J. Robert Flores, Administrator June 2004

U.S. Department of Justice

Office of Justice Programs

Office of Juvenile Justice and Delinquency Prevention 

Access OJJDP publications online at www.ojp.usdoj.gov/ojjdp

Office of Justice Programs • Partnerships for Safer Communities • www.ojp.usdoj.gov

Crowe, 1998; Bilchik, 1998; Cocozza, 1992;

Teplin, 2001).

The Northwestern Juvenile Project is a

study of 1,829 juveniles sampled from

intake at the Cook County Juvenile Temporary Detention Center in Chicago, IL.

Researchers gathered extensive self-report

data on substance use and collected urine

samples for drug analysis. This Bulletin

describes the self-report and urinalysis

findings, with the goal of providing practical guidance for juvenile justice policymakers and administrators planning drug

detection and treatment programs. 

The Bulletin has four sections. The first

presents background information on the

effects of substance use and abuse on adolescent development, demonstrating the

significant role of this factor in delinquency. The second section reviews literature

on the measurement of illicit substance

use in detained and securely confined juvenile populations and assesses the state

of the science. The third section presents

empirical findings from the Northwestern

Juvenile Project on the relative merits of

self-report and urinalysis measures and

on the prevalence of illicit substance use

among detained juveniles by age, gender,

Detection and Prevalence 

of Substance Use Among

Juvenile Detainees

Gary M. McClelland, Linda A. Teplin, and Karen M. Abram

Identifying and responding to juvenile

substance use and abuse are central to

the mission of the juvenile justice system.

The reasons are clear:

◆ Of the approximately 2.4 million juvenile

arrests each year, more than 203,000

are for drug charges (Snyder, 2002).

As of October 27, 1999, nearly 109,000

juvenile offenders were in custody in

juvenile residential placement facilities; approximately 9,880 of these youth

(9 percent) were held for drug charges

(Sickmund, forthcoming). 

◆ Many youth in the justice system have

a substance use disorder (Atkins et al.,

1999; Gray and Wish, 1998; Marsteller

et al., 1997; Teplin et al., 2002), and many

more regularly use illicit substances

(Crowe, 1998; Dembo et al., 1993, 1999;

Feucht, Stephens, and Walker, 1994;

Kang, Magura, and Shapiro, 1994). 

Juveniles are not likely to be candid about

their use of drugs and, like adult detainees,

juveniles in detention are especially reticent. Juvenile justice authorities should,

therefore, be prepared to identify substance use problems among detainees and

to use this information to provide treatment and diversion (Gray and Wish, 1998;

A Message From OJJDP

Research indicates that many juveniles who enter detention facilities

have used drugs. To provide effective deterrence and treatment for

such youth, juvenile justice authorities need reliable information on

substance use problems. While

questioning detainees about their

drug use does not necessarily produce valid results, alternative methods of testing for drugs also have

shortcomings.

Using data from the Northwestern

Juvenile Project’s study of high-risk

youth detained in Cook County, IL,

the authors of this Bulletin assess

two widely used measures of drug

use: self-reporting and urinalysis.

Their assessment covers a range of

substances but focuses on cannabis

and cocaine, the drugs most commonly used by juvenile detainees.

The study confirms a high rate of

drug use among juvenile detainees

and identifies detainees who require

special attention. The authors conclude that because cannabis use is

so common and often leads to more

serious drug use, most youth entering detention can be considered at

risk of developing substance abuse

problems. The study’s findings

indicate that the best approach to

detecting substance abuse is to

combine self-reporting with urinalysis and also use other resources

such as treatment and drug arrest

histories and information from

families and schools.
2

race/ethnicity, and type of substance. The

final section discusses the implications of

these findings.

The authors conclude that presently there

is no single reliable method for detecting

substance use and abuse among juvenile

detainees. The best approach to reliable

assessment uses a combination of existing

methods, together with information from

a range of other sources that indicate a

youth’s involvement with drugs. 

Background: Substance

Use in Adolescent

Development

Drug use is implicated in a number of

developmental problems in adolescence:

poor academic performance (Lynskey and

Fergusson, 1995; McCluskey et al., 2002),

sexual precocity (Elliott and Morse, 1989),

aggression and violence (Brook, Whiteman, and Finch, 1992; Windle, 1990), gang

involvement (Fagan, 1989), and mental

distress and disorder (Cohen et al., 1990).

Drug use is prevalent among American

youth: 4.9 million youth between 12 and 17

years of age report using illicit substances

in the past year, and more than 1 million

of these youth have a substance dependence disorder (U.S. Department of Health

and Human Services, 2002). More than

half of all 12th grade students report using

illicit substances, and about one-quarter

report using them in the past 30 days

(Johnston, O’Malley, and Bachman, 2003).

In addition, 28.5 percent of all high school

students report being offered drugs, selling drugs, or obtaining drugs on school

property in the past year (Grunbaum et

al., 2002). 

Recent advances in the understanding of

adolescent development make these figures on substance use even more disturbing. It is now known that deviant careers

have distinct patterns. Problem behaviors

cluster together in time, and they often

follow typical sequences of development

over the life span. These patterns are

often called pathways.1 Although there is

no universally accepted categorization of

these patterns or pathways, the following

generalizations about drug use and adolescent development are generally recognized: 

◆ Substance use commonly follows a

sequence from tobacco and alcohol

to cannabis and then to more dangerous substances (Newcomb and Bentler,

1990; Rutter, 1996; Yamaguchi and

Kandel, 1984a, 1984b).

◆ Beginning substance use and abuse in

early adolescence is associated with:

❖ More serious delinquency and longer

deviant careers (Moffitt, 1993a; Craddock, Collins, and Timrots, 1994;

Harrison and Gfroerer, 1992; Brook

et al., 1996; Loeber, StouthamerLoeber, and White, 1999).

❖ Antisocial personality disorders

in later life (Myers, Stewart, and

Brown, 1998; van den Bree, Svikis,

and Pickens, 2000). 

❖ More numerous risk behaviors

(Elliott and Morse, 1989; Pedersen

and Hegna, 2003; Duncan, Strycker,

and Duncan, 1999).

◆ Substance abuse is associated with

poor academic performance (McCluskey

et al., 2002).

◆ More severe substance abuse and

dependence are associated with more

serious criminal offenses in general

(Elliott, Huizinga, and Menard, 1989;

Mason and Windle, 2002).

