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Keywords:

  • Adolescents;
  • alcohol;
  • drug tests;
  • drugs;
  • prevention;
  • school-based programs;
  • students

We offer our thanks to the reviewers for their valuable insights [1-3]. We agree that random student drug testing (RSDT) is a controversial topic in need of further study as part of the broader conversation on substance use prevention.

Gilvarry [1] notes some of the limitations of RSDT as a stand-alone intervention—particularly that the intentions do not always match the programs as implemented. We agree that interventions targeting the overall school culture are likely to have the most positive outcome, and second the call for more work in this area. The potentially complex needs of students who test positive for drugs further stresses the importance of building a strong system of school-based support around any testing program with access to appropriate resources to create interventions that are beneficial to the identified at-risk adolescents.

Sznitman [2] argues rightly that, given the conflicting evidence, a more useful research question is: ‘how to use RSDT most effectively to maximize benefit and minimize risks?’. Elucidating protocols and policies based in other evidenced-based practices (e.g. utilizing motivational interviewing interventions following positive tests, rather than suspension, etc.) would probably add significant value to the discussion.

Finally, Galea [3] made valuable points regarding the need for more evidence-based policy decisions in the field of substance use, as well as practical considerations and the emotionality that is sometimes attached to this topic. We agree that there is a need for better communication and collaboration between scientists and policymakers. The University of Florida (UF) has addressed this issue directly through the opening of the UF Drug Policy Institute, ‘delivering evidence-based, policy-relevant, information to policymakers, practitioners, scholars, and the community to make educated decisions about issues of policy significance in the field of substance use, abuse and addiction’ (http://drugpolicyinstitute.psychiatry.ufl.edu/about-us/).

Implementation of any school-based drug prevention strategy, including RSDT, should be informed by and geared towards the specific needs of individual schools, their students and the students' families. In addition to identifying drug- and alcohol-related incidents, schools can gather historical substance use data from state-wide student surveys or through the administration of anonymous self-report surveys on substance use, other risky behaviors, as well as potentially positive behaviors such as participation in athletics, volunteering and extracurricular activities. Prevention should be evidence-based and begin with an accurate and comprehensive picture of emerging problems, including academic and social difficulties in addition to health-risk behaviors. Identifying points of possible intervention with at-risk students, in addition to positive random drug tests in schools with RSDT, with evidence-based practices can broaden and probably enhance schools' approaches to drug prevention, and lead ultimately to better academic outcomes.

We thank Addiction for this unique opportunity to review the evidence—as limited as it is—on RSDT. RSDT is one of many substance use prevention options for schools. Continuing high rates of adolescent substance use are abundant evidence of the public health challenge that lies ahead.

We believe that RSDT, if implemented appropriately, can be an important part of comprehensive efforts to reduce drug use and to help youth with drug problems become and stay drug-free.

Declarations of interest

Robert L. DuPont MD is Executive Vice President of Bensinger DuPont & Associates, a company that provides drug testing program management services such as policy development, random selections, collection sites and laboratory services to employers, Employee Assistance Programs and schools. He is also President of the Institute for Behavior and Health, Inc., a non-profit organization focused on drug policy that has long supported random student drug testing in schools. In his role at the Institute he served as an expert witness to the first Supreme Court case ruling on random drug testing in schools.

Acknowledgements

  1. Top of page
  2. Acknowledgements
  3. References

Partial funding for this work was received from the National Institute on Drug Abuse (R01-DA14845 and P50-DA027841).

References

  1. Top of page
  2. Acknowledgements
  3. References
  • 1
    Gilvarry E. Limited evidence: many pitfalls. Addiction 2013; 108: 846847.
  • 2
    Sznitman S. Exploring the promise of random student drug testing by comparing it to other school drug prevention strategies. Addiction 2013; 108: 848850.
  • 3
    Galea S. Values, compelling ideas, the pace of science and the implementation of evidence-based policy. Addiction 2013; 108: 847848.