials: EY
authors.lastname: Hilario
authors.affiliation: Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Griffin
authors.affiliation: Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: R Kathryn
authors.initials: RK
authors.lastname: McHugh
authors.affiliation: Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA 02478, USA.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: McDermott
authors.affiliation: Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Hilary S
authors.initials: HS
authors.lastname: Connery
authors.affiliation: Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA; Laboratory for Psychiatric Biostatistics, McLean Hospital, Belmont, MA 02478, USA; Department of Biostatistics, Harvard School of Public Health, Boston, MA 02115, USA.
authors.forename: Garrett M
authors.initials: GM
authors.lastname: Fitzmaurice
authors.affiliation: Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA. Electronic address: rweiss@mclean.harvard.edu.
authors.forename: Roger D
authors.initials: RD
authors.lastname: Weiss
mesh_terms: D000328:Adult; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000523:psychology / Q000652:urine*; D063487:Prescription Drug Misuse / Q000523:psychology / Q000706:statistics & numerical data*; D057566:Self Report; D016482:Urinalysis / Q000523:psychology / Q000706:statistics & numerical data*
keywords: Addiction; Opioid use disorder; Opioids; Pain; Prescription opioid dependence; Self-report; Substance use disorder; Urine screens