Drug Testing in Child Welfare
Drug testing is one tool that child welfare workers often use to determine if a parent is using substances and to facilitate decision making with families affected by substance use disorders. Drug testing refers to the use of various biologic sources, such as urine, saliva, sweat, hair, breath, blood, and meconium to determine the presence of specific substances or their metabolites in an individual’s system. Drug tests, however, do not provide sufficient information for substantiating allegations of child abuse or neglect or for making decisions about the disposition of a case. The best way to identify a substance use disorder or determine if a child is at risk is to use a combination of screening and assessment processes that include a safety and risk assessment, clinical instruments, random drug testing, self-reports, and observations of behavioral indicators. Assuming there are no other safety concerns, a positive drug test or a series of positive drug tests should not be used as a condition of child visitation, particularly for supervised visitation. Visitation should not be taken away as a punitive response – team members should instead assess the adequacy of the treatment plan for continued use as a part of the response.
The guidelines and materials below provide an overview of the general best practice guidelines of drug testing in child welfare and across systems.
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Policy and Practice Resources
Drug Testing in Child Welfare: Practice and Policy Considerations (PDF 92 KB)
Substance Abuse and Mental Health Services Administration. 2010
This document guides child welfare agency policymakers in developing practice and policy protocols regarding the use of drug testing in child welfare practice. This guidance describes the practice and policy issues that policymakers must address to include drug testing in the comprehensive assessment and monitoring that child welfare agencies provide.
Drug Testing: A White Paper of the American Society of Addiction Medicine (ASAM) (PDF 838 KB)
American Society of Addiction Medicine. October 2013
Recognizing that drug testing is vastly underutilized throughout health care, the American Society of Addiction Medicine (ASAM), the nation's largest organization of physicians specializing in the prevention and treatment of addiction, has produced this White Paper to highlight the wide range of applications in which drug testing can promote prevention, early detection, and lifelong recovery from addiction in the interests of individual and public health. This paper describes the uses of drug testing as a primary prevention, diagnostic, and monitoring tool to identify the presence or absence of drugs of abuse or therapeutic agents related to addiction management in multiple settings.
Drug Testing Reference Tables for Drug Courts (PDF 22 KB)
National Council of Juvenile and Family Court Judges, 2009
Table shows the detection period, advantages, and disadvantages of the different types of drug testing specimen collected (urine, sweat, oral fluid, hair, blood, eye scanning/pupilometer).
Drug Testing in a Drug Court Environment: Common Issues to Address(PDF 156 KB)
Office of Justice Programs Drug Court Clearinghouse and Technical Assistance Project, 2000
This paper addresses the most frequent issues associated with drug testing in drug court programs; it provides an overview for drug court program officials regarding the most critical topics related to the development and maintenance of a drug testing capability.
State and Local Examples
Drug Testing White Paper (PDF 109 KB)
Kentucky In-depth Technical Assistance Project, 2011
This document provides basic information on drug testing, as well as recommendations and, such as guidelines on the use of drug test results and other indicators of substance use, and considerations for determination of risk when a parent tests positive for prescription medications, including those prescribed for Medication Assisted Treatment.
Connecticut RSVP Drug Screening Protocol (PDF 90 KB)
Connecticut Recovery Specialist Voluntary Program
Developed through the NCSACW In-Depth Technical Assistance Project, this document offers a protocol for drug screening developed for the Connecticut Recovery Specialist Voluntary Program (RSVP).
“Guidelines for testing and reporting drug exposed newborns in Washington State”
Washington State Department of Health, 2014
The purpose of this 16-page document is to provide consistent guidance related to maternal and newborn screening and testing and reporting drug-exposed newborns to DSHS. These guidelines were developed in response to calls from hospital staff and hospital legal counsel about issues around reporting positive newborn toxicology screens and testing/consent issues.
Drug Testing Practice Guidelines (PDF 155 KB)
State of Arizona, Department of Child Safety, 2016
These guidelines discuss the processes for drug testing parents involved with child welfare services, including the appropriate use of testing, how to determine testing frequency and schedules, and how to discuss drug screens with parents.
“Clinical Drug Testing in Primary Care”
Substance Abuse and Mental health Service Administration, 2012
For clinical practitioners such as physicians, nurse practitioners, and physician assistants in primary care office and community health center settings. This publication provides information that will assist the practitioner in whether they would want to implement drug testing at their facilities and if they do, guidance on implementing drug testing.
“Drug Testing for Welfare Recipients and Public Assistance”
National Conference of State Legislators, 2016
This website includes federal rules permitting drug testing as part of the TANF block grant, states that have proposed legislation, and details on the previously mentioned states’ recent legislation.
Related Research Articles
Carrieri, M., Trevisan, A., & Bartolucci, G. B. (2001). Adjustment to concentration-dilution of spot urine samples: Correlation between specific gravity and creatinine. International Archives of Occupational and Environmental Health, 74, 63-67. Available from http://www.ncbi.nlm.nih.gov/pubmed/11196084
Dolan, K., Rouen, D., & Kimber, J. (2004). An overview of the use of urine, hair, sweat and saliva to detect drug use. Drug and Alcohol Review, 23, 213-217. Available from http://www.ncbi.nlm.nih.gov/pubmed/15370028
Gryczynski, J., Schwartz, R. P., Mitchell, S. G., O’Grady, K. E., & Ondersma, S. J. (2014). Hair drug testing results and self-reported drug use among primary care patients with moderate-risk illicit drug use. Drug and Alcohol Dependence, 141, 44-50. doi: 10.1016/j.drugalcdep.2014.05.001. Available from http://www.ncbi.nlm.nih.gov/pubmed/24932945
Moeller, K. E., Lee, K. C., & Kissack, J. C. (2008). Urine drug screening: Practical guide for clinicians. Mayo Clinic Proceedings, 83(1), 66-76. doi: 10.4065/83.1.66. Available from http://www.ncbi.nlm.nih.gov/pubmed/18174009