4.3 Article

Discordance Between Self-reported and Biologically Tested Exposure to Fentanyl Among People at Risk of Opioid Overdose

Journal

JOURNAL OF ADDICTION MEDICINE
Volume 16, Issue 6, Pages 722-724

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ADM.0000000000000969

Keywords

drug testing; overdose; substance use

Funding

  1. Johns Hopkins Center for AIDS Research [1P30AI094189]
  2. National Institutes of Health [5R03DA049998]
  3. National Institute for Drug Abuse [T32DA007292]
  4. Behavioral Health System Baltimore [AS019HRO-JHPH]

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This study aimed to measure the concordance between self-reported and biologically tested fentanyl exposure. The study found that only 54% of participants who reported daily fentanyl use had a positive result in biological testing, indicating low agreement between self-reporting and biological detection.
Drug overdose remains a leading cause of death in the US, and the majority of opioid overdose fatalities involve fentanyl. This study aims to measure the degree of concordance between self-reported and biologically tested exposure to fentanyl. We conducted a cross-sectional analysis using survey and urinalysis data collected between 2019 and 2020 from Anne Arundel County, Maryland. Among urinalysis participants (n =113), 30% reported daily fentanyl use, and among this group, only 54% had a fentanyl-positive result. Cohen Kappa between self-reported and biologically detected fentanyl use was 0.26, indicating minimal agreement between the 2 markers. Limitations to interpreting self-reported and urinalysis data are discussed in this report.

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