tag:theconversation.com,2011:/global/topics/drug-tests-7124/articlesDrug tests – The Conversation2023-02-27T13:24:07Ztag:theconversation.com,2011:article/2006182023-02-27T13:24:07Z2023-02-27T13:24:07ZCan eating poppy seeds affect drug test results? An addiction and pain medicine specialist explains<figure><img src="https://images.theconversation.com/files/512239/original/file-20230224-1769-g9ij77.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2121%2C1412&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Eating culinary poppy seeds won’t get you high, but they could lead to a failed drug test.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/midsection-of-woman-holding-bagels-in-plate-royalty-free-image/691138209">Linda Caldwell/EyeEm via Getty Images</a></span></figcaption></figure><p><em>The U.S. Defense Department <a href="https://media.defense.gov/2023/Feb/21/2003164614/-1/-1/1/POPPY-SEEDS-WARNING-MEMO-SIGNED-CONTACT-REDACTED.PDF">issued a memo</a> on Feb. 17, 2023, warning service members to avoid eating poppy seeds because doing so may result in a positive urine test for the opiate codeine. Addiction and pain medicine specialist <a href="https://psychiatry.ufl.edu/profile/reisfield-gary/">Gary Reisfield</a> explains what affects the opiate content of poppy seeds and how they could influence drug tests.</em></p>
<h2>What are poppy seeds?</h2>
<p>Poppy seeds come from a species of poppy plant called <a href="https://www.britannica.com/plant/opium-poppy"><em>Papaver somniferum</em></a>. “Somniferum” is Latin for “<a href="https://www.mcgill.ca/oss/article/drugs-health-history-quirky-science/what-drug-may-have-been-detected-had-dorothys-and-cowardly-lions-urine-been-tested-they-entered">sleep-bringing</a>,” which hints that it might contain opiates – powerful compounds that depress the central nervous system and can induce drowsiness and sleep.</p>
<p>There are two main uses for the opium poppy. It is a source of the opiates used in painkillers, the most biologically active of which are morphine and codeine. Its seeds are also used for cooking and baking.</p>
<p>Poppy seeds themselves don’t contain opiates. But during harvesting, the seeds can <a href="https://www.deadiversion.usdoj.gov/drug_chem_info/unwashed_poppy_seed.pdf">become contaminated</a> with opiates contained in the milky latex of the seed pod covering them.</p>
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<a href="https://images.theconversation.com/files/512234/original/file-20230224-1815-nrztn1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Close-up of opium poppy heads with drops of opium milk latex leaking from the pod." src="https://images.theconversation.com/files/512234/original/file-20230224-1815-nrztn1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/512234/original/file-20230224-1815-nrztn1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=473&fit=crop&dpr=1 600w, https://images.theconversation.com/files/512234/original/file-20230224-1815-nrztn1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=473&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/512234/original/file-20230224-1815-nrztn1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=473&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/512234/original/file-20230224-1815-nrztn1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=594&fit=crop&dpr=1 754w, https://images.theconversation.com/files/512234/original/file-20230224-1815-nrztn1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=594&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/512234/original/file-20230224-1815-nrztn1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=594&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">The milky latex of poppy seed pods contains opiates.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/opium-poppy-heads-papaver-somniferum-drops-milk-royalty-free-image/1445043432">Daniel Prudek/iStock via Getty Images Plus</a></span>
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<h2>What affects opiate content in poppy seeds?</h2>
<p>Many factors determine the opiate concentrations and ratios of poppies. As with wine grapes, the opiate profile of the poppy plant – and thus its seeds – is <a href="https://doi.org/10.1042/bj0140618">affected by its terroir</a>: climate, soil, amount of sunshine, topography and time of harvest.</p>
<p>Another factor is the variety or cultivar of the plant. For example, there are genetically engineered opium poppies that produce no <a href="https://www.abc.net.au/science/articles/2004/09/23/1203133.htm">morphine or codeine</a> and others that produce <a href="https://doi.org/10.1111/ppl.12086">no opium latex</a> at all.</p>
<h2>Can you get high from eating poppy seeds?</h2>
<p>Practically speaking, you cannot eat enough poppy seeds to get you high. Furthermore, processing dramatically decreases opiate content – for example, by <a href="https://doi.org/10.1021/acs.jafc.0c01681">washing</a> or <a href="https://doi.org/10.3389/fchem.2020.00737">cooking or baking</a> the seeds.</p>
<h2>Do poppy seeds affect drug tests?</h2>
<p>Poppy seeds don’t have nearly enough opiates to intoxicate you. But because drug tests are exquisitely sensitive, consuming certain poppy seed food products can lead to <a href="https://doi.org/10.1016/j.forsciint.2014.04.042">positive urine drug test results for opiates</a> – specifically for morphine, codeine or both. </p>
<p>Under most circumstances, opiate concentrations in the urine are too low to produce a positive test result. But <a href="https://doi.org/10.1093/jat/bkac079">certain food products</a> – and it’s generally impossible to know which ones, because opiate content does not appear on food labels – contain enough opiates to produce positive test results. Moreover, because of overlap in opiate concentrations and morphine-to-codeine ratios, it can sometimes be <a href="https://doi.org/10.1093/jat/bkac079">challenging to distinguish</a> test results that are due to the consumption of poppy seeds from those that are due to the use of opiate drugs. </p>
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<a href="https://images.theconversation.com/files/512229/original/file-20230224-1687-j2ktnx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Bowl and scoop of poppy seeds" src="https://images.theconversation.com/files/512229/original/file-20230224-1687-j2ktnx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/512229/original/file-20230224-1687-j2ktnx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/512229/original/file-20230224-1687-j2ktnx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/512229/original/file-20230224-1687-j2ktnx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/512229/original/file-20230224-1687-j2ktnx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/512229/original/file-20230224-1687-j2ktnx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/512229/original/file-20230224-1687-j2ktnx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Processing poppy seeds decreases the opiate content that may be on the seed.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/poppy-seeds-royalty-free-image/1257842791">Burcu Atalay Tankut/Moment via Getty Images</a></span>