◆ Substance use and abuse are associated

with higher rates of psychiatric disorders and with more severe psychiatric

disorders (Elliott, Huizinga, and Menard,

1989; Abram, Teplin, and McClelland,

2003; Brook, Cohen, and Brook, 1998;

Deykin and Buka, 1997; Shedler and

Block, 1990).

Although substance use is not thought

to cause all of these problems, it is empirically associated with a number of problem behaviors and with adolescent delinquency in general. For this reason, the

detection of substance use among juveniles in the justice system will help identify youth at greatest risk for serious

problems and those most likely to benefit

from treatment and diversion. 

Measuring Substance

Use Among Detainees:

Self-Report or

Bioassay?

Self-report and bioassay are the two techniques most commonly used to detect

substance use in detained populations.

There is great variety within each of these

techniques. Self-report information can

be obtained by using a mail questionnaire, a self-administered computerized

instrument, or a face-to-face interview.

Bioassay, or biological measurement, can

be done with various tissues and fluids.

No gold standard exists for assessment

of substance use. Each method has its

strengths and weaknesses.

Self-Report 

Self-report is the least expensive, most

easily administered method of assessing

substance use. For this reason, large

national studies rely on self-report data

to generate prevalence rates of substance

use (Craddock, Collins, and Timrots, 1994;

Harrison and Gfroerer, 1992; Golub et al.,

2002; U.S. Department of Health and Human

Services, 1996). For self-report data to be

valid, subjects must understand the questions, accurately recall the information

requested, and disclose information honestly (Lessler and O’Reilly, 1997; Turner et

al., 1998; Wasserman et al., 2002; Catania

et al., 1990; Huang, Watters, and Case,

1988; Miller, 1997). Each of these requirements poses challenges in juvenile justice

settings.

Understanding questions. Drugs of abuse

have a wide range of street names, and

these names vary greatly from setting to

setting. Because subjects may be unfamiliar with street names of drugs used

in other neighborhoods, social strata,

or ethnic groups, interviewers must be

trained to be sensitive to each subject’s

background, demeanor, and linguistic preferences. In addition, because many juvenile justice detainees have limited reading

skills, self-administered questionnaires

and computerized instruments that are

useful in other settings may be problematic

for detained youth.

Recalling information. Drug use itself

might compromise a subject’s ability to

recall specifics. However, although impaired

recall poses problems for assessing patterns and details of substance use, recall

of recent use is unlikely to be so impaired

as to prevent identification of youth in

need of treatment. 

Answering honestly. The greatest barrier

to accurate self-reporting of drug use

is unwillingness to disclose honestly.

Detainees—both adult and juvenile—are

understandably reticent about reporting

illegal behavior, and self-reported drug

use data from these groups, therefore, are

likely to lack validity.2 
3

Bioassay

At its best, bioassay promises to circumvent the problems of self-reporting. Bioassay, however, does not solve all the

problems associated with measuring drug

use. Common to any bioassay is the premise that the drug or a metabolic byproduct

unique to the body’s processing of the

drug will be present in the fluids or tissues tested. Two issues confront all bioassay methods: first, what tissue or fluid to

test; and second, how to measure the presence of a drug or its metabolite. These

two issues frame most of the debate over

the validity and usefulness of bioassay. 

Choosing tissues or fluids. Bioassays

can be done with urine, hair, saliva, sweat,

blood, and semen. Most detention facilities use urine or hair, both of which are

relatively easy to collect.3 In general, urine

testing is sensitive only to drugs used

within the last 2 or 3 days (Mieczkowski

and Newel, 1993; Cone, 1997; Council on

Scientific Affairs, 1987; Wolff et al., 1999).4

Although hair analysis initially promised

to provide a record of drug use for weeks

or even months, troublesome issues have

yet to be resolved: external contamination

may result in false-positive findings,5 and

cocaine may bind to hair more readily

than cannabis or opiates and may bind

more readily to some types of hair than

others (which may cause racial differences

in sensitivity to hair analysis) (Baumgartner, Hill, and Blahd, 1989; Mieczkowski

and Newel, 1997; Miller, Donnelly, and

Martz, 1997).

Choosing a method of analysis. Many

techniques are available for identifying

drugs in urine or hair (Visher and McFadden, 1991; Riley, Lu, and Taylor, 2000):

◆ Gas chromatography/mass spectrometry. GC/MS is the best method for

detecting drugs (i.e., the least likely to

produce false-negative or false-positive

results), but it is also the most costly.

GC/MS requires trained technicians,

lengthy preparation of samples, and

expensive laboratory equipment. 

◆ Other chromatographic methods.

High-performance liquid chromatography (HPLC) performs well but also

requires expensive equipment. Thinlayer chromatography (TLC) is inexpensive but not as reliable as other

chromatographic methods.

◆ Immunoassay. The most commonly

used immunoassay methods are radioimmunoassay and enzyme-multiplied

immunoassay. In both methods, a drugbinding antibody is added to a sample,

and the level of antibody activity is

then measured. Although these methods are relatively inexpensive and easily executed, they have drawbacks: a

different antibody must be developed

for each drug tested, and the antibodies sometimes bind to substances that

are chemically similar to the drug in

question (resulting in false positives,

such as mistaking over-the-counter

cold remedies for amphetamines).

Previous Studies

Research has demonstrated not only high

levels of substance use among detained

youth but also shortcomings of self-report

measures in this population. Table 1 summarizes seven studies that used self-reports

and/or bioassays to measure drug use in

juvenile detainees.

As the table shows, the level of self-reported

cannabis and cocaine use varies markedly

from study to study. For both drugs, selfreports of use decline sharply when subjects are asked about more recent use.

Urinalysis results for cannabis are fairly

consistent for three of the four studies;

results for cocaine are more consistent

across studies. Hair analysis results vary

for both drugs. The variation in bioassay

results may be attributable to the studies’

methodological differences: they sampled

youth at different stages of the juvenile

justice process, were designed for different purposes, and had different rates of

refusal or noncompliance.

Veracity of self-report data could be computed for only a few of the studies. For

cannabis, one study found that 60.4 percent

of juveniles who tested positive reported

use in the past 3 days, and another found

that all juveniles who tested positive reported lifetime use and 81.0 percent reported

“recent” use. For cocaine, veracity of selfreport data was strikingly poor: of those

who tested positive, only 22.7 percent

reported use in the past 3 days, 22.1 to 23.4

percent reported use in the past 3 months,

and 50.0 percent reported “recent” use.

In other words, at least half of recent

cocaine users denied use.

