Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 8;4(1):29.
doi: 10.1186/s42238-022-00139-8.

Validity between self-report and biochemical testing of cannabis and drugs among patients with traumatic injury: brief report

Kristin Salottolo  1   2   3   4 , Emmett McGuire  1 , Robert Madayag  2 , Allen H Tanner 2nd  3 , Matthew M Carrick  4 , David Bar-Or  5   6   7   8
Affiliations

Validity between self-report and biochemical testing of cannabis and drugs among patients with traumatic injury: brief report

Kristin Salottolo et al. J Cannabis Res. .

Abstract

Background: The relationship between drug use and traumatic injury is well documented, yet only a small proportion of patients are biochemically tested for cannabis and other substances. The study objective was to determine whether patient self-report can be used as a proxy for biochemical drug testing following traumatic injury.

Methods: This study was a secondary analysis that included 320 patients admitted to four level I trauma centers in Colorado and Texas, primarily involved in motor vehicle crash (89%). If performed, biochemical testing was collected via urine toxicology screen ("tox screen") for cannabis, amphetamines, barbiturates, cocaine, opiates, PCP, and benzodiazepines. All patients were screened for self-reported current drug use, which was evaluated for any drug and specifically for cannabis use. Analyses used to compare results of self-reported drug use and tox screen included sensitivity, specificity, positive, and negative predictive values, and percent agreement.

Results: Among 320 patients, 23% (n = 75) self-reported drug use; cannabis was the most frequently reported drug (n = 63). A tox screen was performed in 59% of patients (n = 190); the proportion of patients who had a tox screen was similar for those self-reporting drug use (60.0%) to those who denied using drugs (59.2%), p = 0.90. Among patients who had a tox screen performed, 18% (n = 35) tested positive for any drug, 12% (n = 22) tested positive for THC, and 7% (n = 13) tested positive for opiates. The percent agreement was 80% for any drug and 81% for cannabis. The specificity was 84-85%, indicating a high likelihood that a patient will not have a positive tox screen if they do not report using drugs. Negative predictive values were 90-95%, indicating a negative self-report correctly identified nearly all patients testing negative on tox screen. Sensitivity was only 60% and positive predictive values were 30-47% for cannabis and drugs, respectively.

Conclusion: These findings may negate the need for biochemical drug testing in this population, particularly as a "rule out" based on self-reporting. Future studies are needed to confirm these findings and should address risk of selection bias.

Keywords: Biochemical testing; Cannabis; Self-report validity; Toxicology screen; Traumatic injury.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Arroyo-Novoa CM, Figueroa-Ramos MI, Balas M, Rodriguez P, Puntillo KA. Opioid and benzodiazepine withdrawal syndromes in trauma ICU patients: a prospective exploratory study. Crit Care Explor. 2020;2(4):e0089. doi: 10.1097/CCE.0000000000000089. - DOI - PMC - PubMed
    1. Cherpitel CJ. Screening for alcohol problems in the U.S. general population: comparison of the CAGE, RAPS4, and RAPS4-QF by gender, ethnicity, and service utilization. Rapid alcohol problems screen. Alcohol Clin Exp Res. 2002;26(11):1686–1691. doi: 10.1111/j.1530-0277.2002.tb02471.x. - DOI - PubMed
    1. Cherpitel CJ, Ye Y, Bond J, Borges G, Macdonald S, Stockwell T, et al. Validity of self-reported drinking before injury compared with a physiological measure: cross-national analysis of emergency-department data from 16 countries. J Stud Alcohol Drugs. 2007;68(2):296–302. doi: 10.15288/jsad.2007.68.296. - DOI - PubMed
    1. Chung C, Salottolo K, Tanner A, 2nd, Carrick MM, Madayag R, Berg G, et al. The impact of recreational marijuana commercialization on traumatic injury. Inj Epidemiol. 2019;6(1):3. doi: 10.1186/s40621-019-0180-4. - DOI - PMC - PubMed
    1. Claudius IA, Jontz A, Levine M, LoVecchio F, Dabrowski P, Kreisler R. Marijuana self-report compared with testing in trauma patients before and after legalization. Clin Toxicol (Phila). 2020;58(8):801–803. doi: 10.1080/15563650.2019.1693045. - DOI - PubMed

LinkOut - more resources