O.C.-Based Group’s Home Drug Tests Spark Debate

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 too have 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 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 that the kit, with its handy penlight and tips on drug prevention, is a trust builder in the family and 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, a former mayor of West Covina and the 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 of the nation’s professional and college sports figures, including Los Angeles Dodgers manager Tommy Lasorda, Los Angeles Rams head coach John Robinson, former Green Bay Packers quarterback Bart Starr and Denver Broncos head coach Dan Reeves.

Besides a penlight, the kit contains 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. The program, which has been revised, expanded and renamed several times, is now called the “Super Deluxe Winner’s Kit.”

A key part of the program, however, is an eye test similar to that used by law enforcement officers during field sobriety tests. It takes no more than a minute or two.

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 that urinalysis can be done 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 across the country, and Hannah estimates that the group has sold kits to about 10,000 families in the Southland alone and made enough money to cover its overhead.

“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, then marketed under the name “Rapid Eye Check Kit,” was being sold for home use.

Members of the group from UCLA also said they were worried that Bruins 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.

After reviewing the eye test and the kit’s videotape, the doctors contacted the news media about their conclusions.

UCLA physicians said in interviews with The Times that 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 impact 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, such as jerky motions while following an object, dilated or constricted pupils, the inability to focus on an object inches from the face, 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 and could cost families thousands of dollars for unnecessary urine tests. They said 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 pupil expert at the University of Iowa, to further evaluate the kit. Thompson and four other neuro-ophthalmologists agreed with UCLA’s conclusions. Ophthalmologists at USC and Dr. Irving Leopold, a retired UC Irvine professor and an expert on the effect of drugs on the eye, had similar concerns.

“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.

Coach Donahue, who appeared in the kit’s videotape, has dropped out of Athletes for a Strong America. He declined to comment on the reasons.

“The last thing we in the substance abuse field need are Oliver North-type loose cannons rattling around,” said Dr. J. Thomas Ungerleider, a UCLA psychiatry professor and former presidential appointee to the National Committee on Marijuana and Drug Abuse during the Nixon Administration.

Tennant and Hannah, who say they never have been confronted with UCLA’s concerns, 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.

Tennant pointed out that it is common knowledge among law enforcement officials, drug treatment experts and medical professionals that drugs frequently affect the eyes in ways that can be easily detected with a little training.

“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 can detect drug use 80% to 90% of the time. Tennant said that has been his experience testing drug users at his clinics as well as that of law enforcement officers.

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 credibility and 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 falsely indicated drug use 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 in that case, David Derdeyn, a former University of Colorado track team member who now lives in Hollywood, flunked the eye test, qualifying him to take a urine test, which 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 80% to 90% of athletes fail the test although they haven’t taken drugs. 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.

The University of Colorado lawsuit is under appeal.

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.

They say the exam could bring a heavy-handed, police atmosphere into the house if parents insist on testing children who are not using drugs and should be suspicion-free.

“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. “Overcontrol could have a reverse effect and widen the gap between parent and child.”

Naomi Siegal, a licensed clinical social worker in Los Angeles who deals with family problems, said approaching an adolescent with a home drug test is bound to threaten an already difficult stage in the parent-child relationship.

“During adolescence, there is experimentation and rebellion,” said Siegal, former director of psychiatric social work at St. John’s Hospital in Santa Monica. “If you have a heavy-handed and authoritarian kind of practice, it could really give the kid something to rebel against.”

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.”

As proof, Hannah said, a survey by Athletes for a Strong America found that only six of 400 parents felt they could not give their children the eye test. If the test is given in a caring, understanding way, there should be no problem, Hannah said.

Yet some parents remain skeptical.

“From a medical standpoint it is not functional, and as a parent I’d be ill-advised to use it,” said Dawn Ahart, a registered nurse and chairwoman of Orange County Parents Against Drug Abuse.

Ahart said the group did not endorse the technique because the membership was afraid of a high inaccuracy rate. When members of Parents Against Drug Abuse got a look at the kit for the first time a while ago, “some of them laughed,” Ahart said.