Few things about the marijuana issue inflame me more than workplace and student drug testing.  I’m still trying to imagine how, if you had a time machine, we could visit Thomas Jefferson and the other hemp farmers discussing our Bill of Rights and explain to them in America of the future, employers routinely seize citizens’ urine to determine their fitness for employment and discriminate against them if hemp shows up in their system.  I think Ben Franklin would actually LOL.

Of course we all know that cannabis metabolites show nothing about one’s current impairment and will remain in one’s system for weeks or months following cessation of use.  We’ve talked about the perverse incentive this creates to use alcohol and other toxic addictive drugs that clear from one’s system in two to three days.  And now, this information from the American Psychiatric Association leads me to better understand why we’re seeing such an uptick in prescription drug abuse.

Medical News: APA: Drug Test Results Often Flawed – in Meeting Coverage, APA from MedPage Today.

NEW ORLEANS — That poppy seeds can lead to false-positive results on tests for opioid abuse is not just an urban legend, researchers said [at the American Psychiatric Association's annual meeting last May].

Another example is that most standard drug tests don’t screen for the opioid drug oxycodone, as well as a handful of other opioids including methadone and fentanyl, noted Smith, who conducted the research while he was at Boston Medical Center.

Opioid tests screen for morphine and codeine, which are two of the most common metabolites of many — but not all — opioids. They’re not metabolites of oxycodone, methadone, fentanyl, tramadol (Ultram), and buprenorphine (Subutex, Suboxone), Smith said.

Similarly, only certain metabolites of benzodiazepines are detected on most assays. That means diazepam, nordiazepam, and oxazepam (Serax) will be detected, but alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin) aren’t frequently screened.

In their review, the researchers found that drug tests generally have a sensitivity of 90% to 95%, and a specificity of 85% to 90%. These numbers are a “pretty good basis” for making clinical decisions, Smith said, but that means “one in 20 [tested patients] are going to have inaccurate results, and those are more likely to be false positive than false negative.”

Many substances aside from poppy seeds cause these false-positives. Cold medications can give a positive read on amphetamines, as can bupropion (Wellbutrin) and tricyclic antidepressants.

Sertraline (Zoloft) and oxaprozin (Daypro) can alert physicians to a benzodiazepine problem when there is none.

The HIV medication efavirenz (Sustiva) can come up as a positive for marijuana use, and dextromethorphan, rifampin, and quinolones could show as an opioid problem.

There is a Jackson’s Food Store – a gas station / convenience store chain out West – that is two blocks from my home.  I walk my dog there every day as I pick up my fountain Diet Coke refill for lunch.  I’ve gotten to speak with most of the employees about marijuana – my pot leaf hat leads to lots of these conversations.  One of the kids pumping gas there is a sweet young man who is a migraine sufferer whom I’ve told would be a shoo-in for a medical marijuana card.

Then one day recently I notice that there are a whole bunch of new workers.  I find out that the store had come up $1,800 short in an audit, so in response, Jackson’s was drug testing all their employees.  Three employees admitted to occasional marijuana use and now they are unemployed.  There is no evidence that any of them were filching cash from register and since the firings the shortages from the till haven’t ceased.  But Jackson’s feels better, I guess, for having some scapegoats to blame.

Ironically, the one young man who could really use medical marijuana still has his job.  ”I only toke a tiny bit and only if the pain is just unbearable,” he told me, “because I just can’t lose this job – I have to take care of my wife and kid.  Luckily I hadn’t had a bad migraine for a few weeks, so I was able to pass the test.”  Even if he had a medical marijuana card, his job wouldn’t be protected.  My wife, a migraine patient herself, volunteered that her regular use of cannabis has turned what used to be weekly migraines to seasonal migraines – maybe four a year – and when they do come, they are moderate and not “drill a hole in my head” painful like before.

Now some would say, “Well, they knew the rules on drug testing; they don’t have to work there.”  Keep in mind that Portland, Oregon is suffering some >10% unemployment.  And then try to imagine your life if finding aspirin or ibuprofen or acetaminophen or naproxen in your system meant the end of your job and you have a splitting headache.

WASHINGTON (CNN) — A former middle-school student who was strip-searched by school officials looking for ibuprofen pain medication won a partial victory of her Supreme Court appeal Thursday in a case testing the discretion of officials to ensure classroom safety.

Redding was an eighth-grade honor student in 2003, with no history of disciplinary problems at Safford Middle School, about 127 miles from Tucson, Arizona.

