Unlike individuals applying for federal employment (who are covered by the standards developed under the Federal Workplace Drug Testing Act), individuals who are drug tested in a hospital and/or CPS setting do not have the benefit of procedural safeguards requiring that an initial positive result be confirmed using a secondary method. These positive toxicology results (usually urine immunoassay), when they form the basis for CPS report of child abuse or neglect, are not generally confirmed before the report is filed. Studies have called into question the validity of positive results from urine immunoassays, particularly when the urinalysis is performed on a newborn. These concerns are compounded by the tendency of common household products and over-the-counter medications to cause false positives in urine screens more generally. In addition, health care professionals have been observed to exhibit race and class-based biases in making decisions to report a positive toxicology test to CPS.
This page contains peer-reviewed clinical studies on the problems with the methodology used in drug testing (particularly for infants), as well as the wider societal damage and harm to patient/doctor relationship which occurs from mandated reporting.
Studies on False Positives & Other Issues
- Barakauskas, V.E. et al. (2012). Unresolved discrepancies between cannabinoid test results for infant urine. Clinical Chemistry, 58(9), 1364-1367. (free full text)
- Cotten, S.W. et. al. (2012). Unexpected interference of baby wash products with a cannabinoid (THC) immunoassay. Clinical Biochemistry, 45(9), 605-9. (free full text)
- Rollins, D.E., Jennison, T.A., & Jones, G. (1990). Investigation of interference by nonsteroidal anti-inflammatory drugs in urine tests for abused drugs. Clinical Chemistry, 36(4), 602-606. (free full text)
- Vincent, C.E., Zebelman, A., & Goodwin, C. (2006). What common substances can cause false positives on urine screens for drugs of abuse? Journal of Family Practice, 55(10), 893-897. (free full text)
Studies on Bias & Impact of Reporting
- Chasnoff, I., Landress, H.J., & Barrett, M.E. (1990). The prevalence of illicit-drug or alcohol use during pregnancy and discrepancies in mandatory reporting in Pinellas County, Florida. New England Journal of Medicine, 322, 1202-1206. (free full text)
- Kerker, B.D., Horwitz, S.M., & Leventhal, J.M. (2004). Patients’ characteristics and providers’ attitudes: Predictors of screening pregnant women for illicit substance use. Child Abuse & Neglect, 28, 209-233.
- Kunins, H.V. et al. (2007). The effect of race on provider decisions to test for illicit drug use in the peripartum setting. Journal of Women’s Health, 16(2), 245-255.
- Roberts, S.C.M. & Nuru-Jeter, A. (2010). Women’s perspectives on screening for alcohol and drug use in prenatal care. Women’s Health Issues, 20(3), 193–200. (free full text)
- Roberts, S.C.M., & Pies, C. (2010). Complex calculations: How drug use during pregnancy becomes a barrier to prenatal care. Maternal & Child Health Journal, 15. (free full text)
- Roberts, S.C.M., & Nuru-Jeter, A. (2011). Universal screening for alcohol and drug use and racial disparities in child protective services reporting. Journal of Behavioral Health Issues & Research, 39.
- Seib, C.A. et al. (2012). Screening of alcohol and drug use in pregnancy. Midwifery, 28, 760-764.
Last updated: March 4, 2014 at 19:33 pm
