The effectiveness of mandatory-random student drug testing: a cluster randomized trial

Parent Perceptions regarding High School Drug Testing

Adolescent drug use remains a critical public health issue. Almost 38 percent of school districts currently implement student drug testing, and more schools may be considering implementation due to emerging recreational drug use laws. Parents are an essential key stakeholder and decision-maker in school policies. Purpose: The purpose of this study was to examine Colorado parents' perceptions regarding high school drug testing. Methods: A cross-sectional research design was used to assess parental support for implementing drug testing in public high schools. A total of 205 participants completed a survey evaluating support, attitude, and beliefs regarding this policy. Descriptive statistics, chi-square, and logistic regression analyses were conducted to examine the data. Results: The majority of parents perceived that alcohol (68.3%), cannabis (77.6%), and illicit drugs (51.2%) were a problem amongst students at their child's high school. Parents overall were supportive of drug testing students (61.9%), except for parents who were current cannabis users (p = .002). The majority of parents are supportive of drug testing because they believe it could help students resist peer pressure (65.9%), facilitate early intervention (e.g. counseling; 71.2%), while not violating student privacy rights (57.6%) or creating a negative school climate (50.7%). Conclusions/Importance: Parents recognize there may be an adolescent drug use problem. Parental support of drug testing is an important consideration for superintendents/school districts who are contemplating implementation of a drug testing policy for high schools.

A Practical Guide to Cluster Randomized Trials in School Health Research

BACKGROUND

When well-designed and implemented, cluster randomized trials can meet the high standards federal agencies and other funders increasingly require for evidence on the effectiveness of school health programs and services. However, designing and implementing these studies can present more challenges than at first appears.

METHODS

I reviewed summaries of the methodological literature on cluster randomized trials. I then conducted a search to identify practical applications of these methods in school health research.

RESULTS

The review identified 6 key issues or decisions school health researchers must address when designing, conducting, and analyzing data from a cluster randomized trial: (1) reasons to use a clustered design, (2) sample size calculation, (3) the use of matching or stratification, (4) definition of the school and student samples, (5) consent gathering, and (6) analysis methods.

CONCLUSIONS

School health researchers can take several practical steps to ensure the availability of high-quality research evidence and meet the growing demands for evidence and accountability in education policy and programming. These steps include selecting the right research design for the intervention and evaluation setting, identifying appropriate sample definitions and analysis methods, and developing appropriate procedures for gathering parental permission and student assent.

Mandatory Drug Testing of Dental Students: To Test or Not to Test: Viewpoint 1: Drug Testing of Dental Students Should Be Mandatory for the Benefit of Students, Institutions, Patients, and the Profession and Viewpoint 2: Mandatory Drug Testing of Dental Students Carries Costs and Risks for Institutions and Students and Has Unproven Benefits

An educational institution's decision to test or not test its students for drug use is controversial and complex. Although negative consequences of substance use disorder are well known, the consumption of prohibited substances continues to increase in young adults. Given the awareness of increasing drug use on college campuses and the potential impact on future health care professionals, issues associated with mandatory drug testing of dental students warrant investigation. The purpose of this Point/Counterpoint article is to present opposing viewpoints on whether mandatory student drug testing (MSDT) should be implemented for dental students. Viewpoint 1 affirms that MSDT is legal, ensures public safety, is recognized as a need in health care education, promotes professional and ethical responsibility, and is cost-effective. Viewpoint 2 asserts that MSDT has not been proven to be an effective deterrent for student drug use and it poses risks and costs for both institutions and students, ranging from potential violation of students' civil liberties to the consequences of false positive tests. This article's presentation of the recent literature on both sides of this issue provides dental educators with pertinent information for considering implementation of MSDT in their institutions.

A review of illicit psychoactive drug use in elective surgery patients: Detection, effects, and policy

Limited information is present in literature regarding detection of illicit drug users visiting physicians when planning elective surgery; also, there is no update manuscript that is illustrating the effects of illicit drugs use that require reconstructive surgery interventions. Aims of this manuscript are: 1) to summarize existing knowledge, and give surgeons information how to detect patients who might possible use illicit drugs; 2) to review the effects of illicit drug use that specifically require reconstructive surgery interventions; 3) to assess on existing policies on asymptomatic illicit drug users when planning elective surgery. Studies were identified by searching systematically in the electronic databases PubMed, Medline, The Cochrane Library and SveMed+. Because of the nature of research questions to be investigated (drug policy and surgery), a "systematic review" was not possible. In spite of some existing policies to detect illicit drug use in specific situations such as workplaces or acute trauma patients, there is a lack of data and lack of information, and subsequently no policy has ever been made, for detection and management of illicit drug use asymptomatic patients requesting or referred for plastic surgery interventions. This manuscript poses questions for further ethical evaluations and future policy.

The impact of extracurricular activities participation on youth delinquent behaviors: An instrumental variables approach

The purpose of this study was to examine the association between extracurricular activities (EA) participation and youth delinquency while tackling an endogeneity problem of EA participation. Using survey data of 12th graders in South Korea (n = 1943), this study employed an instrumental variables approach to address the self-selection problem of EA participation as the data for this study was based on an observational study design. We found a positive association between EA participation and youth delinquency based on conventional regression analysis. By contrast, we found a negative association between EA participation and youth delinquency based on an instrumental variables approach. These results indicate that caution should be exercised when we interpret the effect of EA participation on youth delinquency based on observational study designs.

Adolescent drug testing policies in schools

More than a decade after the US Supreme Court established the legality of school-based drug testing, these programs remain controversial, and the evidence evaluating efficacy and risks is inconclusive. The objective of this technical report is to review the relevant literature that explores the benefits, risks, and costs of these programs.

Middle and high school drug testing and student illicit drug use: a national study 1998-2011

PURPOSE

This study uses 14 years of data from nationally representative samples of U.S. middle and high school students in the Monitoring the Future study to examine associations between school student drug testing (SDT), substance use, and participation in extracurricular activities.

METHODS

Analyses use questionnaire data collected from 1998 to 2011 from 89,575 students in 883 middle schools and 157,400 students in 1,463 high schools to examine: (1) the current prevalence of SDT; (2) SDT trends over time; (3) associations between substance use and SDT type, volume, or duration among the general student population or students participating in activities subject to testing; (4) associations between students' beliefs/attitudes about marijuana use and SDT; and (5) associations between extracurricular participation rates and SDT.

RESULTS

Moderately lower marijuana use was associated with any random testing of the general high school student population and for SDT of middle and high school sub-populations specifically subject to testing (athletes or participants in nonathletic extracurricular activities). However, SDT generally was associated with increased use of illicit drugs other than marijuana.

CONCLUSIONS

Because the study design is observational and the data are cross-sectional, no strong causal conclusions can be drawn. However, there is evidence of lower marijuana use in the presence of SDT, and evidence of higher use of illicit drugs other than marijuana. Until further research can clarify the apparent opposing associations, schools should approach SDT with caution.