This story was originally published by CalMatters. Sign up for their newsletters.
California’s parole board is using unreliable drug test results in decisions about releasing incarcerated people despite flaws that were exposed in a rash of false positives two years ago, more than a dozen state prison doctors and state-appointed attorneys say.
As a result of the practice, which conflicts with policies governing prison health care, more and more incarcerated people are walking away from life-saving addiction treatment over fears that a false positive could cost them their freedom.
Records obtained by CalMatters show that 11 prison physicians last fall urged the parole board to stop using drug tests, which they wrote are prone to error, to determine whether to release someone. The practice, they said, erodes trust and has already begun dissuading their incarcerated patients from seeking help.
Fallout from addiction treatment comes at a critical time for the prison health system, which is trying to reverse a 39% increase in fatal overdoses among the people it served between 2019 and 2023.
The system uses an evidence-based intervention known as medication-assisted treatment, which combines counseling with medication that reduces cravings and prevents overdoses. Such interventions are “more important than ever,” a recent Correctional Health Care Services report stated.
Participating in the program requires frequent drug testing, which physicians use as a clinical tool to monitor treatment. The results “should be used only by healthcare providers,” wrote Correctional Health Care Services in an April 2025 memo. The presumptive tests can increase the likelihood of falsely testing positive for substances other than the prescribed medication.
“When someone refuses life-saving medication because they fear it will keep them in prison, the system has failed them,” Robb Layne, executive director of California’s Association of Alcohol and Drug Program Executives, said in an interview. “Unless this is done correctly, medical treatment is being weaponized against people who need it the most.”
It’s not the first time the parole board has come under fire for keeping people in prison based on treatment records. Between April and July 2024, a lab error resulted in thousands of suspected false positive drug tests in California prisons. Nearly 100 people who tested positive for opiates during that time were denied parole, according to the corrections department.
Last year, the board recommended parole for about 24% of the incarcerated people who had hearings, according to state records. Denials typically cite multiple factors in the decision, but state-appointed parole board attorneys like Christine Morse suspect drug test failures can be decisive.
“It will sound like there are five or six different reasons,” Morse told CalMatters, “but sometimes, if you really read what the (parole board) commissioners are saying, it would all be different if that false positive weren’t there.”
In a statement to CalMatters, California Department of Corrections and Rehabilitation spokesperson Terri Hardy said the parole board “wants incarcerated people to seek treatment for their substance-use issues and strongly encourages them to rehabilitate so they can safely reenter the community.”
“For many parole candidates who come before the board for a suitability hearing, substance use is a risk factor that contributed to their commitment offense and is one of the most frequent parole violations,” the statement continued. “Because substance use can lead to future criminal conduct, the board considers all relevant and reliable information available to them, as required by our regulations.”
Drug testing in addiction treatment
In 2020, California prisons began providing addiction treatment as fatal overdoses soared nationwide. Roughly 50,000 incarcerated people have received medication-assisted treatment since then. As part of the program, Correctional Health Care Services requires presumptive drug testing at least every 90 days.
Those tests, which include disclaimers regarding the possibility of false positives, are meant to encourage an open dialogue with patients to help them in their recovery and should not be used punitively, according to Correctional Health Care Services’ policy and training materials for the parole board obtained by CalMatters. That policy reflects standards set by the American Society of Addiction Medicine.
In a September letter to the parole board, prison physicians noted that “urine toxicology, like many medical tests, is imperfect.” It’s why they should be understood in a clinical context, they wrote.
“We have personally had some of our most successful, stable patients test positive for substances they did not take due to false positives and cross-reactivity (prescribed medications interacting with the drug test),” the letter continued.
The parole board’s practice has resulted in a growing distrust of the treatment program, the physicians wrote. They noted that several of their patients no longer want to participate in the program “because the use of these tests by the parole board can be the reason between continued incarceration or freedom – even though these tests are not reliable indicators of a patient’s recovery.”
In interviews with CalMatters, four state-appointed parole board attorneys echoed those concerns and cited major due process violations during parole hearings. For example, some said the parole board relies on medical records that have not been disclosed to incarcerated people or their attorneys prior to a hearing, despite legal requirements to do so.
Attorney Cheryl Sommers said that, since 2024, roughly a dozen of her clients have been denied parole because of positive drug tests that they say are wrong.
“It’s very defeating for them to work so hard and not have anybody believe them,” she said. “Do you keep trying to fight it and prove that it’s wrong or do you just fall on the sword and admit it even though you didn’t do it?”
One attorney, who spoke with CalMatters on the condition of anonymity because of fear of professional retaliation, now includes a warning page about medical records in the packet of materials they send to their incarcerated clients to help prepare them for a parole hearing.
