LA Times on student drug testing

LA Times on student drug testing

http://www.latimes.com/la-he-drugtesting21may21,0,7094993.story?coll=la-home-middleright

Put to the test

More schools are asking students to take drug tests, saying it gives
them a reason to 'say no.' Addiction experts contend results are
unreliable.

By Shari Roan
LA Times Staff Writer
May 21, 2007


ONCE a year or so, Roy Tialavea is summoned from his classes at
Oceanside High School to report to the athletic director's office
bathroom. He receives a urine specimen cup and heads for a stall.

The 17-year-old is unruffled. Random drug testing has been going on for
two years at the school. He's used to it. "I don't use drugs so I don't
have to worry about getting caught," he says.

His mother, Robyn, thinks her son steers clear of drugs and alcohol.
But, she says, no parent can know for sure what a teenager is up to.

"If he doesn't like testing, I really don't care," she says. "I think
it's a wonderful tool. It creates the fear that they could be tested."

Call it the 2007 version of "just say no."

Concerned with high rates of adolescent substance abuse, hundreds of
middle schools and high schools nationwide have quietly begun testing
some or all students for drugs - to the dismay of some health and
addiction experts.

Although less than 5% of all high schools have such programs, testing is
now common in schools throughout Texas, Florida, Kentucky and parts of
California. In Southern California, many private high schools have
implemented drug testing, as have several public school districts in
Orange County and San Diego. Nationwide, as many as 1,000 schools have
established programs, according to the White House Office of National
Drug Control Policy.

The number of schools administering drug tests is expected to grow.
Federal funding for school drug testing increased 400% between 2003 and
2006. The Bush administration spent $8.6 million on such programs last
year and has requested $17.9 million for fiscal year 2008.

"This is the best new idea to reduce the onset of drug use," says Dr.
Robert L. DuPont, president of the Institute for Behavior and Health, a
nonprofit drug policy organization that has studied school testing.
"About half of high school seniors have used an illicit drug by the time
they graduate and about one-quarter are regular users by the time they
graduate. Those figures are worrisome."

School-based drug testing gives kids a reason to say no, say DuPont and
other proponents. The tests are meant to identify students who are using
and guide them into counseling or treatment programs before they develop
addictions.

But health officials, by and large, oppose school-based drug testing.
NAADAC, the Assn. for Addiction Professionals, has released a statement
critical of such programs. And in March, the American Academy of
Pediatrics cautioned against random school-based drug testing until more
research is completed. The two groups are among those who say testing is
not reliable enough, violates trust between adults and teens and is not
set up to deal effectively with students who have positive results.

Though adults debate testing's merits, students at some high schools
hand over urine specimen cups as comfortably as they turn in late
library books.

"Kids pretty much know who does drugs and who doesn't," says Alex
Podobas, a senior at San Clemente High School, which has had voluntary
testing for several years. "But no one says, 'Oh, you're a pothead' when
you get called out for testing."

Screening kids for marijuana, cocaine, amphetamines and other illegal
drugs at school is an offshoot of two decades of experience with
workplace and military drug testing, experts say. Testing methods have
improved during that time to reduce the number of false test results
while providing greater privacy and confidentiality, says DuPont.

And though substance abuse among teens has dropped in the last decade,
parents and school administrators still consider the rates unacceptably
high. Just over 20% of eighth-graders and about half of all high school
seniors say they have taken an illicit drug, according to 2006 data from
Monitoring the Future, the University of Michigan's nationwide annual
survey. About 30% of high school seniors say they have been drunk in the
last month.

Little faith is put in traditional classroom drug education programs to
further drive down substance abuse rates, says Jennifer Kern of the Drug
Policy Alliance, a New York City-based organization that focuses on a
harm-reduction approach to drug education.

"People are overwhelmed and are looking for new approaches," she says.
"A lot of the concern comes from a good place. We haven't done a good
job preventing substance abuse."

School drug testing got its biggest boost in 2002 when the Supreme Court
ruled that schools may conduct random drug tests among students who wish
to participate in school-sponsored extracurricular activities, such as
sports, marching band or debate team.


"Fifteen years ago, school drug testing was too controversial," says
John P. Walters, director of the White House Office of National Drug
Control Policy. "People thought the test was going to throw kids out of
school or give them a criminal record. The Supreme Court decision was an
enormously positive step."

But critics say the court's decision opened the floodgates for programs
that have not been studiously researched or properly evaluated.