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<p>This is not a problem with most <a href="https://www.ecfr.gov/current/title-49/subtitle-A/part-40#40.137">workplace drug testing</a>. Test results are reviewed by a specially trained physician called a medical review officer. Unless the physician finds evidence of unauthorized opiate use, such as needle marks or signs of opiate intoxication or withdrawal, even relatively high concentrations of opiates in the urine that produce positive test results are generally ruled to be negative.</p>
<p>It turns out, though, that <a href="https://www.washingtonpost.com/nation/2023/02/22/poppy-seeds-drug-test-military/">drug testing in the military</a> is different, and poppy seeds pose potential problems. One such problem, as highlighted in recent news reports, concerns service members who test positive for codeine and assert a “poppy seed defense.” They are still regarded as having taken codeine, sometimes with <a href="https://www.defense.gov/News/News-Stories/Article/Article/3306336/service-members-should-avoid-foods-with-poppy-seeds/">serious consequences</a>, such as a disciplinary action or discharge from the service.</p><img src="https://counter.theconversation.com/content/200618/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gary Reisfield does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Poppy seeds can become contaminated with opiates during harvesting. For the US Defense Department, invoking a ‘poppy seed defense’ may not be enough to rule out a positive drug test result.Gary Reisfield, Associate Professor of Psychiatry, University of FloridaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1705152021-11-12T13:36:22Z2021-11-12T13:36:22ZThe FDA’s lax oversight of research in developing countries can do harm to vulnerable participants<figure><img src="https://images.theconversation.com/files/430539/original/file-20211105-9885-4tg5rc.jpg?ixlib=rb-1.1.0&rect=0%2C30%2C6800%2C5059&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Nearly 80% of participants in FDA-reviewed research trials live in foreign countries.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/approved-concept-rubber-stamp-with-fda-and-medicine-royalty-free-image/1215516118?adppopup=true">Bet_Noire/iStock via Getty Images</a></span></figcaption></figure><p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take about interesting academic work.</em></p>
<h2>The Big Idea</h2>
<p>The Food and Drug Administration provides <a href="https://doi.org/10.1177/1060028020906484">less stringent oversight</a> of overseas research trials used in deciding whether to approve a drug than those conducted domestically. That was the finding of <a href="https://doi.org/10.1002/jcph.1976">my recent study</a>, published in the Journal of Clinical Pharmacology.</p>
<p>My study highlighted loopholes in the agency’s oversight processes that exploited vulnerable people and led to faulty data for drug approval decisions. Until the early 2000s, participants in FDA-reviewed research trials came almost entirely from the U.S. But a 2010 report from the Department of Health and Human Services found that <a href="https://oig.hhs.gov/oei/reports/oei-01-08-00510.pdf">78% of research participants</a> were enrolled overseas. Faster research subject recruitment and lower expenses – paired with these regulatory loopholes – seem to be driving this shift. </p>
<p>It isn’t clear how often these gaps allow problematic trials to slip through the system, because trials that go wrong can simply not be disclosed, and there are virtually no on-site inspections. </p>
<p>In one example, a 2001 trial based in India allowed the <a href="https://doi.org/10.1136/bmj.332.7541.566-a">use of placebo control</a> in patients with severe mental illness when there were effective alternative therapies available. In another Indian trial, patients were untruthfully told that their <a href="https://www.somo.nl/wp-content/uploads/2008/02/Examples-of-unethical-trials.pdf">medication to treat mania was no longer available</a> and that they could receive only an experimental drug or placebo. Some patients did not even know they were in a trial.</p>
<p>In a study I published in 2020, I cited a trial performed in India in which <a href="https://doi.org/10.1177/1060028020906484">electrocardiograms filed for multiple people</a> were later discovered to be fraudulent copies from a single person. I also came across an example of large-scale data manipulation from Chinese study sites to make an experimental drug seem more effective than it really was.</p>
<p>The number of drugs that are approved but later had to be withdrawn or have new serious warnings for adverse events has increased from <a href="https://doi.org/10.1377/hlthaff.2014.0122">21 per 100 drugs before 2012 to 27 per 100 drugs</a> thereafter. This coincides with the dramatic shift to overseas clinical trials intended for FDA drug approval.</p>
<h2>Why it matters</h2>
<p>Before researchers can begin human testing of experimental drugs in research subjects on U.S. soil, companies must submit “<a href="https://www.fda.gov/drugs/types-applications/investigational-new-drug-ind-application">Investigational New Drug</a>” applications to the FDA. These applications describe the lab-based testing they conducted and all the trials they plan to carry out on U.S. citizens. The FDA can prevent unethical trials from beginning in the U.S. given its authority under the <a href="https://www.senate.gov/artandhistory/history/minute/Interstate_Commerce_Act_Is_Passed.htm#:%7E:text=On%20February%204%2C%201887%2C%20both,%E2%80%9D%E2%80%94to%20regulating%20railroad%20rates.&text=The%20bill%20passed%20the%20House%2C%20but%20not%20the%20Senate">Interstate Commerce Act of 1887</a> but only because the experimental drug crosses state lines.</p>
<p>But a <a href="https://doi.org/10.1002/jcph.1976">loophole exists for overseas research</a>, since the experimental drug does not need to cross U.S. state lines. This means companies can begin overseas research trials <a href="https://doi.org/10.1002/jcph.1976">before the FDA assesses the drug application</a>, and they do not have to disclose all the research they intend to perform.</p>
<p>To get an experimental drug approved by the FDA, the companies must submit a <a href="https://www.fda.gov/drugs/types-applications/new-drug-application-nda">New Drug Application</a> to the agency. For research trials that were previously proposed to the FDA, the companies are required to include all trial data. However, when trials are conducted overseas unbeknownst to the FDA, companies can <a href="https://doi.org/10.1177/1060028020906484">cherry-pick supportive trials</a> and leave out those with negative findings. Thus, the FDA may not have a complete picture of the drugs’ potential benefits and adverse events when deciding if it should be approved.</p>
<h2>What’s next</h2>
