Patients in treatment centres: are they all dependents?

The congruence between self reported drug use and urinalysis data among 89 consecutive opioid dependents at their first contact in an outpatient clinic was examined. For this purpose self reports of drug use within preceding 72 hr, laboratory analysis of urine samples by thin layer chromatography (TLC) were carried out for various drugs. The same samples were also confirmed by gas liquid chromatography (GLC). Many subjects reported concomitant poly-drug use. The base rate was found to be low for other drugs besides heroin. The conclusion could be dra wn more con vincingly as regard heroin use. Inaccuracy in self-report of drug use has been observed using GLC as a gold standard. The subjects are likely to be more accurate when they report abstinence than when reporting drug use. These results also suggest that clinicians should be cautious while prescribing agonist/partial agonists especially based on only self-report for long term maintenance program, as many patients may not be really physiolologically dependent.