Pubdate: Tue, 07 Jan 2003
Source: Daily Comet (LA)
Copyright: 2003 Comet-Press Newspapers Inc.
Contact:  http://dailycomet.com/
Details: http://www.mapinc.org/media/1505
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EXPERTS ZERO IN ON TEEN SUBSTANCE ABUSE

In many respects, Michael Lagana is a typical 17-year-old. A junior at 
Dundalk High School in Maryland, he carries a full load of courses, loves 
playing football, and works after school selling newspaper subscriptions.

He began smoking marijuana at 14. At 16, he was smoking three fat marijuana 
cigarettes a day or drinking a couple of 40-ounce bottles of malt liquor.

Donna Lagana, Michael's mother, began to worry last June when she 
discovered some marijuana among Michael's things. He assured her then that 
it was "not a problem."

But Michael's drug and alcohol use only escalated. In September, after he 
drank a fifth of brandy in less than an hour, he passed out and was taken 
to the emergency room for acute alcohol poisoning.

Although Michael steadfastly refused to see a drug abuse counselor, his 
parents worried that he might pose a threat to himself or others.

As a result, Donna Lagana petitioned the Baltimore County Circuit Court to 
order him to undergo a substance abuse evaluation. The court agreed and 
within a few hours, Michael was picked up from school and taken to a local 
hospital.

There he was examined by an addiction specialist and soon was admitted to 
Mountain Manor, an alcohol and drug treatment center for teen-agers in 
Baltimore. It was, the mother recalls, "the hardest day of my life."

"How could I have not noticed it before?" she asked.

In December, researchers at the University of Michigan reported that the 
use of alcohol, nicotine and marijuana among high school students across 
the nation was declining. Nevertheless, levels of teenage drinking and drug 
use remain stubbornly high.

At least 53 percent of all American adolescents have tried an illicit drug 
by the time they have finished high school, according to the Michigan 
researchers.

The Centers for Disease Control and Prevention reported last week that 
between 1993 and 2001 the rate of binge drinking episodes among drinkers 18 
to 20 increased by 56 percent, compared with an increase of 35 percent for 
all American adults. Binge drinking was defined as five or more drinks at a 
sitting, with the intention of getting drunk.

To highlight the continuing problems, a number of doctors who treat 
substance abuse among adolescents will give a report to all members of 
Congress and every state governor on Thursday. The report, by a group 
called the Physician Leadership on National Drug Policy, describes teen-age 
alcohol and drug abuse as a national public health problem.

Dr. Aaron Hogue, a psychologist and a researcher at Columbia University's 
National Center on Addiction and Substance Abuse, said that last year's 
reported decline in drug use by teen-agers did not mean the problem was 
going away.

"I am not sure that these general trends, as important as they are, speak 
directly to those kids who have the most severe substance abuse problems 
and are in the greatest need of treatment services," Hogue said.

Also, because the brains of teen-agers are still developing, many experts 
believe they are at greater risk for becoming addicted. A number of studies 
have shown that teen-agers who begin using illicit drugs before they are 15 
are eight times as likely to develop substance abuse problems as those who 
start at 18 or later.

Anna Joseph, a 15-year-old who lives in Ann Arbor, Mich., is among those 
who have avoided drugs. "I don't feel I need them to have a good time," she 
said.

For her, one of the major deterrents has been seeing other teen-agers at 
school whose lives got messed up because they became dependent on drugs. 
Philip Anderson, a 17-year-old from Ferndale, Md., who began using drugs at 
10 and has abstained now for over a year, explains that young people try 
drugs for a lot of reasons.

"I got into drugs because I thought it was fun," he said. "Some kids see 
their parents using them, others see their friends using them and feel 
pressured to do the same. Some are just curious."

Dr. Marc Fishman, a psychiatrist at Mountain Manor and a faculty member at 
Johns Hopkins, said: "Many adults trivialize how bad these drugs really 
are. They say it's just pot or booze, what's the big deal? But it is a big 
deal when it involves children."

Still, many experts say that more treatment programs tailored to teen-agers 
are needed.

Dr. David Lewis, a physician at Brown University and the lead author of the 
physician group's report, said: "You can't just apply the adult model to 
teen-agers. We need a new investment for what we know works for children."

The physician group wants more money devoted to prevention and treatment 
and less money spent on incarcerating juvenile drug offenders.

Effective drug treatment programs for teen-agers, many addiction experts 
say, are different from those that work for adults. Parents and other 
family members must be involved, and treatment must allow for continued 
school work.

Also, because teen-agers' thought processes often differ from those of 
adults, different approaches to psychological counseling are required. More 
than half the adolescents enrolled in drug rehabilitation programs also 
have some other psychiatric problems - including attention deficit 
disorder, depression and trauma from sexual or physical abuse - that must 
be recognized.

Several studies show that illicit drug use is reduced by 50 percent among 
teen-agers one year after completing substance abuse treatment, although 
fewer than half are still abstaining five years later.

The physicians' report says that these rates of relapses and compliance are 
similar to those seen in programs designed for other chronic, relapsing 
diseases like diabetes and asthma, where patients sometimes do not take 
their medicine.

(STORY CAN END HERE. OPTIONAL MATERIAL FOLLOWS) Another problem is a 
shortage of treatment programs. The report found that 10 percent of 
students who need drug abuse treatment receive it, and of those who do 
receive it, only 25 percent receive enough.

Dr. Jeremiah A. Barondess, president of the New York Academy of Medicine, 
says that "if we had less than the needed facilities to treat diabetes, we 
would be labeled as heartless and accused of practicing medicine that is 
immoral if not criminal."

"I can think of no other disease that is deliberately underfunded in such a 
manner," Barondess added.

What is more, the report says that many pediatricians feel uncomfortable 
treating addiction problems and that financial reimbursement in the form of 
Medicaid or third-party health insurance is limited. About 44 percent of 
all referrals for substance abuse treatment now come from the juvenile 
court system, compared with 22 percent from schools, 17 percent from 
themselves or family and 5 percent from health care professionals.

The rest of the referrals come from a variety of sources.

The physicians' report calls for training judges and criminal justice 
workers to collaborate with health care professionals in proceedings called 
drug courts, which use the court system to get juvenile drug offenders into 
treatment.

As for Michael Lagana, he is not taking his sobriety for granted: "When I 
was using drugs I just didn't think it was such a big deal. Since I began 
treatment four months ago, I've realized that I almost lost my life."
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MAP posted-by: Larry Stevens