Drug Testing in Schools

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Drug Testing in Schools

• Howard Taras, M.D.
• Floralynn Einesman, J.D.
• Jesse Brennan

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United States of AmericaConstitution 4th
Amendment

• The right of the people to be secure in their
  persons, houses, papers, and effects, against
  unreasonable searches and seizures, shall not be
  violated, and no Warrants shall issue, but upon
  probable cause, supported by Oath or affirmation,
  and particularly describing the place to be
  searched, and the persons or things to be seized.

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U.S. Supreme Court Schools can mandate drug
screening if

• Student is enrolled in a school athletic program
  (e.g., school football team) 1995
• - and -
• Student is enrolled in any extra-curricular
  activity (e.g., chess club). 2002

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Does drug testing at school meet criteria for a
sound public health screen?6 basic principles
of public health screening
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Public Health Principles Before Starting a
Screening Program

• DISEASE
• Is the disease of adequate severity?
• Or prevalence?
• What problems will occur by not identifying
  health issue in that population?

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Public Health Principles Before Starting a
Screening Program

• An effective therapy or intervention.

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Public Health Principles Before Starting a
Screening Program

• Therapy available to all who screen positive?
• Screen test Is it of acceptable specificity?
  sensitivity? positive predictive value?

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Public Health Principles Before Starting a
Screening Program

• Screening program is either
• (a) cost-effective or
• (b) a socially desirable expense

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Public Health Principles Before Starting a
Screening Program

• Its being performed on the Target population
• For Schools Evidence that school-based testing
  is most effective location

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• If not a public health screen, then is it a
  deterrent or an educational tool?
• _____________________________________
• If so, we must demonstrate that testing program
• is effective as educational or deterrent.
• does not cause inadvertent harm.

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Does research show drug screening to be a
deterrent?

• Very poor evidence
• High School Principal Survey (McKinney)
• Yamaguchi R, et al. J School Health. (2003). Vol
  73 p-159
• Goldberg L, et al. J Adolesc Health (2003) Vol
  32 p-16

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Potential for Harm (not yet proven)

• Testing may discourage extracurricular activity.
• Positive test may deteriorate an unstable home
  situation
• Adolescent developmental stage estranged from
  their own body
• Screening costs supplant proven educational
  curricula

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Potential for Harm (also unproven)

• 5. Message that youth not trusted by adults.
  School climate.
• Poorer attitudes toward school among tested,
  versus non-tested athletes/Goldberg et al 2003
• 6. Students try to outsmart the tests, use more
  dangerous drugs?
• Use of ecstasy, inhalants, alcohol

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Potential for Harm (also unproven)

• 7. False positive results damage relationships,
  until proven negative
• 8. Counter-productive punitive response to ve
  test? (e.g. Are dismissal from sport
  suspension)

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Sample Questions

• The schools drug testing program makes it easier
  to say no to drugs.
• Drug-testing doesnt work because students know
  how to get around the test.

• True- 52
• False
• True- 24
• False

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If a drug test proved I used alcohol or drugs

• my parents would be angry.
• my safety at home would be at risk.

• True-98
• False
• True-26
• False

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Sample Questions

• For Athletes
• I thought about not joining a school athletic
  activity because I did not want to be
  drug-tested.
• For Non-Athletes
• One of the reasons I did not join a school
  activity is that I did not want to be
  drug-tested.

• True 4
• False
• True -??
• False

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What policies can Schools adopt at this stage?

• Allow drug testing with research that detects
  both potential harm and potential benefit
• Identify signs symptoms of illicit drug use
  (eg, underachievement, truancy, behavior)
• Refer to medical clinics, rather than
  discipline.
• Drug prevention education Select curricula
  that have been proven to be effective.

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• Howard Taras, MD
• htaras_at_ucsd.edu
• 1-619-681-0665
• San Diego, California