Studies of detained adults (Golub et al.,

2002; Gray and Wish, 1999; Harrison, 1995;

Mieczkowski, 1990) have found self-report

veracity levels for cannabis and cocaine

that are similar to those found for juveniles.

As with juveniles, self-reports of use

decline when subjects are asked about

more recent use, and veracity levels are

markedly lower for cocaine than for

cannabis. For adults, the veracity level for

opiate use is generally higher than that for

cocaine use.

To summarize:

◆ Both self-report and bioassay data

confirm that substantial numbers of

juvenile and adult detainees use drugs.

◆ Self-report veracity is poor among both

juveniles and adults, especially when

they are asked about recent use.

◆ Self-report veracity is related to the type

of drug. Cannabis use is more likely to

be reported than cocaine use, probably

because the former is more socially

acceptable (Golub et al., 2002; Harrison,

1995; Mieczkowski et al., 1991; Fendrich

and Xu, 1994) and because it carries

less severe legal consequences.

Two key questions have not been adequately addressed in the existing literature: First, does the veracity of self-reported

drug use differ across demographic groups

(i.e., age, gender, and race/ethnicity)? Second, what is the best approach for identifying drug use among juvenile detainees,

given the demonstrated shortcomings of

the various measures? These questions

are addressed below. 

Findings From the

Northwestern Juvenile

Project

The study reported in this Bulletin uses

self-report and urinalysis results from the

Northwestern Juvenile Project to compare

the veracity of self-reported drug use

across demographic groups and to identify the best approach for assessing drug

use among juvenile detainees. The study

focuses on self-report and urinalysis for

three reasons: they are the most widely

used, best understood measures of substance use; they can be administered by

trained lay personnel (a practical consideration for juvenile justice facilities); and

the level of agreement and disagreement

between the two measures is relatively

well documented.

This section describes the study’s sample

and methods, presents an overview of

findings, and then looks at findings for the

two substances most commonly used by

juvenile detainees—cannabis and cocaine—

by subject characteristics (gender, race/

ethnicity, age, prior treatment for substance abuse, and recent drug charges). 
4

Table 1: Drug Use by Detained Juveniles: Studies of Prevalence and Self-Report Veracity 

Prevalence Prevalence Prevalence Veracity of

Based on Based on Based on Self-Report

Study Design Self-Reports Urinalysis Hair Analysis Data*

Wislar and N=3,048 Past 3 days Cannabis 31.4% Not Past 3 days

Fendrich, 2000 juvenile Cannabis 31% Cocaine 7.3% administered Cannabis 60.4%

arrestees and Cocaine 2.8% Cocaine 22.7%

detainees

Dembo et al., N=80 youth Past 3 months Not Cannabis 32.5% Cannot be 

1999 arrested and Cannabis 51.3% administered Cocaine 18.75% computed†

completing a Cocaine 7.5% at baseline

court-ordered 

treatment 

program

Mieczkowski, N=407 juvenile Past 3 days Cannabis 34.8% Cannabis 38.5% Cannot be

Newel, and Wraight, detainees Cannabis 25.3% Cocaine 7.1% Cocaine 22.0% computed†

1998 interviewed Cocaine 0.9%

within 48 hours Past 30 days

of detention Cannabis 50.6%

Cocaine 3.2%

Ever

Cannabis 85.6%

Cocaine 13.2%

Magura, Kang, and N=121 youth Past 30 days Not Cocaine Past 3 months

Shapiro, 1995 followed up after Cocaine 22% administered 51%– 67%‡ Cocaine 22.1%–

release from jail Past 3 months 23.4%‡

Cocaine 23%

Ever

Cocaine 35%

Feucht, Stephens, N=88 detained Past month Cocaine 7.8% Cocaine 56.8% Cannot be 

and Walker, 1994 youth Cocaine 3.4% computed†

Past 90 days

Cocaine 5.7%

Ever

Cocaine 7.4%

Dembo et al., N=399 detained Authors do not Cannabis 34.3% Not Cannot be

1993 youth provide self- Cocaine 9% administered computed†

report data Opiates 0.5%

Dembo et al., N=66 juveniles Authors do not Cannabis 53% Not Recent§

1987 ordered into provide self- Cocaine 6.1% administered Cannabis 81%

secure detention report data Barbiturates 4.6% Cocaine 50%

(6 refused urine Lifetime

test) Cannabis 100%

* Among youth who tested positive, the percentage who reported use.

† Veracity cannot be computed for several studies because self-report data are not provided specifically for positive urinalysis or hair analysis test results.

‡ The ranges reflect the authors’ two cutoff levels for establishing cocaine content in hair: > 2 ng/10 mg and > 5 ng/10 mg. The latter, more conservative 

figure is the conventional cutoff level.

§ The authors do not define recency of use.
5

Sample and Methods 

Sample. The Northwestern Juvenile Project is an ongoing longitudinal study of

high-risk youth sampled from the Cook

County Juvenile Temporary Detention

Center (CCJTDC) in Chicago, IL. CCJTDC

was selected for study because of its urban

location (most juvenile detainees nationwide are in urban areas) and because

Cook County is ethnically diverse and has

a large Hispanic population (Hispanics are

the largest minority group in the United

States and are overrepresented in the juvenile justice system). In addition, CCJTDC’s

size (approximately 8,500 admissions each

year, daily census of 650, and daily intake

of 20) ensured adequate numbers of subjects for key subgroups such as females

and Hispanics. 

The CCJTDC sample was stratified by gender, race/ethnicity (African American, nonHispanic white, Hispanic), age (10–13 or

14 and older), and legal status (processed

as a juvenile or as an adult). All estimates

reported in this Bulletin were weighted

to reflect the CCJTDC sample (Little and

Schenker, 1995; Cochran, 1977).

Initial sampling and baseline interviews

were conducted between November 1995

and June 1998. The final sample size for

the project was 1,829. Additional information on the sample and study design is

available elsewhere (Teplin et al., 2002;

Abram et al., 2003; Teplin et al., 2003).

Interviews and urine samples. Trained

interviewers used the Diagnostic Interview

Schedule for Children (DISC 2.3) to gather

information on substance use. Subjects

were assured that the information they

revealed would remain confidential and

would have no bearing on their legal proceedings. Interviewers built rapport with

subjects during the questions that preceded the substance use items (basic demographic information, education, life circumstances, and DISC mental health items).

Female subjects were assigned female

interviewers, and Spanish-speaking subjects were assigned bilingual interviewers.