During an investigation into pills found at the school, a student told the vice principal that Redding had given her prescription-strength 400-milligram ibuprofen pills.

The school had a near-zero-tolerance policy for all prescription and over-the-counter medication, including the ibuprofen, without prior written permission.

Redding was pulled from class by Vice Principal Kerry Wilson, escorted to an office and confronted with the evidence. The girl denied the accusations.

A search of Redding’s backpack found nothing. A strip search was conducted by Wilson’s assistant and a school nurse, both females.

Redding was ordered to strip to her underwear and to pull on the elastic of the underwear, so any hidden pills might fall out, according to court records. No drugs were found.

“The strip search was the most humiliating experience I have ever had,” Redding said in an affidavit. “I held my head down so that they could not see that I was about to cry.”

The decision was 8-1.  Justice Clarence Thomas thought the Constitution doesn’t really cover the “preservation of order, discipline and safety in public schools”, so if you want to strip-search 13-year-old girls at school, the Founding Fathers would have been cool with that.  Justices Ruth Bader Ginsburg and John Paul Stevens thought the girl should be able to sue the school administrators who humiliated her, but the rest of the court decided that up til now it hasn’t been very clear how much protection the Constitution gives 13-year-old schoolgirls from strip searches, so the administrators couldn’t be reasonably expected to know they couldn’t just do that (if I’m reading SCOTUSblog’s analysis correctly).

So, from now on, there will be more protection for 13-year-old girls in school to not be expected to strip to their panties for school officials – not police, a freakin’ vice principal’s assistant and a school nurse! - when a teenage snitch lies about them holding drugs.  But all you 13-year-old girls who were strip-searched, you have no recourse.

I don’t suppose anybody ever considered just calling the girls’ parents.  ”Hello, Mrs. Redding? We have a tip your daughter may be holding prescription ibuprofen in violation of our zero-tolerance policy.  Can you come down to the school, please?”  No, wait, excuse me, I forgot, we’re talking about drugs; there’s no room for common sense here!  What am I thinking?  I just expected someone who takes seriously the phrase “zero tolerance” to show common sense.

A divided US appeals court has ruled an Arizona school violated the constitutional rights of a 13-year-old student by conducting a strip search for ibuprofen.

Suspecting that a student had violated a policy against prescription or over-the-counter drugs without permission, public school officials in Safford, Arizona, ordered a search of Savana Redding.

A school nurse had her remove her clothes, including her bra, and shake her underwear to see if Ms Redding was hiding anything.

The 2003 search, prompted by a tip from another girl, did not find ibuprofen, which is found in common medications like Advil and Motrin to treat pain like cramps and headaches.

Higher doses require a prescription.

Previous court decisions ruled the school did not violate the US Constitution’s Fourth Amendment rights against unreasonable searches and seizures because officials have a legitimate interest in protecting students from prescription drugs.

The 6-5 ruling by a panel of the 9th US Circuit Court of Appeals on Friday overturned an earlier decision, setting out its reasoning in an extensive 75-page ruling with many details on the complications of eighth grade life.

“Directing a 13-year-old girl to remove her clothes, partially revealing her breasts and pelvic area, for allegedly possessing ibuprofen, an infraction that poses an imminent danger to no one, and which could be handled by keeping her in the principal’s office until a parent arrived or simply sending her home, was excessively intrusive,” Justice Kim McLane Wardlaw wrote for the majority.

The majority found flaws in the school’s logic that a tip from another student justified the action.

“The self-serving statement of a cornered teenager facing significant punishment does not meet the heavy burden necessary to justify a search accurately described by the 7th Circuit as ‘demeaning, dehumanizing, undignified, humiliating, terrifying, unpleasant [and] embarrassing’.

“And all this to find prescription-strength ibuprofen pills.

“No legal decision cited to us, or that we could find, permitted a strip search to discover substances regularly available over-the-counter at any convenience store throughout the United States.”

A 6-5 decision!  This poor 13-year-old girl was one judge away from having to fight all the way to the Supreme Court!  When people confront me about my drug war activism, they often ask if I hadn’t thought of “better” causes (climate change, voting machines, poverty, AIDS, whatever) to put my efforts into.  Then I show them cases like this, where the demonization of drugs has led to such alarmist conditioning among school faculty and frightened parents that people actually think it is reasonable to strip-search an adolescent girl on the mere accusation from another student, all over a legal drug!