Voluntary drug testing for high school students

Medical Laboratory Observer, March, 1991 by Richard R. Ellis

Voluntary drug testing for high school students

Would any normal teenager willingly participate in a voluntary drug testing program based at school? The answer was a resounding yes when our laboratory plunged into a venture that quickly exceeded our high original hopes.

Voluntary drug testing is a relatively new approach to combating the problem of substance abuse in high schools. We found it fairly easy to develop a successful program by combining the talents and resources of our laboratorians with the enthusiasm and assistance of school personnel.

* First contact. In 1986, the principal and vice principal of a local high school who had begun to develop a voluntary drug testing program for athletic teams approached our lab. The school, having developed the concept for the program, was looking for a licensed laboratory to perform the testing. After some consultation, we decided that we could do the job at minimal cost while providing an excellent service for our community. As medical director of the lab, I took the reins.

During the next year we planned the program. I met with hospital administration and gained their approval to sponsor it. At the same time, the principal and vice principal got the go-ahead from their school board.

* Why sports teams? Support programs thrive on word of mouth. We--the clinical laboratory and the school--wanted students to appreciate the program and to encourage their friends to participate. Targeting boys' and girls' sports programs helped facilitate such involvement. This tactic has worked in several ways.

First is the high visibility of school sports. If members of the football, basketball, baseball, and other teams are actively enrolled and supportive, other students will follow suit.

The second advantage of starting with athletes was a chance to gain the involvement of the coaches. Their encouragement of students to participate was instrumental as the program began and has continued to be so ever since.

The coaches were glad to cooperate. Many had known one or more promising young athletes lost to the devastating effects of drug abuse. In addition, the coaches were familiar with the tragic stories of substance abuse in many amateur and professional sports.

A third reason to begin with student athletes is the prevailing attitude of that group. They want credit for every tackle and home run they achieve. What they don't want is to have their achievements tainted by suspicion of drug use.

*Pep rally. Our primary focus is on deterrence, not detection: to prevent teenagers from experimenting with drugs rather than to point a finger at those who have tried them. We take pride in the voluntary and confidential nature of our program. No student is required to participate, yet participation has been strong--and growing--from the beginning.

We start off each year with a bang. At a special pep rally, usually held just before the debut of fall athletics, we introduce the program. To build it up, we involve the drill team, the local press, and even local celebrities. After the rally, we discuss the program with students, parents, coaches, teachers, administrators, and anyone else who is interested.

We have made it easy to sign up. A simple application form asks for the student's name, address, and telephone number. At the bottom, the student and one or both parents sign their consent to have the testing done. The coaches hand out some applications before our big meeting. Other students receive theirs at the event. The forms are mailed to the chemical dependency unit at the hospital and then passed to me.

* At the lab. Testing is performed once a week. I schedule it on different days so that students never know exactly on what day specimens will be collected. Because weekends present the biggest risk for substance abuse, we often do the testing on Monday mornings.

The students to be tested are determined by a weekly lottery. The procedure is straightforward. I keep all the applications in a folder under lock and key. On each collection day, I pull about five forms out of the file. I notify the school administration of the names drawn that morning.

After a student has been tested, his or her name goes into a second pool. My weekly drawing includes at least one name from the second pool so that those who have already been tested won't let down their guard.

* To the school. The school calls the parents to confirm their approval. The students are usually notified during the first class of the day that their names have come up. An administrator immediately escorts the student to the school nurse's office to provide a urine specimen in a private setting. We collect the specimen early in the day to get as close to a fasting specimen as possible. Voiding is not observed.

No student is required to provide a specimen. We make this policy clear to the students and their parents from the beginning. I do, however, notify by letter any parent whose son or daughter has chosen not to follow through with the test. This situation has occurred only once or twice in the 4-1/2 years of our program.