Guidelines Issued for Drug Testing in Teens

Drug testing in teens and kids may be appropriate in some situations

(RxWiki News) The teenage years are a common time for experimentation, which can include experimenting with alcohol, tobacco and drugs.

Parents can attempt to be vigilant about their children's possible substance use, but some situations may call for alcohol or drug testing.

A recent policy statement from the American Academy of Pediatrics (AAP) offered explanations and guidelines regarding drug testing in teens.

The most commonly used form of drug testing is urine testing, despite some limitations to that method.

"Talk to your kids about drug use."

This policy statement was authored by the AAP's Committee on Substance Abuse, led by Sharon Levy, MD, MPH, and reviews various considerations related to drug testing in teens and children.

There are six main specimen types that can be tested for drugs: urine, blood, breath, saliva, sweat and hair.

Breath can reveal alcohol or tobacco use, though tobacco use can also be detected by measuring cotinine, a compound in tobacco, in blood, saliva, hair or urine.

Blood tests can be used to detect alcohol as well as any other drug use within the previous two to 12 hours, but it is more intrusive than other forms of testing.

Testing saliva and sweat can provide similar information to that provided in blood tests, but these methods tend to be less invasive and require less intensive training for collection.

Drugs that don't yet appear in urine can be detected in saliva within 24 to 48 hours.

The method best used for testing for drug use a longer period of time in the past is hair testing "because drugs and metabolites are incorporated into the hair matrix over time."

However, hair testing will not provide any information about drug use within the past seven to 10 days.

Urine testing can be problematic, according to the statement, because it is susceptible to tampering and it is highly invasive.

"Nonetheless, because it is well standardized and studied, less invasive than blood testing, and provides a longer window of detection for some substances, [urine] is the most common sample used for drug testing in primary care," the committee wrote. One survey found it to be used by more than 90 percent of pediatricians and family doctors.

The statement also discusses the reasons that a teen might be tested for drug use, especially if there is reason to believe the teen may not be honest about drug use.

One such situation where drug testing may be needed is in an emergency situation, such as following a car accident or suicide attempt or if the teen experiences seizures, fainting or an irregular heartbeat.

Another situation where drug testing may be appropriate is if a teen comes to the doctor with a variety of nonspecific symptoms, such as fatigue, moodiness and poor school grades.

In this situation, knowing about possible drug use could help in diagnosing the problem.

"A drug test may be particularly useful for adolescents who report limited or infrequent drug use. In these cases, a negative test result would be expected and would support the adolescent’s history," the committee wrote.

The committee also offered guidance to pediatricians in understanding how to interpret tests, including the potential for false positives and false negatives.

This statement was published May 26 in the journal Pediatrics. It did not require external funding, and no disclosures were provided for authors or committee members.

Review Date: 
May 25, 2014