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 The Academy recommends against school-based “suspicionless” drug
testing in the new issue of the journal Pediatrics.
Identifying kids who use drugs and entering them into treatment
programs should be a top priority, but there is little evidence that
random drug testing helps accomplish this, said Dr. Sharon Levy,
director of the adolescent substance abuse program at Boston
Children’s Hospital and lead author of the new policy statement.
“Evidence on either side is very limited,” Levy told Reuters Health
by phone.
Scientifically, the best way to test the value of random drug tests
would be to put some kids into a drug testing program and others
not, in a single school, but practically, that is difficult to
accomplish. Instead, researchers have compared schools with drug
testing programs to similar schools without them - and found mixed
results.
One study did find a short-term reduction in kids’ self-reported
drug use at a school with random testing, but the kids were followed
for a relatively short period and reductions in use applied only to
the drugs included in the testing. This is a problem since most drug
testing panels do not include alcohol, Levy said.
“It’s possible that you do get some prevention out of these
programs, but on the other hand it seems very expensive, very
invasive, and has pretty limited results,” she said.
Adolescent drug use is usually sporadic, so even a kid who does use
illegal substances may easily pass a random annual test and then
feel comfortable to use freely for the rest of the year, she said.
Drug tests can result in false positives, and even a true positive
says nothing about frequency or quantity of drug use, according to
Ken C. Winters of the psychiatry department at the University of
Minnesota Medical School in Minneapolis, who is not in the AAP.
Testing alone is not a vehicle for behavior change, Winters told
Reuters Health by email.
The tests may also uncover traces of students’ prescription
medications, which may be a violation of their privacy, Levy noted.
Drug testing does have a place as part of a treatment program for
kids who’ve been diagnosed with substance use problems or disorders,
Levy said, but it is not appropriate for general screening.
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The statement should lead schools with a random drug testing policy
to reconsider. It’s not clear, however, how common the practice is.
“Turns out that it’s incredibly difficult to find out how common it
is, it’s a decision made by individual school boards and local towns
and that’s not published information,” Levy said.
Confidential self-reported screening for drug use has actually been
relatively successful, and is much less expensive to implement, she
said.
When kids do test positive for drugs at school, they often face
punishment, when the focus should be on evaluation and intervention,
she noted. The AAP supports school involvement in preventing,
identifying and intervening to reduce adolescent substance use.
“One of the big difficulties that forms the basis of much of my
research is, what do we do with kids who have substance use
disorders who need more than a primary care program but less than a
rehabilitation program,” Levy said. “There’s not a lot in the
middle.”
“We absolutely think that schools could have a really major role in
the whole spectrum of care in substance use disorders,” Levy said.
SOURCE: http://bit.ly/1kCYrQ1Pediatrics,
online March 30, 2015.
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