Transcript No Slide Title

Module 5 Overview
Context
Content Area: Policy Decisions about Drug Use/Abuse Issues
Essential Question (Generic): What should be done when
preventable causes of disease are found?
Essential Question (Drug Abuse Specific): What should be done
when preventable causes of drug abuse are found?
Enduring Epidemiological Understanding: Policy decisions are based on more than the
scientific evidence. Because of competing values - social, economic, ethical,
environmental, cultural, and political factors may also be considered.
Synopsis:
In Module 5, students explore specific drug policy questions and become aware of the
factors that influence their own and others' positions on those questions.
Lessons:
Lesson 5-1: Individual and Societal Decision Making
Lesson 5-2: Drug Policy Question - Should needle exchange programs be implemented?
Lesson 5-3: Drug Policy Question - Should high school students be drug tested?
Lesson 5-4: Drug Policy Question - Should D.A.R.E. be taught in all schools?
Lesson 5-5: Drug Policy Question - Should marijuana be legal for medical purposes?
DrugEpi 5-3 Policy Question: Drug Testing
Module 5 - Policy Decisions about Drug Use/Abuse
Lesson 5-3 Drug Policy Question Assignment Should high school students be drug tested?
Content
• Explanation of how scientific literacy is
connected to individual and societal decision-making
• Definitions and discussion about policy, risk perception and the acceptability
or unacceptability of risk
• Application of Drug Policy question Assignment to question, Should high
school students be drug tested?
Big Ideas
• In a democratic society, a scientifically literate population is better able to
make informed decisions about issues of public health
• Societal decisions about acceptability versus unacceptability of risk often
consider other factors besides the actual magnitude of that risk
• The issue of whether or not high school students should be drug tested is
controversial with powerful arguments on both sides
This project is supported by a Science Education Drug Abuse Partnership Award, Grant Number 1R24DA016357-01,
from the National Institute on Drug Abuse, National Institutes of Health.
DrugEpi 5-3 Policy Question: Drug Testing
Where are we?
Essential Questions
Enduring Understandings
1.
How is this disease
distributed?
Health-related conditions and behaviors are not distributed uniformly
in a population. They have unique distributions that can be described
by how they are distributed in terms of person, place, and time.
2.
What hypotheses might
explain the distribution
of disease?
Clues for formulating hypotheses can be found by observing the way
a health-related condition or behavior is distributed in a population.
3.
Is there an association
between the
hypothesized cause and
the disease?
Causal hypotheses can be tested by observing exposures and
diseases of people as they go about their daily lives. Information
from these observational studies can be used to make and compare
rates and identify associations.
4.
Is the association
causal?
Causation is only one explanation for an association between an
exposure and a disease. Because observational studies are
complicated by factors not controlled by the observer, other
explanations also must be considered.
5.
What should be done
when preventable
causes of disease are
found?
Policy decisions are based on more than the scientific evidence.
Because of competing values - social, economic, ethical,
environmental, cultural, and political factors may also be considered.
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Drug Policy Question
Should high school students be drug tested?
A. Orientation to the Enduring Understanding Slides
B. Drug Policy Question “Hip Pocket” Slides
C. Drug Policy Question Summary Slides
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Drug Policy Question
Should high school students be drug tested?
A. Orientation to the Enduring Understanding Slides
B. Drug Policy Question “Hip Pocket” Slides
C. Drug Policy Question Summary Slides
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Enduring Understanding
Policy decisions
are based on more than the scientific evidence.
Because of competing values;
social, economic, ethical, environmental, cultural,
and political factors may also be considered.
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Scientific Literacy
A scientifically literate person is someone who:
… can ask, find, or determine answers to questions derived from
curiosity about everyday experiences
… has the ability to describe, explain, and predict natural phenomenon
… is able to read with understanding articles about science in the
popular press and to engage in social conversation about the validity of
their conclusions
… can identify scientific issues underlying national and local decisions
and express positions that are scientifically and technologically
informed
… (is) able to evaluate the quality of scientific information on the basis
of its source and the methods used to generate it
… (has) the capacity to pose and evaluate arguments based on
evidence and to apply conclusions from such arguments appropriately
National Research Council. (1996) National Science Education Standards, Washington, DC: National Academy Press.