<p>Since the 1990s, the FDA has been increasingly funded by <a href="https://theconversation.com/why-is-the-fda-funded-in-part-by-the-companies-it-regulates-160444">user fees from the companies it regulates</a>. These fees cover the costs of many FDA functions, including product approvals and manufacturing facility inspections. They are paid by pharmaceutical, biotechnology and device companies as well as generic drug manufacturers. User fees were initially introduced to speed up the drug approval process for HIV medications early in the HIV/AIDS epidemic.</p>
<p>These <a href="https://www.fda.gov/industry/fda-user-fee-programs">user fees are negotiated</a> between the FDA and the companies and then approved by Congress. In 2022, the newly negotiated fees are set to go into effect for five years. During the last negotiation in 2017, the <a href="https://doi.org/10.1177/1060028020906484">FDA proposed a fee to fund trial site inspections</a> in developing countries, but the companies refused. As a result, foreign clinical trial sites are <a href="https://oig.hhs.gov/oei/reports/oei-01-08-00510.pdf">27 times less likely to be inspected by the FDA</a> than those in the U.S.</p><img src="https://counter.theconversation.com/content/170515/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>C. Michael White does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Regulatory loopholes for research conducted off US soil allow for questionable trials and misleading data to slip under the FDA’s radar.C. Michael White, Distinguished Professor and Head of the Department of Pharmacy Practice, University of ConnecticutLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/733432017-02-22T04:29:56Z2017-02-22T04:29:56ZYes, we can do on-the-spot drug testing quickly and safely<figure><img src="https://images.theconversation.com/files/157623/original/image-20170221-18627-1q1ya9a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The not-for-profit UK group The Loop said it tested the drug ecstasy with 'loop lasers' at a festival in July 2016. </span> <span class="attribution"><a class="source" href="https://www.facebook.com/WeAreTheLoopUK/photos/a.476925732388189.1073741829.454797594601003/1080182912062465/?type=3&theater">The Loop UK/Facebook</a>, <span class="license">Author provided</span></span></figcaption></figure><p>The Victorian Police Chief Commissioner Graham Ashton’s recent claim that it’s not practical to conduct on-the-spot drug tests “<a href="http://www.abc.net.au/news/2017-02-19/electric-parade-festival-more-than-20-overdose-hospital/8283828">safely and quickly</a>” is, at best, misinformed. These tests have been taking place successfully in Europe for more than a decade.</p>
<p>Ashton’s statement came in response to renewed calls for on-the-spot drug testing in Victoria after more than 20 people were hospitalised as a result of a <a href="http://www.theage.com.au/victoria/more-than-20-drug-overdoses-at-electric-parade-dance-party-20170218-gug5as.html">mass overdose</a> at a dance party in Melbourne on Saturday night. The incident occurred just weeks after <a href="https://www.theguardian.com/australia-news/2017/jan/16/three-dead-after-overdosing-on-bad-batch-of-ecstasy-in-melbourne-court-told">three people died</a> after taking a “bad batch” of MDMA in Chapel Street nightclubs. </p>
<p>In response to the calls, Ashton <a href="http://www.abc.net.au/worldtoday/content/2016/s4623002.htm">appeared to question</a> the availability of the systems required for on-the-spot drug tests.</p>
<blockquote>
<p>That’s a bit of a myth really, that there is a proper testing regime that can suddenly test on-the-spot what quality drugs [are]. We take quite a long time to test drugs when we seize them.</p>
</blockquote>
<p>Ashton <a href="http://www.abc.net.au/news/2017-02-19/electric-parade-festival-more-than-20-overdose-hospital/8283828">told the ABC</a> it takes laboratories days to determine what is in a pill.</p>
<blockquote>
<p>So to do that, at those sort of events, to do it safely and quickly is not really a practical option.</p>
</blockquote>
<p>Years of experience in numerous countries around the world tell us this is factually incorrect.</p>
<p>On-the-spot drug analysis has been taking place in Europe for more than a decade, with the support of <a href="http://www.politics.co.uk/comment-analysis/2016/07/28/how-patch-grass-uk-first-decriminalised-drugs-space">law enforcement</a>, associated forensic toxicologists, analytical chemists and academics. A wide variety of drug testing systems using laboratory technologies are <a href="https://www.theguardian.com/society/2016/jul/24/secret-garden-party-pioneers-drugs-testing-for-festival-goers">successfully deployed</a> at events across Europe. </p>
<p>The <a href="http://idpc.net/profile/trans-european-drug-information-project">Trans European Drug Information (TEDI) project</a> combined the data collected in drug testing systems used in Spain, Switzerland, Belgium, Austria, Portugal and the Netherlands. The TEDI project <a href="http://onlinelibrary.wiley.com/doi/10.1002/dta.1954/full">analysed just over 45,000 drug samples</a> taken from public events in those countries between 2008 and 2013. Most of those 45,000 tests, conducted using forensic equipment, were completed in seven to 25 minutes.</p>
<p>Many on-site drug checking systems use a variety of techniques to chemically analyse the composition and dose of the drugs presented. The technology used includes <a href="http://hiq.linde-gas.com/en/analytical_methods/liquid_chromatography/high_performance_liquid_chromatography.html">high-performance liquid chromatography</a> (HPLC), <a href="https://en.wikipedia.org/wiki/Liquid_chromatography%E2%80%93mass_spectrometry">liquid chromatography–mass spectrometry</a> (LCMS), <a href="https://en.wikipedia.org/wiki/Gas_chromatography%E2%80%93mass_spectrometry">gas chromatography–mass spectrometry</a> (GCMS), <a href="https://en.wikipedia.org/wiki/Thin-layer_chromatography">thin-layer chromatography</a> (TLC), <a href="https://en.wikipedia.org/wiki/Fourier_transform_infrared_spectroscopy">fourier transform infrared spectroscopy</a> (FTIR) and <a href="https://en.wikipedia.org/wiki/Tandem_mass_spectrometry">quadrupole time-of-flight mass spectrometry</a> (Q-TOF). </p>
<p><a href="http://www.checkyourdrugs.at/">Checkit!</a> in Vienna have a mobile van from which they run a range of analytical tests more commonly found in a laboratory. These tests are conducted in seven minutes. <a href="http://www.saferparty.ch/allgemein.html">SaferParty</a> in Zurich uses HPLC and GCMS technology, and these tests take 15 minutes. <a href="https://energycontrol.org/noticias/528-international.html">EnergyControl</a> on the Iberian Peninsula uses TLC and GCMS technology, and provides a result in under 20 minutes.</p>
<p>Professor Fiona Measham of <a href="http://wearetheloop.co.uk/">The Loop</a> in the UK uses a new sampling tool that takes 20 minutes. Professor Measham’s <a href="https://www.dur.ac.uk/news/newsitem/?itemno=23079">methodology</a> is supported by the <a href="http://www.tictac.org.uk/">TICTAC database</a>, one of the largest forensic drug databases in the world.</p>
