American Academy of Pediatrics opposes drug testing in schools

5 Apr

Substance abuse is often a manifestation of other problems that child has either at home or poor social relations including low self esteem. Dr. Alan Leshner summarizes the reasons children use drugs in why do Sally and Johnny use drugs? The National Council on Alcohol and Drug Dependence lists Signs and Symptoms:

1. Physical and health warning signs of drug abuse
• Eyes that are bloodshot or pupils that are smaller or larger than normal.
• Frequent nosebleeds–could be related to snorted drugs (meth or cocaine).
• Changes in appetite or sleep patterns. Sudden weight loss or weight gain.
• Seizures without a history of epilepsy.
• Deterioration in personal grooming or physical appearance.
• Injuries/accidents and person won’t or can’t tell you how they got hurt.
• Unusual smells on breath, body, or clothing.
• Shakes, tremors, incoherent or slurred speech, impaired or unstable coordination.

2. Behavioral signs of drug abuse
• Drop in attendance and performance at work or school; loss of interest in extracurricular activities, hobbies, sports or exercise; decreased motivation.
• Complaints from co-workers, supervisors, teachers or classmates.
• Unusual or unexplained need for money or financial problems; borrowing or stealing; missing money or valuables.
• Silent, withdrawn, engaging in secretive or suspicious behaviors.
• Sudden change in relationships, friends, favorite hangouts, and hobbies.
• Frequently getting into trouble (arguments, fights, accidents, illegal activities).

3. Psychological warning signs of drug abuse
• Unexplained change in personality or attitude.
• Sudden mood changes, irritability, angry outbursts or laughing at nothing.
• Periods of unusual hyperactivity or agitation.
• Lack of motivation; inability to focus, appearing lethargic or “spaced out.”
• Appearing fearful, withdrawn, anxious, or paranoid, with no apparent reason.
Signs and symptoms of Drug Dependence:
Drug dependence involves all the symptoms of drug abuse, but also involves another element: physical dependence.
1. Tolerance: Tolerance means that, over time, you need more drugs to feel the same effects. Do they use more drugs now than they used before? Do they use more drugs than other people without showing obvious signs of intoxication?
2. Withdrawal: As the effect of the drugs wear off, the person may experience withdrawal symptoms: anxiety or jumpiness; shakiness or trembling; sweating, nausea and vomiting; insomnia; depression; irritability; fatigue or loss of appetite and headaches. Do they use drugs to steady the nerves, stop the shakes in the morning? Drug use to relieve or avoid withdrawal symptoms is a sign of addiction.
In severe cases, withdrawal from drugs can be life-threatening and involve hallucinations, confusion, seizures, fever, and agitation. These symptoms can be dangerous and should be managed by a physician specifically trained and experienced in dealing with addiction.
3. Loss of Control: Using more drugs than they wanted to, for longer than they intended, or despite telling themselves that they wouldn’t do it this time.
4. Desire to Stop, But Can’t: They have a persistent desire to cut down or stop their drug use, but all efforts to stop and stay stopped, have been unsuccessful.
5. Neglecting Other Activities: They are spending less time on activities that used to be important to them (hanging out with family and friends, exercising or going to the gym, pursuing hobbies or other interests) because of the use of drugs.
6. Drugs Take Up Greater Time, Energy and Focus: They spend a lot of time using drugs, thinking about it, or recovering from its effects. They have few, if any, interests, social or community involvements that don’t revolve around the use of drugs.
7. Continued Use Despite Negative Consequences: They continue to use drugs even though they know it’s causing problems. As an example, person may realize that their drug use is interfering with ability to do their job, is damaging their marriage, making problems worse, or causing health problems, but they continue to use….

Remember, these are very general signs, specific drugs, narcotics, and other substances may have different signs, it is important to know the specific signs.

Kathryn Doyle of Reuters wrote in Experts caution against random drug testing in schools:

Schools should not be using random drug tests to catch or deter drug abusers, the American Academy of Pediatrics advises in an updated policy statement.

The Academy recommends against school-based “suspicionless” drug testing in the new issue of the journal Pediatrics.

Identifying kids who use drugs and entering them into treatment programs should be a top priority, but there is little evidence that random drug testing helps accomplish this, said Dr. Sharon Levy, director of the adolescent substance abuse program at Boston Children’s Hospital and lead author of the new policy statement…

Scientifically, the best way to test the value of random drug tests would be to put some kids into a drug testing program and others not, in a single school, but practically, that is difficult to accomplish. Instead, researchers have compared schools with drug testing programs to similar schools without them – and found mixed results.

One study did find a short-term reduction in kids’ self-reported drug use at a school with random testing, but the kids were followed for a relatively short period and reductions in use applied only to the drugs included in the testing. This is a problem since most drug testing panels do not include alcohol, Levy said.
“It’s possible that you do get some prevention out of these programs, but on the other hand it seems very expensive, very invasive, and has pretty limited results,” she said.

Adolescent drug use is usually sporadic, so even a kid who does use illegal substances may easily pass a random annual test and then feel comfortable to use freely for the rest of the year, she said.

Drug tests can result in false positives, and even a true positive says nothing about frequency or quantity of drug use, according to Ken C. Winters of the psychiatry department at the University of Minnesota Medical School in Minneapolis, who is not in the AAP.


• From the American Academy of Pediatrics
Adolescent Drug Testing Policies in Schools
1. Sharon Levy, MD, MPH, FAAP,
2. Miriam Schizer, MD, MPH, FAAP,
More than a decade after the US Supreme Court established the legality of school-based drug testing, these programs remain controversial, and the evidence evaluating efficacy and risks is inconclusive. The objective of this technical report is to review the relevant literature that explores the benefits, risks, and costs of these programs.

