Abstract
Because denial of alcohol/drug use and dependence is common, many self-reports underestimate the amount, frequency, and consequences of alcohol/drug use, thus complicating diagnosis. Self-reports of 18 patients admitted to an inpatient alcohol and drug treatment unit were compared with collateral reports obtained from family members and with results of urine and blood screens. Multiple drug dependence was common. Although self-reports were unreliable, their usefulness increased when a structured interview form was used. Family interviews were not consistently helpful. Blood screens were positive when alcohol/drug use occurred within 7 hours of admission; urine screens were positive when use occurred within 2 days. These screening measures played a useful confirmatory role in diagnostic assessment, particularly in the case of benzodiazepines where positive screens often occurred in patients in whom benzodiazepine dependence was undiagnosed. Results suggest that several screening procedures, including self-reports, family interviews, and laboratory screens, should be used in making a diagnosis of alcohol/ drug dependence.