May 2008

Critics question testing's effectiveness, appropriateness

By David Grant Long

Related story

'Drug czarina' advocates random testing of students

During an interview with the Free Press, Bertha Madras of the White House Office of National Drug Control Policy defended the concept of "suspicionless" random drug-testing of public- school students, and maintained that students themselves have no problem with being tested. She said many welcome the scrutiny as a way of resisting peer pressure to use drugs.

However, Jennifer Kern, youth policy manager for the Drug Policy Alliance, which opposes such testing and promotes drug-law reform, cited a recent study that appears to indicate the opposite — that random testing may actually be "counterproductive."

Released by the Oregon Health and Science University in November, that research showed negative attitudinal changes among students subjected to testing "that actually indicates new risk factors for substance abuse,” Kern said in a phone interview.

“Student athletes in schools with drug testing reported less positive attitudes toward school, less faith in the benefits of drug testing, more views of normative use of drugs [finding it more acceptable] and they also reported higher risk-taking behavior,” Kern said. "So all the research backs up concerns that drug testing can erode relationships of trust at school [and] found that testing was not effective in reducing. . . drug use among students.”

Another concern about drug-testing is whether it focuses on the right substances.

Madras identified marijuana as the most serious substance-abuse problem among teens “in terms of numbers,” but added, “obviously alcohol and cigarettes as well.”

“Our authorization for the Office [of National Drug Control Policy] was for illicit drugs, and alcohol was not part of the authorization,” she said, explaining why alcohol is not stressed as the most commonly abused drug among teens. She conceded alcohol is an “illicit” substance that is illegal for teenagers to use. Even according to ONDCP statistics, alcohol outranks marijuana, with about twice as many teen users.

“We don't say we're only interested in people who are addicted to marijuana and cocaine — but our media campaign is focused on illicit drugs because that's the way our office was authorized,” she said.

ONDCP grants do contain a component that addresses underage drinking, she added.

“We’re just embarking in a few weeks on radio tours and media events for this,” she said. “We certainly don't marginalize the impact of alcohol — it is in our treatment programs and our prevention and intervention.

“If you look at medical consequences, if you look at death rates and all that, what you find is that alcohol plus drugs, or drugs alone, are approximately — in terms of addiction numbers — about half of alcohol alone, so the rate's about 2 to 1 in terms of addiction and consequences.

“Our office has clearly not targeted programs to illicit drugs only,” she said, explaining that those decisions are made by the schools. “The schools can choose to screen for whatever they want.”

Even though drug use among students has dropped significantly, Madra said, more needs to be done.

“In the late ’80s, early ’90s we had very low drug-use rates in our country, and then they soared.” Around 1996 they began to drop again, and in the past six years there's been a significant decline, she said.

“But when 26 percent of high school seniors have used marijuana in the past month, that's high — that's not trivial.”

And Madras believes more student testing would help, although critics of random drug-testing remain skeptical.

For instance, the American Academy of Pediatrics, which includes 60,000 physician members, vigorously opposes random student-testing programs.

In a policy statement issued last year, the AAP reaffirmed a statement it released after a 1995 U.S. Supreme Court decision that held random testing of student athletes is constitutional.

“Currently, there is little evidence of the effectiveness of school-based drug testing in scientific literature,” it states. “Few physicans support school-based testing of adolescents for drugs. A national survey of physicians (pediatrics, family medicine and adolescent medicine) found that 83 percent disagreed with drug testing in public schools.”

The AAP said drug testing may actually lead to more student drinking.

“Widespread implementation of drug testing may . . . inadvertently encourage more students to abuse alcohol, which is associated with more adolescent deaths than any illicit drug but is not included in many standard testing panels,” the policy states. “Mandatory drug testing may also motivate some drug-involved adolescents to change from using drugs with relatively less associated morbidity and mortality, such as marijuana, to those that pose a greater danger (e.g. inhalants) but are not detected by screening tests.”

Madras said the AAP was simply making a “political statement” and had no factual basis for its position.

She also dismissed a widely cited study by the University of Michigan that showed no significant difference in the incidence of drug use between public schools that do random drug testing and those that do not.

“Essentially, that study was what we would deem inconclusive,” she said. Besides, she said, the study relied on “self-reports” — students giving information about their own drug use and administrators responding to surveys.

She said only “suspicionless” randomized student testing is statistically valid, and that a previous MU study had relied on contacting school principals and asking them about “for-cause” testing in which students obviously intoxicated were given U/As.

“[For-cause testing] is not a real deterrent — it may deter some students in terms of being intoxicated, but it does not deter general use.

“A randomized drug-testing programs means that everyone is in the pool [and] could be tested at any time,” she explained.

But the Drug Policy Alliance’s Kern called the MU study “good research,” pointing out that it was conducted by Lloyd Johnston, who also conducts an annual study for the ONDCP office called “Monitoring the Future.”.

"It's a peer-reviewed study published in a scientific journal,” she said. “It doesn't give you the end-all, be-all answer to the question of whether drug-testing works because it's survey research, not a randomized experimental trial, but the author fully discloses the limitations of the study.”

Madras conceded that at this time there are no conclusive studies that would indicate whether random student testing is effective, although she said the U.S. Department of Education is currently conducting one that uses both self-reporting and urine-test results to examine the issue.

Madras discounted concerns that students might resent the invasion of their privacy and feel humiliated by being made to urinate under scrutiny.

"What's more important — the health of a child or an invasion of privacy?” she said. “The kids themselves don't think this is an invasion-of-privacy issue.”

Kern disagreed, citing “mountains of anecdotal evidence” of students who object to testing programs.

“I'm sure there are also students who don't find it offensive,” she said, “but to claim none find it offensive is a little ridiculous.”

Montezuma-Cortez High School and the Cortez Middle School currently have no random drug-testing programs, according to Jackie Fisher, chair of the Re-1 School District Board of Directors, but does test “for cause,” or when students are obviously intoxicated. Fisher stressed she was expressing her views only as an individual, not as a spokesperson for the board.

“[Under] our current policy, if there's any indication there's a drug problem then we can request drug testing, but there has to be clear and concise evidence,” she said, and a student's parents would be notified before any test was conducted and their consent would be sought.

“Then, depending on the results, if there's a positive, there's no punitive nature to that and we're obligated to get them into some type of drug rehabilitation, or offer that.

“I think before we ever considered random drug testing there would have to be community involvement because being a locally controlled board of education, all of our policies and practices are reflected by community values.

“I don't believe I would be in favor of mandating [random drug testing],” Fisher said, “only because I feel like we regulate a lot — it comes down to whose responsibility are these students.

“If the school's responsible for everything, then, yes, maybe we have to, but I believe families have responsibilities to their children and as schools I believe we educate the kids.

“It's a tough call, but I don't think randomly looking for culprits is the answer,” she said.