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Comparison of timeline follow-back self-report and oral fluid testing to detect substance use in adult primary care patients.

Publication ,  Journal Article
Nordeck, CD; Gryczynski, J; O'Grady, KE; Polak, K; Svikis, DS; McNeely, J; Wu, L-T; Schwartz, RP
Published in: Drug Alcohol Depend
April 1, 2020

BACKGROUND: Timeline Follow-back (TLFB) interviews using self-report are often used to assess substance use. Oral fluid testing (OFT) offers an objective measure of substance use. There are limited data on the agreement between TLFB and OFT. METHODS: In this secondary analysis from a multisite study in five primary care sites, self-reported TLFB and OFT data collected under confidential conditions were compared to assess concordance (N=1799). OFT samples were analyzed for marijuana, heroin, cocaine, and non-medical use of prescription opioids. Demographic differences in discordance relative to TLFB and OFT concordant results for marijuana, the only substance with an adequate sample size in this analysis, were examined using multinomial logistic regression. RESULTS: Overall concordance rates between TLFB and OFT were 94.9 % or higher for each substance, driven by large subgroups with no use. Among participants with discordant use, marijuana was the only substance with lower detection on OFT than self-report (27.6 % OFT-positive only vs 32.2 % TLFB-positive only), whereas cocaine (65.6 % vs 8.6 %), prescription opioids (90.4 % vs 6.0 %), and heroin (40.7 % vs 26.0 %) all had higher detection via OFT than TLFB. Participants who reported marijuana use but had a negative OFT were more likely to be younger, Hispanic, and White compared to those with TLFB and OFT concordant positive results. CONCLUSIONS: TLFB and OFT show disparate detection of different substances. Researchers should consider the implications of using either self-report or oral fluid testing in isolation, depending on the substance and collection setting. Triangulating multiple sources of information may improve detection of drug use.

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Published In

Drug Alcohol Depend

DOI

EISSN

1879-0046

Publication Date

April 1, 2020

Volume

209

Start / End Page

107939

Location

Ireland

Related Subject Headings

  • Substance-Related Disorders
  • Substance Abuse Detection
  • Substance Abuse
  • Self Report
  • Primary Health Care
  • Mouth Mucosa
  • Middle Aged
  • Male
  • Humans
  • Health Surveys
 

Citation

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Nordeck, C. D., Gryczynski, J., O’Grady, K. E., Polak, K., Svikis, D. S., McNeely, J., … Schwartz, R. P. (2020). Comparison of timeline follow-back self-report and oral fluid testing to detect substance use in adult primary care patients. Drug Alcohol Depend, 209, 107939. https://doi.org/10.1016/j.drugalcdep.2020.107939
Nordeck, Courtney D., Jan Gryczynski, Kevin E. O’Grady, Kathryn Polak, Dace S. Svikis, Jennifer McNeely, Li-Tzy Wu, and Robert P. Schwartz. “Comparison of timeline follow-back self-report and oral fluid testing to detect substance use in adult primary care patients.Drug Alcohol Depend 209 (April 1, 2020): 107939. https://doi.org/10.1016/j.drugalcdep.2020.107939.
Nordeck CD, Gryczynski J, O’Grady KE, Polak K, Svikis DS, McNeely J, et al. Comparison of timeline follow-back self-report and oral fluid testing to detect substance use in adult primary care patients. Drug Alcohol Depend. 2020 Apr 1;209:107939.
Nordeck, Courtney D., et al. “Comparison of timeline follow-back self-report and oral fluid testing to detect substance use in adult primary care patients.Drug Alcohol Depend, vol. 209, Apr. 2020, p. 107939. Pubmed, doi:10.1016/j.drugalcdep.2020.107939.
Nordeck CD, Gryczynski J, O’Grady KE, Polak K, Svikis DS, McNeely J, Wu L-T, Schwartz RP. Comparison of timeline follow-back self-report and oral fluid testing to detect substance use in adult primary care patients. Drug Alcohol Depend. 2020 Apr 1;209:107939.
Journal cover image

Published In

Drug Alcohol Depend

DOI

EISSN

1879-0046

Publication Date

April 1, 2020

Volume

209

Start / End Page

107939

Location

Ireland

Related Subject Headings

  • Substance-Related Disorders
  • Substance Abuse Detection
  • Substance Abuse
  • Self Report
  • Primary Health Care
  • Mouth Mucosa
  • Middle Aged
  • Male
  • Humans
  • Health Surveys