Administering the Test

What Can Students Expect?

Drug testing is commonly a four-step process: collection, screening, confirmation, and review.When called in to take a drug test, the student is met by a trained “collector,” or test administrator, who gives instructions and receives the specimen. It is also the collector’s job to complete the chain-of-custody form, which keeps track of where the specimen has been and who has handled it throughout the process. The form ensures that the specimen was handled properly and in such a way that does not call its source or the test results into question.

If the student is providing a urine sample, a temperature strip is put on the collection container to guard against a substitute sample. A tamper-evident tape is put over the specimen container, and then the student is asked to initial it and verify the chain-of-custody form.

Next, the specimen is screened for drugs or drug metabolites. If the screening test is positive, the test will be confirmed by a second, more exacting test. All confirmed positive tests should then be reviewed by a physician or nurse with knowledge of substanceabuse disorders to rule out legitimate prescription drug use.

Some specimens are screened at the collection site, and the initial results are known within minutes; others are screened at a laboratory. All negative screens—those that show no drugs or drug metabolites—are eliminated from further consideration.

Specimens that test positive for drugs in the initial screen are examined further in the laboratory through a second analytic technique called gas chromatography/mass spectrometry (GC/MS), which is actually a combination of two specialized techniques. Technicians use gas chromatography to separate the various substances in the specimen, then they make a positive identification through mass spectrometry.

Case History: Testing Made the Difference Hunterdon Central Regional High School Teachers and administrators at Hunterdon Central Regional High School in Flemington, New Jersey, were alarmed. A survey taken during the 1996–1997 school year revealed that 45 percent of the school’s 2,500 students had smoked marijuana, 70 percent were drinking alcohol, and 13 percent of all seniors had used cocaine. More than 10 percent of the student population had used hallucinogens, and 38 percent of seniors reported that heroin was readily available to them. “Our drug problem was probably no worse than that of other high schools,” says Principal Lisa Brady. “But for us, this was just unacceptable.” In September 1997, Hunterdon began a random drug-testing program for all student athletes. Urine was tested for marijuana, cocaine, heroin/codeine, amphetamine/methamphetamine, PCP, steroids, and alcohol. If a student tested positive, the school notified the parents and set up a meeting with the student, his or her parents, and a school counselor to discuss treatment options. The student attended a mandatory 4-week drug education course and was suspended from athletic activity until a subsequent test showed the drug use had stopped. “We had one of the best random testing implementations in the country,” says Brady. “It was working well.” Indeed, a survey in 1999 showed that drug use at Hunterdon had declined in 20 of 28 key categories. For example, cocaine use among seniors had dropped from 13 percent to 4 percent, according to the survey. In another encouraging finding, the number of 10th graders reporting little or no use of drugs or alcohol increased from 41.8 percent to 47.3 percent. Brady credits drug testing for the decline. “It was the only variable in the equation,” she says. “Nothing else had changed.” Hunterdon expanded its testing program in February 2000 to include students participating in any extracurricular activity. Even kids who wanted to act in school plays or obtain a parking permit could be called in to take a drug test. Eventually, problems with adulterated urine samples prompted school officials to give up urine testing and start testing oral fluids. In September 2000, however, the school suspended all random testing when the American Civil Liberties Union filed a lawsuit in New Jersey state court on behalf of students who claimed their Fourth Amendment rights were violated. (The suit is still pending.) Since the school halted testing, Brady has seen what she believes to be clear evidence that drug use at Hunterdon has begun to rise. “There’s no question it’s gotten worse,” she says. Before drug testing began at Hunterdon, many people in the community resisted the idea, explains Brady. “Now parents are demanding that we test their kids.”

Alcohol-specific tests may be performed entirely at the collection location if appropriate breath-alcohol testing equipment and procedures are used. Some oral fluid tests can also be used to obtain an immediate initial test result, with the positive screen going on to a laboratory for confirmation.

The purpose of drug testing is to keep students from using drugs, and to help those who may be drug dependent.

