Drug Testing - What drugs will tests detect?

Drug testing can be done for a variety of different drugs. It appears that high school drug testing programs most commonly screen athletes for amphetamines, marijuana (cannainoid or THC), cocaine, opiates, and phencyclidine (PCP). Many certified laboratories offer standard screening packages which include these drugs for a reasonable cost. (See How much does drug testing cost and how accurate is it? for more info.). These standard packages leave out several commonly used substances such as alcohol (ethanol) and tobacco (nicotine) which are the most frequently used drugs by young people, and exact the greatest toll in health and social consequences. Anabolic steroids are also not part of typical standard screening packages and require additional testing and associated costs. Steroid use is usually done to boost performance and, secondly, to improve appearance. In addition to health concerns, both physical and psychological, and concerns of violating state and federal law, steroid use also raises ethical concerns about fair play. Testosterone, which is a naturally occurring steroid in both males and females, is also used to build strength and mass to improve performance. A ratio of testosterone to epitestosterone (another naturally occurring steroid) is measured to determine is more than the natural amount of testosterone is present. This ratio (usually 6:1) is usually set high in order to reduce false accusations. Thus, an athlete could take synthetic testosterone to improve their performance, yet remain under this ratio for a positive test. Furthermore, there are some drugs for which there are no tests currently available like human growth hormone(hGH), a related anabolic hormone called insulin-like growth factor (IGF-1), and erythropoietin (EPO).

The purpose for testing may also determine which drugs are to be tested. If tests are done primarily to keep athletes from getting an unfair advantage over competitors, then the drugs tested should be those that have evidence of enhancing performance. In the 1998 Olympics Games, an athlete who won a medal tested positive for marijuana and the medal was in jeopardy. The finding was contested. The athlete claimed no marijuana use and the only reason for the positive test was second hand smoke from marijuana use by others. After reviewing the case, the medal was awarded to the contestant. One of the primary reasons for the ruling was that marijuana was not previously identified as a drug that could improve performance in that particular event. This points out the importance of matching the drugs to be screened with purpose for testing. Of course, there could be several reasons for drug testing which could broaden the spectrum of drugs that are tested. The drugs tested should match the reasons for testing, which should be clearly spelled out in the purpose for the drug testing program.

For more information about testing performance enhancing drugs, two resources are "The Steroids Game," authored by Dr. Charles E. Yesalis and Virginia S. Cowart and "Anabolic Steroids in Sport and Exercise," edited by Dr. Charles E. Yesalis. Both are available from Human Kinetics. For further information about drugs detected by urine tests and screening packages see the Interscholastic Athletic Administration (Volume 24, No. 1, Fall, 1997) article by Joseph C. Franz, M.D., entitled: Legal Issues: Options should be explored before starting student drug-testing program.