The DISC instrument measures use of

alcohol, cannabis/hashish, uppers/speed,

downers (e.g., barbiturates), tranquilizers

(e.g., Valium, Librium, and Ativan), heroin

and opiates (including morphine, methadone, and codeine), cocaine/crack cocaine,

hallucinogens (including LSD and PCP),

and inhalants (e.g., glue). The instrument

asks about lifetime use, age at first use,

frequency of use in the past year, any

use in the past 6 months, and treatment.

Because it is designed to assess patterns

of use, it does not ask about use in the

past 2 or 3 days.

Of the 1,829 subjects interviewed, 1,745

(about 95 percent) provided urine samples.6 Some subjects were unwilling or

unable to provide samples, and some samples were unavailable for administrative

reasons.7 The final sample size for the

analyses reported in this Bulletin is 1,742

(3 subjects did not complete the DISC

portion of the interview).8

Urinalysis. Enzyme-Multiplied Immunoassay Tests (EMIT) were used to identify illicit drug use by the subjects. The

EMIT–10 panel tests for the presence

of amphetamines, barbiturates, benzodiazepines (diazepam, nordiazepam,

oxazepam, chlordiazepoxide, and norflurazepam), cannabis, cocaine (benzoylecgonine is a cocaine metabolite found in the

urine), methaqualone (Quaaludes), opiates (including codeine and morphine),

PCP, and propoxyphene (Darvon). Some

EMIT–10 panel categories are not exact

matches for self-report categories.9

Drug charges. Data on recent drug

charges (e.g., possession or sale of controlled substances) against subjects were

collected from the Cook County Court

Clerk’s computer system. The period of

coverage for these data was from 90 days

prior to intake at CCJTDC to 30 days after

intake (to account for lagtime between

arrests and charges).

Overview of Findings

Table 2 presents an overview of findings—

self-reported use, urinalysis results, and

computations of veracity, prevalence, and

bias (see “Definitions” sidebar, below)—

among the total sample of all detained

juveniles. 

Self-reported use. Self-reported use of any

substance was quite common. Use in the

past 6 months was reported by 77.3 percent

of youth, lifetime use by 90.1 percent. The

figures for cannabis were about the same

(77.1 percent and 90.1 percent, respectively), an indication that almost all youth

who report any substance use report

cannabis use. Self-reported use of substances other than cannabis was much

less common: 8.0 percent and 13.0 percent

Definitions

The measures reported in tables 2–4 and analyzed in the accompanying text

are defined below.

Self-reported use: percentage of detained youth who reported substance use.

Urinalysis results: percentage of detained youth who tested positive for substances in EMIT–10 urinalysis.

Veracity: percentage of detained youth who tested positive by urinalysis who also

reported use.

Minimum prevalence: estimated prevalence of substance use among detained

youth, based on combined self-report and urinalysis results.

Minimum bias for self-report: estimated percentage of detained youth who use

drugs and would go undetected if self-report is used without urinalysis (calculated

as the difference between minimum prevalence and self-reported use).

Minimum bias for urinalysis: estimated percentage of detained youth who use

drugs and would go undetected if urinalysis is used without self-report (calculated

as the difference between minimum prevalence and urinalysis results).

Self-reported use and the related measures of veracity, prevalence, and bias are

presented separately for use in the past 6 months and ever (lifetime). Prevalence

and bias estimates are “minimum” because both self-report and urinalysis measures are expected to underestimate true rates of substance use.
6

(6-month and lifetime, respectively) for

any other substance, 5.5 percent and 9.4

percent for hallucinogens, 4.4 percent and

6.2 percent for cocaine, and even less for

the other categories measured (opiates,

uppers, downers, and tranquilizers). 

Urinalysis results. In many ways, patterns

of use detected by EMIT–10 urinalysis

were similar to patterns of self-reported

use. However, use rates based on urinalysis results generally were lower than those

based on self-reports of 6-month and lifetime use. This is not surprising, given that

in urinalysis, the window of sensitivity to

drugs generally is only 2–3 days. Twothirds (66.4 percent) of detainees tested

positive for any drug, 65.9 percent for cannabis, 5.8 percent for any substance other

than cannabis, 4.8 percent for cocaine,

and 1.1 percent for hallucinogens. 

Veracity. Overall, self-reporting had a surprisingly high level of veracity. Among all

detainees with positive urinalysis results,

87.7 percent reported use of any substance

in the past 6 months and 94.1 percent

reported lifetime use of any substance.

However, although the veracity figures

for cannabis (87.6 percent for 6 months

and 94.1 percent for lifetime) were nearly

identical to the overall figures, those for

any drug other than cannabis were much

lower (27.5 percent and 37.8 percent). This

means that cannabis alone was responsible for the high level of veracity in selfreporting of overall drug use. More than

three in five detainees who tested positive

for use of illicit substances other than cannabis did not accurately report their use.

Minimum prevalence. Based on a combination of self-report and urinalysis results,

the minimum prevalence estimates show

that at least 85.4 percent of detained

youth had used some kind of illicit substance in the past 6 months and at least

94 percent had used an illicit substance at

some point in their lifetime. For substances

other than cannabis, however, minimum

prevalence was much lower: 12.2 percent

for 6 months and 16.6 percent for lifetime.

Minimum bias for self-report. This measure, which is the difference between the

minimum prevalence estimate and the

self-report estimate, indicates that selfreporting without urinalysis overlooked

at least 8.2 percent of detained youth who

had used some kind of illicit substance in

the past 6 months, or almost 1 in 10 youth

in detention. This bias drops to 3.9 percent for lifetime use. For substances other

than cannabis, self-reporting without urinalysis overlooked 4.2 percent of youth

who had used a substance in the past 6

months and 3.6 percent of those with lifetime use. These values were low because

overall use of these substances was low.

Nevertheless, as the bias and prevalence

figures show, self-reporting overlooked

one-fourth (3.6/16.6) to one-third (4.2/12.2)

of juveniles who had used substances

other than cannabis. 

For cocaine specifically, 6-month selfreporting overlooked 3.6 percent of

detainees and lifetime self-reporting overlooked 3.4 percent of detainees. The 6-

month minimum prevalence for cocaine

use was only 8.1 percent, so overlooking

3.6 percent means missing more than 

one-third of confirmed cocaine users. 

For uppers, downers, and tranquilizers,

self-reported use was less than 2 percent

and EMIT urinalysis findings were zero.

Therefore, veracity could not be computed

for these substances, and table 2 does not

present self-report bias figures for them.

