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April 5, 2004, 12:01 a.m. EST
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Zach Barber/Susan Craig
Children's Hospital Boston Study Finds Limitations and Risks in Home Drug Testing
Parents should look to pediatricians before the Internet for drug testing advice
With adolescent substance use still playing a harmful role in society, a growing number of parents are turning to the Internet as a source of information regarding home drug testing for their children. Although the Internet provides a large amount of information on this topic, most of that information is not regulated or scientifically peer reviewed. Several websites that sell drug testing kits recommend that parents implement home drug testing policies to monitor their teenaged children.
In a study being published in the April issue of Pediatrics, researchers from Children's Hospital Boston's Center for Alcohol and Substance Abuse Research examined eight different websites that market home drug testing kits to parents and concluded that none of these sites provide parents with enough information to select the correct test for their child, collect a valid specimen and thoroughly evaluate the results. Although many of the Internet websites did provide some accurate information, researchers found they fell short of addressing the technical challenges of drug testing, unanticipated consequences between parents and their children, the potential negative effects on parent-child relationships as a result of coerced testing, unsubstantiated benefits of the test and advice that appears to conflict with professional society guidelines.
''The home drug testing websites that we examined did provide a small amount of useful information to parents, such as the signs of drug use, but that is simply not enough,'' said Dr. Sharon Levy, lead author of the study at Children's Hospital Boston. ''There are many risks involved with adolescent drug testing, and these websites do not fully address them. Since adolescent substance use is such a sensitive subject, parents must be cautious not to disrupt open communication between themselves and their children. With all the risks of these home testing devices, parents would benefit by consulting with their child's pediatrician or a mental health professional for evaluation and assistance with these problems, rather than drug testing at home.''
In the study, researchers looked at eight Internet sites that sold home drug testing products and that also contained a ''parent's section.'' Within these sites, a variety of drug testing products were available that test for an assortment of substances. Researchers noted the test type (instant or laboratory), sample type (urine, hair, saliva, breath), drugs detected and cost. Researchers saw that each of the sites gave parents multiple reasons to perform drug testing and indicated that drug testing would allow parents to know with certainty whether their children are using drugs. However, researchers concluded that the complexity of drug testing makes this procedure impractical for home use.
Laboratory testing for drug use is a technically challenging task for medical professionals, much the less the untrained public, and researchers noted that the websites did not address this potential problem. Researchers found it difficult to decipher which products would test for specific drugs, making it nearly impossible for parents to choose the proper test for their specific situation, even if they did know which drugs their child was using. Drug tests can also yield false positive and false negative results. For example, over the counter medications and certain foods can make drug tests positive even if a child is not using illicit substances. A drug test may also be negative even if a child is using drugs if parents test for the wrong substance, miss the detection window (about 48 hours for most substances) or if a teen alters the urine specimen such as by diluting it with water.
Researchers went on to state that even if a teen is using drugs, the appropriate intervention would depend on the diagnosis. For example, a teen who is experimenting with drugs would require a very different treatment approach as compared with a teen who has a diagnosis of drug abuse or dependence. A description of the stages of drug use and insight into the different treatment needs for drug users were lacking in all of the websites. Researchers concluded that to determine appropriate treatment, distinguishing between the stages of drug use was critical, and the websites did not provide useful guidance on this issue.
The study also addressed the unanticipated consequences between parents and their children that could result from home drug testing. Such consequences could be a decrease in honest communication between family members or a delay in the diagnosis of a serious substance disorder. In some cases, teens may become deceitful in their attempts to beat the test or to keep their drug use undetected. By routinely beating the test, teens may become incidentally enabled and more confident in their drug use, feeling that they have evaded their parent's drug testing measures. Furthermore, only one of the websites gave clear advice that a child should not be tested against his or her will. By forcing such tests, the parent-child relationship could further be disrupted.
Overall, Children's Hospital researchers suggest that with all the risks involved with home drug tests, parents would be well advised to rely on a medical professional to handle these sensitive issues. The American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Ambulatory Pediatric Association all recommend that a professional trained in the interpretation of drug tests should supervise all drug testing. The study was supported by Grant #040557 from the Robert Wood Johnson Foundation Substance Abuse Policy Research Program.
Children's Hospital Boston is the nation's premier pediatric medical center. Founded in 1869 as a 20-bed hospital for children, today it is a 300-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. More than 100 outpatient specialty clinics are located at Children's. Children's Hospital Boston is the primary pediatric teaching affiliate of Harvard Medical School, home to the world's leading pediatric research enterprise, and the largest provider of health care to the children of Massachusetts. For more information about the hospital visit: www.childrenshospital.org.