Drug testing practices deter prison addiction treatment and influence parole outcomes.
California’s parole board is facing renewed criticism for relying on drug test results that medical experts say are not reliable when deciding whether incarcerated people should be released. Doctors and state-appointed attorneys argue that this practice is discouraging people in prison from seeking addiction treatment, even as overdose deaths inside the system continue to rise.
At the center of the concern is how drug testing is used within California’s medication-assisted treatment program. This program combines counseling with medication to reduce cravings and lower the risk of overdose. It has been offered in state prisons since 2020 and has served tens of thousands of people. As part of treatment, participants must take regular urine drug tests that are meant to help doctors track recovery and adjust care.
Medical staff say these tests were never designed to be used to decide parole outcomes. The tests are known to produce false positives, sometimes because of prescription medications or lab issues. Prison doctors warned the parole board in writing that using these results outside of a medical setting breaks health care rules and damages trust between patients and providers.
Despite those warnings, parole commissioners continue to review test results when weighing release decisions. Attorneys representing incarcerated people say that a single disputed test can tip the balance against parole, even when a person has a strong record of rehabilitation. They argue that this places people in an impossible position: accept treatment and risk a test error or refuse care to protect a chance at freedom.
The issue became more visible after a lab error in 2024 led to thousands of suspected false positive drug tests in California prisons. Nearly 100 people were denied parole during that period after testing positive for opiates. Although the corrections department later reviewed some of those cases and granted a limited number of new hearings, attorneys and advocates say the response did not go far enough.
Doctors report that patients are now dropping out of addiction treatment out of fear. Some have stopped taking medications that help with recovery because they worry those drugs could interfere with testing. Medical staff say this trend is especially alarming because fatal overdoses among incarcerated people rose sharply between 2019 and 2023.
Legal advocates also raise due process concerns. Several parole board attorneys say medical records are sometimes used in hearings without being shared with the incarcerated person or their lawyer beforehand. This leaves little opportunity to challenge test results or present medical explanations. Some attorneys now warn clients in advance that anything shared during treatment could be used against them later.
State officials say the parole board considers many factors when making decisions and does not rely on drug tests alone. Corrections officials state that substance use history is often linked to past offenses and parole violations, making it relevant to public safety. However, critics argue that relevance does not equal reliability and that flawed tests should not carry such weight.
Medical leaders point out that national addiction standards say drug tests should support treatment, not punishment. They stress that recovery is not linear and that test results must be read in context by trained clinicians. Even confirmatory testing, rolled out in limited cases, raises concerns when people do not fully understand how results may affect parole.
Several incarcerated individuals have shared stories of being denied parole despite years of sobriety, work programs, and positive evaluations from doctors. In some cases, physicians explicitly stated in medical records that test results were likely false positives. Parole decisions still cited those results as signs of poor insight or failed rehabilitation.
Advocates warn that the system is sending a dangerous message. When people believe seeking help could extend their incarceration, many will avoid treatment altogether. Doctors and attorneys argue that this undermines public health goals and puts lives at risk, both inside prison and after release.
The broader debate highlights tension between medical care and punishment in the prison system. Experts say addiction treatment works best when patients feel safe being honest and engaged. As long as parole decisions hinge on disputed medical data, critics argue that trust will continue to erode, and the people most in need of help will be the ones most likely to go without it.
Sources:
Why CA prison doctors want parole board to stop citing drug tests
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