Comparison of self-reported benzodiazepine use and urinalysis among consecutive treatment seekers at a tertiary care drug dependence treatment centre

Information provided by drug dependent patients might be incomplete and/or discrepant. Benzodiazepines are frequently abused, but not necessarily reported, even bythe treatment seeking population. The study aims to compare the self reported benzodiazepine use with a quick and effective urinalysis method. A total of 51 consecutive adult patients were included after an informed consent during their first visit to a tertiary care drug dependence treatment centre. The socio-demographic and clinical details were recorded on a semi-structured proforma. Patients were specifically asked for ever, current and recent benzodiazepine use and thereafter ten ml urine sample was collected to perform urinalysis with cassette test for benzodiazepines. The sample, predominantly males, had a mean age of 37.86 +/-10.46 years. The common primary drugs of use were heroin (52.9%), alcohol (23.5%) and other opioids (21.6%). Drug use was uninterrupted in most of users (72.5%) and ranged from one to forty years. The recent benzodiazepine use was reported by 21.6% of all users whereas urinalysis by cassette test was positive in 50.9% of the treatment seekers. Denial among users was 69.2% and denial among negative self report was 45%. A poor level of agreement (K) was found between results of self-report and urinalysis for all the treatment seekers. Self report of benzodiazepine use is highly questionable among treatment seekers. The urinalysis with cassette test is a quick objective method which is recommended for routine screening.