California’s parole board is using drug-test results from a state program that provides medication-assisted treatment for incarcerated people with substance use disorders, prison physicians and state-appointed parole attorneys say, warning the tests can misidentify people and steer decisions about release. They argue that the board’s reliance on presumptive drug results conflicts with how correctional health authorities say the tests should be used: for clinical monitoring by healthcare providers. The dispute is playing out as California’s prison health system seeks to reverse an increase in fatal overdoses among the people it served, and as access to treatment becomes increasingly intertwined with the parole process.
In interviews and letters reviewed by CalMatters, the doctors and attorneys said that the parole board has treated drug-test outcomes from the treatment program as a decisive factor in suitability hearings, even though the tests are designed as a screening tool rather than a conclusive diagnosis. They described a growing reluctance among incarcerated people to participate in treatment, worried that a false positive could jeopardize their freedom rather than help their recovery. “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.
The concerns focus on medication-assisted treatment, which combines counseling with medication intended to reduce cravings and prevent overdoses. Participating in the program requires frequent drug testing, and Correctional Health Care Services requires presumptive testing at least every 90 days, according to the state’s treatment materials described in the CalMatters reporting. Doctors and attorneys said that presumptive urine tests come with disclaimers about false positives and cross-reactivity, but that the parole board still uses the results in decisions about whether a person should be released.
According to records obtained by CalMatters, 11 prison physicians urged the parole board last fall to stop using drug tests to determine whether someone should be released. The physicians argued the screening tests are prone to error, and that using them in parole decisions erodes trust in the treatment program. They also wrote that the practice was already dissuading their incarcerated patients from seeking help. The physicians argued that medicine and recovery are clinical questions that should be interpreted with context rather than treated as proof of abstinence failure.
Attorneys appointed for parole proceedings raised additional concerns about how medical records are handled in suitability hearings. In interviews, four state-appointed parole board attorneys echoed the doctors’ worries and also pointed to due process problems they said occur during parole hearings. For example, some attorneys said the board relies on medical records that they say were not disclosed to incarcerated people or their attorneys before a hearing, despite legal requirements to provide such information. Attorney Cheryl Sommers said that since 2024, roughly a dozen of her clients had been denied parole based on positive drug tests that her clients said were wrong.
Sommers described the effect of those experiences on her clients. “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?” Another attorney, who asked not to be identified to discuss the cases because of fear of professional retaliation, said they started including a warning page about medical records in the materials they provide incarcerated clients ahead of hearings, telling clients that the information they provide for medication-assisted treatment could be used at the parole board.
The parole board and correctional health officials have said they want incarcerated people to seek treatment and that the agency follows applicable regulations. 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.” Hardy said the board considers “all relevant and reliable information available to them, as required by our regulations,” and that for many parole candidates, substance use is a risk factor that contributed to the commitment offense and is also a frequent parole violation.
The doctors’ and attorneys’ critiques build on a prior testing failure that drew scrutiny of how drug-test results were being interpreted in parole decisions. Between April and July 2024, a lab error resulted in thousands of suspected false positive drug tests in California prisons, according to the corrections department. Nearly 100 people who tested positive for opiates during that time were denied parole, the department said. After the problem, parole board attorneys reviewed hearings to determine whether, without the positive drug screening, there was sufficient evidence to support a denial of parole suitability, and the corrections department said that roughly a dozen parole applicants were granted new hearings.
Correctional Health Care Services later reiterated guidance that presumptive urine testing results are intended for clinical use only. In an April 2025 memo to the parole board executive director Scott Wyckoff, Correctional Health Care Services deputy director of medical services Renee Kanan, and the corrections department, wrote that the urine test results “are performed for clinical use only and not intended for other uses,” and that any other use of these results without clinical interpretation and confirmatory testing should be avoided. The CalMatters reporting also said that since the 2024 lab error, Correctional Health Care Services instructed parole board commissioners to avoid interpreting drug test results.
Confirmatory testing and consent also became part of the debate. The reporting included comments from Brian Hurley, medical director of the Bureau of Substance Abuse Prevention and Control for the Los Angeles Department of Public Health, who said confirmatory testing would be unfair unless a person consents and understands that it is being “collected as almost, like, evidence related to their case and their incarceration — it’s not being collected to help them.” Hurley also suggested parole commissioners should discuss patients with physicians to understand the context of their treatment, rather than adjudicating solely on screening tests.
CalMatters interviewed incarcerated people who said false positive drug tests contributed to their parole denial. Phil Stamps, who started medication-assisted treatment in 2020 after opioid addiction, told the parole board in September 2025 that he had been sober since 2021, describing a brief relapse after the death of two family members. Commissioners cited six instances of positive methamphetamine tests between January 2023 and January 2025, which Stamps denied. His attorney cited a progress note in which the addiction medicine provider wrote it was “unlikely” that the positive methamphetamine represented a true return to use and said that, given other negative urine drug screens, he was convinced the patient either had a lab mix-up or a false positive.
In a transcript reviewed by CalMatters, parole commissioner William Muniz said the clinician’s notes indicated the positives could be due to a lab mix-up or false positive, and Muniz suggested that as a panel, the board’s finding did not fall within the time frame of the opioid use and the faulty reagent used by the testing lab. But the board still denied Stamps parole, and his attorney appealed, arguing the decision was flawed, including alleged failures to disclose medical records in advance of the hearing and to accept expert medical testimony. Stamps said the denial left him crushed and that the parole board’s actions made people afraid to ask for help. “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.