Despite some bright spots, national
statistics on illicit drug use are alarming.
More than a third of US high school students have
tried an inhalant or illicit drug by the time they are in eighth grade. More
than half use an illegal drug by the time they finish high school. Eighty
percent of today’s high school students have used alcohol.
So 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.
Medically testing your teen for drug use may seem
like a straightforward way to get an answer. But it probably is not the best
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.
If your teen does undergo a drug test, it should be
voluntary. The American Academy of Pediatrics (AAP) opposes involuntary drug
tests. Consult your pediatrician if you believe your teen should be tested for
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
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
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.
Teens also may try to
“cheat” on a urine test. They might dilute their urine
samples with tap or toilet water, or drink a lot of water before the
test to flush drugs from their systems. Some users buy products designed
to beat the test at nutritional supplement stores or through the
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
Sinus or allergy medicines may show up
as amphetamines in drug tests. Other common medicines can test as
The poppy seeds baked into many foods
can cause false positives for opiate use. Some antibiotics also may show
up as opiates in tests.
Keep these possibilities in mind if your
teen does take a drug test. Consider the test a preliminary screen. Most
importantly, seek additional lab tests to confirm any positive
While further analysis can almost always
pinpoint the cause of a positive drug test, it may take days or weeks to
complete. Meanwhile, remember that your teen may be bearing the brunt of
false suspicion—so try to avoid jumping to conclusions until all
the results are in.
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.
The court system or your teen’s school
may require a drug test. While still a controversial policy, many schools screen
young athletes for drug use. Some private schools test all their students.
Urine tests also may help teens who are
receiving drug treatment stay away from drugs.
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.
Finally, 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.
You can buy home drug testing kits at pharmacies
or through the Internet. But home test kits also may give false or deceptive
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.
Certain symptoms and behaviors are red flags for
drug use. But keep in mind they may also indicate other problems, such as
Alcohol, smoke, or other chemical odors
on your teen’s breath or clothing
Obvious intoxication, dizziness, or
Changes in dress and grooming
Changes in choice of friends
Frequent arguments, sudden mood changes,
and unexplained violent actions
Changes in eating and sleeping
Loss of interest in activities
Runaway and delinquent behavior
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.
Privacy is crucial. One-on-one talks are most
likely to produce the honest answers from your teen that you need.
Teens also want to know their answers to drug
use questions will remain confidential. Your pediatrician will respect your
child’s privacy, but will tell both of you up front that a breach of
confidentiality could occur if
Your teen requires parental
Your teen agrees to your request for
Your teen lies to your pediatrician.
Your pediatrician believes your teen may
come to harm or harm someone else.
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
Below is a list of Internet sites that focus on
substance abuse. This list is not comprehensive, but includes sites with links
to other resources.
National Institute on Drug
Abuse, a division of the National Institutes of Health
For Real, sponsored by the
Center for Substance Abuse Prevention
Parenting is Prevention,
sponsored by the Center for Substance Abuse Prevention
American Council for Drug Education
National Clearinghouse for Alcohol
and Drug Information, sponsored by the Center for Substance
Medem, founded by the
American Academy of Pediatrics and other national medical societies
Some teens can stop using drugs based on a
strong personal desire to change their lives, and little else. Others stop using
drugs when they learn about the risks and potential costs of substance abuse.
Many youths stop using alcohol or drugs as they reach late adolescence.
But sometimes teens need outside help to quit.
Your pediatrician can help you find the right counseling and treatment. That may
mean psychiatric treatment. Or it may mean a referral to a detoxification
Teen drug use is a serious problem. You do not
have to handle it alone. Do not be afraid to seek professional help from your
pediatrician, a counselor, support group, or treatment program. They can help
you provide the support that is so crucial to the success of any treatment