Hair testing and self-report often disagreed on substance use in teens from the ABCD study
Among community-based adolescents in the ABCD Study, concordance between self-reported substance use and hair toxicology analysis was limited, with hair testing detecting use that teens did not report.
Quick Facts
What This Study Found
Hair toxicology detected substance use (including cannabis) in adolescents who denied use on self-report surveys. Concordance between the two methods was limited, suggesting self-report underestimates true substance use in youth.
Key Numbers
ABCD Study sample. Hair analysis by LC-MS/MS and GC-MS/MS compared with self-reported past-year substance use. Discordance identified between methods, particularly for cannabis.
How They Did This
Cross-sectional analysis from the ABCD Study comparing self-reported past-year substance use with hair toxicological analysis (LC-MS/MS and GC-MS/MS) in community-based adolescents.
Why This Research Matters
Most adolescent cannabis research relies on self-report. If teens significantly underreport use, studies may underestimate both prevalence and the associations between cannabis and health outcomes.
The Bigger Picture
The validity of self-reported cannabis use is a fundamental challenge in adolescent research. If hair testing reveals substantially more use than surveys capture, the entire evidence base built on self-report may underestimate true exposure and its consequences.
What This Study Doesn't Tell Us
Hair testing has its own limitations: external contamination, variable drug incorporation by hair color and type, and limited detection window for some substances. Cross-sectional comparison at one time point. Not all ABCD participants had hair samples available.
Questions This Raises
- ?Should adolescent cannabis studies routinely incorporate biomarker verification?
- ?How much would prevalence and association estimates change if all studies used hair or other biological confirmation?
Trust & Context
- Key Stat:
- Hair toxicology detected cannabis use in teens who denied it on surveys
- Evidence Grade:
- Large established cohort study with validated biological measurement. Cross-sectional comparison but strong methodology.
- Study Age:
- Published 2023.
- Original Title:
- Concordance between substance use self-report and hair analysis in community-based adolescents.
- Published In:
- The American journal of drug and alcohol abuse, 49(1), 76-84 (2023)
- Authors:
- Wade, Natasha E(18), Sullivan, Ryan M(9), Tapert, Susan F(18), Pelham, William E, Huestis, Marilyn A, Lisdahl, Krista M, Haist, Frank
- Database ID:
- RTHC-05006
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Do teenagers lie about using cannabis?
This study found that hair testing detected substance use, including cannabis, in adolescents who did not report it on surveys. Whether this reflects intentional underreporting, forgetting, or not recognizing exposure, the practical implication is the same: self-reported surveys underestimate teen cannabis use.
How accurate is hair testing for cannabis?
Hair testing can detect cannabis use over a period of months and is difficult to fake. However, it has limitations: dark hair may incorporate more drug than light hair, external contamination from secondhand smoke is possible, and very recent use may not yet appear in hair. Despite these caveats, it provides an objective check on self-report data.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-05006APA
Wade, Natasha E; Sullivan, Ryan M; Tapert, Susan F; Pelham, William E; Huestis, Marilyn A; Lisdahl, Krista M; Haist, Frank. (2023). Concordance between substance use self-report and hair analysis in community-based adolescents.. The American journal of drug and alcohol abuse, 49(1), 76-84. https://doi.org/10.1080/00952990.2023.2164931
MLA
Wade, Natasha E, et al. "Concordance between substance use self-report and hair analysis in community-based adolescents.." The American journal of drug and alcohol abuse, 2023. https://doi.org/10.1080/00952990.2023.2164931
RethinkTHC
RethinkTHC Research Database. "Concordance between substance use self-report and hair analy..." RTHC-05006. Retrieved from https://rethinkthc.com/research/wade-2023-concordance-between-substance-use
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.