“Medication-assisted treatment is not confidential! Everything you said to medical/medication-assisted treatment can and will be used against you at (the parole) board,” the warning page states.
‘Results for clinical use only’
After the 2024 lab error, parole board attorneys reviewed hearings “to determine whether, without the positive drug screening, there (was) sufficient evidence to support an incarcerated person’s denial of parole suitability, and if not, order a new hearing,” said the corrections department in an email to CalMatters. According to the department, roughly a dozen parole applicants have been granted new hearings.
The scandal highlighted the perils of the parole board’s access to medical records, prison physicians and legal experts said. The board’s review of hearings was the “only remedy” that the parole board implemented, said attorney Natasha Baker from the organization UnCommon Law, which advocates for people in the parole process.
She said she’s concerned about people who were affected by false positive drug tests but have not yet had their parole board hearings.
“The (parole) board seems to have taken the position that this limited review is enough and will not engage in further policy change,” she wrote. “Thus, the deeper issue remains and it’s a matter of life and death: the (parole) board continues to rely on inconclusive drug tests from the medication-assisted treatment program, defying expert medical guidance — even from the California Department of Corrections and Rehabilitations’ own doctors.”
Since the review, Correctional Health Care Services has again instructed parole board commissioners to avoid interpreting drug test results, according to the training documents obtained by CalMatters.
“It is important to note that the urine drug testing results completed by the laboratory are performed for clinical use only and not intended for other uses,” wrote Renee Kanan, deputy director of medical services of Correctional Health Care Services and the corrections department in an April 2025 memo to parole board executive director Scott Wyckoff obtained by CalMatters. “Any other use of these results without clinical interpretation and confirmatory testing should be avoided.”
In July 2025, Correctional Health Care Services rolled out tests to confirm results for positive opiate drug tests, according to court documents.
Brian Hurley, medical director of the Bureau of Substance Abuse Prevention and Control for the Los Angeles Department of Public Health, said confirmatory testing would be unfair unless a person consents and understands that it’s being “collected as almost, like, evidence related to their case and their incarceration — it’s not being collected to help them.”
“But I also think that using testing to make that adjudication is itself kind of problematic and there are other measures to look at somebody’s readiness for release,” he said, suggesting, for instance, that parole commissioners talk to physicians about patients in order to understand the context of their treatment.
‘Afraid to ask for help’
CalMatters spoke with eight incarcerated people who believe false positive drug tests contributed, either fully or in part, to their parole denial. Many said they were never told the parole board would have access to their medical records when they joined the medication-assisted treatment program.
That was the case for Phil Stamps, who started medication-assisted treatment in 2020 to help address an opioid addiction after years of struggling with back pain.
When he appeared before the board in September 2025, commissioners cited six instances in which he tested positive for methamphetamine between January 2023 and January 2025. Stamps denied all of them, maintaining that he has been sober since 2021, when he said he had a brief relapse following the death of two family members.
During the hearing, his attorney cited a February 2025 progress note from his addiction medicine provider, who wrote that he found it “unlikely” that the positive methamphetamine “was a true return to use.”
“Patient remains extremely engaged in both his work, his recovery programs and his community,” the physician wrote in medical records reviewed by CalMatters. “Given his other negative urine drug screens, I am convinced that patient either had a lab mix up or a false positive.”
Stamps told parole commissioners that, under his physician’s care, he stopped taking his antidepressant medication and one of his inhalers because they can trigger false positives.
His attorney also noted his extensive participation in rehabilitative programming, clean record of prison rule violations, and work as an Americans with Disabilities Act caregiver. Despite that record, the board denied Stamps parole.
“The clinician writes in the notes about your positives for methamphetamine and amphetamine-type substances, that it’s either a lab mix up or a false positive,” said William Muniz, a parole commissioner, in a transcript reviewed by CalMatters. “So interestingly, that’s like, it could be this, it could be that. As a panel, that doesn’t fall in the timeframe of the opioid use and the faulty reagent that was used by the testing lab.”
The positive drug tests, Muniz said, demonstrated that Stamps had not “internalized (his) programming, especially understanding the complexities of relapse and the complexities of criminal thinking.”
Three months later, Stamps’ attorney appealed, arguing the decision was “fundamentally flawed,” including the parole board’s failure to disclose medical records in advance of the hearing, adhere to the Correctional Health Care Services policy regarding drug testing, and accept expert medical testimony.
“By discarding the expert clinical interpretation that the tests were false positives and violating notice requirements, the panel’s finding of unsuitability was based on prejudicial errors,” he wrote.
Stamps said he was crushed by the denial and wishes he had never started medication-assisted treatment in the first place.
“The program can do a lot of good for people with substance use disorders, but because of what the parole board is doing, people are afraid to ask for help,” he said.
Cayla Mihalovich is a California Local News fellow.
