Willingness to provide a hair sample for drug testing: results from an anonymous multi-city intercept survey

ABSTRACT

Background: Hair provision for drug testing can provide secondary measurement to complement self-reported drug use data, thereby providing a more accurate representation of an individual’s drug use. Understanding factors associated with hair provision offers valuable insights into recruitment methods.

Objective: To identify demographic and drug-related correlates of providing hair samples in a multi-site venue-intercept study.

Methods: We utilized venue-intercept sampling for our Rapid Street Reporting study across 12 US cities between January and November 2022. Participants reported past 12-month drug use and were asked if they would provide a hair sample. We conducted multivariable (generalized linear model with logit link) analyses on demographics and drug use characteristics correlated to hair provision for drug testing.

Results: Among 3,045 participants, 55.8% were male, 13.6% provided hair samples. Compared to males, those identifying as “other gender” had higher odds of hair collection (adjusted odds ratio = 2.24, 95% confidence interval: 1.28–3.80). Participants identifying as Black (aOR = 0.32, CI: 0.23–0.45) or “other race” (aOR = 0.50, 95% CI: 0.29–0.80) had lower odds of providing hair than those identifying as White. All levels of reported drug use - one drug (aOR=1.50, 95% CI: 1.15-1.96), two-three drugs (aOR=1.51, 95% CI: 1.11-2.05), four or more (aOR = 2.13, 95% CI: 1.50–3.01) – had higher odds of providing hair samples than those reporting no drug use. Similar associations applied to reporting cannabis use with or without another drug (aOR = 1.52–1.81, 95% CI: 1.15–2.38).

Conclusion: Differential hair provision based on participant sex, race/ethnicity, and drug use may introduce biases in drug testing, limiting generalizability to individuals from minority backgrounds.

KEYWORDS:

• Hair samples
• biological testing
• hair provision
• drug use
• substance use
• venue intercept survey

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Numbers [U01DA051126 (PI: Cottler)], [T32DA035167 (PI: Cottler)], [R01DA044207 (PI: Palamar)], and [R01DA057289 (PI: Palamar)]. Nae Yeon Won is supported by the UF Substance Abuse Training Center in Public Health from the National Institute on Drug Abuse (NIDA) of the National Institutes of Health [T32DA035167; PI, Linda Cottler]. The content is solely the authors’ responsibility and does not necessarily represent the official views of the National Institutes of Health.