ABSTRACT
When warning signs of cannabis abuse occur in student, it is far better to light a candle, by ordering tests for drugs of abuse in urine, than to curse to darkness. When clinically indicated, drug tests may well foreshorten the clinical diagnosis of cannabis abuse by one year or more. In private pediatric practice, such requensts ususally come from the student's parents or guidance counselor in response to marked deterioration in academic performance, serious problems with conduct at home or school, and episodes of observed intoxication or possession of drugs. While obtaining a routine social and medical history, I have found that positive answers to four questions alert me to a possible drug abuse problem. (1) Do you smoke cigarettes every day? (2) How many times have you been drunk and, if more than once, when was the last time? (3) Did you receive more than one D or F grade on your last report card? (4) Are you into partying? Positive responses to several of the above items, especially when there is a strong family history of alcoholism or parental or sibling drug abuse. A series of positive tests offers eloquent testimony as to loss of control over the drug in question. A series of negative tests offers strong support to innocence and causes other than drug use must be sought for. Immuno-assay screening tests for cannabis are today, acceptably accurate, rapidly performed, and informative. It is necessaary for the clinician to understand the specific terminology of drug tests and to be aware of the pitfalls in interpreting results of such tests.