Because very few detainees tested positive for hallucinogens, very few users of

hallucinogens would be missed by selfreporting alone. As noted in endnote 9,

the EMIT panel detects PCP but not the

other hallucinogens in the DISC questionnaire. Therefore, the minimum prevalence

estimates for hallucinogens (6.1 percent

and 10.1 percent for 6-month and lifetime

use, respectively) are biased downward

relative to estimates for the other categories of substances. For these reasons,

Table 2: Drug Use by Detained Juveniles in Cook County, IL: Overview of Findings (%)

Substance Minimum Minimum

Self-Reported Detected Minimum Bias for Bias for

Substance Use by Veracity Prevalence Self-Reporting Urinalysis

Drug 6-Month Lifetime Urinalysis 6-Month Lifetime 6-Month Lifetime 6-Month Lifetime 6-Month Lifetime

Any substance 77.3 90.1 66.4 87.7 94.1 85.4 94.0 8.2 3.9 19.0 27.6

Cannabis 77.1 90.1 65.9 87.6 94.1 85.3 94.0 8.2 3.9 19.4 28.1

Other than cannabis 8.0 13.0 5.8 27.5 37.8 12.2 16.6 4.2 3.6 6.4 10.9

Cocaine 4.4 6.2 4.8 21.7 28.1 8.1 9.6 3.6 3.4 3.4 4.8

Opiates 1.2 2.6 0.2 65.7 65.7 1.3 2.6 0.1 0.1 1.1 2.5

Uppers 0.8 1.8 0.0 * * 0.8 1.8 †† ††

Downers 0.3 0.5 0.0 * * 0.3 0.5 †† ††

Tranquilizers 0.3 0.6 0.0 * * 0.3 0.6 †† ††

Hallucinogens 5.5 9.4 1.1 33.3 39.3 6.1 10.1 ‡‡ ‡‡

Note: N=1,742. For explanations of veracity, minimum prevalence, and minimum bias, see “Definitions” sidebar on page 5.

* Veracity cannot be computed because the EMIT urinalysis result is zero.

† Bias figures are not presented because self-reported use is very limited and bias computations would not, therefore, be meaningful.

‡ Bias figures are not presented because the EMIT urinalysis panel detects PCP but not the other hallucinogens in the DISC self-report instrument and 

bias computations would, therefore, be misleading.
7

table 2 does not present self-report bias

figures for hallucinogens.

Minimum bias for urinalysis. Minimum

biases were greater for urinalysis than for

self-reporting, in part because urinalysis

has a limited window of sensitivity to

drugs. When not combined with selfreporting, urinalysis overlooked one in

five detained youth (19.0 percent) who

reported using any substance in the past

6 months and one in four (27.6 percent)

who reported lifetime use. For substances

other than cannabis, urinalysis overlooked

6.4 percent of self-reported 6-month users

and 10.9 percent of lifetime users. Table 2

does not present urinalysis bias figures

for uppers, downers, tranquilizers, and

hallucinogens for the same reasons it does

not present self-report bias figures for these

substances (see above). (The urinalysis

bias for hallucinogens was quite large, but

this is probably because of the limited

scope of the EMIT test for hallucinogens.) 

Analysis: Cannabis

This section analyzes findings for cannabis. See table 3 and “Definitions” sidebar

(page 5). 

Gender

◆ Although self-reported use of cannabis

was about the same for boys and girls

(around 75 percent for 6-month use

and 90 percent for lifetime use), urinalysis results differed dramatically: 67.4

percent for boys and 45.5 percent for

girls. This suggests either that cannabis

use was less common among girls than

boys or that the temporal association

between using cannabis and being

arrested was stronger for boys than

for girls.

◆ Veracity in reporting cannabis use was

about the same for boys and girls, i.e.,

most detainees with positive urinalysis

results also reported use. However,

because boys had a higher rate of positive urinalysis results, their 6-month

self-report bias (8.4 percent) was greater than that for girls (5.2 percent). In

other words, cannabis use during the

past 6 months was more likely to go

undetected among boys than among

girls if self-reporting was used without

urinalysis. Lifetime self-report bias was

similar for boys (3.9 percent) and girls

(3.3 percent).

◆ Urinalysis biases were much higher for

girls (34.9 percent for 6 months and

46.4 percent for lifetime) than for boys

(18.2 percent 6 months, 26.7 percent

lifetime), which means that cannabis

use would be much more likely to go

undetected among girls than among

boys if urinalysis testing is used without self-reporting. This again suggests

that recent cannabis use was less common among girls than among boys. 

Race/ethnicity

◆ Among males, self-reported cannabis

use was roughly equal for all three

racial/ethnic groups.

◆ Boys in all three racial/ethnic groups

had reasonably good veracity for

reporting cannabis use, although 6-

month veracity was slightly lower for

African American boys (86.8 percent)

than for other boys (94.6 percent for

non-Hispanic whites and 91.1 percent

for Hispanics). Because the rate of positive urinalysis results was higher for

African American boys than other boys,

the 6-month self-report bias was greater

for African Americans (9.2 percent) than

for others (3.2 percent for non-Hispanic

whites and 5.2 percent for Hispanics).

◆ Among boys, urinalysis bias for detecting cannabis use was lower for African

Americans (24.4 percent for lifetime

use) than for other groups (33.6 percent for non-Hispanic whites and 34.3

for Hispanics). The proportion of lifetime cannabis users who would be

overlooked when urinalysis is used

without self-report methods is smaller

for African Americans than for other

racial/ethnic groups. 

◆ Unlike males, female detainees in the

three racial/ethnic groups differed substantially in their rates of self-reported

cannabis use. Only 71.6 percent of

African American girls reported use in

the past 6 months, compared with 85.4

percent of non-Hispanic whites and

81.2 percent of Hispanics. Lifetime selfreport rates also were lower for African

American girls than for other girls.

◆ Because of the differences in selfreported use, the 6-month self-report

bias for cannabis was greater for African

American girls (6 percent) than for

other girls (3.7 percent for non-Hispanic

whites and 3.3 percent for Hispanics).

The 6-month urinalysis bias was greater

for non-Hispanic white girls (41.6 percent) than for African American girls

(31.5 percent) and Hispanic girls (37.9

percent). In short, self-reporting alone

was most likely to overlook cannabis use

among African American girls, whereas

urinalysis alone was most likely to overlook its use among non-Hispanic white

girls. This finding suggests that among

girls, African Americans’ self-reports of

cannabis use are the least reliable.

Age

◆ Among both boys and girls, self-reported

cannabis use was less common for

detainees ages 10–13 than for older

detainees. Among detainees ages 10–13,

use in the past 6 months was reported

by 56.7 percent of boys and 50.8 percent of girls (compared with 77.3 percent of all boys and 75.1 percent of

all girls).

