Concordance between urinalysis results and self-reported drug use by applicants for methadone maintenance in Australia

This study examined concordance between self-reported drug use and urinalysis data among 341 applicants for methadone treatment in Sydney, Australia. Rates of underreporting of use of specific drugs were low (0% to 10%). Irregular drug use, short half-life of some abused drugs, and relatively low sensitivity of the TLC assay procedure led to most detected drugs being found in only one of two urine samples collected. Subjects reported having recently used nearly twice as many drugs as were detected in their urine. Agreement (kappa) between self-report and urinalysis results was in the fair to good range for most drugs. None of the six predictors of misreporting examined were found to be of practical value.