"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."
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.