<p><a href="https://en.wikipedia.org/wiki/Marquis_reagent">Reagent tests</a> – the easily available kits that change colour when they come in contact with a drug – are advocated and used by many in the Australian music festival scene. But this is only because there is nothing else to offer.</p>
<p>Reagent tests only identify one substance in a sample, even when many substances are present. With 750 different drugs now on the market, and often used in conjunction with each other, these simple tests are not adequate. Drug testing is also best done by professionals.</p>
<p>This information is widely available. Drug testers are happy to <a href="https://ndarc.med.unsw.edu.au/event/2015-national-drug-trends-conference">discuss</a> their methodology; they are proud of it. They’ve also published it. In Europe, there are publicly available <a href="http://newip.safernightlife.org/digital-library">good practice guidelines</a>. And the technology is already in Australia. By my calculations, there are in excess of 10,000 GCMS machines in laboratories across Australia. </p>
<p>So why the disbelief from the Victorian Police Chief Commissioner?</p>
<p>It could be because the majority of illicit drug samples in Australia are processed by forensic laboratories at the request of law enforcement, and do take some time. The tests run for use in trials are often run multiple times, and analysts take days to return their results. This is entirely appropriate in a legal setting. But we don’t do that in medicine.</p>
<p>We don’t get 10 chest X-rays to confirm a chest infection. We use the appropriate equipment, ensure that it’s well calibrated, and act on the results that we are confident are real.</p>
<p>It is important to acknowledge the role law enforcement plays in stemming the flow of drugs in the community. But it is not the only, or even the best, way to prevent the harm and deaths caused by bad batches of drugs and drug overdoses. </p>
<p><a href="http://www.lapresse.ca/videos/actualites/201309/12/46-1-faire-tester-sa-drogue-en-vingt-minutes.php/c2e6226bdc9c4b828f029c8f9f123800">Drug testing at music festivals</a> is very much about intervention and encouraging behavioural changes, rather than just drily delivering a result. We know from <a href="http://www.sciencedirect.com/science/article/pii/S0955395906001058">research</a> that the majority of consumers would not take a pill if test results indicated the substance wasn’t what they thought it was.</p>
<p>My own work in South Australia between 2002 and 2007 showed clearly that two thirds of consumers chose to do something other than take their pills when they found they contained a substance other than what they expected. The modern generation is <a href="http://www.abc.net.au/triplej/programs/hack/will-sylvia-chois-stereosonic-death-change-pill-testing-policy/6991736">far more interested</a> in having their pills tested than when this practice started.</p>
<p>In addition to changing people’s behaviour, drug testing provides us with information about the specifics of the drugs available. This is an ever changing market. Drug testing can identify substances that <a href="http://www.abc.net.au/triplej/programs/hack/drug-dogs-cost-nsw-9-million-per-year/7444908">sniffer dogs</a> are not yet trained to detect.</p>
<p>In the past year a consortium of scientists, nongovernmental organisations and doctors (including myself) has reached out to the Victorian Department of Health, the Office of the Commissioner and the Victoria Police Forensic Services Department to offer them the opportunity to review our methodology and discuss collaborating in this space. Both have declined.</p>
<p>Should they ever change their minds, our door remains open.</p><img src="https://counter.theconversation.com/content/73343/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David Caldicott is a member of Harm Reduction Australia and ATODA, and is the Clinical Lead in the Australian Drug Observatory. He has offered bipartisan academic advice in the development of medical cannabis legislation and drug early warning systems in Australia and overseas. He has no political affiliations or financial disclosures to make.</span></em></p>Victorian Police Chief Commissioner Graham Ashton said conducting on-site drug tests at public events “safely and quickly is not really a practical option”. But the technology is available.David Caldicott, Emergency Medicine Consultant, Australian National UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/630322016-07-28T01:37:30Z2016-07-28T01:37:30ZWhat’s really behind our obsession with ‘clean’ athletes?<figure><img src="https://images.theconversation.com/files/132260/original/image-20160727-21587-1yr9c23.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Do PEDs make athletes less human? </span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-19376155/stock-photo-athletic-cyborg-with-injuries-in-a-back.html?src=csl_recent_image-1">'Cyborg' via www.shutterstock.com</a></span></figcaption></figure><p>The Rio Summer Olympics are only days away, but a cloud of performance-enhancing drug (PEDs) scandals hovers over the Olympic Games.</p>
<p>Earlier this year, Russian tennis star Maria Sharapova <a href="https://www.theguardian.com/sport/2016/mar/08/meldonium-maria-sharapova-failed-drugs-test">tested positive for meldonium</a>, a drug that increases blood flow so more oxygen can be carried to muscle tissue. The Russian government was <a href="http://www.nytimes.com/2016/05/13/sports/russia-doping-sochi-olympics-2014.html?version=meter+at+0&module=meter-Links&pgtype=article&contentId=&mediaId=&referrer=https%3A%2F%2Fwww.google.co.in%2F&priority=true&action=click&contentCollection=meter-links-click">accused of sponsoring a state-run doping scheme</a> that gave Russian athletes an unfair advantage at the 2014 Winter Olympics in Sochi. Now, for Rio 2016, the World Anti-Doping Agency wants all Russian athletes to be banned – <a href="http://www.bbc.com/sport/olympics/36881326">and it’s still unclear how many will be allowed to compete</a>.</p>
<p>Although some studies have shown that public opinion on allowing athletes to dope <a href="http://www.thehastingscenter.org/Publications/BriefingBook/Detail.aspx?id=2206">is divided</a> (some think it could increase entertainment value), most sporting authorities maintain that athletes should not dope.</p>
<p>It’s an emotional topic, one that threatens the relationship between athletes and their fans. People worldwide felt a sense of <a href="http://usnews.nbcnews.com/_news/2013/01/17/16531687-from-belief-to-betrayal-how-america-fell-for-lance-armstrong">extreme betrayal and disappointment</a> when the extent of Lance Armstrong’s doping was finally revealed. Studies have shown how even an <em>allegation</em> of use <a href="http://digitalcommons.salve.edu/cgi/viewcontent.cgi?article=1059&context=pell_theses">can severely damage an athlete’s reputation</a>. Meanwhile, we spend an extraordinary amount of energy on <a href="http://www.ncbi.nlm.nih.gov/pubmed/22368183">finding new ways to test for PEDs</a> and <a href="http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2546029">studying the effect of doping</a> on public attitudes toward sports.</p>
