Module 2: Screening and Assessment

5C. Drug Testing

Drug testing (also called chemical testing, laboratory testing, or toxicology screening) is an additional form of screening and assessment used in the juvenile justice system. Breath, saliva, and urine are used in the most practical, accurate, and cost-effective drug testing methods. Urine analyses are commonly used to chemically test for alcohol and other substances. This is an area of rapid technological development, and the most recent innovations should be considered.

Drug recognition techniques are useful before drug testing. They provide immediate information and are minimally intrusive. However, care must be taken with youth who have co-occurring disorders since the signs and symptoms of substances may overlap with signs and symptoms of mental illness.

Advantages of Drug Testing

Of the several screening approaches, drug testing is the most accurate in determining current or recent substance use. Drug testing can be used for initial screening and assessment purposes and for monitoring treatment compliance.

It is not meant to replace the screening and assessment techniques previously mentioned but serves as additional information and corroborates the youth's self-report. It can also be used during the course of treatment to detect relapse and help youth remain motivated.

Many intensive treatment interventions use random and scheduled drug testing as an integral part of the treatment program. The truthfulness of a youth’s self-report of substance use often improves with concurrent use of drug tests.

Disadvantages of Drug Testing

A disadvantage of drug testing is the limited timeframe for detecting substance use, depending on the substance and the method of testing. For instance, alcohol is eliminated from the body within several hours of ingestion. Other drugs remain in the body longer. Detection limits can range from a few hours to about 30 days. One way to address this problem is to repeat the drug test over an extended period (two or three times in a week). This strategy also indicates the frequency and severity of substance use (Drake, Alterman, & Rosenburg, 1993). Unfortunately, given the large number of youth on most caseloads, repeated drug testing is often difficult to do.

Drug testing is an intrusive and often expensive process that may not be practical in all settings. Although it can point to specific substances being used, it cannot replace the assessment process to diagnose the substance use disorder or interactions with mental illness. All agencies using drug tests should have policies and procedures for conducting these screens that specify what consequences result from positive findings.