I occasionally get requests from parents to drug test their teenager at his or her annual physical without the child’s knowledge or consent. The parent usually advises, “Just say you’re doing a cholesterol check.” I tell the parent that this is not possible, and we discuss ways to initiate a conversation regarding drug use.

Drug testing teenagers under false pretenses is unethical and against the policy of my practice setting, but I also believe it is illegal. Am I correct? — Betsy Groth, APRN, Essex, Ct.

Drug testing is legal and can be of diagnostic and therapeutic value in the context of treatment in individuals with substance-abuse problems or those in emergency situations. However, involuntary drug-testing is not recommended by the American Academy of Pediatrics (AAP) in a person considered competent, such as an older adolescent (Pediatrics. 2007;119:627-630).

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Parental permission is not sufficient for involuntary screening. This is not to say that health-care providers should not screen for drug use and abuse. The AAP recommends the use of a validated screening tool like the CRAFFT, brief office interventions and appropriate referrals (Pediatrics. 2011;128:e1330-e1340). — Julee B. Waldrop, DNP (163-2)

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