September 12, 2022

During child welfare cases, substance use and misuse by parents frequently play a role in determining child safety in homes. However, in many cases, drug testing results do not receive the proper weight in determining child permanency. Without a doubt, drug screening is an essential part of case planning, but knowing how and when to use these results can drastically change the outcome of child welfare assessment and planning.

Just One Tool to Determine Cases

In cases of child welfare and permanency, the child’s home environment is the center of the assessment process, and it should not rely on a single determining factor. Yet drug testing results are often the primary determining factor in permanency cases. The black-and-white nature of drug screening seems like straightforward evidence for case planning, but child welfare requires much greater research and nuance to make well-informed decisions, both for children and for their families. Agencies risk relying too much on drug test results to inform decisions on child removal, parent-child family time, reunification, and termination of parental rights.

Instead of this single piece of evidence, courts and caseworkers need to utilize drug testing results in conjunction with observation, professional input, and positive support structures. Together, caseworkers and officials can paint a more complete picture of the home environment beyond substance use concerns, which then gives the best opportunity to create stability for the family.

According to the National Center on Substance Abuse and Child Welfare (NCSACW), caseworkers should utilize four specific tools to identify and assess parental substance use in these cases. With these four tools, they can better see, understand, and address placement concerns in a more supportive and motivational manner.

Screening Questions

Standardized questions serve as a simple starting point for case planning. Prior to any drug testing mandates or more intense interventions, screening questions allow caseworkers to determine the need for further assessments. This information can inform recommendations for clinical SUD assessments, as well as referrals to SUD treatment providers.

Observational Indicators

Through behavioral and environmental observation, caseworkers have an opportunity to see specific signs and symptoms of substance use or misuse. This tool focuses on building context for substance use, rather than relying on the limited information gained through questionnaires, as well as giving further context to drug testing results. In-home observations of physical and environmental conditions, as well as behavioral indicators of more serious issues, allows courts and attorneys to better understand the situations that may be leading to substance use concerns.

Child Risk Safety Assessment

In addition to basic observations and screening questions, a more systematic collection of information is necessary to determine immediate dangers to child safety. The risk assessment can also play a role in identifying the potential for future maltreatment. And since the home is foundational to a child’s safety, getting a more in-depth assessment is invaluable.

Drug Testing

While it’s often the most concrete evidence of substance use, drug testing is frequently misunderstood as a clear-cut determining factor in parenting time or permanency. Instead, drug testing only indicates the presence of a particular substance or its metabolites in an individual. While still important, it’s just one of many inputs that needs to be considered.

The PharmChek® Drugs of Abuse Patch determines drug use over an extended period of time (up to 14 days). This testing, however, cannot determine if a parent has a SUD, nor should it be the determining factor in child welfare cases. Instead, it is one component of a larger set of tools to determine child safety, permanency, and case planning.

The Role of Drug Testing in Child Welfare

Drug testing, according to NCSACW, should not be used as a punitive measure. The presence of a substance does not automatically indicate a SUD, nor does it determine child safety. A failed drug test should not be the central evidence to take away parenting rights or restrict parent-child family time. Instead, the presence of a substance in a drug test result should be a piece of the larger puzzle in determining a treatment pathway.

Determining a SUD should be left to a qualified SUD treatment professional, not a mere drug test. To achieve this higher standard, caseworkers and treatment professionals need to utilize drug testing methods that provide a better picture of a person’s long-term use patterns.

In addition, drug testing must be a positive reinforcement instead of a justification for punishment. Using drug testing results in conjunction with self-reporting, treatment professionals can evaluate parents’ progress towards recovery if a SUD has been diagnosed. They can also help encourage and support parents to maintain sobriety. When tests only lead to punishment, there is a far greater chance of compromised results due to tampering; and dishonesty when answering questions, all to avoid potential penalties.

Caseworkers and treatment professionals can work towards lasting family reunification, stability, and sobriety by using drug testing as data points instead of punishments. All parties involved benefit greatly, but more than anything, the welfare of the children involved improves significantly.

A Chance for Motivation and Engagement

The typical response to a lapse in substance use is negative, but this response must change. The stigma surrounding substance misuse often compounds the issue. For treatment professionals and caseworkers, flipping that paradigm could be the turning point in a parent’s recovery effort.

Each lapse should serve as an opportunity to learn what helps or hinders recovery efforts, as well as a chance to see the supportive and encouraging network they have around them. By positively addressing recovery lapses indicated by drug testing, observational data, and screening questions, caseworkers can help build a path to full recovery.

When discussing a drug test result, here are some important things to keep in mind:

  • Have a discussion within 48 hours of the test result. An immediate discussion means a better assessment of child safety, including the child’s location during the lapse and whether or not an established child safety plan was followed.
  • Focus on the parent’s strengths, rather than the lapse, to provide them with a better chance to openly discuss the results.
  • Use your responses to motivate parents to engage or re-engage with SUD treatment support groups, such as AA, NA, or Celebrate Recovery. If possible, encourage them to attend a meeting on that same day.
  • Work with the parent’s SUD treatment provider to create a consistent response. When both the case worker and treatment professional respond consistently, there is a much better opportunity to support both child safety and parent recovery.
  • In some circumstances, determine if a meeting with the parent’s informal and formal supporters will be needed to discuss the return to use. This can also assist in determining risk factors, potential child safety concerns, and other collateral information that could help the recovery process.
  • Discuss next steps with the parent, talking through any perceived barriers that may occur.

This supportive and motivational approach works towards consistent recovery efforts across the board. Family and friends, caseworkers, treatment professionals, and parents are all connected to support the recovery efforts while simultaneously maintaining a high standard for child safety and welfare.

A Better Drug Testing Method

Within this context, the PharmChek® Drugs of Abuse Sweat Patch plays a key part in creating and maintaining positive motivation for recovery. Where conventional drug testing falls short, the strengths of the sweat patch provide a more accurate observation of substance use.


The PharmChek® Sweat Patch is tamper-evident. A trained observer can quickly and easily determine whether a patch has been removed or compromised, providing more reliable test results. This level of visibility encourages more open discussions about recovery progress and lapses.

Long-Term Sampling

Rather than relying on a narrow window from a single sample, the sweat patch provides continuous drug use monitoring for up to 14 days. This reinforces positive lifestyle changes while maintaining a more transparent look at substance use throughout the timeframe.

Simple and Sanitary

PharmChek® Sweat Patch reduces the number of appointments required to collect samples, making it easier for parents to provide court-mandated, non-invasive, and hygienic drug tests. And the application and removal process takes only minutes.

Court-Supported Testing Results

The PharmChek® Sweat Patch has a long history of court-supported efficacy in determining substance use. Caseworkers and treatment professionals can be confident that its tamper-evident continuous monitoring will help support parental recovery efforts without causing discomfort or frustration.

Supporting the Well-Being of Children and Families

A more accurate and long-term drug testing method provides many benefits to recovery efforts, child welfare, and safety. Ultimately, case determinations should be made through a multi-faceted assessment of parent behavior, home environment, and potential substance use concerns. Without a complete picture of each situation, caseworkers cannot make a properly informed decision about child placement and permanency.

Instead of a punitive and reactive plan, caseworkers should use drug test results to motivate and encourage parents to engage in recovery efforts to create a positive and safe environment for their children. With conversational screening, treatment support systems, and comprehensive safety assessments, caseworkers have the tools necessary to use drug testing to benefit both parents and children in child welfare cases.