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Drug testing

Abstract: The use of drug testing is pervasive in community supervision requiring probationers to regularly submit to urine drug testing. Positive drug tests may result in sanctions, technical violations, probation revocations, and even prison sentences. However, experts in addiction medicine recommend testing be used to support recovery rather than to exact punishment. This article reviews the literature on drug testing offering information on efficacy, best practices, and limitations. Recommendations for drug testing include improved communication between probation officers and treatment providers and clients, as well as utilizing specialized probation.

Biological drug testing is a tool that provides information about an individual's recent substance use. Like any tool, its value depends on using it correctly; that is, on selecting the right test for the right person at the right time. This document is intended to clarify appropriate clinical use of drug testing in addiction medicine and aid providers in their decisions about drug testing for the identification, diagnosis, treatment, and recovery of patients with, or at risk for, addiction. The RAND Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) process for combining scientific evidence with the collective judgment of experts was used to identify appropriate clinical practices and highlight areas where research is needed. Although consensus panels and expert groups have offered guidance on the use of drug testing for patients with addiction, very few addressed considerations for patients across settings and in different levels of care. This document will focus primarily on patients in addiction treatment and recovery, where drug testing is used to assess patients for a substance use disorder, monitor the effectiveness of a treatment plan, and support recovery. Inasmuch as the scope includes the recognition of addiction, which often occurs in general healthcare settings, selected special populations at risk for addiction visiting these settings are briefly included.

"Hawai'i’s Opportunity Probation with Enforcement (HOPE) Hawai'i’s Opportunity Probation with Enforcement probation relies on a regimen of regular, random drug testing tied to swift and certain, but modest, sanctions to motivate probationer compliance. In two 2007 studies in Hawai'i, a comparison-group quasi-experiment and a randomized controlled trial, HOPE was demonstrated to improve compliance with terms of probation at 12-month followup, with large reductions in drug use, recidivism, and overall incarceration for offenders assigned to the program … This study extends the original HOPE evaluations to an almost ten-year followup, addressing whether the improvements in criminal-justice outcomes observed during the active HOPE intervention persist after the term of probation. The study also documents changes in HOPE practices and ongoing implementation fidelity to the model … HOPE probationers performed better than those supervised under routine supervision. They were less likely to be revoked and returned to prison" (p. 2-3).

HOPE II Cover

Results from projects implementing new strategies for drug interdiction within an institutional setting are presented. This compilation includes findings from final evaluation reports provided by Maryland, California, Kansas, New York, and Florida.

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