Implications

What are the implications of the current study’s findings? The most important finding is the general confirmation of high rates of drug use among youth entering detention. Virtually all (94 percent) of the youth entering detention had used drugs during their lifetime, and 85.4 percent had used drugs in the past 6 months. Two-thirds (66.4 percent) of detainees tested positive for drugs in urinalysis. Probably because cannabis use is commonplace among these youth, their veracity in reporting its use was generally good. The low self-report and urinalysis biases for cannabis are an indication that few juveniles who use it will be overlooked by either approach to detection. Because cannabis use often leads to more serious drug use (Kandel and Yamaguchi, 1993; Yamaguchi and Kandel, 1984a, 1984b), almost all youth entering detention can be considered at risk for developing substance use problems.

Identifying youth in acute need of treatment is much more difficult. For example, detecting use of substances other than cannabis is far more problematic than detecting cannabis use. Although the minimum prevalence estimates indicate that only one in eight detainees had used a substance other than cannabis, neither self-reporting nor urinalysis appears to provide an acceptable measure of such use. As can be seen in table 2, self-reports alone overlooked at least one-third of detainees who used substances other than cannabis in the past 6 months (4.2/12.2 [minimum bias for self-reporting/ minimum prevalence]=34.4 percent), and urinalysis alone overlooked at least half of these detainees (6.4/12.2 [minimum bias for urinalysis/minimum prevalence]=52.5 percent).

In addition, certain groups of detainees require special attention. For example, in this study, younger detainees, African American detainees, and detainees with recent drug arrests in particular lacked veracity in self-reporting drug use. Females had lower rates of detection by urinalysis, although further research is needed to understand exactly why. Detainees with histories of substance abuse treatment require special attention because of their higher rates of substance use and their histories of drug abuse.

In short, among youth who have made the transition to using drugs more serious than marijuana, neither self-reporting nor urinalysis provides a good measure of use. Most detained youth who test positive by urinalysis for substances other than cannabis do not reply honestly to questions about their drug use. Furthermore, use of these substances is likely to go undetected in urinalysis because the test has such a limited window of sensitivity to drugs.

The practical lesson is that self-reporting and urinalysis should be used in combination with each other and in conjunction with other resources, such as histories of treatment for substance abuse, records of drug-related arrests and charges, and information from families and schools on youth’s drug use. All avenues should be explored in efforts to identify those youth in greatest need of intervention.

Detection and Prevalence of Substance Use Among Juvenile Detainees	OJJDP Bulletin • June 2004