Abstract
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Aim: Approximately 3 million Americans are currently diagnosed with opioid use disorder (OUD; Azadfard et al., 2023). While medications for Opioid Use Disorder (MOUD) are highly efficacious for reducing mortality, it is important to identify substance use outside of treatment to prevent overdose and/or treatment complications. The present study evaluated the reliability of self-reported substance use amongst patients receiving MOUD.
Methods: Thirty-nine patients receiving methadone or buprenorphine were recruited from a local substance use clinic. At enrollment, all participants denied current illicit substance use and had no evidence of such use documented in their medical record over the past 30 days. Participants met with the research team for 14 days. Each day, participants reported on drug and alcohol use over the past 24 hours. Participants submitted to a urine screen twice over the study period. Participants were encouraged to report honestly and were ensured that their self-report and toxicology would remain confidential; No information would be shared with clinical personnel or used to guide treatment.
Results: Only one participant (2.56%) self-reported illicit substance use during the study. Yet, 20.51% of participants had at least 1 non-prescribed substance (excluding alcohol), detected through urinalysis. Alcohol use was confirmed in at least one sample from 10.26% of participants. In 60.0% of these instances, alcohol use was self-reported by the patient 1-4 days prior to testing.
Conclusions: This data suggests poor reliability of self-reported substance use amongst MOUD patients even in instances where confidentiality assurances are provided.
Financial Support: NIH/NIDA; 1R43DA050399-01A1