<p>But what’s really behind our obsession with “clean” athletes and “clean” sports? What if it’s more about us – and our relationship with technology – than them? </p>
<h2>Technology enhances sports in other ways</h2>
<p>What if sports officials just accepted PEDs as simply another “technology” that enhances the game? Couldn’t PEDs simply be thought of as a technological advance – no different from equipment upgrades that improve an athlete’s ability, like replacing wooden tennis rackets with modern, graphite ones?</p>
<p>After all, tennis now allows “hawkeye” technology to determine if a ball is in or out, no longer relying on the fallible eyesight of multiple linesmen and the umpire. FIFA has finally agreed to use <a href="https://www.theguardian.com/technology/2014/jun/16/world-cup-goalline-technology-football-brazil-2014">goal-line technology</a> to bolster the abilities of referees, who are often put in the position of judging whether a soccer goal has been scored from half a field away. </p>
<p>From a wider societal perspective, we use technology in virtually every aspect of our lives. GPS helps us get from one destination to the next, while we use the internet to order food and arrange dates. </p>
<h2>Everyday life rife with performance enhancers</h2>
<p>Of course, none of these technological advances is entering our bodies. Nor do they (on the surface, at least) have the potential to negatively influence our health.</p>
<p>Researchers believe that high doses of PEDs over sustained periods of time <a href="http://press.endocrine.org/doi/abs/10.1210/er.2013-1058">adversely affect athletes’ health</a>. However, it’s unethical to conduct controlled studies in case they do harm the athlete, so we can glean information only through observation. In other words, we <em>think</em> PEDs are harmful, but we don’t know for sure. Perhaps legalizing PEDs would allow the proper authorities to make recommendations for safe dosages and prevent health risks. But this is unlikely to happen because of society’s extraordinary investment in “clean” sports.</p>
<p>In one sense, it’s remarkable that sports, alone, should have to maintain its performance standards <em>sans</em> enhancement. </p>
<p>We now live in a world in which it’s generally acceptable for young women to use technologies like cosmetic surgery to improve their looks and advance their careers. <a href="https://theconversation.com/inspired-by-kim-kardashian-a-feverish-legion-of-followers-struggle-to-achieve-online-fame-51534">See the Kardashians</a>, whose “natural” endowments have been enhanced by modern medicine. Cosmetic surgery isn’t illegal, although it’s been shown to have <a href="http://www.forbes.com/sites/jennagoudreau/2011/06/16/hidden-dangers-of-cosmetic-surgery/#7a7c451b8805">negative and lasting physical and emotional side effects</a>.</p>
<p>Drugs like Ritalin and Adderall are prescribed to (or used illegally by) <a href="https://healthyhorns.utexas.edu/studydrugs.html">students who want to improve their focus</a>. Yet there’s no drug-testing in place for students.</p>
<p>If beauty or concentration is no longer the result of lucky genes, does athletic prowess have to be? If technology can help sports officials perform their jobs more efficiently and fairly, why can it not be used to help athletes do their jobs more effectively?</p>
<p>The answer is quite simple: Athletes have to be human.</p>
<h2>Are athletes the last domino in a post-human world?</h2>
<p>In a time when technology has become an integral part of the lives of billions of people, it’s athletes who bear the burden of displaying essential human characteristics: vulnerability, grit, the courage to confront challenges and the ability to “dig deep,” reaching beyond one’s physical and mental limits to transcend adversity. </p>
<p>Yes, athletes are superhumans who possess rare physical gifts. But the emphasis is on the human. And perhaps athletes must exhibit distinctively human qualities so that they can help us believe that we are still better than machines.</p>
<p>Ironically, modern technology has helped us overcome many existential threats, whether it’s refrigeration to preserve food or clean water that prevents water-borne disease. But it’s also made us more insecure about our own significance and has caused <a href="http://www.koreascience.or.kr/search/articlepdf_ocean.jsp?url=http://ocean.kisti.re.kr/downfile/volume/kocon/E1CTBR/2011/v7n2/E1CTBR_2011_v7n2_17.pdf&admNo=E1CTBR_2011_v7n2_17">about one-third of the population to feel some level of technophobia</a>, or “abnormal fear or anxiety about the effects of advanced technology.” The level of dependence on technology is such that researchers have <a href="http://onlinelibrary.wiley.com/doi/10.1111/jcc4.12109/full">documented phenomena such as “smartphone separation anxiety.”</a></p>
<p>As the news broke about Maria Sharapova’s doping admission, there was also a headline announcing <a href="http://www.theatlantic.com/technology/archive/2016/03/the-invisible-opponent/475611/">a major accomplishment for artificial intelligence</a>: Google’s AlphaGo went head to head against the human champion, Lee Sedol, in the complicated Chinese game of Go – and won resoundingly. </p>
<p>This has stoked familiar fears: Who are we if a machine can do what we do, but better? </p>
<p>Our attitudes toward technology are also reflected in popular culture. Hit shows like the British-American series “Humans” convey contemporary anxieties about technology. Featuring “synths” – robots that are almost indistinguishable from humans – the show explores a fear that has been successfully mined by sci-fi writers for decades: When technology replicates our fundamental abilities, what does it mean to be human? Do we simply become the “Wizard of Oz’s” rusty Tin Man in search of the human heart?</p>
<p>It’s why fundamental human characteristics – intangibles such as altruism, love, empathy (in addition to irrational grit and extraordinary willpower) – become symbolic of what it truly means to be human. Nearly all films and books that deal with robots or aliens end on this note. We’re humans just because we are. We want to believe that no machine can replicate the breadth of the human heart. </p>
<p>And that is what we expect most of all athletes, that they display heart. </p>
<p>If athletes succumb to widespread usage of PEDs, our fundamental conception of ourselves as human also becomes tarnished; apparently, we can’t afford that right now. </p>
