DRUG CHAT IN CLASS PROVES CHALLENGING

I had an interesting experience over the past several weeks. I designed and
taught several classes on drug use to my daughter's eighth-grade class. As
is usually the case with teaching, I learned more than I taught.

As I looked around the class, I had flashbacks to my own adolescence. I
could remember thinking, "Great, another adult is going to tell us how to be
good kids -- how boring."

But I was ready for them.

I started the class with a warning: This was not going to be the standard
"just say no" party line. I have long since ceased to believe that such a
strategy works -- for drugs, sex or rap. My goal was to present facts about
drugs as I understood them, as a physician, one who uses drugs as the tools
of his trade.

So I challenged them. Instead of taking the ostrichlike tact of believing
that I could convince them otherwise, I acknowledged what statistics clearly
demonstrate: that well over half of them would be experimenting with
alcohol, tobacco and other drugs over the next few years.

My interest was not in affirming the decision of those who would not be
using drugs. My audience was precisely those others, the ones I knew would
be experimenting.

I talked about the importance of facts versus opinions regarding drug use.
Much of what passes for fact these days is, in fact, biased propaganda. My
observation is that the very ones who are most at risk can smell it a mile
away.

We talked about what drug dependency really means; that drugs such as
marijuana and hallucinogens are not narcotics at all and really have minimal
capacity for physical dependency. You do not get "hooked" after a single
puff or 10.

Then I introduced the concepts of set and setting: the user's psychological
state and the environment in which drugs are used, and that it is so crucial
to their effect. I explained that the habitual use of any drug to escape
depression or stress is a recipe for psychological dependence.

The real killer drugs

We discussed the statistics. I explained the fact that nicotine, one of the
most addictive substances known to science and legally sold by every grocer
in our country, is responsible for the premature deaths of 300,000 Americans
per year.

I explained that alcohol is the most challenging drug of all. The same drug
that is enjoyed by millions -- including many of their parents -- is also a
stealthy killer, responsible for another 100,000 deaths per year. Alcohol,
not methamphetamine, will be the biggest drug challenge for most of these
students.

Then we reviewed the statistics of the illegal drugs. In terms of actual
lives lost, there is no comparison. Fact: Less than 5,000 people per year
die from their use of illegal drugs. Doesn't that prove that the "war on
drugs" is working? The facts don't support it. Instead of dying, most
junkies live meaningless, burnt-out lives, hustling, scraping by on the
government dole.

We reviewed the dismal failure of the 18th Amendment and discussed some
troubling comparisons with our current situation: The fact that our
government spends more than $16 billion a year to "fight drugs."

The fact that more than half a million people in our proud country are in
prison for drug-related charges. And yet most drugs continue to be easily
available in most high schools across this country.

Hardly a victory.

We talked about the neurochemistry of how different drugs act on our brains.
I shared some stories from the Emergency Department. Most students had no
idea that we use narcotics more than any other drug when we help people with
the pain of their injuries. I told of the almost weekly tragedy of psychotic
brains, depleted of their stimulatory transmitters by months of
methamphetamine bingeing.

By the end, the class was silent. I had no idea that 13- and 14-year-olds
could be so quiet. As I left, one student made it all worthwhile: "Thanks,
you told us the facts."