Alcohol isn’t the problem – behaviour is: Why hair test results are only part of the story for cases involving drug and alcohol abuse

“They used alcohol and drugs; therefore, they cannot be trusted.”

When it comes to making care decisions about vulnerable families and individuals, social workers know the reality is not so clear-cut.

An alcoholic might still be a good parent to her children. A drug user might still care for his disabled relative. Test results that indicate whether a person used drugs or alcohol are only part of the story; not the whole story.Instead, understanding an individual’s behaviour around drugs or alcohol - their personality, their history of violence or abuse - is the key to making correct care decisions. For this to happen, the role – and limits – of hair drug and alcohol tests must be clearly understood by the social workers and family courts commissioning them.

Yes or no?

A hair test proves whether an individual used drugs or alcohol. The evidence is binary: they did, or they didn’t.

Human behaviour does not reflect this on/off simplicity. We are emotional, erratic and individual – forced to behave in certain ways by context. Hair test results do not reflect these complexities. Instead, a hair test result indicates whether or not an individual used a substance at a certain time.

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Making a care decision around this single piece of data is a dangerous game for social workers and family courts. Instead of asking whether a hair test result was positive or negative, they must instead ask a more difficult question: did the individual’s substance use correlate with other signs of their ‘bad’ behaviour?

One piece of the puzzle

Hair test results do not give evidence of the context for drug or alcohol use. Context is the all-important factor for making fair, reasonable care decisions.

A hair test might prove a mother positive for cocaine use. It cannot show that the mother was forced to take the drug by an abusive partner. A professional driver might test positive for the drug ketamine, but this might have been the result of their drink being spiked.

It’s true that hair tests can determine the difference between an individual consuming drugs or alcohol, and having only been in the same environment as them – in turn giving evidence about the nature of the donor’s behaviour. This is important in cases where the donor claims they haven’t used a substance themselves, but have been in the room when another person did so.

But the fact remains that a hair test is only an indicator of whether an individual - knowingly or unknowingly - used a substance. It makes no ethical judgement. Drug use doesn’t mean a person is unfit to be a parent. Their behaviour is the key to making a fair judgement about their future; not their test result.

For social workers, making an accurate judgement about how substance abuse affects families is crucial for deciding how to protect those families in the future.

Making a decision to hair test an individual using an accredited laboratory is part of the solution.

But those commissioning hair tests have a crucial responsibility to understand exactly what a test result is and isn’t saying. Then, they must consider the test result within the wider context of a donor’s drug or alcohol use.

The result alone is not enough to make a good decision. Getting it wrong could have awful consequences for the families involved.

Found this useful? Read our five case studies of social workers using hair testing in critical care situations, here.