Drug Testing

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Pee For Recreation, Not For Education

ONDCP's abhorrent traveling drug testing show made its first stop of the year in Charleston, SC this week. As usual, the push to implement student drug testing in schools around the country was met with serious opposition from drug policy reformers.

Still, no matter how logical and scientific our arguments may be, there are always those who fail to recognize what's at stake. From The Charleston Post and Courier:

Senior Antwan Edwards plays four sports at North Charleston High and is captain of the football and wrestling teams. Random testing would be a good way to keep some students from using drugs, he said.

It also would prepare students for life after high school by starting those tests now, he said.

If life after high school means having your urine collected by agents of the state and inspected for molecular evidence of unapproved conduct, who wants to grow up? The idea of drug testing as a form of socialization reeks of dystopian fascism. But you can't blame Antwan Edwards, who was probably off giving urine samples when the 4th Amendment was being taught.

"If you don't have anything to hide, why not take the test?" he said.

Oh, there are so many answers to this question. In Antwan Edwards' case, I'd worry that a false positive drug test could be exactly what it takes to ruin his otherwise promising future. And there are plenty of easy ways to get a false positive. They don't happen a lot, but when they do, no one believes you except your mom.

Some students don't care about their privacy, or having newer books instead of urine collection programs, or being presumed innocent, or the fact that their peers may switch to more-dangerous less-detectible drugs, or the evidence that these programs don't work.

Sadly, some students don’t care about these things. But they should care about false positives. They should be terrified. The companies that manufacture these tests claim that there are no false positives, so imagine trying to convince them that there's been a mistake.

If you don't have anything to gain, why take the test?

Location: 
United States

Newsbrief: White House Announces Dates, Locations for 2007 Regional Student Drug Testing Summits

courtesy NORML News

The White House Office of National Drug Control Policy (ONDCP) will once again sponsor a series of regional summits to encourage middle-school and high-school administrators to enact federally sponsored random student drug testing. The 2007 summits will mark the fourth consecutive year that the White House is funding the symposiums, which are scheduled to take place this winter and spring in Charleston, South Carolina (January 24), Newark, New Jersey (February 27), Honolulu, Hawaii (March 27), and Las Vegas, Nevada (April 24).

https://stopthedrugwar.org/files/drugtestinglab.jpg
drug testing lab
Under newly revised federal guidelines, federal education funds may be provided to public schools for up to four years to pay for the implementation of random drug testing programs for students who participate in competitive extra-curricular activities.

Since 2005, the Education Department has appropriated more than $20 million to various school districts to pay for random drug testing programs. Federal grant funds may not be used to pay for separate drug education and/or prevention curricula, nor may any funds be used to train school staff officials on how to implement drug testing. Only federal investigators are eligible to review data collected by the school programs, which will be evaluated as part of a forthcoming federal assessment of the efficacy of random drug testing to deter illicit student drug use.

A previous evaluation of student drug testing programs conducted by the Robert Wood Johnson Foundation concluded, "Drug testing, as practiced in recent years in American secondary schools, does not prevent or inhibit student drug use." Investigators collected data from 894 schools and 94,000 students and found that at every grade level studied -- 8, 10, and 12 -- students reported using illicit drugs at virtually identical rates in schools that drug tested versus those that did not.

Currently, only five percent of schools randomly drug test student athletes, and some two percent of schools test students who participate in extra-curricular activities other than athletics. Both the National Education Association and the American Academy of Pediatrics oppose such student testing programs.

Visit http://www.cmpinc.net/dts/ to register online to attend any of this year's summits. Visit http://www.norml.org/index.cfm?Group_ID=3406 to download NORML fact-sheets on random student drug testing.

Canine teams sniffing out drugs in prisons

Location: 
FL
United States
Publication/Source: 
The Gainesville Sun
URL: 
http://www.gainesville.com/apps/pbcs.dll/article?AID=/20070105/LOCAL/70105009/-1/news

Proposal would expand DWI to include drugs

Location: 
United States
Publication/Source: 
Southeast Missourian
URL: 
http://www.semissourian.com/story/1181292.html

Soldiers say drug use is an increasing problem in Iraq

Location: 
United States
Publication/Source: 
The Philadelphia Inquirer
URL: 
http://www.philly.com/mld/inquirer/news/nation/16149499.htm

Queen's guards 'fail drugs test'

Location: 
London
United Kingdom
Publication/Source: 
BBC News
URL: 
http://news.bbc.co.uk/2/hi/uk_news/england/london/6197938.stm

Screening of soldiers uncovers illegal use of drugs (Globe and Mail, Canada)

Location: 
United States
URL: 
http://www.theglobeandmail.com/servlet/story/RTGAM.20061124.wxdnd24/BNStory/National/home

Scientists Design Simple Dipstick Test For Cocaine, Other Drugs (ScienceDaily)

Location: 
United States
URL: 
http://www.sciencedaily.com/releases/2006/11/061113175828.htm

Canada: Supreme Court Rejects Random Drug Tests of Probationers

In a ruling last week, the Canadian Supreme Court held that the country's Criminal Code does not allow judges to require offenders on probation to submit to drug tests or other demands for a sample of bodily substances. The ruling came in the case of Harjit Singh Shoker, who in 2003 climbed naked into bed with an RCMP officer's wife with rape on his mind in the midst of a methamphetamine binge.

