Random drug-testing of schoolchildren

Neil McKeganey

A review of the theory and ethics of random drug testing of UK schoolchildren and as an assessment of its likely effectiveness.

The idea of randomly drug-testing UK schoolchildren to see if they have used illegal drugs has received supportive comments recently from both the Prime Minister and the Leader of the Opposition. But is school-based random drug-testing a development we should welcome in the UK, or is it something we should seek to avoid?

This review of current literature draws together information from a range of sources to review all aspects of the issue. It considers evidence in support of drug testing, including experience in the US, where random drug-testing is commonplace. It asks whether such testing is in accordance with human rights legislation and the rights of the child. As well as ethical issues, it reviews practical questions of the feasibility of testing pupils in UK schools, as well as concerns about how such testing programmes might fundamentally alter children's experience of school.

The author finds that such programmes, whilst they might help some pupils, may harm others. He concludes that, before random drug-testing programmes are widely developed in UK schools, this initiative should be subjected to rigorous and independent evaluation.

Summary

Summary

Requesting children and young people to provide urine samples as part of a school-based random drug-testing programme is commonplace within the United States but relatively rare within the United Kingdom. However, in 2004 both the Prime Minister, Tony Blair, and the Leader of the Opposition, Michael Howard, expressed support for such testing as a way of reducing illegal drug use among pupils: this high profile political support may make the practice increasingly common in the UK. This study, by Neil McKeganey, Professor of Drug Misuse Research at Glasgow University, reviews the ethics and practicalities of such testing and considers its likely effectiveness. He found:

  • There is a dearth of high quality studies evaluating the impact of school-based random drug-testing programmes. It is therefore very difficult to be clear about the impact such programmes may have both on pupils' levels of drug use and on other aspects of their education.
  • Such testing will pick up only a small - and clearly random - selection of pupils. Occasional use of cannabis is the most common form of drug use among pupils. Random testing therefore seems unlikely to be effective in getting early support for pupils using illegal drugs.
  • Random drug-testing programmes raise a wide range of concerns. These include:
    • costs, which can vary widely depending on the approach;
    • ethical issues, such as who to test, getting informed consent, observation of tests and confidentiality of results;
    • the responses of both school and pupils to a positive drug test;
    • the risk that some pupils may switch from more easily detectable 'soft' drugs to 'harder' drugs that are more difficult to trace; and
    • the possible undermining of trust between staff and pupils.
  • It is difficult to judge how widely programmes will be developed in the UK. There is currently no government funding for testing; however, already one state school within England has developed a programme of drug testing and it is conceivable that other schools may follow.
  • The researcher concludes that developing random drug-testing procedures would be controversial and ethically complex with, at present, very little clear positive evidence of effectiveness. He recommends that the UK avoid the ad hoc proliferation of testing programmes until there is clear evidence of their effectiveness obtained on the basis of rigorous and independent research.

Theory
The theory underpinning drug-testing assumes that making a hidden behaviour more visible reduces the likelihood of its occurrence. However, the power of surveillance to act in this way is likely to be greater in the case of those pupils who have either not used illegal drugs or who have used illegal drugs on only a few occasions. More regular users may be more resistant to the impact of surveillance in reducing their drug use.

Similarly whilst it has been proposed that randomly drug-testing pupils presents the opportunity of targeting help on those pupils who are using illegal drugs at a much earlier point than would otherwise be possible, the random nature of the testing programme means that this benefit is only likely to be extended to a small number of pupils (i.e. those who are randomly selected for testing). In addition, since most illegal drug use on the part of pupils involves occasional use of cannabis it is not easy to see what kind of therapeutic intervention would be judged appropriate.

Guidance from central government
The Department of Education and Skills has produced guidance that expresses considerable caution regarding the development of random drug-testing programmes within UK schools. Where schools are considering implementing such programmes they are encouraged to solicit the agreement of the wider school community and to consider whether the cost of such programmes are an appropriate use of school resources, whether such testing is culturally sensitive, and what response they would make to a possible positive test from pupils.

Existing evaluations
Despite the extensive development of drug-testing programmes within the US and the high profile support such programmes have recently received from political leaders in the UK, in fact there have been very few independent and rigorous evaluations undertaken to identify the impact of drug testing programmes. Where research has been carried out the evidence that such programmes lead to a reduction in illegal drug use is far from clear-cut.

Practical and ethical concerns

Cost
There is very little clear-cut information on the cost of drug-testing programmes. This will vary enormously depending on the number of pupils tested, how frequently pupils are tested and what proportion of tests involves both indicative analysis and confirmatory analysis. Testing programmes which confirm that drugs have been taken are more expensive than programmes which indicate that drugs might have been taken.

