IS ONE OF THEM HIGH?

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

Tialavea 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 latest version of "just say no."

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

Although less than 5 percent of all high schools have such programs,
testing is common in schools throughout Texas, Florida, Kentucky and
parts of California. 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 percent 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 Association 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 past decade,
parents and school administrators still consider the rates
unacceptably high. Just over 20 percent 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 percent of high school
seniors say they have been drunk in the past 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
percent 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 percent 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," Levy says. "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 might be likely to use, such as
inhalants, OxyContin and Ecstasy. Standard urine tests only detect use
that has occurred in the past 48 to 72 hours.

The belief that testing deters kids from using drugs or gives them a
peer-worthy reason to say no has not been proved, some say. 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. "There may be unintended
consequences to drug testing," says Dr. Howard Taras, a pediatrics
professor at the University of California, 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?" DuPont
says 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."

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," Taras says. "But until you study it, you can't really say
anything about it."

Schools, however, might 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,"
Walters says. "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."

Schools vary widely in how they conduct drug testing.

Deciding when and whom to test: Some schools test students only when
there is a suspicion of drug use. A growing number, however, use
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 buy 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 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
community drug-treatment and counseling resources. 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 also can 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.