If your teen suddenly becomes moody, is spending time with a different group of friends, or starts failing in school, you may wonder if drugs are to blame. While medically testing your teen for drug use may seem like a straightforward way to get an answer, it probably is not the best way.
Drug tests are not always reliable, and your teen may resent being tested. Other methods may be better. Through confidential interviews and questionnaires, your pediatrician can help assess whether your teen has a drug problem without resorting to lab tests.
Where we stand
If your teen does undergo a drug test, it should be voluntary. The American Academy of Pediatrics opposes involuntary drug tests. Consult your pediatrician if you believe your teen should be tested for drug use.
Types of drug testing
Drug tests most commonly analyze urine. However, many body tissues and fluids can be tested for drug use. Hair, saliva, nails, and sweat are among them. Some of these alternatives show promise. For example, hair tests are difficult to fool and may reveal drug use months after it occurs.
But hair tests are fairly new and do not detect recent drug use. Hair color and type or secondhand marijuana smoke also may skew hair test results. Saliva, nail, and sweat testing need to be refined as well.
Limits of urine drug testing
A chemical analysis of urine—or urinalysis—is the most common drug test. But the test has limits and parents should consider the following pitfalls:
- Test may not detect all illicit drugs. Most routine urine tests do not catch LSD, ketamine, Ecstasy, inhalant, or anabolic steroid use. They also may not detect alcohol, the substance that teens are most likely to use.
- Test results may be false negatives. Other drugs are detectable for only a short time after they are used. Most drugs—other than marijuana—can be flushed from the user's system in as few as 12 hours. Within 2 or 3 days, these drugs are almost always undetectable.
- Test results may be false positives. Urine tests that do detect drug use may be misleading and should be confirmed by more specific tests. For instance, routine urine test results may show marijuana use days—or even weeks—after your teen has quit using the drug. Some drug tests may mistake traces of legal painkillers containing ibuprofen or naproxen for signs of marijuana use. Other false positives can be caused by:
- Sinus or allergy medicines may show up as amphetamines in drug tests. Other common medicines can test as tranquilizers.
- The poppy seeds baked into many foods can cause false positives for opiate use.
Some antibiotics also may show up as opiates in tests.
- Testing may damage the pediatrician-patient relationship. Involuntary drug testing may undermine your teen's trust in your pediatrician. Even results showing no drug use can be harmful if your teen feels coerced into the test. If your teen does use drugs, trust in your pediatrician is vital to successful substance abuse treatment.
Home drug tests
You can buy home drug testing kits at pharmacies or through the Internet. But home test kits also may give false or deceptive results.
Accurate or not, the test can create hard feelings. Your teen may resent what seems to be a clear sign of distrust and become less open with you. Or anger could turn to rebellion. At the least, a resentful teen is less likely to turn to you for the emotional support that helps deter drug use.
Your pediatrician can help
Your pediatrician may be able to identify drug use by interviewing your teen. Though you may want to participate, let the doctor talk to your teen alone and in strict confidence. Do not worry that you will be kept in the dark about a serious problem. Your pediatrician will tell you if your teen is at immediate risk.
If drug testing is called for...
- You and your pediatrician should work together to ensure you get reliable lab results.
- Make sure your teen's sample is carefully collected and handled by an experienced, certified laboratory.
- Guard against human error or false positives.
- Be certain the results are properly recorded and kept confidential.
- Remember that a lab test is just one measure of drug use. Your pediatrician also will take into account your teen's behavior as a whole.