Home Drug-Testing Your Teenager

"What are your thoughts on testing a teen suspected of using drugs through the use of a home drug-testing kit that can be purchased online?"

Home drug-testing kits sold on the Internet may not be the best way to determine if a teen is or is not using drugs, because it is not easy for moms and dads to know which test to choose, how to collect a urine or hair sample for testing, or understand the limits of test results. Parents who are anxious to know whether their kids are using drugs have easy access to kits sold on the Internet, but home drug testing is not consistent with the guidelines of professional medical organizations. The mother or father using these kits may be reassured by a "false negative," or mistakenly accuse their youngster of using drugs because of a "false positive".

I recommend that the parent who suspects that her youngster is using drugs seek a professional assessment rather than conduct a drug test at home. I want to caution you about the limitations and potential risks of home drug-testing products. Testing for drug use at home, with or without the consent of the teen, can also seriously undermine the parent-child relationship.

Moms and dads who are concerned that their youngster is using drugs may not know exactly which drug the youngster is using, and using the wrong test may delay the correct diagnosis of a serious substance abuse disorder. There are several types of tests for alcohol, marijuana, amphetamines and other drugs common among teens.

Laboratory testing for drugs of abuse is a technically challenging procedure, even for medical professionals, and tests performed at home by an untrained  parent may have higher rates of error than professional tests. I have cited one study in which a certified laboratory had false negative tests between 6% and 40%, depending on the drug detected.

False positives are also a problem as in the case of amphetamines, especially if the youngster is using high doses of caffeine or cold medications containing pseudoephedrine or theophylline. Similarly, poppy seeds contained in bagels and other foods may result in a false positive for morphine.

Collecting a urine or hair sample is not an easy task for a parent. The standard protocol for collecting urine samples requires "observation" to avoid adulteration or dilution with water, and teenagers are quite adept at beating the tests. In addition, teens can purchase products from the Internet that "clean" urine by interfering with standard drug tests. But, observing the collection of a urine sample would not be acceptable to most families -- and is not advisable. The Web sites we reviewed did not address these issues, nor did they offer any details about how to collect a hair sample.

Coerced home drug testing by parents may be perceived by teens as invasive and a violation of their rights, potentially damaging the parent-child relationship. Only one of the eight Web sites viewed gave clear advice on testing a youngster against his or her will.

Many of the claims of benefits of home drug testing made by the Web sites are "unsubstantiated." Seven of the eight sites claimed that random drug testing prevented drug use by reducing peer pressure, but I can’t find any studies to substantiate that claim.

Here are five ways that adolescents may try to cheat drug tests. They're all described elsewhere on the Internet, so you should be aware of them:

1. Popping vitamins: Perhaps this works because niacin (aka vitamin B3) is known to aid metabolism, or perhaps it's because Scientologists are said to take it in excess to flush their bodies of toxins. Whatever the reasons, some adolescents got the idea that extreme doses of this vitamin would erase any trace of their illicit drug use. Instead, it almost cost them their lives. In two separate incidents, emergency physician Manoj Mittal of Children's Hospital of Philadelphia has found adolescents who downed at least 150 times the daily recommended dose of niacin (15 mg) to cheat drug tests. Both kids were vomiting, had low blood sugar, and had "significant" liver toxicity when they arrived at the ER. And the niacin didn't even do what they'd intended; both tested positive for illicit drugs. People might think that since niacin is a vitamin it's harmless. But these cases suggest that our bodies have limits.

2. Swapping urine samples: Whether they use a friend's clean urine, synthetic pee, or even freeze-dried urine purchased online, some adolescents try to pass off foreign samples as their own. The biggest tip-off is temperature. Anything significantly lower than body temperature is suspicious, which is why some have tried to shuttle samples in armpits or taped to thighs to keep them warm. Possibly the oddest trick of all is a device marketed to those trying to beat witnessed drug collections: a sort of prosthetic penis called the "Whizzinator" that claims to come equipped with clean urine "guaranteed" to remain at body temperature for hours, with the help of special heat pads. Believe it or not, the prosthesis comes in different colors.

3. Switching drugs: Perhaps most alarming is that adolescents bent on defeating drug tests will sometimes switch their drug of choice to an undetectable (or harder to detect) substance that's considerably more hazardous. Inhalants, for example, include numerous types of chemical vapors that typically produce brief, intoxicating effects. You don't excrete inhalants in your urine, but inhaling is acutely more dangerous than marijuana. Indeed, inhalants can trigger the lethal heart problem known as sudden sniffing death in otherwise healthy adolescents, according to the National Institute on Drug Abuse.

4. Tampering: A sprinkle of salt or a splash of bleach, vinegar, detergent, or drain cleaner is all that's needed to muck up a urine specimen. These and other household substances are all too often smuggled into the bathroom and used to alter the composition of urine, making the presence of some illegal substances undetectable. Same goes for chemical concoctions sold all over the Internet. Sometimes these additives or "adulterants" will cloud or discolor urine, easily casting suspicion on the specimen, but others leave the sample looking normal. Laboratory toxicologists employ simple tests to catch these cheats. For example, a few drops of hydrogen peroxide will turn urine brown if it's been mixed with pyridinium chlorochromate, an otherwise-imperceptible chemical designed to foil drug tests.

5. Water-loading: Gulping fluids before providing urine, a long-standing tactic, is still the most common way that adolescents try to beat tests. Whether cheats use salty solutions to induce thirst, flushing agents that increase urine output, or just plain old H2O, their aim is to water down drugs so they can't be detected. Some testing facilities may check urine for dilution and deem overly watery samples "unfit for testing." But consuming too much fluid too quickly can occasionally have dire consequences. 

As I stated earlier, the best way to drug test your adolescent is to have a professional (e.g., doctor) do it.

My Out-of-Control Teen: Help for Parents