Abstract and Introduction

Abstract

Objective. To determine the attitudes of incoming pharmacy students toward a mandatory, random urine drug-screening program.

Methods. This was an anonymous, voluntary survey of students at the McWhorter School of Pharmacy (MSOP) using an instrument composed of 40 items. The instrument was administered during orientation week prior to the session during which the policies and procedures of MSOP's drug-screening program were to be discussed.

Results. The survey instrument was completed by all 129 (100%) students in the class. Two-thirds of the students were aware of MSOP's drug-screening program prior to applying, but only a few felt uneasy about applying to the school because of the program. The greatest concerns expressed by the students included what would happen if a student unintentionally missed a drug screen or was busy with other matters when called for screening, how much time a drug-screening would take, and the possibility of false-positive drug screen results. The vast majority of students agreed with statements regarding the potential benefits of drug testing. Students who consumed alcohol in a typical week and those with current or past use of an illegal substance held less favorable attitudes toward MSOP's mandatory drug-screening program compared with students who did not share those characteristics.

Conclusion. Although there were definite concerns expressed regarding pragmatic issues surrounding drug screening, the first-year pharmacy students held generally favorable opinions about the school's mandatory drug-screening program.

Introduction

Use and abuse of alcohol, prescription drugs, and illicit drugs among American college students are well-known.[1–3] Unfortunately, the extensive knowledge that pharmacy students possess about addicting substances does not confer protection against use of these agents.[4] Published studies concerning the extent of alcohol and drug use among pharmacy students have accumulated over the years,[5–12] revealing some disturbing findings. McAuliffe and colleagues discovered that about two-thirds of pharmacy students had used a controlled substance without a prescription at some point in their lives, while approximately 40% had done so within the past year.[5] Miller and colleagues found current-use rates of marijuana, amphetamines, tranquilizers, and cocaine among pharmacy students to be approximately 14%, 7%, 4%, and 3%, respectively.[6] Kriegler and colleagues revealed pharmacy students' past-year use of nonprescription stimulants, marijuana, sedatives, amphetamines, and opiates to be approximately 19%, 11%, 8%, 6% and 5%, respectively.[7] Kenna and Wood discovered that the percentages of pharmacy students who engaged in monthly use of marijuana, stimulants, cocaine, and ecstasy were approximately 14%, 4%, 1%, and 1%, respectively.[9] Lord and colleagues found that approximately 5% of pharmacy students had misused prescription opioids and another 5% had misused prescription stimulants in the past year.[11] Even more concerning are findings that pharmacy students exhibited troubling behaviors as a consequence of alcohol and drug use, such as going to class or work under the influence, providing patient care while under the influence, missing class or work, and stealing drugs from an employer or practice site.[7,8,10]

In part because of such concerns, many experiential training sites, including community pharmacies, hospitals, and other health-system settings, have started to require drug testing for pharmacy students. The response of colleges and schools of pharmacy to this requirement has been quite varied. We are aware of the following models: no official drug-screening program, with student and experiential site to coordinate testing; nonrandom drug screening for a specific purpose, as in the case of students being assigned to a site that requires such testing; random drug screening that occurs in predetermined years of the curriculum; and random drug screening that occurs throughout all years of the curriculum. Although the latter option is relatively rare among colleges and schools of pharmacy, the McWhorter School of Pharmacy (MSOP) chose to implement an extensive mandatory, random urine drug-screening program throughout the entire 4-year curriculum, beginning in the fall of 2008. Because class sizes are relatively large and introductory and advanced pharmacy practice experiences occur in each year of the curriculum, MSOP conducts an estimated 1,800 experiential courses each year. Further, based on requests from preceptors, practice sites, and students, MSOP conducts approximately 600 schedule changes each year. Thus, conducting routine random drug screening instead of continuously responding to required testing of specific students assigned to specific training sites made practical, administrative sense. The implementation and details of this program have been published elsewhere.[13]

Despite the primary benefit (ie, meeting contractual obligations) and secondary benefits (eg, detecting and aiding students with substance abuse issues and discouraging misuse of stimulants for studying purposes) of a random drug-screening program at MSOP, there were concerns about implementing such a program. How does the implementation of such an extensive program affect applicants' decisions, especially when many competitor schools do not require such testing? Are our students overly concerned about policies and procedures associated with the program? Finally, do our students perceive the drug-screening program as positive and meaningful or invasive and worthless? The objective of this study was to determine the attitudes of incoming MSOP pharmacy students toward the school's mandatory, random urine drug-screening program.