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.

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."