◆ Among boys, biases for both self-report

and urinalysis varied greatly by age:

compared with older boys, those ages

10–13 had greater biases (i.e., their cannabis use was more likely to go undetected when either detection method

was used alone). In contrast, biases

among girls did not vary greatly by age. 

Prior treatment for substance abuse

◆ Almost all boys and girls who reported

prior treatment for substance use had

very substantial self-reported cannabis

use and consequently had very low

self-report bias.

◆ Urinalysis detection for cannabis was

much more common for boys who

reported prior treatment (87.9 percent)

than for girls who reported prior treatment (57.4 percent). Because so many

boys who reported prior treatment

tested positive, their urinalysis bias

(11.9 percent for lifetime use) was

Age at Onset of 

Substance Use

Juvenile detainees who reported

using drugs were asked about age

at first use. Their response is disturbing. Ten percent of the youth who

reported using drugs said they first

used them at or before age 11, and

25 percent reported first use at or

before age 12. Ten percent of youth

who reported using cocaine said they

first used it before age 11, and 50 percent reported first use before age 15.
8

much smaller than that for girls who

reported prior treatment (42.6 percent

for lifetime use).

Recent arrests for drug offenses

◆ Self-reported cannabis use and positive

urinalysis results for cannabis were

more common among detainees with

recent drug arrests than among those

with no recent drug arrests.

◆ Detainees with recent drug arrests

were quite forthcoming about their

cannabis use: veracity for self-reported

use in the past 6 months was well

above 80 percent for both males and

females, and lifetime veracity was

above 90 percent. 

◆ For both 6-month and lifetime use, minimum prevalence exceeded 90 percent

for male and female detainees with

recent drug arrests.

Analysis: Cocaine

This section analyzes findings for cocaine.

See table 4 and “Definitions” sidebar 

(page 5).

Gender 

◆ Rates of self-reported cocaine use

among detainees were more than twice

as high for girls as for boys: 9.6 percent

versus 4 percent for 6-month use and

12.4 percent versus 5.7 percent for lifetime use.

◆ In contrast, rates of positive urinalysis

results for cocaine were slightly lower

for girls (3.7 percent) than for boys (4.9

percent). As discussed above (page 3),

other studies have found that veracity

in reporting cocaine use is generally

Table 3: Drug Use by Detained Juveniles in Cook County, IL: Analysis of Findings for Cannabis (%)

Substance Minimum Minimum

Self-Reported Detected Minimum Bias for Bias for

Substance Use by Veracity Prevalence Self-Reporting Urinalysis

6-Month Lifetime Urinalysis 6-Month Lifetime 6-Month Lifetime 6-Month Lifetime 6-Month Lifetime N

MALE 77.3 90.2 67.4 87.6 94.2 85.7 94.1 8.4 3.9 18.2 26.7 1,126

Race

African American 77.1 89.9 69.9 86.8 93.7 86.3 94.3 9.2 4.4 16.4 24.4 552

Non-Hispanic white 81.0 91.7 59.5 94.6 97.8 84.2 93.0 3.2 1.3 24.4 33.6 199

Hispanic 78.1 91.6 58.9 91.1 97.3 83.3 93.2 5.2 1.6 24.4 34.3 372

Age

10–13 56.7 70.3 46.6 70.5 81.4 70.5 79.0 13.8 8.7 23.9 32.3 306

14–15 75.5 88.2 69.0 85.0 90.6 85.9 94.6 10.4 6.5 16.9 25.7 344

16+ 82.5 95.6 70.0 91.8 98.7 88.3 96.5 5.7 0.9 18.2 26.5 476

Prior treatment

No 95.6 98.2 74.8 97.5 99.0 97.4 99.0 1.8 0.7 22.6 24.2 616

Yes 99.3 99.7 87.9 100.0 100.0 99.3 99.7 0.0 0.0 11.4 11.9 158

Recent drug charges

None 74.7 88.5 60.6 88.2 95.0 81.8 91.5 7.1 3.0 21.2 30.9 857

Any 82.4 93.6 81.2 86.5 93.0 93.4 99.3 10.9 5.7 12.1 18.1 269

2+ 84.9 97.7 77.5 89.8 98.8 92.8 98.6 7.9 0.9 15.3 21.1 87

FEMALE 75.1 88.5 45.5 88.6 92.7 80.3 91.8 5.2 3.3 34.9 46.4 616

Race

African American 71.6 86.1 46.1 87.1 90.8 77.6 90.3 6.0 4.2 31.5 44.2 404

Non-Hispanic white 85.4 96.3 47.5 92.3 97.4 89.0 97.6 3.7 1.2 41.6 50.1 81

Hispanic 81.2 93.1 46.6 93.0 97.8 84.5 94.1 3.3 1.0 37.9 47.5 130

Age

10–13 50.8 68.3 22.4 71.1 71.1 57.3 74.8 6.5 6.5 34.9 52.4 50

14–15 76.5 89.1 44.8 90.4 93.6 80.8 92.0 4.3 2.9 36.0 47.1 334

16+ 78.4 92.1 51.2 88.1 93.7 84.5 95.3 6.1 3.3 33.3 44.1 232

Prior treatment 

No 94.4 98.5 55.5 98.9 99.4 95.0 98.8 0.6 0.3 39.4 43.3 311

Yes 97.8 100.0 57.4 97.8 100.0 99.1 100.0 1.3 0.0 41.7 42.6 94

Recent drug charges

None 74.2 88.0 42.6 89.4 93.1 78.7 91.0 4.5 2.9 36.1 48.4 547

Any 82.6 92.4 67.2 84.7 90.9 92.8 98.5 10.2 6.1 25.7 31.3 69

2+ 86.7 92.2 67.9 88.5 88.5 94.5 100.0 7.8 7.8 26.6 32.1 14

Note: For explanations of veracity, minimum prevalence, and minimum bias, see “Definitions” sidebar on page 5.
9

poor among both juvenile and adult

detainees. In the current study, veracity

for cocaine was much lower among

boys than among girls, for both 6-month

use (20.8 percent for boys, 36.2 percent

for girls) and lifetime use (27.4 percent

for boys, 39.4 percent for girls).

◆ Combining self-report and urinalysis

results, minimum prevalence rates were

higher for girls (12 percent for 6-month

use, 14.6 percent for lifetime use) than

for boys (7.8 percent 6-month, 9.2 percent lifetime). Self-report bias was

greater for boys than for girls (3.7 percent versus 2.4 percent, respectively,

for 6-month reports).