<p>Presidential candidates like Donald Trump and Bernie Sanders keep telling us that “the game” is rigged against us. So perhaps we need to believe that there is still such a thing, somewhere, as a level playing field.</p><img src="https://counter.theconversation.com/content/63032/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Melissa Tandiwe Myambo does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>As technology becomes fully integrated into our everyday lives, we may see athletes as the last vestiges of our humanity.Melissa Tandiwe Myambo, Fublright-Nehru Scholar, Research Associate, Centre for Indian Studies, Wits University, University of California, Los AngelesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/401582015-06-16T20:25:25Z2015-06-16T20:25:25ZSwift and certain sanctions: does Australia have room for HOPE?<figure><img src="https://images.theconversation.com/files/84801/original/image-20150612-11433-jt1s32.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Judge Steven Alm pioneered the HOPE project, the first of scores of swift and certain sanction programmes in the US.</span> <span class="attribution"><a class="source" href="https://www.youtube.com/watch?v=CkNvaedALcU&index=9&list=PL794bs5JErfCzA0wfzM7NXAQs1dtBDmK3">Youtube/PBS screenshot</a></span></figcaption></figure><p><em>This article is part of the <a href="https://theconversation.com/au/topics/beyond-prison">Beyond Prison</a> series, which examines better ways to reduce re-offending, following the recent <a href="https://theconversation.com/au/topics/state-of-imprisonment">State of Imprisonment</a> series.</em></p>
<hr>
<p>At a time of <a href="https://theconversation.com/au/topics/state-of-imprisonment">increasing prison numbers</a>, could <a href="http://www.thecrimereport.org/news/articles/2014-08-can-swift-and-certain-sanctions-fix-the-criminal-jus">swift and certain sanction</a> (SAC) programmes be a desirable model for Australia?</p>
<p>The best-known programme of this nature is Hawaii’s Opportunity with Probation Enforcement (<a href="http://hopehawaii.net/">HOPE</a>). It received an <a href="http://www.civilbeat.com/2013/05/harvard-praises-hawaiis-hope-probation-program/">Innovation in American Government Award</a> from Harvard University in 2013 and an <a href="http://www.courts.state.hi.us/news_and_reports/featured_news/2014/08/criminal_justice_program_award_2014.html">Outstanding Criminal Justice Program Award</a> from the National Criminal Justice Association in 2014. </p>
<p><a href="http://www.pbs.org/newshour/bb/law-july-dec13-hawaiihope_11-24/">Judge Steven Alm</a> launched the pilot programme in 2004. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/VoG7NUIJfJw?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Hawaii State Judge Steven Alm explains the HOPE probation programme.</span></figcaption>
</figure>
<p>HOPE adopts a “good parenting model”‘ and works as follows:</p>
<ul>
<li><p>The judge gives a 15-20 minute <a href="http://www.nij.gov/topics/corrections/community/drug-offenders/%20documents/229023-appendix-2-example-warning-hearing.pdf">“warning hearing”</a> to a group of HOPE participants.</p></li>
<li><p>Offenders are told that they can count on a short jail sanction for every violation.</p></li>
<li><p>Offenders are given a colour code and must call a hotline every morning to hear which colour has been selected. </p></li>
<li><p>If their colour is chosen, they must appear at the probation office before 2pm that day for a drug test. Compliance and a negative test results in the assignment of a new colour associated with less regular testing.</p></li>
<li><p>If an offender fails to appear, a bench warrant is issued and served immediately.</p></li>
<li><p>Offenders who fail the drug test are arrested immediately and brought before a judge within 72 hours.</p></li>
<li><p>Offenders who are found to have violated their probation (by missing an appointment or returning a positive drug test) are immediately sentenced to a short jail stay, with sentences increasing for successive violations. </p></li>
<li><p>Drug treatment is provided for those who request it or who cannot stop using drugs or alcohol on their own. </p></li>
</ul>
<h2>Evaluations of HOPE</h2>
<p>The National Institute of Justice (<a href="https://www.ncjrs.gov/pdffiles1/nij/grants/229023.pdf">NIJ</a>) funded a randomised-controlled trial evaluation comparing 330 high-risk drug offenders on HOPE with 163 similar offenders on standard probation. Compared with the control group, HOPE offenders were:</p>
<ul>
<li><p>55% less likely to be arrested for a new crime;</p></li>
<li><p>53% less likely to have their probation revoked;</p></li>
<li><p>72% less likely to test positive for illegal drugs; and</p></li>
<li><p>61% less likely to miss appointments with their probation officers.</p></li>
</ul>
<p>Offenders on HOPE also spent 48% fewer days in prison. </p>
<p>A <a href="https://www.ncjrs.gov/pdffiles1/nij/grants/229023.pdf">process evaluation</a> found that probation officers, offenders and defence lawyers were enthusiastic about the programme. However, prosecutors and court employees were less pleased, with court staff reporting increased workloads. </p>
<h2>Other SAC programmes</h2>
<p>In 2012, the <a href="http://www.nij.gov/journals/269/pages/hope.aspx">NIJ and Bureau of Justice Assistance (BJA)</a> selected four sites across the US to replicate HOPE. They engaged an independent research agency to conduct process, outcome and cost-assessment evaluations, using <a href="https://en.wikipedia.org/wiki/Randomized_controlled_trial">randomised controlled trials</a>. This research is expected to be finalised this year. The NIJ has also funded research to examine the long-term impact of HOPE. </p>
<p>A programme based on HOPE in Alaska found that participants <a href="http://justice.uaa.alaska.edu/forum/28/2-3summerfall2011/c_pace.html">reduced their drug use</a> (positive tests fell from 25% to 9%). South Dakota’s 24/7 Sobriety Project developed independently of HOPE, with over 17,000 participants between 2005 and 2010. An <a href="http://connection.ebscohost.com/c/articles/84399649/efficacy-frequent-monitoring-swift-certain-modest-sanctions-violations-insights-from-south-dakotas-24-7-sobriety-project">evaluation</a> found that it led to a 12% reduction in repeat arrests for drink driving and a 9% reduction in arrests for domestic violence. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/vmuvD4DAeA8?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Beau Kilmer, co-director of the RAND Drug Policy Research Centre, discusses the 24/7 Sobriety Project.</span></figcaption>
</figure>
<p>Currently, <a href="http://hopehawaii.net/assets/sac-in-oz-%282015%29.pdf">160 SAC programmes are running in 21 states</a> across the US. Since 2012, all offenders in <a href="http://www.corrections.com/news/article/36939-replicating-hope-can-others-do-it-as-well-as-hawaii-">Washington State</a> subject to supervision in the community (about 15,000 people) are monitored under a SAC model. </p>
<p>In the UK, the Conservative government announced its intention to introduce “Fast Sanctions and Testing” (<a href="http://www.telegraph.co.uk/news/general-election-2015/11536622/Petty-criminals-face-two-nights-in-the-cells-under-Conservative-justice-plans.html">FAST</a>) as part of its election policy.</p>