A positive test result does not automatically mean the student uses illegal drugs. In fact, positive results are sometimes triggered by other, legal substances. Certain over-the-counter medications, for example, can cause a positive reading for amphetamines. So when the GC/MS confirmation test comes back positive, it is important for a doctor, nurse, or other specialist to review the results and determine if illicit drugs are indeed the culprit.

In the Federal Drug-Free Workplace Program, a medical review officer is required to go over positive test results with the donor and determine if there could be a legitimate explanation. Everything is done confidentially, and safeguards are in place to make sure workers are not falsely labeled drug users when their positive test results are found to have a legitimate cause.

Schools should also take care that a student’s confidentiality and privacy are not violated, and that students who test positive because they are taking prescription medications are not wrongly branded as drug users. It bears repeating that the purpose of drug testing is to keep students from using drugs, and to help or refer to treatment those who may be drug dependent.

What Happens If the Test Is Positive?

Results of a positive drug test should not be used merely to punish a student. Drug and alcohol use can lead to addiction, and punishment alone may not necessarily halt this progression. However, the road to addiction can be blocked by timely intervention and appropriate treatment.

When a positive test result has been reviewed and confirmed for illegal drug use, the school's crucial next step is to contact the parents and help them stop their child's drug use. Parents play a key role in drug-abuse prevention, so they need lots of guidance and support. They also need to know that anger, accusations, and harsh punishment could make the situation worse. The best approach for parents is usually to stay firm and to treat their child with respect as they work together as a family to change his or her behavior.

After involving the parents, school officials may refer the student to a trained substance-abuse counselor, who can perform a drug assessment and determine whether the child needs treatment or other specialized help. For young people who use drugs occasionally, a few words from the counselor or parents—coupled with the prospect of future drug tests—may be enough to put an end to the drug use. For frequent users or those in danger of becoming drug dependent, treatment will likely be necessary.

Many schools require drug-positive students to enroll in a drug education course or activity. Some also offer Student Assistance Programs, whose trained counselors are linked to resources in the greater community and can help students cope with a variety of problems, including substance abuse. In any case, the school will want to perform follow-up drug tests on students with positive results to make sure they stay drug free.

Can Students “Beat” the Tests?

Many drug-using students are aware of techniques that supposedly detoxify their systems or mask their drug use. Some drink large amounts of water just before the test to dilute their urine; others add salt, bleach, or vinegar to their sample. In some cases, users call on their drug-free friends to leave bottles of clean urine in the bathroom stalls.

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 masking products do not work, cost a lot of money, and are almost always easily identified in the testing process. But 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.

Who Does the Testing?

Laboratories all over the country perform drug tests, but not all of them produce consistently accurate and reliable results. Many schools choose labs from among those certified by the Substance Abuse and Mental Health Services Administration (SAMHSA) to perform urine testing for Federal agencies. A list of SAMHSA-certified labs is available on the Internet at http://workplace.samhsa.gov/DrugTesting/Level_1_Pages/CertifiedLabs.aspx.

Before deciding on a laboratory, school officials should carefully assess the drug problem in their community.

Before deciding on a laboratory, schools should carefully assess the drug problem in their community. The standard Federal workplace test screens for the presence of marijuana, cocaine, opiates, amphetamines, and PCP. But if a school faces a significant threat from Ecstasy, methamphetamine, ketamine, GHB, or some other drug, administrators will need to be sure that any laboratory they are considering is also capable of testing for these drugs.

How Much Do Drug Tests Cost?

The price of drug testing varies according to the type of test and the drugs involved, but generally the cost is between $10 and $30 per test, with hair testing somewhat higher. The price for onsite alcohol tests usually ranges from $1 to $10 per test.

Some schools have paid for drug tests through Federal grants from SAMHSA or the U. S. Department of Education’s Safe and Drug-Free Schools Program. Others get money for testing from private foundations.When school-based programs begin to expand, testing providers will likely start offering volume price incentives.

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