Vice Squad
Tuesday, April 20, 2004
Admitted Heroin Users Reticent About Cocaine Use

When people show up at an emergency room or for other medical care, knowledge of the drugs that they use can be of vital importance for themselves and their physicians. But people are not so willing to reveal that they use socially-frowned-upon drugs, and perhaps especially illegal ones. (Yet another cost of drug prohibition: it acts as a supplement to the disincentive to reveal, even to health-care professionals, important medical information.)

Self-reports of vice activity in general tend to be quite untrustworthy. Some people might be motivated to own up to their drug use, however, if they hope to be accepted into a treatment program, for instance. It might be thought that admitted heroin users would come clean about their use of other drugs, but that seems not to be the case. Perhaps heroin users look down upon cocaine users?

A research report that appears in the May 2004 issue of the journal Addiction finds that more than one-third of admitted heroin users who tested positive (via tests of hair samples) for cocaine use did not report that use, even in a secure environment and in knowledge of the fact that their hair would be tested for cocaine. Men were particularly unforthcoming about their cocaine use.

The article offers several hypotheses to explain the findings, including the possibility that those who did not self-report cocaine use tended to be light cocaine users, so they did not think their occasional cocaine consumption worthy of mention. This hypothesis is consistent with the findings that the concentrations of detected cocaine were much smaller in those who tested positive but did not report cocaine use than for those who admitted cocaine use. Perhaps surprisingly, heavier opiate users were less likely to own up to their coke use than were lighter users of heroin.

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