From Marilyn Huestis and colleagues: Just say "I don't": lack of concordance between teen report and biological measures of drug use

Pediatrics. 2010 Nov;126(5):887-93. doi: 10.1542/peds.2009-3059. Epub 2010 Oct 25.

Just say "I don't": lack of concordance between teen report and biological measures of drug use.

Delaney-Black V, Chiodo LM, Hannigan JH, Greenwald MK, Janisse J, Patterson G, Huestis MA, Ager J, Sokol RJ.

Source

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

Abstract

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.