Drug Use in High Security Settings: An Analysis of Urine Drug Screenings

This study examined drug use among 392 patients in high security in Flanders using urine drug screenings. Although nearly 60% had a substance use disorder, only 11% tested positive, and 7% of all tests were positive. Cannabis and cocaine were the most common illicit substances, while benzodiazepines, buprenorphine, and methadone were the most frequent non-prescribed medications. Ongoing drug use during treatment was significantly associated with substance use disorder. The findings underscore the need to address substance use while balancing therapeutic aims and safety. High refusal rates also highlight limitations of urine testing and the need for alternative screening methods.