Drug testing in child welfare: A systematic review

Although its true prevalence is unknown, drug testing is a common practice with child welfare-involved parents. In fact, the Center for Substance Abuse Treatment (2010) suggests that “some child welfare agencies have decided to conduct drug tests on all parents under court jurisdiction” (p. 6). Unfortunately, researchers have largely overlooked this practice. This paper presents findings from a systematic review of the studies that measured drug testing and utilized a child welfare-involved sample. Eighteen studies met inclusion criteria and were analyzed according to seven research questions, including drug test operationalization, testing frequency, and implications of testing. Reviewed studies reported using drug tests to measure an array of concepts beyond substance abstinence. Proportion of parents required to provide drug tests ranged from 29% to 88% across samples. Disparities in mandates to drug test were observed for parent gender and race/ethnicity. Reports of test frequency ranged from 1 to 10 tests over 15 months to three times per week. Non-compliance rates ranged from 23% to 62%. Drug test results were associated with a variety of outcomes, including maltreatment substantiation and parent-child reunification. Our findings suggests that best practices for drug testing found in family treatment court, criminal justice, and substance use treatment literatures are infrequently, if at all, implemented in traditional child welfare settings. Given the lack of generalizable existing studies, implications of test results at various time points in the child welfare trajectory for various child-welfare involved populations are unknown. Future child welfare-specific research is needed to fill the many gaps in knowledge identified in this review. •We systematically review literature on drug testing in the child welfare system and identify 18 studies.•Existing studies are methodologically limited but suggest that drug testing is incredibly common and test results affect case outcomes.•Whether testing is conducted in accordance with evidence-based principles is unknown but, based on reviewed studies, unlikely.