Drug Use During Pregnancy: Validating the Drug Abuse Screening Test Against Physiological Measures

• Published in: Psychology of addictive behaviors 2010-12, Vol.24 (4), p.719-723
• Main Authors: Grekin, Emily R, Svikis, Dace S, Lam, Phebe, Connors, Veronica, LeBreton, James M, Streiner, David L, Smith, Courtney, Ondersma, Steven J
• Format: Article
• Language: English
• Subjects: Acasis; Adult; African Americans; Biological and medical sciences; Birth; Disclosure; Drug Abuse; Drug Usage Screening; Female; Hair; Hospitals; Human; Humans; Inpatient; Low income women; Mass Screening; Medical sciences; Poverty; Pregnancy; Pregnant women; Prenatal Exposure; Psychology. Psychoanalysis. Psychiatry; Psychometrics. Diagnostic aid systems; Psychopathology. Psychiatry; ROC Curve; Screening; Sensitivity and Specificity; Substance Abuse Detection; Substance-Related Disorders - diagnosis; Techniques and methods; Test Validity; Urine
• ISSN: 0893-164X; 1939-1501
• DOI: 10.1037/a0021741

This study examined the ability of the Drug Abuse Screening Test (DAST-10) to identify prenatal drug use using hair and urine samples as criterion variables. In addition, this study was the first to use "best practices," such as anonymity, ACASI technology, and a written screener, to facilitate disclosure in this vulnerable population. 300 low-income, post-partum women (90.3% African-American) were recruited from their hospital rooms after giving birth. Participation involved (a) completing a computerized assessment battery that contained the DAST-10 and (b) providing urine and hair samples. Twenty-four percent of the sample had a positive drug screen. The sensitivity of the DAST-10 was only .47. Nineteen percent of the sample had a positive toxicology screen but denied drug use on the DAST-10. Findings suggest that brief drug use screeners may have limited utility for pregnant women and that efforts to facilitate disclosure via reassurance and anonymity are unlikely to be sufficient in this population.