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Clinical Trial
. 2023 Mar 1:244:109769.
doi: 10.1016/j.drugalcdep.2023.109769. Epub 2023 Jan 14.

Self-report and urine drug screen concordance among women with co-occurring PTSD and substance use disorders participating in a clinical trial: Impact of drug type and participant characteristics

L M Ruglass  1 , A Shevorykin  2 , Y Zhao  3 , T K Killeen  4 , A G Bauer  5 , A A Morgan-López  6 , S E Back  4 , S Fitzpatrick  7 , T López-Castro  8 , S B Norman  9 , L M Saavedra  6 , D A Hien  5
Affiliations
Clinical Trial

Self-report and urine drug screen concordance among women with co-occurring PTSD and substance use disorders participating in a clinical trial: Impact of drug type and participant characteristics

L M Ruglass et al. Drug Alcohol Depend. .

Abstract

Background: Self-report measures are important in substance use assessment, yet they are susceptible to reporting errors. Urine drug screens (UDS) are often considered a more valid alternative. However, collecting in-person UDS may not always be feasible, contributing to the need to understand factors that influence the validity of self-reported substance use.

Methods: In this secondary analysis of data from 295 women with co-occurring PTSD and substance use disorders (SUD) who participated in a clinical trial testing behavioral interventions, we examined concordance and discordance between self-reported drug use and associated UDS results. Generalized linear mixed models were used to examine the impact of treatment type and participant characteristics on the associations between self-reported drug use and UDS results.

Results: Findings revealed higher disagreement between self-report and UDS for opioids and sedatives (ranging from.77 to.90) and lower disagreement rates for cannabis and cocaine (ranging from.26 to.33). Treatment type was not a significant moderator of the associations between self-report and UDS across all drugs. Among those with a positive opioid UDS, those who reported employment in the past three years were more likely to self-report no opioid use compared to their counterparts without employment in the past three years.

Conclusions: Findings add to the literature that supports the validity of self-reported cannabis and cocaine use. The greater discrepancies between self-report and UDS test results of opioids and sedatives suggest adjunctive UDS may be required, although a variety of factors other than inaccurate self-report may be associated with this discrepancy.

Trial registration: ClinicalTrials.gov NCT00078156.

Keywords: PTSD; Self-report; Substance use disorder; Treatment; Urine drug screen; Women.

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Conflict of interest statement

Declaration of Competing Interest None.

Figures

Figure 1.
Figure 1.
Predicted Probability of Reporting No Cocaine Use (Urine Positive)
See this image and copyright information in PMC

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