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Agreement Between Self-reports and Urine Toxicology Measures of Illicit Methamphetamine and Cocaine Use During Early Pregnancy.

Authors :
Sujan AC
Alexeeff SE
Slama NE
Goler N
Avalos LA
Adams SR
Conway A
Ansley D
Pal A
Gunn RL
Micalizzi L
Young-Wolff KC
Source :
Journal of addiction medicine [J Addict Med] 2024 Jan-Feb 01; Vol. 18 (1), pp. 28-32. Date of Electronic Publication: 2023 Oct 05.
Publication Year :
2024

Abstract

Objective: This study aimed to assess agreement between self-report and urine toxicology measures assessing use of 2 illicit simulants (methamphetamine and cocaine) during early pregnancy.<br />Methods: This cross-sectional study of 203,053 pregnancies from 169,709 individuals receiving prenatal care at Kaiser Permanente Northern California between January 1, 2011, and December 31, 2019, assessed agreement ( κ , sensitivity, and specificity) between self-reported frequency and urine toxicology measures of methamphetamine and cocaine early in pregnancy.<br />Results: Prenatal use of the illicit stimulants was rare according to toxicology (n = 244 [0.12%]) and self-report measures (n = 294 [0.14%]). Agreement between these measures was low ( κ < 0.20). Of the 498 positive pregnancies, 40 (8.03%) screened positive on both measures, 204 (40.96%) screened positive on toxicology tests only, and 254 (51.00%) screened positive by self-report only. Relative to toxicology tests, sensitivity of any self-reported use was poor with 16.39% (95% confidence interval [CI], 11.75%-21.04%) of pregnancies with a positive toxicology test self-reporting any use in pregnancy. Relative to self-report, sensitivity of toxicology tests was also poor with 13.61% (95% CI, 9.69%-17.52%) of pregnancies who self-reported any use having positive urine toxicology tests. The sensitivity improved slightly at higher frequencies of self-reported use: daily, 17.50% (95% CI, 5.72%-29.29%); weekly, 25.00% (95% CI, 11.58%-38.42%); and monthly or less, 11.06% (95% CI, 6.89%-15.23%). Specificity was high (>99%), reflecting the high negative rate of use.<br />Conclusions: Findings suggest that using self-report and toxicology measures in combination likely provides the most accurate information on methamphetamine and cocaine use in early pregnancy. Findings also highlight the need to provide supportive nonstigmatizing environments in which pregnant individuals feel comfortable disclosing substance use without fear of punishment.<br />Competing Interests: The authors report no conflicts of interest.<br /> (Copyright © 2023 American Society of Addiction Medicine.)

Details

Language :
English
ISSN :
1935-3227
Volume :
18
Issue :
1
Database :
MEDLINE
Journal :
Journal of addiction medicine
Publication Type :
Academic Journal
Accession number :
37801372
Full Text :
https://doi.org/10.1097/ADM.0000000000001230