Revealed: drug tests in California prisons yielded false positives, affecting thousands of people

Suspect Drug Tests Impact California Prison Parole Decisions

Thousands of drug tests conducted by a major diagnostic firm in California prisons last year are suspected of producing inaccurate positive results, a significant error that has potentially undermined parole considerations for numerous incarcerated individuals, according to legal advocates and internal prison medical documentation. Officials within the California Department of Corrections and Rehabilitation (CDCR) have been aware of this issue for several months, yet reportedly have not corrected inmate records or mitigated the repercussions faced by those affected by the faulty tests.

Quest Diagnostics at the Center of Testing Concerns

The testing discrepancies stem from procedures utilized by Quest Diagnostics, a national healthcare service provider and the exclusive contractor for clinical drug screening within the CDCR system. Between mid-April and July of the previous year, Quest utilized an “alternative” chemical reagent in its urine opiate drug screenings at CDCR facilities due to a supply shortage of its standard reagent.

Reagent Change Leads to Spike in Positive Results

According to a letter from Quest to prison health administrators, this substitution resulted in a higher incidence of “presumptive positive results” compared to tests using their usual chemical. Upon reintroducing the original reagent, the positivity rate returned to its typical historical average. UnCommon Law, an Oakland-based nonprofit legal group focused on parole advocacy, acquired this letter after a client received it from their healthcare provider. UnCommon Law also obtained public records and testing data, subsequently shared with news outlets.

Data Shows Significant Increase in Positive Drug Test Rates

While Quest‘s letter stated the alternative reagent “passed all quality-control metrics” and the performance difference was only “slightly different,” state data obtained by UnCommon Law indicated a considerable surge in positive tests. From January to April, when the standard chemical was in use, monthly positive opiate rates across CDCR institutions ranged from 6.6% to 6.8%. This percentage abruptly jumped to 17.1% in May, 20.5% in June, and 17.1% in July. After the company reverted to the original reagent in August, the positivity rate decreased back to 6.8% and remained consistent for the remainder of the year.

State Acknowledges Potential for False Positives

In January, the state acknowledged the situation to the Prison Law Office (PLO), a civil rights organization monitoring CDCR medical practices as part of court-mandated oversight due to persistent deficiencies. Prison healthcare representatives informed PLO via letter that they had “generated a list of patients that may have received a false positive result” from Quest. Alison Hardy, an attorney with PLO, reported that officials provided a list encompassing roughly 6,000 individuals who received positive results during the period the substitute reagent was used.

vCard.red is a free platform for creating a mobile-friendly digital business cards. You can easily create a vCard and generate a QR code for it, allowing others to scan and save your contact details instantly.

The platform allows you to display contact information, social media links, services, and products all in one shareable link. Optional features include appointment scheduling, WhatsApp-based storefronts, media galleries, and custom design options.

Concerns Over Impact on Parole Decisions

Data analysis by UnCommon Law suggests potentially over 5,000 false positives, potentially including multiple tests for single individuals. This figure is an estimated calculation based on total tests administered from April through July, assuming the positivity rate would have remained stable had the reagent not been changed. Dr. Fred Rottnek, an expert in addiction medicine at Saint Louis University who reviewed Quest records for UnCommon Law, characterized the 300% increase in positive rates as rendering the tests “basically worthless.”

Expert Calls for Review of Affected Cases

“There should be a mandate to re-examine all medical files and ascertain whether these lab findings had any bearing on parole board deliberations,” asserted Dr. Rottnek, who previously served as medical director for St. Louis County Jail.

Parole Denials and Disputed Drug Test Results

The Quest tests are employed within prisons’ substance use treatment programs primarily for clinicians to monitor patient progress, not for disciplinary measures. Guidelines prohibit providers from sharing results with correctional officers, however, the Board of Parole Hearings (BPH) can access and utilize these tests when evaluating an incarcerated person’s parole eligibility.

Advocates Question Reliability of Tests in Parole Process

Attorneys have frequently challenged this practice, emphasizing that test outcomes often lack confirmatory testing and are assessed without proper context of treatment progress. Inmates are sometimes unaware of results until they are cited in formal hearings, limiting their opportunity to challenge them. PLO reported in a legal filing that some individuals affected by false positives only became aware of the results at their parole hearings. Advocates argue the Quest issue highlights the unreliability of these tests for significant decisions like granting freedom.

Case Example: Parole Impacted by False Positive

One of UnCommon Law’s clients, a man in his 60s incarcerated for decades since a teenage violent crime conviction and now parole eligible, exemplifies these concerns. His lawyers requested anonymity to prevent jeopardizing his parole process. In his 2023 parole denial, commissioners cited a past drug use rule violation among other factors. During a standard review last year, the board opted against expediting a new parole hearing, noting positive opiate tests from May and July while he was in substance use treatment. The board wrote that this raised “considerable concern” about “continued substance abuse … and … continuing struggles with criminal thinking.”

