Revised May 2014
What is drug testing?
Some schools, hospitals, or places of employment conduct drug testing. There are a number of ways this can be done, including: pre-employment testing, random testing, reasonable suspicion/cause testing, post-accident testing, return to duty testing, and follow-up testing. This usually involves collecting urine samples to test for drugs such as marijuana, cocaine, amphetamines, PCP, and opioids (both heroin and prescription pain relievers.) Some schools have initiated random drug testing and/or reasonable suspicion/cause testing, using models established in the workplace.
- In random testing, schools selectone or more students to undergo drug testing using a random process (like flipping a coin). Legally, only students who participate in competitive extracurricular activities (including athletics and school clubs) can be subject to random drug testing.
In reasonable suspicion/cause testing, a student suspected of using an illegal substance is asked to provide a urine sample, if the school has sufficient evidence to warrant it. Such evidence may include direct observations made by school officials that a student has used or possesses illicit substances, exhibits physical symptoms of being under the influence, and/or has patterns of abnormal or erratic behavior. Why do some schools conduct random drug tests?
Schools that have adopted random student drug testing seek to decrease drug use among students via two routes. First, they hope random testing will serve as a deterrent and give students a reason to resist peer pressure to take drugs. Secondly, drug testing can identify teens who have started using drugs and would be good targets for early intervention, as well as identify those who already have drug problems, so they can be referred for treatment. Using drugs not only interferes with a student's ability to learn, but it can also disrupt the teaching environment, affecting other students as well.
Is student drug testing effective?
Drug testing should never be undertaken as a stand-alone response to a drug problem. If testing is done, it should be a component of broader prevention, intervention and treatment programs, with the common goal of reducing students' drug use.
If a student tests positive for drugs, should that student face disciplinary consequences?
The primary purpose of drug testing is not to punish students who use drugs but to prevent drug abuse and to help students already using become drug-free. If a student tests positive for drugs, schools can respond to the individual situation. If a student tests positive for drug use but has not yet progressed to addiction, the school can require counseling and follow-up testing. For students diagnosed with addiction, parents and a school administrator can refer them to effective drug treatment programs to begin the recovery process.
Why test teenagers at all?
Adolescents’ brains and bodies are still developing, and this makes them especially vulnerable to the harmful effects of drug use. Most teens do not use drugs, but for those who do, it can lead to a wide range of adverse effects on their behavior and health.
Short term: Even a single use of an intoxicating drug can affect a person's judgment and decision making—resulting in accidents, poor performance in school or sports activities, unplanned risky behavior, and the risk of overdosing.
Long term: Repeated drug use 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 use disorder or addiction. Conversely, if teens stay away from drugs while in high school, they are less likely to develop a substance use disorder later in life.
How many students actually use drugs?
Drug use among high schools students has dropped significantly since 2001. In December, the 2013 Monitoring the Future study of 8th, 10th, and 12th graders showed that drug use was down from 31.8 percent in 2001 to 28.4 percent. While drug use is still below that from 2001, it has been increasing over the last several years largely due to increased marijuana use.
About 50 percent of 12th graders say that they've used any illicit drug at least once in their lifetime, and over 35 percent report using marijuana in the last year. Abuse and misuse of prescription drugs are also high—for example, in 2013, 7.4 percent of high school seniors reported non-medical use of the prescription stimulant Adderall in the past year.
What testing methods are available?
There are several testing methods currently available that use urine, hair, oral fluids, and sweat. These methods vary in cost, reliability, drugs detected, and detection period. Schools can determine their needs and choose the method that best suits their requirements, as long as the testing kits are from a reliable source.
Which drugs can be tested for?
Various testing methods normally test for a "panel" of five to ten different drugs. A typical drug panel tests for marijuana, cocaine, opioids (including the prescription pain relievers OxyContin and Vicodin), amphetamines, and PCP. If a school has a particular problem with other drugs, such as MDMA, GHB, or steroids, they can include testing for these drugs as well. It is also possible to screen for synthetic cannabinoids, commonly known as spice and K2.
What about alcohol?
Alcohol is a drug, and its use is a serious problem among young people. However, alcohol does not remain in the blood long enough for most tests to detect most recent use. Breathalyzers, oral fluid tests, and urine tests can only detect use within the past few hours. The cut-off is usually detection of the presence of alcohol for the equivalent of a blood alcohol content greater than 0.02 percent (20mg/1dL). Teens with substance use problems are often polydrug users (they use more than one drug) so identifying a problem with an illicit or prescription drug may also suggest an alcohol problem.
How accurate are drug tests? Is there a possibility a test could give a false positive?
Tests are very accurate but not 100 percent accurate. Usually samples are divided so that if an initial test is positive a confirmation test can be conducted. Federal guidelines are in place to ensure accuracy and fairness in drug testing programs.
Can students "beat" the tests?
Many drug-using students are aware of techniques that supposedly detoxify their systems or mask their drug use. Popular magazines and Internet sites give advice on how to dilute urine samples, and there are even companies that sell clean urine or products designed to distort test results. A number of techniques and products are focused on urine tests for marijuana, but masking products increasingly are becoming available for tests of hair, oral fluids, and multiple drugs.
Most of these products do not work, are very costly, are easily identified in the testing process, and need to be on hand constantly due to the very nature of random testing. Moreover, even if the specific drug is successfully masked, the product itself can be detected, in which case the student using it would become an obvious candidate for additional screening and attention. In fact, some testing programs label a test "positive" if a masking product is detected.
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.
What has research determined about the utility of random drug tests in schools?
Research in this area shows mixed results, however study authors generally agree that student drug testing should not be a stand-alone strategy for reducing substance use in students, and that school climate (the quality and character of school life) is an important factor for achieving positive results in drug prevention programs.
- A NIDA-funded study published in 2013 found significant associations between both random and for-cause student drug testing and use of marijuana or other drugs. The authors note that while drug testing was associated with moderately lower marijuana use, it was also associated with higher use of other illicit drugs. 
- A study published in 2013 found that perceived school climate was associated with reduced likelihood of marijuana and cigarette initiation and cigarette escalation, and that student drug testing was not associated with improved drug use outcomes. The authors conclude that improving school climates is a promising strategy for preventing student substance use, while testing is a relatively ineffective drug-prevention policy. 
- A study published in 2012 found that students subject to mandatory random student drug testing reported less substance use than comparable students in high school without such testing. The study found no impact of randing drug testing on intention to use substances, perceived consequences of substance use, participation in covered activities, or school connectedness. 
- Results from a study published in 2012 indicate that drug testing is primarily effective at deterring substance use for female students in schools with positive climates. The authors conclude that drug testing should not be implemented as a stand-alone strategy for reducing substance use, and that school climate should be considered before implementing drug testing. 
- A NIDA-funded study published in 2012 showed little empirical evidence supporting or refuting the efficacy of random student drug testing in schools. 
- A NIDA-funded study published in 2007 found that student athletes who participated in randomized drug testing had overall rates of drug use similar to students who did not take part in the program, and in fact some indicators of future drug use increased among those participating in the drug testing program. 
Because of the conflicting findings on student drug testing, more research is needed.
 Yamaguchi R, Johnston L, O’Malley P., 2003. Drug Testing in Schools: Policies, Practices, and Association With Student Drug Use. YES Occasional Papers. Available at: http://www.drugpolicy.org/docUploads/Johnston_sdt_study.pdf
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