Trust
There are concerns that imposing a programme of random drug-testing on pupils may undermine the level of trust between staff and pupils. As a consequence, pupils may be reluctant to disclose the details of their drug use to staff. This matters because, in forming a judgement as to how serious the drug use is, it is important to obtain more detailed information from the young person on the frequency with which drugs have been used, the quantities used and the circumstances of use. Some young people may be reluctant to disclose such details as a result of what they may see as a testing programme that has been unfairly imposed upon them. In the event that the trust between staff and pupils were diminished as a result of an imposed drug-testing programme, pupils may be less likely to disclose other concerns they may have to staff.

Punishment
Whilst the theory of drug-testing is often framed in terms of helping pupils rather than punishing those who test positive, for these programmes to act as a disincentive to drug use some element of punishment needs to be included in the response to a positive drug test. Within the US, there is considerable variation as to the nature of the punishment that is given to pupils. However, this commonly involves some level of suspension from school privileges or from involvement in extra-curricular school activities.

Concealment
There are concerns that drug-testing programmes may lead not to a reduction in drug use but to an escalation in the means pupils use to conceal their drug use from school staff. Evidence on the use of drug-testing within the employment sector for example, suggests that such concealment may be commonplace.

Who to test?
There are questions as to who to include within a testing programme. Whilst to date the discussion has been about randomly testing pupils, an equally strong case can be made for testing school staff since they clearly play an important role within schools. It is likely that both individual school staff members and their representative bodies would put up a degree of resistance to the imposition of random testing programmes on staff.

Observed or unobserved testing
Where drug-testing programmes are used within criminal justice or drug treatment settings there is often a requirement to observe the production of a urine sample to ensure that the sample being tested does indeed correspond to the named individual. Within a school setting such observation would ordinarily be judged as intrusive and, in some cases, as a violation of individual human rights.

Attraction of a negative test result
It is possible that, whilst the majority of pupils would regard a positive drug test as carrying considerable social stigma, some young people may perceive the test result in a very different way and as carrying a certain cachet amongst their particular social group.

Switching to use more dangerous drugs
One of the adverse results of implementing a drug-testing programme could be to encourage individuals to switch from using substances that remain in the body for a protracted period (such as cannabis) to using other drugs that are cleared from the body much more quickly (such as heroin). In the event of such drug switching, a drug-testing programme might itself lead to an escalation in the seriousness of any existing drug use.

Confidentiality of test results
Concerns about confidentiality include who should be informed about an individual's test results, how such results may be stored, over what time period the information may be regarded as current, and who would have access to such sensitive information.

Informed consent and withheld consent
There are concerns as to whether such testing can or should be imposed upon pupils and also what to do in circumstances where pupils or their parents/guardians withhold consent for pupils to be tested. It is not at all clear that a programme of random drug-testing of pupils would be judged to be congruent either with the UN Charter on the Rights of the Child or the European Charter on Human Rights.

The likely development of programmes in the UK
It is difficult to judge the likelihood of such programmes being widely developed within the UK. Despite supportive comments from senior politicians, there has been no central government funding allocated to such programmes. This situation contrasts with that within the US where substantial federal funds have been allocated to drug-testing programmes in schools; as a result, such programmes have been widely developed.

Conclusion
Developing random drug-testing procedures within UK schools would be an ethically complex and controversial measure for which at present there is very little clear positive evidence of effectiveness. In the light of this it would seem preferable to avoid the ad hoc proliferation of random drug-testing programmes until such time as there are clear data on effectiveness available. Where random drug-testing schemes are being piloted there is a need to evaluate their impact rigorously and independently. Such evaluations would need to be undertaken on a large enough sample of schools to control for possible confounding variables that might influence the level of drug use within individual schools. Evaluative research in this area would also need to consider the possible impact of a drug-testing programme on young peoples' wider educational experience. Finally, it will be important to monitor the development of school-based drug-testing programmes within the UK in order to identify any increase in drug-testing and in the development of different testing regimes within local schools.

About the project
The researcher was Neil McKeganey, Professor of Drug Misuse Research at the University of Glasgow. The study involved reviewing the guidance on drug-testing programmes within UK schools provided by the Department of Education and Skills, assessing the available research evidence on the impact of school based drug-testing programmes, considering the theory underpinning school based drug-testing and looking at the ethics and the practicalities of drug-testing pupils.

Downloads

Downloads