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Susan Laine , Burness Communications 301-652-1558
Prabhu Ponkshe, SAPRP 703-918-4860

Embargoed For Release: Monday, February 6 -- 4PM ET

MANY PHYSICIANS DO NOT KNOW OR UTILIZE PROPER YOUTH DRUG TESTING PROCEDURES

Washington, D.C. -- February 6 - A new study appearing in the February issue of Archives of Pediatrics & Adolescent Medicin e reveals that primary care physicians do not always conduct drug testing according to proper procedures, nor do they have a sufficient knowledge base to interpret these tests correctly. For example, almost 90% of the physicians surveyed were not aware that the most routine drug tests do not detect oxcycodone, the medication in OxyContin®.

Youth drug testing has proliferated in the last 25 years, and two U.S. Supreme Court rulings in 1995 and 2002 opened the door for testing of student athletes and of any student who participates in extra-curricular activities. Today, more and more testing is being done in schools and in the offices of pediatricians and primary care physicians. Concerned parents often turn to their family physician for advice if they suspect that their child is involved with drugs. The objective of the study was to test physicians' knowledge of urine drug testing and customary practices when testing adolescent patients.

"It shouldn't be a surprise that physicians do not know how to properly conduct a drug test because these procedures are not taught in medical school or residency." said Sharon Levy, MD, Center for Adolescent Substance Abuse Research at Children's Hospital Boston and the survey's lead author. "On the other hand, we're performing more and more drug testing without really having the infrastructure to support it and this can result in some very bad outcomes."

Improperly conducted drug tests can result in reporting illicit drug use where none exists and or result in false reassurance in cases where drug use goes undetected.

Levy and her research team surveyed 1,085 physicians selected randomly from the national membership rolls of the American Academy of Pediatrics (AAP), the Society of Adolescent Medicine (SAM) and the American Academy of Family Physicians (AAFP). Of the 1,085 surveyed, 359 or 42 percent of eligible physicians completed the survey, a response rate similar to that of other published physician surveys. Physicians who provided primary or urgent care to an average of 10 adolescents (12-18 years old) per week were eligible for the study.

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Of those surveyed, more than 95 percent reported ever ordering a urine drug test. However, less than a quarter said they were using recommended urine collection guidelines. Urine concentration normally varies over a wide range, but some teens try to defeat drug tests by excessive dilution - either by drinking large amounts of fluid, using diuretics, or adding fluid to the specimen after it has been collected. Checking for dilution and using effective procedures for urine collection (either use of federal collection guidelines, i.e., patient provides identification, empties pockets, uses bathroom without running water, blue dye placed in standing water, and immediate check of specimen temperature, or directly observed urination) help minimize the opportunities for dilution or adulteration.

It was a surprise to learn how few physicians use gold standard practices in their testing," said Dr. Levy. "Only a small number actually knew which drugs are detectable on a routine urine drug test screening panel, and what substances can cause false positive screens."

For instance, less than two thirds of the physicians knew that inhaled nitrous oxide is not detected on routine drug screening panels; less than a half knew that Ecstasy (3,4 methylenedioxymethamphetamine) is not reliably detected in routine laboratory testing, and only 12 percent knew that oxcycodone, a semi-synthetic opioid used increasingly among teens, must be specifically requested when ordering urine drug tests.

According to the authors, misinterpretation of a false positive can put adolescents at risk for false accusation of substance use and diminished trust from parents, school personnel and counselors. In the survey the majority of respondents misidentified at least one substance that can cause a false positive drug screen.

The authors caution that while drug testing is on the rise, the primary care physician work force is not prepared to provide guidance to schools, parents or patients with questions regarding drug testing. Options to improve the situation include further training or consultation with a toxicologist or addiction specialist for physicians who order drug tests infrequently.

The Substance Abuse Policy Research Program ( www.saprp.org ) of the Robert Wood Johnson Foundation is a $54 million program that funds research into policies related to alcohol, tobacco and illegal drugs.

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 30 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. Helping Americans lead healthier lives and get the care they need-the Foundation expects to make a difference in our lifetime. For more information, visit www.rwjf.org .