"If you look on the surface, drug testing seems like a good idea; a
simple thing to do," says Dr. Sharon Levy, director of the Adolescent
Substance Abuse Program at Children's Hospital Boston. "It's only when
you sit down and look at it closely that it really starts to unravel a
bit."

Chief among the pediatricians' complaints is the reliability of testing.

A study published in April in the journal Pediatrics found a substantial
risk of error even when drug testing was performed as part of an
established adolescent substance abuse program. In the study, Levy and
her colleagues reviewed 710 random urine tests from 110 teens and
compared the results with confirmatory lab tests. (Initial screening
samples should be confirmed with a second, more rigorous, analysis -
something most school programs say they do.) They found 12% of the tests
were subject to misinterpretation. For example, some of the urine
samples were diluted (despite rigorous collection procedures designed to
prevent kids from cheating) and could not be interpreted properly.

Further, of the samples, 21% were positive due to legitimate
prescription drug use, Levy says. And several samples that were found in
confirmatory testing to be positive for the painkiller OxyContin - a
popular drug of abuse among teens - were identified as negative in the
initial screen.

"Drug testing is premature policy," says Levy. "We need to understand
the combination of risks and costs compared to the benefits. That hasn't
been done at all."

Further, critics say, the drug testing panels used by schools are
typically those used in the workplace - screens for marijuana,
amphetamines, cocaine, opiates and PCP. The panels usually do not assess
alcohol or other drugs kids may be likely to use, such as inhalants,
OxyContin and Ecstasy. Standard urine tests only detect use that has
occurred in the last 48 to 72 hours.

Negative screens may mislead parents, school personnel and the community
from searching for a truer picture of adolescent drug and alcohol use,
Kern says.

"Parents can say 'OK, the schools are doing testing, we'll know what is
going on,' " she says. "But drug testing gives you very little
information. It can give parents a false sense of security."

Even the belief that testing deters kids from using drugs or gives them
a peer-worthy reason to say no has not been proven, Kern says. A 2003
study by the University of Michigan surveying 76,000 students found no
difference in marijuana or other illicit drug use in schools with
testing compared with those without programs.

Podobas, the San Clemente senior, says few students fear being caught.
The tests don't pick up all drugs and are administered too infrequently
to worry teens, he says. Others have learned to beat the system by
sharing a clean urine sample when called to the bathrooms in groups. "I
don't think it has lessened the number of kids using drugs," says
Podobas, although he thinks some kids use less frequently than they
otherwise would.

Others critics of the program say school drug testing can make teens
feel guilty before being proven innocent. While many programs - such as
several in Orange County - only test students if they and their parents
consent, kids may feel that adults distrust them, Kern says.

"There may be unintended consequences to drug testing," says Dr. Howard
Taras, a pediatrics professor at UC San Diego, who studies school health
issues. "Kids may be deterred from joining a sport or extracurricular
activity because they will be tested. Those are the kids that most need
extracurricular activities. They may not get engaged in math or science
but they may get engaged by a sport or dance class."

Proponents of drug testing say such shortcomings simply don't exist in
most schools. The programs, they say, are diligent about collection
procedures and lab analysis, privacy issues and follow-up for kids found
to have used drugs.

"Where are they finding these programs doing the bad things?" says
DuPont of the critics. A study by his office of nine programs found all
were following testing protocols and handling kids with positive tests
nonpunitively.

Even if testing programs aren't perfect, recent research on the effect
of drug use on adolescent brains warrants an aggressive approach to the
problem, Walters says. Studies show that heavy drug use during
adolescence may permanently damage parts of the brain related to
learning and memory. People who avoid drinking and using drugs before
age 21 are far less likely to abuse drugs or develop an addiction later.

"This is an area where doing the right thing for our kids is durable,"
Walters says. "We can change the face of substance abuse for
generations."

Students feel secure knowing that adults are savvy about drug use in
their schools, proponents add. "Middle and high school kids are aware of
their peers who are involved in drinking and drugging," says Walters.
"They will frequently ask 'Why do we look the other way? Why do we allow
this to happen?' In schools with random drug testing, they feel safe."

Local school administrators say programs have drawn little protest from
parents and students.

In Oceanside Unified School District, which is in its second year of
testing all high school students who wish to participate in sports,
community focus groups are held on a regular basis to gauge reaction.
The program is funded through the Office of National Drug Control
Policy.

"Our community has always been cooperative, and I think it's because we
included them in the process when we were developing the program," says
Tim Ware, the district's school intervention manager. "I think our kids
have reacted better than anyone. It's part of what we do."

One of the few complaints, he says, is that athletes feel they are being
singled out and that all students should be randomly tested.

