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A total of 272 participants were randomized (1:1 ratio) to methadone or buprenorphine\/naloxone. Following treatment initiation, participants were followed-up every 2 weeks for 24 weeks. During each visit, participants provided urine samples for UDS and self-reported their substance use over the past 2 weeks. Self-reported use was dichotomized to align with UDS detection windows. Tetrachoric correlations and 2\u2009\u00d7\u20092 contingency tables were used to estimate the sensitivity, specificity, positive predictive value and negative predictive value of self-reported use. A generalized linear mixed model assessed how substance type, time in the study, treatment assignment, study site, unstable housing, and sex impacted self-report accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant differences were found between substance types (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and study sites (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Fentanyl, cannabis, and amphetamines consistently showed the greatest concordance between measurement methods. Hydromorphone, oxycodone, heroin, and benzodiazepines had low sensitivity and low positive predictive value. Participants from Qu\u00e9bec showed higher concordance between UDS and self-reported use compared to those from British Columbia, Alberta, and Ontario. There was no moderating effect of treatment assignment (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.174), time in the study (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.221), unstable housing (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.733), or sex (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.321) on the concordance between UDS and self-reported use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results indicate that concordance between UDS and self-reported use is impacted by several factors. Combining UDS and self-reported use could help provide a more accurate assessment of substance use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>This study was registered in ClinicalTrials.gov (NCT03033732).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/07067437251367180","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:41:33Z","timestamp":1756381293000},"page":"41-52","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Concordance Between Urine Drug Screening and Self-Reported Use in the Context of a Pragmatic Randomized-Controlled Trial in People with\n                    <i>Prescription-Type<\/i>\n                    Opioid Use Disorder: Concordance entre le d\u00e9pistage de drogues dans l\u2019urine et l\u2019usage autod\u00e9clar\u00e9 dans le contexte d\u2019un essai pragmatique contr\u00f4l\u00e9 \u00e0 r\u00e9partition al\u00e9atoire chez des personnes pr\u00e9sentant un trouble li\u00e9 \u00e0 l'usage d\u2019opio\u00efdes vendus sur ordonnance"],"prefix":"10.1177","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7969-9998","authenticated-orcid":false,"given":"Gabriel","family":"Bastien","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al"},{"name":"Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Montr\u00e9al"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9356-9233","authenticated-orcid":false,"given":"Anita","family":"Abboud","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al"},{"name":"Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Montr\u00e9al"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2787-2792","authenticated-orcid":false,"given":"Christina","family":"McAnulty","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al"},{"name":"Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Montr\u00e9al"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2069-4552","authenticated-orcid":false,"given":"Amani","family":"Mahroug","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al"},{"name":"Centre hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Montr\u00e9al"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6406-4973","authenticated-orcid":false,"given":"Bernard","family":"Le Foll","sequence":"additional","affiliation":[{"name":"University of Toronto"},{"name":"University of Toronto"},{"name":"Centre for Addiction and Mental Health"},{"name":"University of Toronto"},{"name":"Waypoint Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2556-7049","authenticated-orcid":false,"given":"M. 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