Concordance between urinary cotinine levels and self-reported tobacco use among drug-dependent persons: a pilot study.

Self-reported drug use is a principle measure in the evaluation of treatment outcome. As there have been concerns about the accuracy of self-reporting, it is necessary to establish its validity by an objective method. The aim of the study was to examine the concordance between urinary cotinine concentrations and self-reported tobacco use among drug dependents seeking treatment at National Drug Dependence Treatment Centre, AIIMS, New Delhi, India. Eighty consecutive male drug addicts attending the OPD at National Drug Dependence Treatment Centre were interviewed by the clinician. Their tobacco as well as drug use history was recorded, and thereafter their urine sample was analyzed for drug testing. Mean age of the subjects was found to be 33 years (SD: 10). Urinalysis showed high concentration of cotinine (mean ± SD: 586.40 ± 222.15 ng/ml) in 95% of the subjects. High concordance was observed between self-report of tobacco use and urinary cotinine. The quantity of tobacco consumption and FTND scores were also correlated with the urinary cotinine levels. Urinalysis also showed misuse of opioids, benzodiazepines and antihistaminics. The treatment for tobacco use has been given low priority in the de-addiction centers. Tobacco is highly prevalent among the drug abusers. The effectiveness of the treatment program may be increased by using the combination of urine analysis along with self-report.