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Substance use assessment: comparing self-reports with objective data in a research setting
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DOI：10.3389/fpubh.2025.1628519.png)
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Abstract
En 中文
Accurate assessment of substance use is essential in public health; clinical; and research settings. While self-reports are widely used; they are prone to biases such as social desirability and recall errors. Objective biological measures; such as hair toxicology; offer a longer detection window and may improve data validity. This study examined the concordance between self-reported substance use and hair toxicology results; with a particular focus on cannabis. It also explored the prevalence and predictors of underreporting; and the relationship between cannabis use patterns and THC detection in hair. Data were collected from 75 adult participants. Self-reported substance use was assessed via questionnaire; and hair samples were analyzed using liquid chromatography–mass spectrometry (LC-MS/MS) to detect drug use over the prior 3 months. Underreporting was defined as a negative self-report with a positive hair test. Results showed that 21.3% of participants underreported use of at least one substance. While group differences were not statistically significant; moderate-to-large effect sizes were observed; these effect sizes are descriptive in nature and may reflect possible discordance for substances such as MDMA and cocaine. No sociodemographic factors or alcohol use patterns significantly predicted underreporting. However; self-reported cannabis use frequency and quantity were significant predictors of THC detection; while years of use and time since last use were not. These findings highlight the limitations of relying solely on self-reports and emphasize the value of integrating objective biological measures. A combined approach improves the accuracy of substance use assessment and helps address underreporting biases; particularly in settings where legal or social pressures may influence disclosure.
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