DRUG PROBLEM NEEDS MOST ATTENTION

Substance abuse has been called the nation's No. 1 health problem,
according to the U.S. Department of Health and Human Services report of
March 2001. The President's Office of the National Drug Control Policy
states in this year's report to Congress "the metaphor 'war on drugs' is
misleading ... cancer is a more appropriate metaphor for the nation's drug
problem."

With our new national understanding of what war against unseen enemies
means, it does appear that currently there certainly is not a war on drugs,
nor a war on crime. However, considering that our children's lives are
under attack by drug lords and their agents domestically and
internationally, perhaps the allegorical inference of terrorism is more
accurate.

Regardless of the nation's current lack of sufficient offensive strength in
its struggle with substance abuse of its citizens, it is more the defensive
attitude that we can apply within our community which I would like to address.

Substance abuse is a psychiatric diagnosis and, as a child and adolescent
psychiatrist and physician, I have seen a spectrum of suffering secondary
to substance abuse ranging from vehicular accidents to homicide and
suicide, the No. 1, 2 and 3 causes of death in our children and
adolescents. If not a matter of mortality, rape, violence, sexually
transmitted diseases, and arrested development are very often the morbidity
associated with substance abuse.

So what is the perception of our community toward substance abuse? One
study that may offer some insight is the 2000 Springfield Area Citizen
Survey, commissioned by the City of Springfield. In that study, the top
four neighborhood concerns were: speeding; traffic congestion; cluttered,
junky yards and porches; and drugs.

Traffic congestion was also given as the biggest problem for the city of
Springfield. This concerns me, as a predominant protective factor for our
kids resisting substance abuse is their perceived attitude of the family
and the community toward substances. A laissez-faire point of view is
non-protective and in fact, a risk factor.

What are kids saying? A report titled "Substance Use, Delinquent Behavior,
and Risk and Protective Factors Among Students in the State of Missouri:
2000" prepared for the Missouri Department of Mental Health, Division of
Alcohol and Drug Abuse in February 2001 indicates the problems we face in
our part of the state are as problematic as the rest of the state.

For southwest Missouri, data suggest that 30 percent of our kids use
alcohol, 21 percent use tobacco, and 14 percent use illegal substances.
Particularly when one considers that half of this population was pre-high
school, these numbers are alarmingly high.

This study further points out risk factors exist in each domain of the
individual - peer, family, school and community. The strongest risk factors
were early initiation of substance abuse and family and community attitudes
favorable toward tolerance of substance abuse.

Protective factors include strong family relationships and commitment to
school or church. Community protective factors included non-availability of
substances, laws and societal norms unfavorable to substance abuse, and
opportunities/rewards in the community for conventional involvement.

New laws may be necessary to help decrease risk factors and increase
protective factors. Also tighter enforcement of existing laws is necessary,
such as recent legal action taken by the Attorney General Jay Nixon against
retailers who have a non-compliance rate to selling tobacco and alcohol to
minors as high as 50 percent. Perhaps restrictions toward advertising
suggesting permissive norms with respect to alcohol and tobacco use should
be reviewed.

Generally the issues of substance abuse and the related issues of violence,
crime and health need to be given more community attention and public
funding, perhaps at least to the status of traffic congestion.