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Policy
A course or principle of action
adopted or proposed by
a government, party, business, or individual
John M. Last, A Dictionary of Public Health
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Policy
A course or principle of action
adopted or proposed by
a government, party, business, or individual
John M. Last, A Dictionary of Public Health
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Drug Policy
A course or principle of action
adopted or proposed by
a government, party, business, or individual
that affects drug use
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Pre-Drug Policy Question Assignment Survey Summary
Should high school students be drug tested?
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Drug Policy Question
Should high school students be drug tested?
A. Orientation to the Enduring Understanding Slides
B. Drug Policy Question “Hip Pocket” Slides
C. Drug Policy Question Summary Slides
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Fourth Amendment
The right of the people to be secure in their persons,
houses, papers, and effects, against unreasonable
searches and seizures, shall not be violated, and no
warrants shall issue, but upon probable cause,
supported by oath or affirmation, and particularly
describing the place to be searched, and the persons
or things to be seized.
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Fourth Amendment
Privacy
HP
DrugEpi 5-3 Policy Question: Drug Testing
Legitimate
government
interest
Should high school students be drug tested?
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
I also authorize the Vernonia School District to have a
representative run a urine test for drugs / alcohol and
to release the information regarding the results to the
Vernonia School District as deemed necessary.
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Dear Mr. and Mrs. Acton:
District Policy JFCI requires the parent and / or
guardian and the student athlete to sign a written
consent for drug testing prior to participating in the
athletic program. Since you are not willing to sign the
required consent, your son James will not be permitted
to participate in the District’s athletic program.
However, should you change your mind and permit
James to be tested, he will be allowed to participate.
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Vernonia School District v. Wayne Acton
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Vernonia School District v. Wayne Acton
Fourth Amendment
The right of the people to be secure in their persons, houses,
papers, and effects, against unreasonable searches and
seizures, shall not be violated, and no warrants shall issue,
but upon probable cause, supported by oath or affirmation,
and particularly describing the place to be searched, and the
HPpersons or things to be seized.
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Vernonia School District v. Wayne Acton
Fourth Amendment
The right of the people to be secure in their persons, houses,
papers, and effects, against unreasonable searches and
seizures, shall not be violated, and no warrants shall issue,
but upon probable cause, supported by oath or affirmation,
and particularly describing the place to be searched, and the
HPpersons or things to be seized.
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Vernonia School District v. Wayne Acton
Fourth Amendment
The right of the people to be secure in their persons, houses,
papers, and effects, against unreasonable searches and
seizures, shall not be violated, and no warrants shall issue,
but upon probable cause, supported by oath or affirmation,
and particularly describing the place to be searched, and the
HPpersons or things to be seized.
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Vernonia School District v. Wayne Acton
Blanket searches, because they involve thousands or
millions of searches, pose a greater threat to liberty
than do suspicion based ones, which affect one person
at a time. …I dissent.”
Justice Sandra Day O’Connor
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Earls v. Tecumseh School District

Lindsay Earls filed suit
after her high school forced her
to take a drug test before it
would let her join the choir.
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Earls v. Tecumseh School District
“(W)e find that testing students
who participate in extracurricular activities
is a reasonably effective means of addressing
the School District’s legitimate concerns in
preventing, deterring, and detecting drug use.”
Justice Clarence Thomas, June 27, 2002
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
“Schools should not implement a drug testing
program until they’re proven to work. ….
They are too expensive. It’s like having experimental
surgery that’s never been shown to work.”
Linn Goldberg, Oregon Health and Science University
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
“… the efficacy of this means for addressing the
problem (is) self-evident.”
