AAP updates drug testing guidelines

May 29, 2014

The American Academy of Pediatrics (AAP) has updated its recommendations for drug testing of children and adolescents.

 

The American Academy of Pediatrics (AAP) has updated its recommendations for drug testing of children and adolescents.

In its new version of the clinical report, “Testing for Drugs of Abuse in Children and Adolescents,” AAP says that drug testing is “a complex medical procedure” that can be helpful, but that is “invasive” and “yields limited information.” The report also explains that “results are easily misinterpreted.” As such, the report is meant to guide physicians in determining when and whether such testing is appropriate.

According to the AAP, the report advises against involuntary drug testing of adolescents and provides guidance on how parents and healthcare providers can proceed with testing adolescents who refuse drug testing that is clinically indicated. Situations in which involuntary testing may be appropriate include after an accident, suicide attempt, or unexplained seizure that renders the teenager incapable of informed consent; in assessing problems such as extreme fatigue, excessive moodiness, failure in school, or when a parent or another adult suspects drug use may be a factor; and to assess compliance/success with a therapy program for substance abuse.

The Academy does not endorse home drug testing, mostly because of the potential for parents to misinterpret results and the potential damage it can do to a parent-child relationship.

The panel also recommends in its latest version of the report that a discussion about who will receive the results of the testing, as well as an action plan for both positive and negative results, occur before drug testing ensues.

The researchers counsel that although such testing is useful for identifying substance abuse and monitoring treatment of substance abuse, the results of such testing are invasive, can be falsely negative or positive, and can be misinterpreted, and so should be used with caution. The panel says that drug testing should never be the sole basis for a diagnosis of substance abuse and it should never be used alone to rule out substance abuse. 


 

 

To get weekly clinical advice for today's pediatrician, subscribe to the Contemporary Pediatrics eConsult.