Shoker was convicted of breaking and entering with the intent to commit sexual assault and was sentenced to 20 months in prison and two years probation. His sentencing judge including as conditions of his probation that he must undergo drug treatment, abstain from using alcohol and drugs, and undergo drug tests on demand. He appealed those conditions of his sentence.

In 2004, the British Columbia Court of Appeals ruled that the trial judge had no authority to order Shoker into treatment without his consent, nor did he have the authority to demand that Shoker submit to drug tests. Since then BC judges have continued to order probationers to avoid drugs and alcohol, but have foregone what had been an almost automatic companion order to submit to drug testing.

The BC Crown Prosecutors Office did not challenge the drug treatment ruling, but did appeal the ruling on drug testing -- even though the province had eliminated funding for the drug testing program in 2003. But BC prosecutors got no solace from the Supreme Court.

Justice Louise Charron, who authored the ruling, called drug testing so "highly intrusive" that it required "stringent standards and safeguards to meet constitutional requirements." Parliament could craft such standards, making a drug testing requirement legal, she noted. "There is no question that a probationer has a lowered expectation of privacy," Charron wrote. "However, it is up to Parliament, not the courts, to balance the probationers' charter rights as against society's interest in effectively monitoring their conduct."

If Parliament wants judges to be able to impose drug testing as a condition of probation, it must address the issue and not leave it to the whim of individual judges. "The establishment of these standards and safeguards cannot be left to the discretion of the sentencing judge in individual cases," Charron wrote. "Those are precisely the kinds of policy decisions for Parliament to make having regard to the limitations contained in the charter."

What a difference a border makes! On the US side, coerced drug treatment and drug testing is the norm. On the Canadian side, it's unconstitutional, at least the way they tried it.

Feature: Pain Patients, Pain Contracts, and the War on Drugs

Pain contracts. Pain management contracts. Medication contracts. Opioid contracts. Pain agreements. They go by different names, but they all mean the same thing: A signed agreement between doctor and patient that lays out the conditions under which the patient will be prescribed opioid pain medications for the relief of chronic pain. (To see a standard pain contract, click here.)

https://stopthedrugwar.org/files/oxycontinpills.jpg
Oxycontin pills
For some of the tens of millions of Americans suffering from chronic pain, opioid pain medications, such as Oxycontin or methadone, provide the only relief from a life of agony and disability. But with the Office of National Drug Control Policy's ongoing campaign against prescription drug abuse and the Drug Enforcement Administration's (DEA) ongoing crackdown on physicians it believes are prescribing opiates outside the bounds of accepted medical practice, the medical establishment is increasingly wary of pain patients and adequate treatment of pain is a very real issue for countless Americans.

In recent years, doctors and hospitals have turned increasingly to pain contracts as a means of negotiating the clashing imperatives of pain treatment and law enforcement. Such contracts typically include provisions requiring patients to promise to take the drugs only as directed, not seek early refills or replacements for lost or stolen drugs, not to use illegal drugs, and to agree to drug testing. And as the contract linked to above puts it, "I understand that this provider may stop prescribing the medications listed if... my behavior is inconsistent with the responsibilities outlined above, which may also result in being prevented from receiving further care from this clinic."

"Pain agreements are part of what we call informed consent," said Northern Virginia pain management and addiction treatment specialist Dr. Howard Heit. "They establish before I write the first prescription what I will do for you and what your responsibilities are as a patient. They are an agreement in order to start a successful relationship that defines the mutual responsibilities of both parties. More and more states are suggesting we use agreements as part of the treatment plan with scheduled medications. Such agreements are not punitive; they protect both sides in functional way."

If Heit sees a cooperative arrangement, others disagree. "This is really an indication of how the current DEA enforcement regime has created an adversarial relationship between patients and physicians where the doctors feel the need to resort to contracts instead of working cooperatively with patients," said Kathryn Serkes, spokesperson for the Association of American Physicians and Surgeons (AAPS), which has been a fierce critic of criminalizing doctors over their prescribing practices. "The pain contracts are a tool to protect physicians from prosecution. He can say 'I treated in good faith, here's the contract the patient signed, and he violated it.' It's too bad we live in such a dangerous environment for physicians that they feel compelled to resort to that," she told the Chronicle.

"Patients aren't asked to sign contracts to get treatment for other medical conditions," Serkes noted. "We don't do cancer contracts. It is a really unfortunate situation, but it is understandable. While I am sympathetic to the patients, I can see both sides on this," she said.

"There is no evidence these pain contracts do any good for any patients," said Dr. Frank Fisher, a California physician once charged with murder for prescribing opioid pain medications. He was completely exonerated after years of legal skirmishing over the progressively less and less serious charges to which prosecutors had been forced to downgrade their case. "The reason doctors are using them is to protect themselves from regulatory authorities, and now it's become a convention to do it. They will say it is a sort of informed consent document, but that's essentially a lie. They are an artifact of an overzealous regulatory system," he told the Chronicle.

