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Letters to the Editor

Pediatricians condemn killing of Kian

/ 05:02 AM September 02, 2017

We at the Philippine Pediatric Society, an advocate of the wellbeing and rights of children, strongly condemn the merciless killing of 17-year-old Kian Loyd delos Santos and of thousands of other suspected drug users and pushers. The death of a child is a singular tragedy but death in such a brutal way leaves families with unrelenting grief. Their lives will never be the same again. And neither should ours. As pediatricians, we work to save lives and we cannot remain silent as the carnage continues. We call upon the authorities to wage the war on drugs with due respect to human rights and to always uphold the sanctity of life.

Adolescents are most vulnerable to drugs, and we recognize the importance of addressing drug use among the young. But the government’s plan to conduct random drug testing has to be studied closely. Proponents argue that this will prevent students from using drugs and that the negative consequences of a positive drug test can deter further use. Let us examine the existing research and recommendations from respected medical bodies.

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Is it effective? In April 2015, the American Academy of Pediatrics, in a policy statement titled “Adolescent Drug Testing Policies in Schools,” supports the efforts of schools to address student substance abuse, but recommends against random drug testing in schools. It claims that there is as yet limited evidence to show the efficacy of such action. Many available psychoactive substances are not detectable by standard drug testing. Adolescents may attempt to outsmart drug testing by switching to a substance that is not detectable by urine testing.

Is drug testing easy to do? Authorities have to consider that a nationwide random drug testing in schools requires complex medical procedures. Sample collection requires directly observed urine collection and a two-step testing procedure: drug detection and confirmation of results. Confirmatory testing is necessary to differentiate between “false-negative” and “false-positive” test results. Interpretation of random drug testing should be done by trained clinicians.

Is it cost effective? Another important issue is the cost-effectiveness of this random drug testing. Confirmatory tests, which are the gold standard for detection of substances, are quite expensive. With the government’s limited financial means, a random school-based drug testing program may drain the resources of the Department of Education and other cooperating agencies.

What is the potential harm? Risks include potential breach of confidentiality between student and school, deterioration of school-student relationship, and mistakes in interpretation of drug tests that result in false positives. Moreover, this approach may be damaging to the adolescent who may be subjected to harsher consequences once identified, not only by the school but also by the community at large. Quick and fast solutions, such as the irrational elimination of suspected drug users, may be resorted to as a plausible solution.

Drug addiction is not just a criminal issue. It is primarily a health and economic issue. Solving the drug problem demands a concerted, long-term, multilevel and multisectoral endeavor. We believe the following steps are part of the solution:

1. Working with families by strengthening family systems and values, improving parent-child communication, providing drug education, rule setting and parental monitoring and supervision.

2. Early detection of risk factors like academic failure, early aggression, and school dropout, to be addressed by schools and communities.

3. In adolescents, drug education, competence in drug resistance skills and reinforcement of antidrug attitudes, and strengthening personal commitments against drug use.

4. Consistent messages delivered through a concerted effort by the community—families, schools, barangay leaders, and faith-based organizations.

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The quick solution offered by the ruthless elimination of drug users can seem more dramatic, but the impact on families and the dissolution of relationships are tantamount to destroying the very core of our society. When this happens, children and adolescents are often left alone to deal with the aftermath. They will turn to temporary and quick solutions, like drug use, to ease the bitterness and misfortune of their situation. Our recommended solutions may be more laborious, but they will have longer lasting and positive effects on children, adolescents, and the community as a whole.

DR. MA. ROSA H. NANCHO and DR. EMMA LLANTO, Philippine Pediatric Society, and Philippine Society of Adolescent Medicine

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