In response to Dr Hoffman's remarks we would like to address his concerns.
Dr Hoffman maintains that, "without survey of the subjects" for self-reported data on drug abuse, "there are few conclusions to be made, and certainly no major conclusions regarding (changes in) the pattern of substance abuse . . . ." Experience in our clinical setting and the English-language literature suggests that self-reported risk behaviors by adolescents may be inaccurate; underestimating the actual prevalence of risk behaviors.1- 5 Self-reported drug use data are available for the patients in the 1995-1996 study year; it was collected when urine samples were obtained. We are analyzing the data for an article discussing the validity of self-reported drug use and the use of self-report with biological testing as a method of obtaining "true prevalence." While we recognize that self-reported data may provide an additional viewpoint on the challenging question of actual drug use prevalence, we think Dr Hoffman's evaluation of our report is overly harsh. We recognize here, and in the article, that urine screening only captures recent drug use. Recall also that the focus of our article is on the "changing pattern" of drugs of abuse in our adolescent clinic. Both study samples were drawn from the same clinic environment under similar conditions, therefore we believe the samples can be compared to determine fluctuations in drug use in our clinic population.
Brasseux C, D'Angelo LJ, Guagliardo M, Hicks J. Urine Screening for Drugs of Abuse in Urban Adolescents—Reply. Arch Pediatr Adolesc Med. 1998;152(10):1040. doi: