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ARTICLE |

The Self-reporting of Cocaine Use FREE

John Rich, MD; JudyAnn Bigby, MD
JAMA. 1992;268(17):2375-2375. doi:10.1001/jama.1992.03490170045015
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To the Editor.  —We are disturbed about several aspects of the study of cocaine use and self-report recently published in JAMA.1We disagree with the authors' statement that the study situation replicates a patient-physician interaction. The interaction lacked personal physician-patient contact and an explanation about why the questions on drug use were relevant to the study on STDs and the presenting complaints. Patients had no reason to believe that the question about cocaine use was relevant to their clinical problem or to the STD study in which they consented to participate by submitting a urine sample. Since cocaine use is illegal, the study population could not be sure how an admission of cocaine use might affect their clinical care.The authors conclude that self-report of cocaine use is unreliable. However, the interaction specifically does not replicate the appropriate way to obtain a substance abuse history since questions about quantity

REFERENCES

McNagny SE, Parker RM.  High prevalence of recent cocaine use and the unreliability of patient self-report in an inner-city walk-in clinic. JAMA . 1992;;267:1106-1108.
Whitmer P, Kinney J.  Routine screening and initial assessment.  In: Clinical Manual of Substance Abuse . St Louis, Mo: Mosby Year Book; 1991;:34-47.
Kamerow DB, Pincus HA, McDonald DI.  Alcohol abuse, other drug abuse and mental disorders in medical practice: prevalence, costs, recognition, and treatment. JAMA . 1986;;255:2054-2057.

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McNagny SE, Parker RM.  High prevalence of recent cocaine use and the unreliability of patient self-report in an inner-city walk-in clinic. JAMA . 1992;;267:1106-1108.
Whitmer P, Kinney J.  Routine screening and initial assessment.  In: Clinical Manual of Substance Abuse . St Louis, Mo: Mosby Year Book; 1991;:34-47.
Kamerow DB, Pincus HA, McDonald DI.  Alcohol abuse, other drug abuse and mental disorders in medical practice: prevalence, costs, recognition, and treatment. JAMA . 1986;;255:2054-2057.
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