Pubdate: Fri, 03 Jan 2003
Source: Slate (US Web)
Copyright: 2003 Microsoft Corporation
Contact: http://slate.msn.com/code/fray/theFray.asp
Website: http://slate.msn.com/
Details: http://www.mapinc.org/media/982
Author: Maia Szalavitz

TRICK OR TREATMENT

Teen Drug Programs Turn Curious Teens Into Crackheads.

America loves its quick fixes. Think your child might be on drugs? Test 
him. Think your child's school is full of addicts? Test them all. Institute 
a policy of zero tolerance: One strike and it's off to a drug treatment 
program. Get those rotten apples out and clean them up before they can 
poison the whole batch. Last year's Supreme Court decision in Board of 
Education v. Earls allowed for a massive expansion of drug testing in 
schools. And increases in drug testing increase the numbers of offenders. 
As a result, schools and juvenile courts are increasingly turning to both 
"zero tolerance" and "treatment, not punishment" as a remedy.

The number of teenagers in drug treatment as a result of court coercion and 
school diversion increased by nearly 50 percent between 1993 and 1998 
according to the U.S. Department of Health and Human Services' Substance 
Abuse and Mental Health Services Administration, and the number of teen 
admissions to treatment programs in general rose from 95,000 in 1993 to 
135,000 in 1999. But what if drug "treatment" doesn't work for teens? What 
if, rather than decreasing drug use, teen treatment actually encourages it 
by labeling experimenting kids as lifelong addicts? What if it creates the 
worst sorts of peer groups by mixing kids with mild problems with serious 
drug users who are ready and willing to teach them to be junkies? What if 
suggestible kids respond poorly to the philosophies that have made 
Alcoholics Anonymous and Narcotics Anonymous successful for many adults? 
Then we'd be using "treatment" to turn ordinary adolescents into problem 
drug abusers.

That's precisely what we're doing. A 1998 study of nearly 150 teenagers 
treated in dozens of centers across the country found that there was 202 
percent more crack abuse following treatment and a 13 percent increase in 
alcohol abuse. In other words, recent research suggests that parents and 
schools may be sending binge-drinking/social marijuana smokers off to 
treatment and getting back crackheads in their stead.

Michael's case illustrates some of the dangers inherent in shipping 
youngsters off to treatment programs. An 18-year-old marijuana smoker and 
cocaine user I interviewed regarding drug treatment, Michael was recently 
sent by his parents for drug treatment at the respected Caron Foundation. 
But his $11,000 one-month treatment program degenerated into a fruitless 
debate when his counselor wanted him to admit that he was "powerless" over 
drugs. Michael, who didn't use daily, wouldn't accept that. What teenager 
would admit to being "powerless" over anything? Michael used again within 
four hours of leaving treatment.

Michael's reaction may be the rule for teenagers, not the exception. For an 
adult who has lost his wife, his job, his health, and his home, admitting 
to a loss of control might help him recognize that quitting drugs is the 
only way to solve his problems. But a teenager may not be "in denial" when 
he says he can control his intake. Most teenagers can. Conversely, forcing 
a teen to assert that they have no control may do more harm than good, if 
they have only been experimenting with drugs but are convinced, via 
treatment, that they are serious addicts. If a teenager has been persuaded 
that she's powerless and has a 90 percent chance of relapse, she's far less 
likely to exercise self-control when confronted with a drink or drugs. In 
fact, a 1996 study published by Bill Miller, professor of psychology at the 
University of New Mexico, found that those adults who most accepted the 
idea of personal powerlessness had the most severe and dangerous relapses. 
Since teenage identities are fluid anyway, encouraging them to view 
themselves as powerless addicts may cement an anti-social identity that a 
teen was just trying on for size.

The core problem with teen treatment programs is that most teen drug or 
alcohol users are just not out-of-control addicts. More than one teen in 
six who's forced into treatment does not even fit the criteria for a 
"substance abuse disorder" (the less serious diagnosis for an abuser), and 
most also don't have substance dependence (the psychiatric term for 
addiction) at all, according to SAMHSA. More troubling, SAMHSA statistics 
also show that about three-quarters of the U.S. teens now being sent to 
treatment programs are diverted there by courts or schools, rather than 
being referred by professionals. In other words, many have problems no more 
serious than those of their friends who've escaped detection.

In addition to labeling kids as addicts, drug programs may also surround 
them with the worst possible influences. Studies show that teens are more 
subject to peer pressure than adults-and more influenced by the people 
around them. Teen treatment programs remove teens from a healthy peer group 
and surround them with other problem kids, virtually guaranteeing that 
their role models will be negative. Group therapy during such treatment 
invariably involves discussions of their drug experiences-which only makes 
the hard-drug users seem "cooler" because their stories are so much more 
exciting. Worse, aside from providing a way for relatively inexperienced 
kids to learn about different ways of getting high and obtaining drugs, 
these programs frequently offer kids new connections. One 17-year-old girl 
from Florida told me that she hadn't used cocaine until after treatment-her 
new best friend from rehab scored it for her.

There are treatments for teens that don't reinforce the labeling or peer 
problems inherent in most drug programs. Research presented at a spring 
conference held by the National Institute on Drug Abuse compared teens 
who'd been sent to traditional group sessions with peers to teens who 
received family therapy, with a third group who had both kinds of care 
combined. The kids in the peer-group sessions used 50 percent more 
marijuana after treatment, while the kids in the combined treatment used 11 
percent more pot. The teenagers treated with their parents, however, 
decreased their marijuana use by 71 percent.

The greatest irony in the current well-intentioned treatment efforts is 
that they ignore the few things we do know to be effective in helping teens 
stop getting high, and chief among them is finishing their education. The 
better educated someone is, the less likely he is to become an addict or to 
have a lengthy course of addiction if he does. So removing kids from school 
and placing them with a more deviant peer group in an unproven therapy is 
madness-and not much smarter than simply expelling them and tossing them on 
the street. Not only is the education provided in treatment programs often 
inferior to that in ordinary school, but having a drug-related disciplinary 
record diminishes the chances of admission to a decent college.

Ultimately, it's clear that the vast majority of teenagers (even those with 
the very worst problems) simply "mature out" of drug use. This natural 
recovery process is seen in statistics from the annual federal household 
survey of drug use, which, for example, find that while 18.4 percent of the 
population ages 18-24 in 2001 qualified for a diagnosis of alcohol or other 
drug abuse or dependence, only 5.4 percent of those over 26 meet these 
criteria. Since less than 2 percent of the total population annually 
receives treatment (including self-help), most of these young people are 
clearly recovering on their own.

Why, then, do we insist on herding teenagers into inappropriate treatment 
programs when allowing them to finish school works better? Do parents 
really want their pot-smoking, experimenting binge-drinkers (who are 
actually typically more moderate than their own parents were at their age) 
tossed into "therapy" with heroin injectors and told that they are 
powerless to resist?

Studies show that family therapy and behavioral one-on-one counseling work 
better for teens than programs modeled on adult addicts. Even for kids with 
genuine drug addictions, these sorts of treatments may be more helpful, and 
it's long past time that such programs were implemented in communities 
rather than debated in the academy. For kids with minor drugs problems 
or-as is more often the case-for kids who are just being kids, the 
philosophy must be: First, do no harm. Although we may hate the idea, 
leaving kids alone and letting them grow out of their habits makes far more 
sense than testing, punishing, and "curing" them-by making them worse. 
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MAP posted-by: Keith Brilhart