Eye Kit for Drug Screening Not Accurate, Doctors Say

The war on drugs is turning into a battle of credibility for the promoters of a do-it-yourself eye test that some of the nation’s leading medical experts say is useless in helping parents ferret out drug abuse on the home front.

Since its introduction more than a year ago, the Winners Program kit, marketed by Athletes for a Strong America, has become the center of a debate over whether it is an effective tool or a gimmick to make a buck off the country’s alarm about drugs.

In August, a federal judge in Colorado deemed the eye test extremely inaccurate. A month later, prominent doctors and researchers cut through the exam’s glowing testimonials from sports figures and concluded that the $49 kit was almost worthless. Family counselors have also joined the fray, saying the weekly regimen of home testing could destroy trust between parent and child.

“The wholesale use of the eye test needs to be evaluated very carefully,” said Dr. Don Catlin, a UCLA professor of medicine, who directed drug testing for athletes in the 1984 Los Angeles Olympic Games. “I am concerned about this product and other products that go out on the market in an attempt to diagnose things.”

But Athletes for a Strong America, a nonprofit organization based in Mission Viejo, is undaunted by its critics. The group’s directors say the kit is the best available tool to screen children for drugs.

“Our critics don’t see enough addicts to put in a thimble,” said Dr. Forest Tennant, a drug adviser to the National Football League, who helped adapt the eye examination for the home. “If people don’t start learning how to recognize drug use and get people off drugs by using this test, I don’t think we have any choice but to legalize drugs.”

Tennant, the former mayor of West Covina and owner of a string of drug treatment clinics in Los Angeles, Santa Barbara and Fresno, developed the test for home use more than 14 months ago at the urging of Athletes for a Strong America.

Since then, support for the organization has come from more than 100 professional and college sports figures, including Los Angeles Dodgers manager Tommy Lasorda, Los Angeles Rams coach John Robinson, former Green Bay Packers quarterback Bart Starr and Denver Broncos head coach Dan Reeves.

The kit contains a penlight, a scale for measuring pupil size, an instructional videotape and a 32-page manual to teach parents how to recognize and prevent drug use. It also contains tips on how to maintain a child’s self esteem.

A key part of the program, however, is an eye test similar to that used by law enforcement officers during field sobriety tests. During the exam, parents check for redness, puffiness and excessive tearing. Next, pupils are checked for dilation or constriction and whether they react properly to light. Finally, the eyes are observed for involuntary jerking and the inability to focus on an object coming toward them.

If drug use is suspected, the kit recommends an urinalysis test at Tennant’s Community Health Projects Medical Group, which owns 25 drug and alcohol clinics. Urine tests can cost up to $100.

Tennant and David Hannah, president of Athletes for a Strong America, hope the eye check will become as commonplace as the toothbrush or thermometer. To institutionalize the technique in the family, they suggest that parents start the test when their children are about 7 years old and administer it every few days from then on as a deterrent and detection device.

Although much of the group’s activity is in Southern California, colleges, school districts and businesses in several states have adopted the test. The promoters also have appeared on radio and television talk shows throughout the country, and Hannah estimates that the group has sold kits to about 10,000 families in the Southland alone.

“We are struggling with a tremendous drug problem,” Hannah said, “and the eye test is the best method we’ve got. As a screening tool, it can be tremendously helpful. If there is a better deterrent you can give to parents, I want it.”

But a group of ophthalmologists, pharmacologists, medical researchers and sports medicine experts at UCLA Medical Center and the University of Iowa are not convinced. They became concerned about the eye test last summer after the media reported that the device, marketed under the name “Rapid Eye Check Kit,” was being sold for home use.

Members of the UCLA group also said they were worried that Bruin head football coach Terry Donahue, who was co-chairman of Athletes for a Strong America, was lending his name and the university’s reputation to something they thought didn’t work. (Donahue, who appeared in the kit’s videotape, has since dropped out of Athletes for a Strong America. He declined to comment).

