Random drug testing programs in schools are costly and destroy trust, research shows.

As stories about teenagers hooked on painkillers and even heroin increasingly make their way into our news feeds, authorities are scrambling for ways to head off the abuse. But the American Academy of Pediatrics (AAP) says not so fast when it comes to drug testing programs in schools.

A policy statement and report by the AAP was published online today in the journal Pediatrics. The AAP supports and encourages efforts to identify drug use in teens but warns so-called “suspicionless” or random drug testing may do more harm than good.

In the report, Dr. Sharon Levy, director of the adolescent drug treatment program at Boston Children’s Hospital, led a team that reviewed recent research about school drug testing in adolescents. She stressed drug testing children requires a rigid protocol to insure accuracy, and that can be very expensive.

The authors noted a previous study that showed drug testing costs schools about $3,000 per positive test result. That study, co-sponsored by the American Civil Liberties Union and the Drug Policy Alliance, concluded the money may be better spent on school-based counselors. Counselors could provide prevention programs for everyone, as well as specialized help for students with substance abuse problems.

“Most published studies of therapeutic drug testing recommend weekly or more frequent testing to achieve a deterrent effect,” the AAP authors wrote. “High-frequency testing is costly and inconvenient for most schools and unpopular among students.”

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Moreover, random drug tests can lead to a lack of trust among students, parents, and schools, the AAP report cautions. The tests can have additional unwanted consequences when positive results are false or when school discipline and legal punishments interrupt a child’s education, ultimately harming their chances of success.

“The original intent of school-based drug testing was to identify students with possible substance use to intervene with early treatment,” the authors of the AAP report wrote. “Research studies to date have shown that students often face harsh punitive consequences for positive test results, including suspension and even expulsion, and treatment may not be initiated. School suspension or expulsion has significant academic consequences, and the opportunity to ensure compliance with treatment may be lost.”

Just over 10 years ago the U.S. Supreme Court declared such tests legal. Only children enrolled in sports or other extracurricular activities can be tested.

Darren Bizarri coaches men’s basketball at Black Hawk College in Moline, Illinois. Bizarri also worked for many years as a newspaper reporter covering youth sports.

From the teen dynamics he has observed, random drug testing may actually give kids an easy way to say no to drugs. The threat of being tested and perhaps losing their spot on the sports team is a powerful deterrent.

“As a coach and as a parent, one of the biggest influences I worry about is peer pressure,” Bizarri told Healthline. “To combat peer pressure, I think random drug testing is one of the best things we can do for kids to give them an easy and ready reason to simply say, ‘No thanks, I don’t want to get tested.’”

In recent months, several new programs aimed at helping children make better choices about drugs and alcohol have been founded. School-based programs, such as Shatterproof and NOPE, aim to empower teens by giving them scientific information about the hazards of drugs and alcohol.

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The AAP report authors said even the effectiveness of programs with frequent testing have been called into question. In some cases, drug testing may actually make teens more likely to use again.

“Research assessing the relationship between drug testing and student attitudes toward drug use has also been inconclusive, with two studies finding that students who participated in drug testing programs were more likely to endorse positive attitudes toward future drug use,” they wrote.

There are additional concerns about privacy, whether screeners are looking for the right drugs with the tests they use, and the harmful ways children might try to get around the screens. The AAP concluded it “supports effective substance abuse services in schools but opposes widespread implementation of drug testing as a means of achieving substance abuse intervention goals because of the lack of evidence for its effectiveness.”

The AAP said schools that choose to do such testing anyway must “carefully consider and monitor the program for potential adverse effects, including decreased participation in sports, breach of confidentiality, increases in use of substances not included on testing panels, and increases in the number of students facing disciplinary action.”

But the AAP stressed that the pediatricians who make up its membership are in favor of drug abuse interventions and referral programs to get kids into full-time treatment.

Still, Bizarri told Healthline he believes random drug testing at school is a good idea.

“No doubt, random drug testing has its limitations. However, I think it is important to do what we can do to help our kids. There is not going to be a 100 percent solution, but that doesn’t mean that the percentage of effectiveness we get out of random drug testing isn’t worth it.”

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