A more common approach to testing, at least in California, are voluntary
programs in which both the students agree to enroll in random testing
with parental consent. Jon Hamro, athletic director and secondary
teaching assistant principal of San Clemente High School, launched one
of the state's first school-based testing programs in 2001. The program
has expanded to each high school in the Capistrano Unified School
District, which encompasses much of south Orange County. Recently three
district middle schools began offering testing.

The voluntary nature of the program has taken the steam out of would-be
objectors, Hamro says. Samples are collected by an outside lab and the
results shared with the student's parents - not school officials.
Students with positive results are not punished.

"We took a tack of how can we do this where there are no privacy issues
and yet it's a powerful tool to dissuade kids from using," he says.
"It's invisible to the administration, but it's very visible to the
kids."

At San Clemente High School, just over half of the school's 3,100
students are enrolled. Students testing positive are referred to either
fee-for-service or free counseling, including confidential counseling on
campus.

A survey conducted of 2,500 students at the high school last year showed
the program is having an effect, Hamro says. Almost 60% of the students
said the decision on whether or not to enroll in the program prompted a
discussion at home about substance abuse. Almost 60% of the students
said that the program should continue and 48% said it made it easier for
them to avoid using drugs. Just over one-quarter said testing had
reduced their frequency of drug use.

The study will be published in June in the American School Board
Journal.

Even those who disagree about the merits of school-based drug testing
agree that more research should be done to evaluate whether the programs
reduce drug use and help students who are caught using.

"There are these two sides and they can argue until they are blue in the
face," says Taras. "But until you study it, you can't really say
anything about it."

Schools, however, may not wait for academia to weigh in, especially if
the federal government extends money for testing programs.

"I actually believe that what you'll see is a rapid adoption of this,"
says Walters. "In a relatively short period of time we're going to look
back and say 'Why did it take us so long to do this?' This is safe and
it's enormously powerful."

*


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shari.roan@latimes.com

*

(INFOBOX BELOW)

Screening varies from school to school

Schools vary widely in how they conduct drug testing.

* Deciding when and whom to test: Some schools only test students when
there is a suspicion of drug use. A growing number, however, utilize
random, "suspicionless" testing of a large group of students. In some
schools, only students who volunteer for the program and whose parents
consent are tested. Other schools screen all students who wish to
participate in extracurricular activities, such as sports and clubs.

* How testing is conducted: Some schools purchase tests kits and make
them available to parents. Other schools use outside testing labs to
randomly select students, conduct the tests and report back only to
parents - barring school personnel from learning the results. In still
other places, school personnel gather samples, send the results to labs
for assessment and receive the results back at school. School officials
then contact parents.

* Handling positive results: In some cases, the results are made
available to parents only, and it is their choice on how - or whether -
to act. Some labs are under contract to give parents a list of
drug-treatment and counseling resources in the community. Some schools
choose to provide the student's family with references. Many programs
with random, voluntary testing stress that students with positive tests
should be treated nonpunitively. Little is known about the outcome of
students who test positive in terms of whether follow-up counseling is
obtained and is successful.

* Technology and costs: Initial screenings are often done using urine
samples. Saliva, hair, sweat and blood tests can also be used but vary
in cost and reliability. Screening tests for a five-drug urine panel
typically cost $15 to $30 per student, according to the White House
Office of National Drug Control Policy. Many schools finance drug
testing on their own or through fundraisers or community donations.
Others apply for federal grants.

**

Testing resources



For more information on school-based drug testing, as well as arguments
for and against testing, go to:

* White House Office of National Drug Control Policy - the Bush
administration's case for testing, how it works and how to get
information on federal grants. http://www.randomstudentdrugtesting.org

* Monitoring the Future survey - the most recent statistical analysis
of adolescent drug use in the United States, from the University of
Michigan's annual survey. http://www.monitoringthefuture.org

* NAADAC (Assn. for Addiction Professionals) - this nonprofit
organization's policy statement on school-based drug testing.
naadac.org/documents/display.phpDocumentID102

* Institute for Behavior and Health - information for communities,
educators, parents and students on adolescent drug use and testing,
including how to implement testing programs, from an organization that
studies drug prevention and treatment strategies and advocates school
drug testing. http://www.PreventionNotPunishment.org

* Drug Policy Alliance - research on drug testing policies from a
nonprofit group that opposes school-based testing.
http://www.drugpolicy.org

* American Academy of Pediatrics - the most recent policy statement
from the AAP on student drug testing:
aappolicy.aappublications.org/cgi/content/full/pediatrics119/3/627<252>