Race/ethnicity

◆ African American boys and girls reported

almost no cocaine use—less than 1 percent for boys, and less than 2 percent

for girls, for both 6-month and lifetime

use. In addition, their urinalysis detection rates for cocaine were less than

half the rates for other boys and girls.

Urinalysis detection of cocaine was

most common among Hispanic boys. 

◆ Veracity in reporting cocaine use was

good among non-Hispanic whites, especially among girls: 61.5 percent (6-month)

and 78.6 percent (lifetime) for boys,

Table 4: Drug Use by Detained Juveniles in Cook County, IL: Analysis of Findings for Cocaine (%)

Substance Minimum Minimum

Self-Reported Detected Minimum Bias for Bias for

Substance Use by Veracity Prevalence Self-Reporting Urinalysis

6-Month Lifetime Urinalysis 6-Month Lifetime 6-Month Lifetime 6-Month Lifetime 6-Month Lifetime N

MALE 4.0 5.7 4.9 20.8 27.4 7.8 9.2 3.7 3.5 3.0 4.3 1,126

Race

African American 0.4 0.5 3.2 0.0 0.0 3.7 3.8 3.2 3.2 0.4 0.5 552

Non-Hispanic white 21.5 29.5 7.7 61.5 78.6 24.3 31.2 2.8 1.6 17.1 23.5 199

Hispanic 16.2 23.1 12.1 42.0 52.7 22.8 28.8 6.6 5.7 11.5 16.7 372

Age

10–13 1.0 1.6 2.1 5.9 5.9 3.0 3.6 2.0 2.0 0.9 1.5 306

14–15 3.2 4.5 4.5 16.0 19.8 6.8 8.1 3.6 3.6 2.5 3.6 344

16+ 5.3 7.4 5.7 25.0 33.9 9.5 11.2 4.2 3.8 3.9 5.5 476

Prior treatment

No 4.7 6.6 4.4 24.9 31.9 7.9 9.6 3.2 3.0 3.6 5.2 616

Yes 10.0 12.9 9.1 33.0 38.1 15.7 18.6 5.7 5.7 7.2 9.4 158

Recent drug charges

None 5.6 7.7 3.8 33.2 40.6 8.0 10.0 2.5 2.3 4.3 6.2 857

Any 1.0 1.5 7.0 7.3 13.0 7.2 7.6 6.3 6.1 0.5 0.6 269

2+ 0.4 0.4 5.0 8.7 8.7 5.0 5.0 4.6 4.6 0.0 0.0 87

FEMALE 9.6 12.4 3.7 36.2 39.4 12.0 14.6 2.4 2.3 8.3 10.9 616

Race

African American 1.5 1.5 2.7 0.0 0.0 4.2 4.2 2.7 2.7 1.5 1.5 404

Non-Hispanic white 26.7 44.0 7.3 83.3 100.0 28.0 44.0 1.3 0.0 20.4 36.7 81

Hispanic 24.7 30.2 6.2 71.3 71.3 26.5 32.0 1.8 1.8 20.1 25.8 130

Age

10–13 4.4 4.4 0.0 * * 4.4 4.4 †† † † 50

14–15 7.7 10.8 2.6 53.0 53.0 8.9 12.1 1.2 1.2 6.3 9.4 334

16+ 13.6 16.3 6.1 26.2 31.3 18.2 20.5 4.5 4.2 12.0 14.4 232

Prior treatment 

No 12.4 15.2 4.1 29.3 34.9 15.3 17.9 2.9 2.7 11.2 13.8 311

Yes 21.5 29.0 5.7 77.4 77.4 22.8 30.3 1.3 1.3 17.0 24.6 94

Recent drug charges

None 10.5 13.4 3.2 47.6 51.8 12.2 15.0 1.7 1.5 9.0 11.8 547

Any 3.2 4.3 7.6 0.0 0.0 10.8 11.9 7.6 7.6 3.2 4.3 69

2+ 0.0 5.5 7.8 0.0 0.0 7.8 13.3 7.8 7.8 0.0 5.5 14

Note: For explanations of veracity, minimum prevalence, and minimum bias, see “Definitions” sidebar on page 5.

* Veracity cannot be computed because the EMIT urinalysis result is zero.

† Bias figures are not presented because self-reported use is very limited and bias computations would not, therefore, be meaningful.
10

83.3 percent (6-month) and 100 percent

(lifetime) for girls. 

◆ In contrast, veracity for cocaine use

among African American boys and girls

was zero, for both 6-month and lifetime

use. Among Hispanic boys, veracity

was 42 percent (6-month) and 52.7 percent (lifetime); among Hispanic girls,

veracity was 71.3 percent for both 

6-month and lifetime reports. 

◆ Among boys, the minimum prevalence

for cocaine use was less than 4 percent

for African Americans, compared with

more than 20 percent for non-Hispanic

whites and Hispanics, for both 6-month

and lifetime use. 

◆ For both 6-month and lifetime use, the

minimum prevalence for cocaine use

was slightly more than 4 percent for

African American girls and exceeded

25 percent for non-Hispanic white girls

and for Hispanic girls. Minimum prevalence was greatest for lifetime use by

non-Hispanic white girls.

Age

◆ Among boys, all of the cocaine measures increased with age, including

rates of self-reported use, positive

urinalysis results, veracity, minimum

prevalence, and biases for self-reporting

and urinalysis. 

◆ Because urinalysis results for cocaine

were zero for girls ages 10–13, veracity

and bias results are not presented for

this group. Among girls ages 14 and

older, all of the cocaine measures except

veracity increased with age. For girls

ages 14–15, the veracity rate for reporting cocaine use was 53.0 percent (for

both 6-month and lifetime use), compared with 26.2 percent (6-month) and

31.3 percent (lifetime) for girls ages 16

and older. 

Prior treatment for substance abuse 

◆ Among both boys and girls, self-report

rates for cocaine use among detainees

who reported prior treatment for substance abuse were about twice as high

as the rates for detainees who did not

report prior treatment. Rates were

higher for girls with prior treatment

than for boys with prior treatment. 

◆ Veracity for reporting cocaine use was

good among girls with prior treatment

(77.4 percent for both 6-month and lifetime use); veracity was much lower

among boys with prior treatment (33

percent for 6-month use and 38.1 percent for lifetime use).

