Concordance Between Self-Report Psychoactive Substance Use and Urine Drug Test Among Students of University of Ilorin, Nigeria

Abstract

Background: 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 deliberate falsehood. 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). Methods: 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, randomly selected to participate in the urine drug test using a commercially available 12-items UDT kit. Results: 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% & 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. Conclusion: There is discordance between self-report 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 centers. Funding Information: The Nigeria Tertiary Education Trust Fund (TETFund). Declaration of Interests: None. Ethics Approval Statement: The Protocol was approved by the University Ethical Research Committee (UERC) of the University of Ilorin. The detail of the study was explained to the participating students who signed consent to participate and were told they could opt out of the study as they wished. The Deans of the Faculties, the Head of Departments, and the Lecturers whose terminal periods were used were also informed about this study after UERC approval. Anonymity was ensured throughout and after the study.