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High Prevalence of Recent Cocaine Use and the Unreliability of Patient Self-Report in an Inner-City Walk-In Clinic

NCJ Number
156668
Journal
Journal of the American Medical Association Volume: 267 Issue: 8 Dated: (February 26, 1992) Pages: 1106-1108
Author(s)
S E McNagny; R M Parker
Date Published
1992
Length
3 pages
Annotation
A study conducted to determine the prevalence of recent cocaine use and the reliability of patient self-reported cocaine use underscored the magnitude of cocaine abuse among black men in the Atlanta inner-city area.
Abstract
The study setting was a walk-in clinic of a large public hospital in Atlanta. Study participants included male patients between 18 and 39 years of age who presented to the triage desk for immediate care during weekdays. Of 415 eligible men who agreed to participate, the average age was 29.5 years, 91.6 percent were black, and 89 percent were uninsured. Outcome measures involved a comparison of self-reported illicit drug use with results from urinary assays for benzoylecgonine, a major cocaine metabolite. The study sought to determine which drug history questions produced the most accurate responses using anonymous urine testing as the criterion standard. Findings showed that 39 percent of patients tested positive for the presence of benzoylecgonine and were statistically more likely to be older, and black, and to have a prior history of sexually transmitted disease. About 72 percent of men with positive urinary assays denied illicit drug use in the 3 days prior to sampling. When queried with several formats, subjects with positive urinary assays were more likely to admit to any illegal drug use than to the more specific any form of cocaine use within the prior year. The authors conclude that cocaine abuse among black, inner-city men is significant and that patient self-report of illicit drug use is highly inaccurate. 21 references and 2 tables

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