Recent arrests for drug offenses

◆ Among both boys and girls, rates of selfreported cocaine use were lower and

rates of positive urinalysis results for

cocaine were higher among detainees

with recent drug arrests than among

those with no recent drug arrests. 

◆ Veracity for self-reported cocaine use

was much poorer among detainees with

recent drug arrests than among those

with no recent drug arrests. Among

boys, veracity was more than 30 percent for detainees with no recent drug

arrests but only 7.3 percent (6-month

use) and 13 percent (lifetime use) for

those with a drug arrest. Among girls,

veracity was about 50 percent for

detainees with no recent drug arrests

but zero for those with a drug arrest. 

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. Twothirds (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. 

Endnotes

1. The concept of patterns or pathways

of problem behavior is widely discussed

in the literature (Newcomb and Bentler,

1990; Cohen et al., 1990; Elliott, Huizinga,

and Menard, 1989; Kandel and Yamaguchi,

1993; Kandel and Logan, 1984; Loeber and

Hay, 1997; Loeber et al., 1991, 1993; Moffitt, 1993a, 1993b; Rutter, 1996; Yamaguchi

and Kandel, 1984a, 1984b).

2. A large body of research has questioned

the validity of self-reported drug use data

from adult arrestees (Golub et al., 2002;

DeJong and Wish, 2000; Gray and Wish,
11

1999; Harrison, 1995; Mieczkowski, 1990;

Mieczkowski et al., 1991; Mieczkowski

and Newel, 1993) and detained juveniles

(Dembo et al., 1987, 1993, 1999; Feucht,

Stephens, and Walker, 1994; Magura, Kang,

and Shapiro, 1995; Mieczkowski, Newel,

and Wraight, 1998; Wislar and Fendrich,

2000).

3. Saliva analysis has problems of contamination and different absorption rates for

different drugs. Sweat collection is impractical in many settings because the subject

must be available for 24 to 48 hours. Collection of blood requires a licensed health

care professional. Semen presents obvious

collection problems and is, of course,

gender specific. Both urine and hair can

be collected by trained lay personnel.

Urine has additional advantages: many

substances are concentrated in the urine

by normal kidney functions, and, compared with other fluids, urine is relatively

free of cellular components that can interfere with drug testing. The collection of

any fluid or tissue, including urine and

hair, poses special problems for juvenile

justice settings: because subjects are

detained, they may feel coerced and are

more likely to be noncompliant. In fact,

collection for forensic purposes may

require a court order.

4. However, the detection period for

urinalysis can be as long as 3 weeks for

heavy use of cannabis and as long as

30 days for use of phencyclidine (PCP),

benzodiazepines, and some long-acting

barbiturates.

5. How drugs become part of the hair

follicle is not clear. They may pass from

the blood to the follicle as it is formed,

or they may be transferred to the follicle

from sweat and sebum (in which case

environmental exposure rather than

actual drug use could result in a positive

finding).

6. The mean time between intake and

sampling was 1.5 days. The median time

was 1 day.

7. Fourteen subjects refused to provide a

sample, 17 were unable to urinate, 7 samples were too small to analyze, and 8 were

not collected because too much time had

elapsed since intake. Thirty-eight samples

were missing because procedures were

not yet in place or equipment and supplies were unavailable. 

8. Some subjects who were included in the

analysis did not complete certain portions

of the DISC interview. One subject refused

to answer items about heroin and opiate

use. Of greater concern for purposes of

this analysis were the subjects who reported lifetime use but refused to answer

questions about use in the past 6 months

(1 for marijuana, 16 for cocaine, 17 for

heroin/opiates, 1 for downers, 46 for hallucinogens, and 3 for tranquilizers).

9. Barbiturates, methaqualone, and

propoxyphene should be combined for

comparison to self-reported use of “downers”; however, there were no positive

EMIT results for either methaqualone

(which is no longer produced in the United States) or propoxyphene. EMIT tests

for benzodiazapenes were compared to

self-reported use of “other tranquilizers,

Valium, Librium, Ativan.” Phencyclidine is

the only hallucinogen test in the EMIT–10

panel; self-reported hallucinogen use

(“hallucinogens, LSD, peyote, mescaline,

PCP, mushrooms”) was compared only to

the EMIT phencyclidine test.

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The research reported in this Bulletin was

supported by grant number 1999–JE–FX–1001

from the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs,

U.S. Department of Justice, and grant numbers

R01MH54197 and R01MH59463 from the National Institute of Mental Health. 

Major funding was also provided by the Centers

for Disease Control and Prevention’s National

Center on Injury Prevention and Control and

National Center for HIV, STD, and TB Prevention; the National Institutes of Health’s Center

on Minority Health and Health Disparities, Office of Rare Diseases, and Office of Research

on Women’s Health; the National Institute on

Alcohol Abuse and Alcoholism; the National

Institute on Drug Abuse; the Substance Abuse

and Mental Health Services Administration’s

Center for Mental Health Services, Center for

Substance Abuse Prevention, and Center for

Substance Abuse Treatment; the Robert Wood

Johnson Foundation; and the William T. Grant

Foundation. 

Additional funds were provided by the Chicago

Community Trust, the John D. and Catherine T.

MacArthur Foundation, and the Open Society

Institute. 

Points of view or opinions expressed in this

document are those of the authors and do

not necessarily represent the official position

or policies of OJJDP or the U.S. Department

of Justice.

Acknowledgments

The authors of this Bulletin are affiliated with the Department of Psychiatry and

Behavioral Sciences, Feinberg School of Medicine, Northwestern University. Gary

M. McClelland, Ph.D., is Senior Analyst, Psycho-Legal Studies; Linda A. Teplin,

Ph.D., is Owen L. Coon Professor of Psychiatry and Behavioral Sciences and

Director, Psycho-Legal Studies; and Karen M. Abram, Ph.D., is Associate Director,

Psycho-Legal Studies. The authors thank all of the funding agencies and organizations for their collaborative spirit and steadfast support.

Many individuals contributed to this project. The authors thank OJJDP’s Karen

Stern, Ph.D, who provided valuable substantive and editorial comments; all project

staff, especially Amy M. Lansing, Ph.D., and Amy A. Mericle, Ph.D., who supervised the data collection; Jacques Normand, Ph.D., for insightful comments; and

Laura Coats, Kate Elkington, and Erin Gregory for their meticulous library work,

editing, and manuscript preparation. The authors greatly appreciate the cooperation of everyone working in the Cook County systems, especially David H. Lux,

project liaison. Without the county’s cooperation, this study would not have been

possible. Finally, the authors thank the study subjects for their time and willingness

to participate.

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