Justice Antonin Scalia, 1995
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Healthy
People
Random
Assignment
Time
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Drug
Testing
Program
Non-Drug
Using
Healthy
Students
People
Random
Assignment
Drug
Testing
Program
Time
HP
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Drug
Use
Drug
Testing
Program
Drug
Use
Non-Drug
Using
Healthy
Students
People
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Assignment
Drug
Testing
Program
Drug
Use
Drug
Use
Time
HP
DrugEpi 5-3 Policy Question: Drug Testing
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Healthy
People
Time
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Drug
Use
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Use
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People
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Testing
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Use
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Use
Time
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Time
HP
DrugEpi 5-3 Policy Question: Drug Testing
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Drug
Testing
Program
Drug
Use
Drug
Testing
Program
Drug
Testing
Program
Drug
Use
Drug
Testing
Program
Time
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Time
HP
DrugEpi 5-3 Policy Question: Drug Testing
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Drug
Testing
Program
Drug
Testing
Program
Drug
Use
Drug
Use
Time
HP
DrugEpi 5-3 Policy Question: Drug Testing
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HP
DrugEpi 5-3 Policy Question: Drug Testing
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or
%
or
%
a b
c d
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No
Drug
Use
Drug
Use
Drug
Testing
Total
Risks
of Drug
Use
or
Relative
Risk
%
a b
No
Drug
Testing
1
c d
HP
DrugEpi 5-3 Policy Question: Drug Testing
or
%
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Case-Control Study
Controlled Trial
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CONCLUSION
This study explored the association between student drug use and drugtesting policies in schools. While lack of evidence for the effectiveness of
drug testing is not definitive, results suggest that drug testing in schools
may not provide a panacea for reducing student drug use that some
(including some on the Supreme Court) had hoped. Research has
shown that the strongest predictor of student drug use is students'
attitudes toward drug use and perceptions of peer use. To prevent
harmful student behaviors such as drug use, school policies that address
these key values, attitudes, and perceptions may prove more important in
drug prevention than drug testing.
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
While this study offers some valuable new findings on an important policy
matter, the study has limitations. First, because of the cross-sectional
design of the study, one cannot make definitive causal interpretations
regarding effects of drug testing; only a panel design in a randomized or
natural experiment can do so. Perhaps schools that instituted drug
testing initially had higher use, and drug testing reduced those levels to
levels similar to those at other schools. The net result would indicate no
association, as observed in this study, despite some effect from drug
testing. This scenario is unlikely, but cannot be ruled out with a crosssectional design. Second, all data on drug testing were obtained from a
single source - a school administrator. It would be helpful to have data on
student awareness of, or views about, drug testing.
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
While this study offers some valuable new findings on an important policy
matter, the study has limitations. First, because of the cross-sectional
design of the study, one cannot make definitive causal interpretations
regarding effects of drug testing; only a panel design in a randomized or
natural experiment can do so. Perhaps schools that instituted drug
testing initially had higher use, and drug testing reduced those levels to
levels similar to those at other schools. The net result would indicate no
association, as observed in this study, despite some effect from drug
testing. This scenario is unlikely, but cannot be ruled out with a crosssectional design. Second
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
While this study offers some valuable new findings on an important policy
matter, the study has limitations. First, because of the cross-sectional
design of the study, one cannot make definitive causal interpretations
regarding effects of drug testing; only a panel design in a randomized or
natural experiment can do so. Perhaps schools that instituted drug
testing initially had higher use, and drug testing reduced those levels to
levels similar to those at other schools. The net result would indicate no
association, as observed in this study, despite some effect from drug
testing. This scenario is unlikely, but cannot be ruled out with a crosssectional design. Second, all data on drug testing were obtained from a
single source - a school administrator. It would be helpful to have data on
student awareness of, or views about, drug testing.
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Drug testing was not associated with
students’ reported illicit drug use, ….
“… the efficacy of this means for addressing the
problem (is) self-evident.”
Justice Antonin Scalia
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Robert L. DuPont, M.D.
President of the Institute for Behavior and Health
First Director of the National Institute on Drug Abuse
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
“These schools were dichotomized based on each school
principal’s answer to this question: ‘In the school year, did your
school test any students for illicit drug use?’”
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
“Not only is it not surprising that no difference in drug use rates
was found between these two heterogeneous groups, but it is
almost inconceivable that there would be any difference based
on this question since there is no assessment of how many
drug tests were done at each school or whether there was any
sort of student drug testing program underway at each school
or not. A school that did a single drug test in a year would be
included in the “yes” along with a school that had a
comprehensive drug prevention program that included
carefully-structured student drug testing.”
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
“This study is the equivalent of taking a sample of all of the
patients in the country over a year, who took one dose of a blood
pressure medicine compared to patients who took no medicine
and, finding no difference in the blood pressures in the two
groups, concluding that antihypertensive treatments do not
work.”