UCLA physicians said the home test is based on some medical fallacies about the eye’s reaction to drugs. Research by Dr. Robert Hepler at UCLA, for example, shows that marijuana has very little, if any, effect on the pupil--a result that prompted warnings to law enforcement about using eye tests in the field as a basis for marijuana arrests.

On the other hand, heroin constricts the pupils, while cocaine can have the opposite effect in large doses. But, the UCLA doctors said, it is unknown whether low and moderate doses of cocaine consistently change the eye in ways that can be measured by the home drug test.

More important, they said, many eye conditions indicative of drug use, frequently occur for reasons unrelated to drugs. Because of this, the group concluded that the test will be highly inaccurate in the hands of parents. They said that many symptoms of drug use are readily noticeable without the home drug test and that parents would be better off consulting their family doctors if drug use is suspected.

“A lot of us get upset in these witch-hunt days,” said Dr. Robert N. Pechnick, an assistant professor of pharmacology, who teaches drug abuse classes at UCLA. “The scientific community must take action to see that something that doesn’t work doesn’t get promoted.”

During the review, the UCLA group asked Dr. Stanley Thompson, a widely known eye pupil expert at the University of Iowa, to further evaluate the kit.

“It seems to us that the pupil test is a sham and the flashlight is just something for parents to wave about in the hope of scaring their kids into staying clean,” Thompson wrote to UCLA in October.

Tennant and Hannah defend the test, saying the physicians and researchers are ignorant about the program and its successes. It was never meant, they say, to be the sole criterion for suspected drug use and must be combined with more accurate urine testing.

“You don’t have to be a whiz kid to do the test,” said Tennant, who has run drug abuse clinics for almost 20 years. “I want these people at UCLA to tell me about their drug clinics, and how many people they examine that have eye signs. The eye test works, and if you are a parent and you don’t have it, you have given your child another chance to get on drugs.”

Athletes for a Strong America claims that if done properly, the eye test is accurate in detecting drug use 80% to 90% of the time. Tennant said that has been his experience in testing drug users at his clinics as well as that of law enforcement officers.

But even if the test were inaccurate, Hannah says, the screening regimen gives children an excuse to stay off drugs. He added that parents are wrong if they think they can detect drug use by merely watching for falling grades, changes in behavior and undesirable friends. By then, he says, it’s too late.

Contrary to Tennant’s and Hannah’s accuracy claims, an August court decision in a civil rights lawsuit challenged the reliability of the eye test, which was given thousands of times to University of Colorado athletes. The suit alleged that the athletic department’s drug testing program, which included the eye test used by Athletes for a Strong America, was unconstitutional.

U.S. District Judge Joseph Bellipanni, armed with the university’s own statistics about the test, concluded that the examination was wrong 97% to 98% of the time. Medical experts said the tests are also capable of yielding false negative results--failing to detect actual drug use.

The plaintiff, David Derdeyn, a former University of Colorado track team member who now lives in Hollywood, flunked the eye test. But a urine test later detected no drug use.

“This thing has Orwellian overtones and a terrible potential for abuse,” said Derdeyn, who described the eye test as “kind of hokey” and “voodoo science.”

Similar inaccuracy rates were reported at Youngstown State University in Ohio, where trainer Dan Wathen estimated that the test is wrong 80% to 90% of the time. Nevertheless, Wathen said he considered the eye exam useful for screening.

Tennant and Hannah contend that University of Colorado trainers improperly flunked athletes for failing one part of the test instead of at least two portions as required. Court testimony indicated otherwise.

Besides questions about accuracy, family counselors and others in the drug abuse field contend that home testing can undermine the trust between parent and child during the already trying time of adolescence.

“To create a situation where the parent is playing detective with teens might fuel resentment and anxiety,” said UCLA Assistant Prof. Tom Kennon, a family counselor. “Over control could have a reverse affect and widen the gap between parent and child.”

But Hannah and Tennant say trust is not an issue. Parents routinely check the whereabouts, health and appearance of their children, so adding another check won’t matter, they say.

“I test my son, and his eyes respond pretty well,” Hannah said. “I have come to realize that this is actually a trust builder in the home and brings out better communication. Kids and parents feel comfortable with it.”