12296 Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York University School of Medicine, New York, NY, USA.
5939 New York City Department of Health and Mental Hygiene, Queens, NY, USA.
Public Health Rep. 2021 Jan/Feb;136(1):47-51. doi: 10.1177/0033354920965264. Epub 2020 Oct 27.
Estimating the prevalence of drug use in the general population is important given its potential health consequences but is challenging. Self-reported surveys on drug use have inherent limitations that underestimate drug use. We evaluated the performance of linking urine drug testing with a local, representative health examination survey in estimating the prevalence of drug use in New York City (NYC).
We used urine drug testing from the NYC Health and Nutrition Examination Survey (NYC HANES) to estimate the prevalence of drug use (benzodiazepines, cocaine, heroin, and opioid analgesics) among the study sample and compare the findings with self-reported responses to questions about past-12-month drug use from the same survey.
Of 1527 respondents to NYC HANES, urine drug testing was performed on 1297 (84.9%) participants who provided urine and consented to future studies. Self-reported responses gave past-12-month weighted estimates for heroin, cocaine, or any prescription drug misuse of 13.8% (95% CI, 11.6%-16.3%), for prescription drug misuse of 9.9% (95% CI, 8.1%-12.1%), and for heroin or cocaine use of 6.1% (95% CI, 4.7%-7.9%). Urine drug testing gave past-12-month weighted estimates for any drug use of 4.3% (95% CI, 3.0%-6.0%), for use of any prescription drug of 2.8% (95% CI, 1.9%-4.1%), and for heroin or cocaine use of 2.0% (95% CI, 1.2%-3.6%).
Urine drug testing provided underestimates for the prevalence of drug use at a population level compared with self-report. Researchers should use other methods to estimate the prevalence of drug use on a population level.
鉴于药物使用对健康可能造成的潜在影响，对一般人群中的药物使用流行率进行估计十分重要，但这极具挑战性。关于药物使用的自我报告调查存在固有局限性，会低估药物使用情况。我们评估了将尿液药物检测与当地有代表性的健康检查调查相联系，以估计纽约市（NYC）药物使用流行率的方法的效果。
我们使用来自纽约市健康与营养检查调查（NYC HANES）的尿液药物检测来估计研究样本中药物使用（苯二氮䓬类、可卡因、海洛因和阿片类镇痛药）的流行率，并将调查结果与来自同一调查的过去 12 个月药物使用问题的自我报告应答进行比较。
在 1527 名参与 NYC HANES 的受访者中，对 1297 名提供尿液且同意未来研究的参与者进行了尿液药物检测。自我报告应答给出了过去 12 个月的加权估计值，其中海洛因、可卡因或任何处方药物滥用的估计值为 13.8%（95%置信区间，11.6%-16.3%），处方药物滥用的估计值为 9.9%（95%置信区间，8.1%-12.1%），海洛因或可卡因使用的估计值为 6.1%（95%置信区间，4.7%-7.9%）。尿液药物检测给出了过去 12 个月的加权估计值，其中任何药物使用的估计值为 4.3%（95%置信区间，3.0%-6.0%），任何处方药物使用的估计值为 2.8%（95%置信区间，1.9%-4.1%），海洛因或可卡因使用的估计值为 2.0%（95%置信区间，1.2%-3.6%）。
与自我报告相比，尿液药物检测提供了对人群药物使用流行率的低估。研究人员应使用其他方法来估计人群层面的药物使用流行率。