Here is the AAP statement:

AAP Opposes In School Drug Testing Due to Lack of Evidence
Drug testing can be useful for pediatricians and other health care providers to assess substance use or mental health disorders in adolescents, but random drug testing in schools is a controversial approach not recommended by the American Academy of Pediatrics (AAP).

In an updated policy statement and technical report, “Adolescent Drug Testing Policies in Schools,” in the April 2015 Pediatrics (published online March 30), the AAP encourages and supports the efforts of schools to identify and address student substance abuse, but recommends against the use of school-based drug testing programs, often called suspicionless or random drug testing.

Proponents of random drug testing refer to potential advantages such as students avoiding drug use because of the negative consequences associated with having a positive drug test results, while opponents of random drug testing agree that the disadvantages are much greater, and can include deterioration in the student-school relationship, confidentiality of students’ medical records, and mistakes in interpreting drug tests that can result in false-positive results.

The AAP recommends against the use of school-based drug testing programs because of limited evidence of efficacy and potential risks associated with this procedure. Pediatricians support the development of effective substance abuse services in schools, along with appropriate referral policies in place for adolescents struggling with substance abuse disorders.
# # #

The American Academy of Pediatrics is an organization of 62,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

The National Institute on Drug Abuse (Institute) has some great information about drug testing. In Frequently Asked Questions About Drug Testing in Schools, the Institute discusses drug testing.

Why test teenagers at all?

Teens are especially vulnerable to drug abuse, when the brain and body are still developing. Most teens do not use drugs, but for those who do, it can lead to a wide range of adverse effects on the brain, the body, behavior and health.
Short term: Even a single use of an intoxicating drug can affect a person’s judgment and decisonmaking—resulting in accidents, poor performance in a school or sports activity, unplanned risky behavior, and the risk of overdosing.
Long term: Repeated drug abuse can lead to serious problems, such as poor academic outcomes, mood changes (depending on the drug: depression, anxiety, paranoia, psychosis), and social or family problems caused or worsened by drugs.
Repeated drug use can also lead to the disease of addiction. Studies show that the earlier a teen begins using drugs, the more likely he or she will develop a substance abuse problem or addiction. Conversely, if teens stay away from drugs while in high school, they are less likely to develop a substance abuse problem later in life….
Is random drug testing of students legal?
In June 2002, the U.S. Supreme Court broadened the authority of public schools to test students for illegal drugs. Voting 5 to 4 in Pottawatomie County v. Earls, the court ruled to allow random drug tests for all middle and high school students participating in competitive extracurricular activities. The ruling greatly expanded the scope of school drug testing, which previously had been allowed only for student athletes.
Just because the U.S. Supreme Court said student drug testing for adolescents in competitive extracurricular activities is constitutional, does that mean it is legal in my city or state?
A school or school district that is interested in adopting a student drug testing program should seek legal expertise so that it complies with all federal, state, and local laws. Individual state constitutions may dictate different legal thresholds for allowing student drug testing. Communities interested in starting student drug testing programs should become familiar with the law in their respective states to ensure proper compliance.

The primary issue is whether students have privacy rights.

Your summarizes the pros and cons of School Drug Testing:

The main purpose of random school drug testing is not to catch kids using drugs, it to keep them from ever using them. Once their using drugs its harder for them to break their addiction. With many employers drug testing its very important for a kid’s future not to use drugs. Drug use is responsible for many crimes. Its worth the inconvenience for all our future.
One of the fundamental features of our legal system is that we are presumed innocent of any wrongdoing unless and until the government proves otherwise. Random drug testing of student athletes turns this presumption on its head, telling students that we assume they are using drugs until they prove to the contrary with a urine sample.
“If school officials have reason to believe that a particular student is using drugs, they already have the power to require that student to submit to a drug test,” said ACLU-NJ Staff Attorney David Rocah.
The constitutional prohibition against “unreasonable” searches also embodies the principle that merely belonging to a certain group is not a sufficient reason for a search, even if many members of that group are suspected of illegal activity. Thus, for example, even if it were true that most men with long hair were drug users, the police would not be free to stop all long haired men and search them for drugs.
Peer pressure is the greatest cause of kids trying drugs. If by testing the athletes or other school leaders, we can get them to say no to drugs, it will be easier for other kids to say no.
Some also argue that students who aren’t doing anything wrong have nothing to fear. This ignores the fact that what they fear is not getting caught, but the loss of dignity and trust that the drug test represents. And we should all be afraid of government officials who believe that a righteous cause warrants setting aside bedrock constitutional protections. The lesson that our schools should be teaching is respect for the Constitution and for students’ dignity and privacy, not a willingness to treat cherished constitutional principles as mere platitudes.

See, What Are the Benefits of Drug Testing?

Substance abuse is often a manifestation of other problems that child has either at home or poor social relations including low self-esteem.


Adolescent Substance Abuse Knowledge Base

Warning Signs of Teen Drug Abuse

Al-Anon and Alateen

National Clearinghouse for Drug and Alcohol Information

The U.S. Department of Health and Human Services has a very good booklet for families What is Substance Abuse Treatment?

The National Institute on Drug Abuse (NIDA) has a web site for teens and parents that teaches about drug abuse NIDA for Teens: The Science Behind Drug Abuse

Where information leads to Hope. © Dr.

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