Teens, Parents Both Underreport Drug Use, Study Finds

Teenagers aren't the only ones who skirt the truth in admitting drug use: Their parents do it too, a new study suggests.

Teens were 52 times more likely to test positive for cocaine use than report using it, while parents were 6.5 times more likely to do the same, the researchers said. Both groups misrepresented their illicit drug use despite knowing they would undergo a drug test.

"If someone asks you a question and you don’t like the answer, it's human nature to provide a socially acceptable answer," lead researcher Dr. Virginia Delaney-Black of the Children’s Hospital of Michigan, told LiveScience. "They're putting a spin on their lives and experiences, and I think it’s perfectly natural." (Delaney-Black is also a professor of pediatrics at Wayne State University in Detroit.)

In one of the first large, nonclinical teen studies with biological testing, the researchers asked more than 430 urban teens and parents about their cocaine and opiate use in face-to-face interviews and questionnaires.

Hair samples – which can reflect drug use for up to three months – were tested, and all participants were promised confidentiality. Parents were also asked to divulge if they suspected drug use among their children.

Despite the checks and balances, both teens and parents also tested positive for opiate use at higher rates than reported – with parents 5.5 times more likely to deny later-proven use.

According to the National Institute on Drug Abuse, 5.3 million Americans ages 12 and older had abused cocaine in 2008. Non-medical use of the opiates Vicodin and OxyContin, both prescription painkillers, increased during the last five years among 10th graders.

"For adults, the perceived threat of legal consequences from acknowledging illicit drug use may contribute to the relative poor sensitivity of self-report," Delaney-Black wrote in the November issue of the journal Pediatrics, which appears online today (Oct. 25).

Patrick J. Hart, a Seattle psychologist specializing in family drug intervention, said removing the stigma from drug dependency is likely to prompt more adults and teens to seek treatment instead of hiding their habit.

"One thing to highlight is the emotions underlying the underreporting," said Hart, who was not involved in the study. "It's a shame-based illness, so the context of shame is an important consideration."

Delaney-Black said she and other researchers were concerned about the substantial discrepancy between how many teens admitted using drugs and how many actually did. Also disturbing was that many parents were not aware their children were users, she said.

The study "confirm(s) our concerns that both teen- and parent-reported teen drug use is limited, at least for youth in high-risk urban settings," she wrote.

Medical professionals should anticipate that teens who claim to be drug-free may not be telling the truth, Delaney-Black said, even if they are reassured the information is confidential.

"The take-home message is to have pediatricians recognize . . . they need not rely on self-reporting,” she said. "I don't think our results are that surprising, if we really thought about it. Nobody likes the truth when they think it might be embarrassing."