Physician Disputes Positive Test Results

However, the man’s physician provided him with Quest’s disclosure letter, confirming both tests coincided with the alternative reagent period, and the patient strongly denied opioid use. His physician concurred, noting in medical records his belief in the patient’s denial of relapse. Lilli Paratore, his attorney at UnCommon Law, believed pre-test results, her client had a strong parole prospect. “It felt within reach. These drug tests, if they remain uncorrected, hugely alter the picture.”

Parole Board Response and Further Complications

Paratore informed the board that Quest’s admission “conclusively demonstrates that [his] two positive tests were false”. She further argued the results should have been deemed inconclusive initially due to lack of confirmatory testing and medical doctor interpretation. The BPH responded citing evidence of other illicit drug use beyond opiates detected in the Quest tests. Paratore clarified that one of these related to his prescribed antidepressant, and another to authorized pain medication. The man conveyed through his lawyer feeling “floored and shocked” upon learning of the false positive opiate tests and stated the parole board “never gave me a chance to defend myself.”

Treatment Program Participation vs. Freedom

Paratore noted her client is now questioning continued participation in his drug treatment program. “He’s in a program that’s helping him achieve sobriety. His doctors say he’s doing well. But to him, it feels like, ‘What’s more important – my participation in this program or my freedom?’” His next parole hearing is scheduled for 2026.

CDCR and Quest Responses

Kyle Buis, a CCHCS spokesperson, declined to comment on the number of patients affected by the alternative reagent. He stated via email that CCHCS identified an “unexpected increase” in positive results last year and “escalated the concern to the laboratory, which identified a change in testing methods resulting in an increase in positive urine test results.” Buis added, “CCHCS is in the process of directly notifying patients who may have been impacted by a falsely positive test due to the change in testing method, via a letter, which will also be placed in their electronic health record,” and “CCHCS is actively reviewing its protocols to ensure the accuracy of results and reiterating that these tests are intended for clinical use only.”

Quest Acknowledges Higher Positivity Rate

Jennifer Petrella, a Quest spokesperson, confirmed the alternative reagent was “cleared” by the FDA but acknowledged the company believed it “led to a higher presumptive positivity rate.” She stated in an email, “It is not uncommon, nor clinically inappropriate, for some variation to occur when different reagents are used.” She did not answer questions regarding the number of suspected false positives generated last year. Petrella emphasized that test reports include disclaimers stating “presumptive screening can, in some cases, generate positive results that, with subsequent confirmatory testing, would be identified as negative. We make clear on our test reports that presumptive results have not been confirmed with definitive testing. In addition, the reports state that drug testing results should be used for clinical purposes only.”

Confirmatory Testing Not Routinely Ordered

Petrella noted that Quest offers “powerful confirmatory testing” to validate initial results, but physicians must request these follow-up tests. “In most cases, CCHCS does not order confirmatory testing,” she stated.

Calls for System-Wide Reforms

Natasha Baker, an UnCommon Law attorney, argued CDCR and BPH should proactively expunge false positive results from individuals’ records and provide a clear mechanism for those already harmed by parole consequences to seek remedy. Dr. Rottnek suggested the parole board’s access should be limited to treatment summaries from doctors, rather than individual clinical drug tests.

Focus on Provider Interpretation, Not Raw Test Results

CCHCS stated in a recent court filing it would “educate” BPH to prioritize “provider’s documentation and interpretation of the urine drug screening results, rather than on the … results alone” when evaluating patients’ addiction recovery. CDCR spokesperson Terri Hardy stated, “The Board of Parole Hearing officers base their suitability findings on a number of factors, including treatment summaries and notes. They are trained to determine the weight and credibility of evidence in the record.”

Concerns Extend Beyond Reagent Issue

Keith Wattley, executive director of UnCommon Law, indicated concerns about inaccurate tests extend beyond the reagent issue of last year. He cited a case of a 50-year-old woman denied parole partly based on an alleged positive opiate test in August 2023. Her provider notes indicated “results are as expected unchanged and no provider follow-up is required,” and two months later, notes stated the patient “has not used any drugs”.

Impact on Inmates and Treatment Programs

Wattley stated, “It’s demoralizing and disrespectful to someone who has fought addiction for their entire lives and finally see years or decades of sobriety only to have the board recklessly mischaracterize their journey in a way that means many more years in prison,” noting that drug use allegations and questions of honesty remain on records, impacting future hearings. He argued BPH reliance on substance use treatment medical records discourages individuals from seeking vital addiction treatment. “The board’s behavior here is lazy, reckless and irresponsible with devastating consequences for incarcerated people and their families.”