Concordance between self-report psychoactive substance use and urine drug test among students of University of Ilorin, Nigeria: a cross-sectional study

Abstract

The prevalence of psychoactive substance use is increasing globally, and university students are not left behind. Self-report, using questionnaire has been the common method of assessing substance use amongst the students' population. This is, however, fraught with problems of poor reporting and intentional lie. Urine Drug Test (UDT) is a biochemical method that tests the recent use of substances either as a direct test of the psychoactive substance or its metabolite(s). This cross-sectional study aims to study the concordance between self-report and UDT amongst students' population. Two thousand five hundred and fifty students of the University of Ilorin, Nigeria completed a questionnaire based on the World Health Organization (WHO) guidelines for student substance-use surveys. Substances investigated in the survey were alcohol, cigarettes, cannabis, strong and mild stimulants, hypno-sedatives, cocaine, opiate, organic solvents, and hallucinogens. A subset of the total population, made of three hundred and two of the students were, subsequently, selected to participate in the urine drug test using a commercially available 12-items UDT kit. The reported lifetime and current prevalence of the substances were: tobacco, 11.5% and 3.7%; alcohol, 38.4% and 15.4%; cannabis, 9.0%and 3.8%; stimulants 32.5% and 15.8%; sedatives 11.7%, 4.8%, opioids 25.3% and 7.6%; cocaine was 4.7% and 1.6%; Hallucinogenic substances lifetime prevalence was 6.6% and a current prevalence of 1.4%. The lifetime prevalence for solvent use was 7.4% while current use was 1.6%. There was discordance between the outcome of the self-report and the result of UDT. Many respondents who tested positive for one substance or the other did not self-report ever using the substance. In conclusion, there is discordance between selfreport and results of the UDT. Many students who did not report ever use of psychoactive substances tested positive for substances. This study further emphasized the superiority of UDT over self-report for psychoactive substances among university students. We recommend that whenever suspicion of possible psychoactive substance use is made among university students, UDT should be the method of assessment. UDT is equally encouraged in school clinics and sports centres.