Drug Testing and Drug Screening for Teens

Drug Testing and Drug Screening for Teens Addiction Drug Use Print Drug Testing and Drug Screening for Teens Teen Drug Abuse By Vincent Iannelli, MD facebook Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years. Learn about our editorial policy Vincent Iannelli, MD Medically reviewed by a board-certified physician Updated on February 04, 2020 Kirby Hamilton / Getty Images More in Addiction Drug Use Cocaine Heroin Marijuana Meth Ecstasy/MDMA Hallucinogens Opioids Prescription Medications Alcohol Use Addictive Behaviors Nicotine Use Coping and Recovery Drug use among teens is a common problem. One drug use survey of high school students found: 72% stated that they had ever drank alcohol42% had drank alcohol in the previous month24% were binge drinkers, having 5 or more drinks in a row at least once in the past month37% had ever smoked marijuana and 20% smoked marijuana in the past month20% had taken prescription drugs without a prescription11% had used inhalants6% had used cocaine, 4% had used methamphetamines, and over 2% had used heroin These high rates of alcohol and drug use make universal screening important. In fact, the American Academy of Pediatrics recommends that all teenagers be screened for tobacco, alcohol, and other drug use at all well-child checkups.? Drug Screening It is important to understand that when we talk about universal screening for alcohol and drug use, we are not actually talking about universal drug testing, in which all kids actually have a drug test. Universal drug screening simply helps you figure out who is at risk for drug abuse by asking them but not with an actual blood or urine test. Many pediatricians use the quick and easy two-part CRAFFT Screening Tool from the Center for Adolescent Substance Abuse Research (CeASAR) at Childrens Hospital Boston to screen teens for high-risk drug and alcohol use. It starts by asking three questions about whether a teen drinks alcohol, smokes marijuana, or uses anything else to get high. If the teen answers yes to any of those questions, they are then asked six other CRAFFT questions, a mnemonic using the keywords in the questions: C - Have you ever ridden in a CAR driven by someone (including yourself) who was high or had been using alcohol or drugs?R - Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in?A - Do you ever use alcohol/drugs while you are by yourself, ALONE?F - Do you ever FORGET things you did while using alcohol or drugs?F - Do your family or FRIENDS ever tell you that you should cut down on your drinking or drug use?T - Have you gotten into TROUBLE while you were using alcohol or drugs? One point is given for each yes response to the CRAFFT questions. Those teens with a total score of two or more are thought to have a positive screen, and according to the AAP, are at high risk of having a substance use disorder. Even a CRAFFT score of one could indicate a moderate risk of having substance use problems, though, and might indicate the need for intervention. Also, keep in mind that even those teens who deny using any drugs or alcohol should still be asked the CRAFFT Car question. In addition to being able to provide brief advice to encourage teens to stop drinking alcohol or using other drugs, and referring them to treatment when necessary, universal screening also allows pediatricians to provide teens who report no drug or alcohol use with brief positive feedback about their ability to make healthy choices. Drug Testing Is your teen using drugs? Do they have new friends, a drop in grades, or are they getting in trouble a lot more? Many parents quickly look to drug testing when they become worried or think that their kids might be using drugs. It is important to keep in mind that drug testing teens is much more complicated than simply buying a home drug test, getting your teen drug tested at school, or even taking your teen to his pediatrician for a drug test. Things to consider include that: the AAP is against involuntary drug testing of teensa drug test may be negative even if a teen is using drugs if the test was done more than two to three days after the last time drugs were used (window of detection)standard drug tests often dont include frequently abused drugs, such as alcohol, ecstasy, and inhalantsdrug tests can be defeated by teens if the urine sample is overly diluted, substituted with someone elses sample, or if the sample is adulterated, especially if the teen isnt directly observed giving the urine sampledrug testing can be seen as an unwarranted invasion of privacy and could create an environment of resentment, distrust, and suspicion among teens and their parents Also, drug tests can sometimes be hard to interpret, especially when faced with a possible false-positive test, a drug test that is positive because of an over-the-counter medication or food, such as poppy seeds. The AAP does state that drug testing can be done as a diagnostic test for teens in drug abuse treatment. Voluntary drug testing may also be used, according to the AAP, when it is necessary to determine the cause of dysfunctional behavior and other changes in mental status or suspicious physical behavior. However, instead of a drug test, teens suspected of drug abuse, but who deny drug and alcohol use on drug screening, should likely be referred to a qualified health care professional for evaluation, counseling, and treatment as needed. Remember, a negative drug test isnt necessarily going to mean that your teen isnt using drugs or alcohol, and a positive drug test will likely prompt a referral anyway. Drug Tests In addition to home drug tests and school-based drug testing, which the AAP are against, drug tests that can be done when appropriate include drug abuse panels that can test for five to 10 drugs, including: Amphetamines (amphetamine and methamphetamine)BarbituratesBenzodiazepines (Valium and Xanax)Cocaine metabolitesMarijuana metabolites (at 20, 50, or 100 ng/mL screens)MethadoneMethaqualoneOpiates (morphine, codeine, hydrocodone)PhencyclidinePropoxyphene Ethyl alcohol can usually be added to most drug abuse panels, too. Remember to consider the pros and cons before doing a drug test on your teen.