The American Academy of Pediatrics opposes involuntary drug testing of adolescents at school, emphasizing that more research is needed on both safety and effectiveness before testing programs are implemented. The below studies and reports examine both the efficacy of random student drug testing programs and the technical challenges of administering the programs.

Drug Testing in Schools: Evidence, Impacts and Alternatives
Ann Roche, Ken Pidd, Petra Bywood and others
In March 2008 the Australian National Council on Drugs released a report concluding, “there is insufficient evidence to support the use of drug testing as a deterrent for drug use in schools.”  The report holds that drug tests are insufficiently reliable for testing in the school setting and takes a detailed look at the significant costs of implementing the programs. The researchers describe an array of effective prevention interventions now available to schools – interventions that focus on building positive relations and developing students' sense of connectedness with the school. 

Outcomes of a Prospective Trial of Student-Athlete Drug Testing: The Student Athlete Testing Using Random Notification (SATURN) Study
Linn Goldberg, Diane Elliot, David MacKinnon and others
In November 2007, researchers from Oregon Health and Science University (OHSU) published research findings from randomized experimental trials that found random drug and alcohol testing did not reliably reduce past month drug and alcohol use among student athletes. The researchers from OHSU also found attitudinal changes among students in schools with drug testing programs indicate new risk factors for future substance use. Student athletes in schools with drug testing reported less positive attitudes toward school, less faith in the benefits of drug testing and less belief that testing was a reason not to use drugs, among other indicators. 

Results of Random Drug Testing in an Adolescent Substance Abuse Program
Sharon Levy, Lon Sherritt, Brigid L. Vaughan and others
This 2007 study published in the Official Journal of the American Academy of Pediatrics seeks to estimate the proportion of drug tests that are susceptible to interpretation error by examining the random urine drug testing program of an outpatient substance abuse program for adolescents. The researchers found that 6 percent of tests were too diluted to examine, and 21 percent of tests were false positives, reflecting the legitimate use of over-the-counter drugs. Furthermore, standard drug testing missed two-thirds of Oxycodone use. School drug-testing programs rarely parallel the rigorous standards used in the study are thus more prone to interpretation error.

Drug Testing of Adolescents in Ambulatory Medicine: Physician Practices and Knowledge
Sharon Levy, Sion Kim Harris, Lon Sherritt, and others
This 2006 study published in the Achieves of Pediatrics and Adolescent Medicine found that most physicians administering drug tests to students do not have enough training to ensure test results are correct and unadulterated. The study raises the concern that few schools will have sufficient staff with proper training to implement drug testing and few physicians will be able to help.

Random Drug Testing of Schoolchildren: A Shot in the Arm or a Shot in the Foot for Drug Prevention?
Neil McKeganey
This 2005 report from the United Kingdom draws on evidence from the United States and examines the complex ethical and practical issues associated with student drug testing. The author systematically debunks a myriad of popular assumptions about youth and drug testing.

Random Drug Testing in Schools
Clare Gerada and Eilish Gilvarry
This 2005 article in the British Journal of General Practice examines random student drug testing in the context of the United Kingdom and concludes that the ethical, practical and economic risks of testing do not out weigh the potential benefits, and stresses the importance of research before introduction of a widespread program that has little evidence.

A Review of Internet-Based Home Drug-Testing Products for Parents
Sharon Levy, Shari Van Hook, and John Knight
Researchers at Children's Hospital Boston conducted a study in 2004 examining home drug-testing products and the Internet-based recommendations intended for parents. They concluded that the surveyed internet sites failed to appropriately educate parents and contained unsubstantiated claims regarding the benefits of drug testing. The study suggested parents may find it difficult to determine which testing method to use, and precisely what drugs the devices detect.

Ethics of Research Involving Mandatory Drug Testing of High School Athletes in Oregon
Adil Shamoo and Jonathan Moreno
This article published in the 2004 American Journal of Bioethics examines the question of whether research can be conducted with high school students in conjunction with a mandatory drug-testing program, while adhering to prevailing ethical standards regarding human-subjects research and specifically the participation of children in research.

Drug Testing in Schools: Policies, Practices, and the Association With Student Drug Use
Ryoko Yamaguchi, Lloyd D. Johnston, and Patrick M. O’Malley
In 2003 researchers from the University of Michigan conducted a follow-up study that contained an enlarged sample of schools and an additional year of data, examining 94,000 students in nearly 900 American schools. In response to some critics of their earlier work, the authors also conducted a deeper analysis of programs that randomly test all students. The results confirmed the team’s original conclusions: drug testing was not significantly associated with a reduction in student drug use in any grade studied.

Relationship between Student Illicit Drug Use and School Drug-Testing Policies
Ryoko Yamaguchi, Lloyd D. Johnston, and Patrick M. O'Malley
This 2003 study published in the Journal of School Health is the first large-scale national study on student drug testing. The researchers found virtually no difference in rates of drug use between schools that have drug testing programs and those that do not.

Safe and Smart: Making the After-School Hours Work for Kids
U.S. Department of Health and Human Services
This 1998 government study looks at the potential of after-school programs, what works, and how communities can meet the need for after-school activities.

Adolescent Time Use, Risky Behaviors and Outcomes
U.S. Department of Health and Human Services
This 1995 government study shows a vastly disproportionate incident of adolescent drug use and other dangerous behavior occurs during the unsupervised hours between the end of classes and parent’s arrival home in the evening.