<p>In Australia, former Victorian Labor attorney-general Rob Hulls recently called for <a href="http://www.rmit.edu.au/news/all-news/media-releases/2015/march/family-violence-report-aims-to-interrupt-cycle/">“flash incarceration”</a> of domestic violence perpetrators who breach their orders.</p>
<p>According to Judge Alm: </p>
<blockquote>
<p>HOPE is one of those rare criminal justice strategies which has few natural enemies. Prosecutors and conservatives tend to like its accountability and potential to save money. Defence counsel and liberals tend to appreciate how HOPE helps defendants to succeed on probation and avoid going to prison.</p>
</blockquote>
<h2>Criticisms of HOPE</h2>
<p>In spite of their promise, programmes of this nature raise a number of concerns. </p>
<p>One <a href="http://link.springer.com/article/10.1007%2Fs11292-012-9168-6#page-1">evaluation</a> suggests that the benefits last only as long as the testing and sanctions. Therefore, such programmes may not lead to lasting behavioural change. </p>
<p>Professor Michael Tonry has described these programmes as <a href="http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2329849">“pernicious”</a>, saying that they:</p>
<blockquote>
<p>… do little except offer legal threats of what will happen if conditions are violated rather than attempt to address the circumstances in the offender’s life that brought him or her into court. </p>
</blockquote>
<p>However, Judge Alm has clarified that HOPE has included treatment and evidence-based principles from its inception, as these are standard components of probation in Hawaii:</p>
<blockquote>
<p>HOPE helped to create the environment … where the [probation officers] could more effectively work with the offenders on their other risk factors. </p>
</blockquote>
<h2>Would HOPE work in Australia?</h2>
<p>There are questions about the extent to which a programme developed overseas <a href="http://hopehawaii.net/assets/sac-in-oz-%282015%29.pdf">could be adopted</a> successfully here. The American and Australian criminal justice systems have significant differences. In particular, the model eschews judicial discretion and the <a href="http://www.hcourt.gov.au/assets/publications/judgment-summaries/2005/hca25-2005-05-18.pdf">instinctive synthesis</a> that underpins our sentencing framework. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/84803/original/image-20150612-11421-105nj7j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/84803/original/image-20150612-11421-105nj7j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/84803/original/image-20150612-11421-105nj7j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=925&fit=crop&dpr=1 600w, https://images.theconversation.com/files/84803/original/image-20150612-11421-105nj7j.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=925&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/84803/original/image-20150612-11421-105nj7j.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=925&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/84803/original/image-20150612-11421-105nj7j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1163&fit=crop&dpr=1 754w, https://images.theconversation.com/files/84803/original/image-20150612-11421-105nj7j.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1163&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/84803/original/image-20150612-11421-105nj7j.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1163&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">In Arresting Incarceration, Don Weatherburn sees the HOPE model as one possible way of reducing sky-high rates of Indigenous imprisonment.</span>
<span class="attribution"><a class="source" href="http://aiatsis.gov.au/publications/products/arresting-incarceration-pathways-out-indigenous-imprisonment">AIATSIS</a></span>
</figcaption>
</figure>
<p>One Australian <a href="http://www.westlaw.com.au/maf/wlau/app/document?docguid=I74e1eb5b557e11e38fa3f057ed117a82&isTocNav=true&tocDs=AUNZ_AU_JOURNALS_TOC&startChunk=1&endChunk=1">sentencing expert</a> has also identified the issue of availability of prison beds and the due process implications of subjecting an offender to incarceration without a court order. In spite of this, she concluded that “trialling a 24/7 type of programme … is also worth serious consideration”. </p>
<p>The implications for Indigenous offenders would need to be considered carefully to ensure this model would not further exacerbate their <a href="http://www.abc.net.au/news/2014-12-04/number-of-indigenous-australians-in-prison-a-catastrophe/5945504">over-representation in our prisons</a>. However, Don Weatherburn has expressed cautious support for HOPE in his book on <a href="http://aiatsis.gov.au/publications/products/arresting-incarceration-pathways-out-indigenous-imprisonment">pathways out of Indigenous imprisonment</a>.</p>
<p>A former White House Drug Chief to presidents Nixon and Ford, Robert DuPont, has gone so far as to describe HOPE as <a href="http://hopehawaii.net/assets/sac-in-oz-%282015%29.pdf">“revolutionary”</a>, as it:</p>
<blockquote>
<p>… provides a new paradigm for successfully managing offenders and is fully scaleable to the entire criminal justice system. </p>
</blockquote>
<p>If a HOPE-style project were to be developed in Australia, a balance would need to be struck between adherence to the core tenets of the model and ensuring the programme is appropriate for the Australian justice system and informed by consultation with relevant stakeholders. </p>
<p>In addition, funding would need to be allocated to ensure all aspects of the programme run effectively (for example, additional resources for court staff). It is also critical that any pilot programme be independently evaluated to ensure it is meeting its objectives.</p>
<p>The Australian prison population has grown to <a href="http://www.abs.gov.au/AUSSTATS/abs@.nsf/allprimarymainfeatures/9B3F80C43A73AF6CCA2568B7001B4595?opendocument">unprecedented numbers</a>. Research indicates that <a href="http://www.aic.gov.au/publications/current%20series/mr/1-20/09.html">two-thirds of police detainees</a> test positive to at least one drug, not including alcohol. Furthermore, <a href="http://www.aic.gov.au/publications/current%20series/tandi/421-440/tandi439.html">nearly half of all police detainees</a> attribute their offending to drugs and/or alcohol.</p>
<p>Meaningful crime prevention requires an ongoing focus on such issues as drug and mental health treatment, housing, education and employment. SAC programmes are clearly not a panacea, but it may be time for Australia to see if they can be part of the solution.</p>
<hr>
