AN F FOR SCHOOL DRUG TESTS

LIEUTENANT Governor Kerry Healy unveiled a plan to identify teens with drug
problems through high school drug testing programs, which were ruled legal
by the United States Supreme Court in 2002. The Bush administration has
also been a proponent of high school drug testing, and has set aside
millions of dollars in federal assistance for local school districts. Dr.
John Walters, the director of the President's Office of National Drug
Control Policy, has previously described drug testing in schools as a
"silver bullet" solution to the epidemic of substance abuse among our youth.

We are in favor of any approach that helps, but we disagree with the
widespread implementation of high school drug testing programs for a number
of reasons. First, we are skeptical that any single public policy will
solve this complex problem.

We also believe that implementation of drug testing should await scientific
evidence that it is both safe and effective -- and we have neither.
Laboratory testing for drugs is an invasive and complex procedure.

In order to ensure the validity of the specimen, urination must either be
directly observed -- an embarrassing procedure for all -- or the collector
must use a protocol that includes temperature testing, controls for
adulteration and dilution, and documentation of a continuous chain of
custody in handling. In a recent national survey we found that very few
physicians have the expertise to collect specimens properly, and we doubt
that most schools have staff that can. Without proper controls, students
can easily falsify urine samples. Even when proper collection procedures
are used, it is fairly easy to fool drug tests, and our clinical
experience indicates that most drug-involved youth are all too familiar
with ways to do so. One need only browse the Internet to see the array of
products whose sole purpose is to thwart the validity of drug tests.

Even when properly collected, drug tests yield very limited information.
With the exception of marijuana, the window of detection for most drugs is
less than 48 hours.

Therefore, negative tests tell us only that the student did not use a drug
during the past two days. Standard drug testing panels also do not
detect many of the drugs most frequently abused by teens, such as alcohol,
Ecstasy (MDMA), OxyContin, and inhalants.

Indeed, we have worked with many teens whose early drug use was missed
because negative drug tests gave parents and physicians a false sense of
reassurance. Furthermore, we are concerned that widespread implementation
of drug testing may inadvertently encourage students to use more alcohol.

It may also motivate drug-involved teens to move from drugs that are less
dangerous, such as marijuana, to those that are more dangerous but not
detected by the test.

We are also concerned about the effects of this potential invasion of an
adolescent's privacy.

Some students will sit in class studying our constitutional protection
against unreasonable search and seizure and then be compelled to produce a
urine specimen against their will. What is the lesson here? For many of
these same reasons, the American Academy of Pediatrics has taken a stand
against drug testing of adolescents as a screening procedure, and we
support that decision.

Drug testing is best employed as a routine component of a drug treatment
program to ensure maintenance of abstinence. Lastly, while we are
encouraged that the current plan would provide money to cities and towns
for substance abuse counseling, we are concerned that funds will not meet
the current need for adolescent drug treatment.

A recent survey of Massachusetts high school students revealed that more
than 30 percent had used marijuana during the past 30 days. What will
happen to those students who test positive?

We applaud Lieutenant Governor Healey for insisting that the focus of drug
testing should be on helping kids find treatment -- and not punishing
them -- but it is largely an empty promise.

As pediatricians, we are confronted daily with the lack of developmentally
appropriate substance abuse treatment for teenagers in Massachusetts. We
often must choose between no treatment and placing youth in adult substance
abuse treatment programs, which is often ineffective.

School drug testing programs will be very costly.

While they are increasing in popularity, their efficacy is unproven and
they are associated with significant technical concerns.

We urge Healey and other public officials to place our scarce resources
first into proven prevention, early intervention, and treatment programs
for adolescents. Let us not rush to accept the illusory view that drug
testing in schools is the silver bullet for the prevention of youth
substance abuse.