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Case-Control Study
Controlled Trial
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“The best study design that could establish whether student drug
testing produced a deterrent effect would be ….”
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Time
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“The best study design that could establish whether student drug
testing produced a deterrent effect would be a randomized
experimental design or ….”
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Drug
Use
Drug
Testing
Program
Drug
Use
Non-Drug
Using
Healthy
Students
People
Random
Assignment
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Testing
Program
Drug
Use
Drug
Use
Time
HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
Case-Control Study
Controlled Trial
“The best study design that could establish whether student
drug testing produced a deterrent effect would be a
randomized experimental design or ….”
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Healthy
People
People
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Should high school students be drug tested?
Case-Control Study
Controlled Trial
“The best study design that could establish whether student
drug testing produced a deterrent effect would be a
randomized experimental design or an examination of
longitudinal results from a “natural experiment” (such as
studying the same school over time, before and after
student drug testing).”
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Drug
Use
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Testing
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Use
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Using
Healthy
Students
People
X
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Testing
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Use
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Use
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HP
DrugEpi 5-3 Policy Question: Drug Testing
Should high school students be drug tested?
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Case-Control Study
Controlled Trial
“The best study design that could establish whether student
drug testing produced a deterrent effect would be a
randomized experimental design or an examination of
longitudinal results from a “natural experiment” (such as
studying the same school over time, before and after
student drug testing). This study did neither. Instead, it was
a simple “cross–sectional”
design that merely
compared
Cohort Study
Cross-Sectional Study
schools to each other in two meaningless categories –
those whose principals said “yes” and those whose said
“no” to that single, simplistic question.”
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“The study in the American School Health Association Journal of
School Health and the article in the New York Times will not
further this important work because they purport to answer the
policy question with data that is completely inadequate to
support the policy positions taken by the experts quoted in the
article and by the means in which the article itself is written.”
HP
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Drug Policy Question
Should high school students be drug tested?
A. Orientation to the Enduring Understanding Slides
B. Drug Policy Question “Hip Pocket” Slides
C. Drug Policy Question Summary Slides
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Should high school students be drug tested?
In Favor of
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Should high school students be drug tested?
In Favor of
DrugEpi 5-3 Policy Question: Drug Testing
Against
Individual and Societal Decision Making
Should high school students be drug tested?
In Favor of
Against
Scientific
Social
Economic
Ethical
Environmental
Cultural
Political
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Should high school students be drug tested?
In Favor of
Against
Policy decisions
are based on more than the scientific evidence.
Because of competing values;
social, economic, ethical, environmental, cultural,
and political factors may also be considered.
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Write a Brief Statement
Forces that Influenced Your Position
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Post-Drug Policy Question Assignment Survey
Should high school students be drug tested?
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Pre-Drug Policy Question Assignment Survey
Should high school students be drug tested?
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Pre-Drug Policy Question Assignment Survey
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Pre- and Post Drug Policy Question Assignment Survey Summaries
Should high school students be drug tested?
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
Citizen - Kings
/ Citizen - Queens
Democracy
“It is both the glory and the burden of democracy
that lay citizens must make the final choice.”
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
All scientific work is incomplete –
whether it be observational or experimental.
All scientific work is liable to be upset
or modified by advancing knowledge.
That does not confer upon us the freedom to ignore the
knowledge we already have, or to postpone the action
that it appears to demand at a given time.
Sir Austin Bradford Hill, “The Environment and Disease: Association or Causation?”
Proceedings of the Royal Society of Medicine January 14, 1965
DrugEpi 5-3 Policy Question: Drug Testing
Individual and Societal Decision Making
DrugEpi 5-3 Policy Question: Drug Testing
Re-Cap
Big Ideas in this Lesson (5-3)
• In a democratic society, a
scientifically literate population
is better able to make informed
decisions about issues of public health
• Societal decisions about acceptability versus
unacceptability of risk often consider other factors besides
the actual magnitude of that risk
• The issue of whether or not high school students should
be drug tested is controversial with powerful arguments
on both sides
DrugEpi 5-3 Policy Question: Drug Testing
Next Lesson
DrugEpi 5-3 Policy Question: Drug Testing