<p><em>You can read other articles in the Beyond Prison series <a href="https://theconversation.com/au/topics/beyond-prison">here</a>.</em></p><img src="https://counter.theconversation.com/content/40158/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lorana Bartels receives funding from the Australian Research Council. She has previously received research funding from the ACT Government to undertake research on swift and certain sanction programs.</span></em></p>The success of probation programmes based on swift and certain sanctions has led to more than 160 such schemes operating in the US. Australia should consider whether the model might work here too.Lorana Bartels, Associate Professor, School of Law and Justice, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/423522015-06-03T04:34:31Z2015-06-03T04:34:31ZTesting at work and nightclubs unlikely to reduce ice demand<p>The chairman of the Northern Territory’s parliamentary inquiry into crystal methamphetamine, Nathan Barrett MP, has <a href="http://www.abc.net.au/am/content/2015/s4242315.htm">advocated</a> for random drug testing of private and public sector workers as well as nightclub goers. Mr Barrett also noted a preference for civil penalties, such as fines, over criminal charges for users who test positive.</p>
<p>When asked by The Conversation to clarify what exactly he was calling for, Mr Barrett said by email:</p>
<blockquote>
<p>I would like to see hair follicle tests become the industry standard. It is able to provide clarity for a longer period of time on use of illicit substances… To be clear, I have doubt that punitive measures will ever effect addicts behaviour… If we can disrupt the market at the functional and recreational end, we can affect price and access at the dependent end of the spectrum. </p>
</blockquote>
<p>Mr Barrett added that he would like to see more discussion of mandating fines for marijuana use, but would not support the decriminalisation of ice.</p>
<p>In fact, it is unlikely that drug testing in workplaces and at nightclubs will have any discernible impact on rates of use.</p>
<p>However, decriminalisation of drug use is at least associated with the reduction of legal-related harms and possibly rates of use in the community.</p>
<h2>How does drug testing work?</h2>
<p>Roadside drug testing is the most common form of illicit drug testing but employees in high-risk workplaces, such as mining, transport and construction, also sometimes face random drug tests at work.</p>
<p>Roadside drug testing operates in a similar way to random breath testing for alcohol, but uses a <a href="http://www.druginfo.adf.org.au/fact-sheets/the-facts-about-roadside-drug-testing-web-fact-sheet">mouth swab</a> that collects saliva for analysis. Other common methods for random testing include hair analysis, blood tests and urine testing. Unlike random breath testing, samples from saliva, hair blood and urine generally need to be analysed by a laboratory.</p>
<p>One of the problems with drug testing as an indicator of use is the detection time. Methamphetamine, for example, can be detected in saliva and blood for up to 12 hours, in urine for up to five days after use and in the hair up to 90 days after use. </p>
<p>This means that users may return a positive test, depending on the type of test used, even when they have no drugs in their system or have not used for some time.</p>
<h2>Does random testing work?</h2>
<p>There has been virtually <a href="https://digital.library.adelaide.edu.au/dspace/handle/2440/82829">no examination</a> of the effect of roadside drug testing on crash outcomes, so it is difficult to say whether it has any long-term benefits.</p>
<p>Given its intrusive nature, our society generally considers workplace testing acceptable only in safety sensitive industries and positions as a harm-minimisation measure.</p>
<p>However, there is little <a href="http://www.ncbi.nlm.nih.gov/pubmed/24922614">evidence</a> that alcohol and drug testing in the workplace impacts on use, improves safety or reduces accident risk.</p>
<p>Drug treatment is an effective demand reduction strategy and is also cost effective <a href="http://www.globalcommissionondrugs.org/wp-content/themes/gcdp_v1/pdf/Global_Com_Alex_Wodak.pdf">compared</a> to supply reduction strategies such as “tough on drugs” style law enforcement.</p>
<p>There is little research into the effects of random (or otherwise) police drug testing or other similar activities, such as use of detection sniffer dogs, in nightclubs and party venues. </p>
<p>Anecdotal reports suggest that these activities may increase harms among party goers; for example, users may “preload” large amounts of a drug prior to entering a venue in anticipation of restricted ability to use during the night due to policing activity. Or they may ingest large amounts to divest themselves of possession of a drug when police appear at a venue. There is little research showing these activities are effective in reducing use. </p>
<h2>Are fines more effective than criminal charges for users who test positive?</h2>
<p>In Australia, we <a href="http://fbe.unimelb.edu.au/__data/assets/pdf_file/0007/784276/1130.pdf">know</a> there has been no discernible increase in marijuana use as a result of decriminalisation of cannabis.</p>
<p>In 2001, Portugal approved a new legal framework in which all drugs were decriminalised. Most drugs were still illegal but possession for personal use and drug use itself are considered administrative violations subject to a fine rather than criminal charges. Drug trafficking is still prosecuted as a criminal offence. </p>
<p>The evaluation of the new policy over a ten-year period <a href="http://www.cato.org/publications/white-paper/drug-decriminalization-portugal-lessons-creating-fair-successful-drug-policies">shows</a> that decriminalisation has had no adverse effect on drug use rates, and in many categories Portugal’s rates are among the lowest in the EU. Indeed EU states with strict criminal sanctions for use and possession are <a href="http://www.cato.org/publications/white-paper/drug-decriminalization-portugal-lessons-creating-fair-successful-drug-policies">more likely</a> to have high rates of use of illicit drugs.</p>
<p>Criminal sanctions appear to do little to deter drug use and in fact there is some evidence to suggest that decriminalisation may be associated with reduced drug use in the community.</p>
<p>Drug testing is an intrusive, time consuming and expensive exercise and there is little evidence that it reduces drug use over the long term, especially taking into account the very low prevalence of recent methamphetamine use in the community (currently <a href="http://www.aihw.gov.au/alcohol-and-other-drugs/ndshs/">estimated</a> to be around 2% of the general population over 14 years).</p>
<p>Other strategies, such as treatment, appear to be more effective in reducing the demand for drugs in the community, and may be more cost effective.</p><img src="https://counter.theconversation.com/content/42352/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicole Lee receives research grants from the Federal Government related to methamphetamine treatment research.
</span></em></p>It is unlikely that drug testing in workplaces and at nightclubs will have any discernible impact of rates of use.Nicole Lee, Associate Professor at the National Centre for Education and Training on Addiction, Flinders UniversityLicensed as Creative Commons – attribution, no derivatives.