"When this first started, it was doctors using them with problem patients, but now more and more doctors and hospitals are doing it routinely," Fisher added. "But the idea that patients should have to sign a contract like that or submit to forced drug testing is an abrogation of medical ethics. Nothing in the relationship allows for coercion, and that is really what this is."

The pain contracts may not even protect doctors, Fisher noted. "When they prosecute doctors, they can use the pain contract to show that he didn't comply with this or that provision, like throwing out patients who were out of compliance. The whole thing is a mess."

https://stopthedrugwar.org/files/michaelkrawitz.jpg
Michael Krawitz (photo courtesy Drug Policy Forum of Virginia)
It is a real, painful mess for a pair of veterans trying to deal with chronic pain through the Veterans Administration -- and it is the drug testing provisions and the use of marijuana that are causing problems. Michael Krawitz is an Air Force veteran who was injured in an accident in Guam two decades ago that cost him his spleen, pancreas, and part of his intestine. Krawitz also suffered a fracture over his left eye, received an artificial right hip, and has suffered through 13 surgeries since then. He had been receiving opioid pain medication at a VA Hospital in Virginia, but things started to go bad a year ago.

"Last year, I refused to sign the pain contract they had just introduced there, and they cut me off my meds because I refused," Krawitz told the Chronicle. "Then I amended the contract to scratch off the part about submitting to a drug test, and that worked fine for a year, but the last time I went in, they said I had to do a drug test, and I again refused. I provided a battery of tests from an outside doctor, but not an illegal drug screen. That's when my VA doctor sent an angry letter saying I was not going to get my pain medicine."

Krawitz has provided documentation of his correspondence with the VA, as well as his so far unheeded complaint to the state medical board. As for the VA, some half-dozen VA employees ranging from Krawitz' patient advocate to his doctor to the public affairs people to pain management consultants failed to respond to Chronicle requests for interviews.

For Krawitz, who has used marijuana medicinally to treat an eye condition -- he even has a prescription from Holland -- but who says he is not currently using it, it's a fight about principles. "I will not submit my urine for a non-medical test," he said. "The VA doesn't have the authority to demand my urine. It's an arbitrary policy, applied arbitrarily. The bottom line is that we vets feel very mistreated by all this. Some of us have sacrificed limbs for freedom and democracy, and now the VA wants to make us pee in a bottle to get our pain medication?"

The imposition of pain contracts is not system-wide in the VA. A 2003 Veterans Health Administration directive on the treatment of pain notes that "adherence with opioid agreement, if used" should be part of the patient's overall evaluation.

Krawitz is preparing to file a federal lawsuit seeking to force the VA to treat him for pain without forcing him to undergo drug testing. For Tennessee vet Russell Belcher, the struggle is taking a slightly different course. Belcher, whose 1977 back injury and spinal fusion had him in pain so severe he couldn't work after 2000, was cut off from pain meds by the VA after he tested positive for marijuana. Belcher said he used marijuana to treat sleeplessness and pain after the VA refused to up his methadone dose.

"It's a wonder to me that some vet ain't gone postal on them," he told the Chronicle. "They pushed me pretty close. To me, not signing the substance abuse agreement is not an option. If you sign it you're screwed, if you don't sign it, you're screwed. I complained for months about the dose being too low, but they said that's all you get and if you test positive for anything we're kicking you out. When the civilian doctors would find marijuana on a drug screen, they told me they would prefer I didn't do that because it was still illegal, but they didn't kick me out of the program. I was using it for medicinal purposes. I have tremendous trouble sleeping, muscle cramps that feel like they'll pull the joint out of the socket. I had quit using for a long time because of this mess with the drug testing, but then they wouldn't increase my pain medicine. I thought I have to do something; it's a matter of self preservation," he said.

"The pain clinic at the VA has discharged me from their care and said the doctor would no longer prescribe narcotics for me unless I attend the substance abuse program," Belcher continued. "They aren't going to be satisfied until I spend 30 days in the detox unit." While Belcher would like to join Krawitz in taking on the VA, in the meantime he is looking for a private physician.

When asked about the veterans' plight, Dr. Fisher was sympathetic. "They made Krawitz sign a contract under duress with forced drug testing as a condition of his continued treatment," he pointed out. "That violates basic rights like the right of privacy. There is no suspicion he is a drug addict. They want to treat all patients as if they were criminal suspects, and that has little to do with what the nature of the doctor-patient relationship should be."

Dr. Heit, while less sympathetic than Dr. Fisher, was decidedly more so than the VA. When asked about the cases of the vets, he explained that he would be flexible, but would also insist they comply with the terms of their agreements. "In the end, you have to choose whether you want me to do pain management with legal controlled substances or you want to use illicit substances, but you don't get to choose both," he said. "I don't disagree that marijuana may help, but the rules are it's an illicit substance. I can't continue to prescribe to someone who is taking an illicit substance."

And here we are. Patients seeking relief from pain meet the imperatives of the drug war -- and we all lose.

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