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Firm, clear, and consistent consequences, such as termination from employment or suspension from athletic participation, enhance the preventive effects of drug tests, since outcome expectations and perceived self-efficacy influence people's actions and behaviors. The drug-testing programs of the U.S. military services illustrate the dramatic effects that can be achieved by use of random drug testing based on standardized testing procedures and backed by strict disciplinary consequences. These findings from two decades of experience are ripe for study in prevention research. While drug-testing programs have also reduced illicit drug use in many arenas, including the workplace, the criminal justice system, and athletic competitions, broader and more consistent efforts are needed in prevention research. Based on these results, it appears that model drug-testing programs in prevention research need to be developed to advance the use of reliable and cost-effective drug-testing programs. More study is also needed on the preventive effects of drug testing on adolescents and young adults. Random drug testing has been implemented in several U.S. school districts, including Dade County, Florida, but the practice is uncommon, and outcome data are unavailable. Research is needed on the results of these pioneering programs. Overall, drug testing provides valuable information to researchers on preventing drug use and extends the information provided by self-reported data on drug use. [ABSTRACT FROM AUTHOR]

The article examines the reasons why most research on drug use has not used drug testing more widely. Drug tests provide evident of recent use of specific drugs but do not reveal patterns of use over time, the amount of drugs used, or information about drug dependence and other consequences of drug use. There is also concern about the accuracy and reliability of drug tests, about the intrusiveness of sample collection, about racial bias, about the possibility that passive exposure could lead to positive drug test results, and finally, about the costs of drug tests.