DRUG MISTREATMENT

Tens of thousands of American teenagers are forced into drug treatment
programs each year by schools, parents, or the courts despite not
having any serious drug problem.

New York teens rally against the drug war.

As he waited for the drug counselor to return, Bill hunched his wiry
frame forward, his leg jittering. He wasn't going through withdrawal
he was just nervous. He didn't know what to expect or exactly what the
point of this questioning was. All he knew for sure was that he needed
to enter a drugtreatment center, or be kicked out of school.

Minutes earlier, the sandyhaired 15yearold (whose name has been
changed) had answered a series of questions. Yes, he occasionally
smoked marijuana with his friends but not on a regular basis, and
always in moderation. No, he had never tried any other illicit drug
and did not drink alcohol.

Bill's drug use, in other words, was by most people's standards
nothing remarkable for an American adolescent, certainly no worse than
that of hundreds of thousands of other healthy, thriving teenagers.
But the counselor at New Bridge Adolescent Treatment Center apparently
thought otherwise.

"She told me I was 'between abuse and dependency,'" the highest level
of drug abuse, Bill says.

The counselor told Bill's mother, Karen (whose name also has been
changed), that Bill would have to attend afterschool treatment four
times a week for the next two to three months, and then once a week
for the remainder of the year. Karen herself would have to attend
Alcoholics Anonymous meetings each week, a requirement for all parents
with kids enrolled in the treatment program, one of the several at the
Center. She would also have to remove all alcohol from her house. To
top it off, Bill's father was to administer random urine tests
whenever the facility's officials ordered him over the phone to do so.
The program costs $100 a day, of which Karen's health insurance would
only cover half.

Such intensive treatment for such a relatively minor problem if one
even considers drug use at Bill's level a problem may sound extreme,
but is increasingly common across the US. Bill is just one of tens of
thousands of adolescents whom a raft of experts say are coerced into
entering drug treatment each year by schools, parents, or the courts,
despite not having any serious drug problem.

Over the past 10 years, more than one million adolescents have been
removed from school for drug policy violations, according to Joel Brown
of the Center for Educational Research and Development, who is
currently studying the effect schools have in forcing youths into
treatment. In a great number of those cases, Brown says, students have
only one way to get readmitted to school: enroll in a treatment
facility. No one knows the full extent of this trend, because there
are no centralized statistics kept on drugrelated school expulsions.
The trend does, however, seem to help explain why adolescent treatment
admissions have shot up by about two thirds since 1990, according to a
recent study by the federal Substance Abuse and Mental Health Services
Administration.

Brown estimates that "less than 10 percent" of the kids who enter
treatment at the insistence of their schools actually have a problem.

"The assumption is that if a kid gets caught in school with drugs,
they automatically have a drug problem, but there's a great number of
kids that are experimenting with substances and still succeeding in
school," says Brown, who stresses that he does not encourage
adolescent drug use.

"You know who gets put into treatment? It's the kids who get caught,"
seconds Ernest Drucker of New York's Montefiore Medical Center, who
headed a methadone clinic for 20 years from 1970 to1990.

Bill says he was pushed into treatment by officials at his school in
Northern California. In January, Bill's principal told Karen that he
suspected Bill of "using" and urged her to have him assessed at a
treatment facility.

Karen, in fact, knew that her son occasionally smoked marijuana. She
wasn't happy about it, but she believed he was using the drug
responsibly. But before Karen had a chance to do anything about the
principal's advice, one of Bill's teachers caught him smoking
marijuana in the school parking lot with one of his friends. Karen
says she was called back to the school and given an ultimatum.

"This time, they basically said, 'You either enroll him into a drug
treatment program or we're going to start procedures for expulsion,'"
she says.

The principal at Bill's school would neither confirm nor deny Karen's
account.

Some experts say many school officials are encouraged to offer the
treatment or expulsion ultimatum by the example set by the federal
government's hardline policy on drugs. The federal government cannot
require schools to follow a set drug policy, but the Department of
Education does offer "model program" guidelines emphasizing a
proactive approach to drug prevention and intervention, according to
DOE spokeswoman Melinda Malico.

School drug policies vary by state and district. Schools usually have
discretion to suspend or expel students who are caught with drugs.
Some simply require a student caught with drugs to go in for an
assessment. But, as Bill's situation reveals, it does not take much to
be diagnosed as an "abuser."

Consider these unassuming questions from the New Bridge Foundation's
self assessment for teens: "Do you sometimes hang out with kids who
drink/use? Have you had anything to drink in the last week? Have you
ever felt guilty or bummed out after drinking/using?"

Such vague questions, many researchers say, help to explain how kids
without real drug problems end up thrown in as hardcore addicts.

Though schools are a primary culprit in pushing youths into unneeded
treatment, parents do their share too. Alan Leshner, director of the
National Institute on Drug Abuse (NIDA), told the Dallas Morning News
in 1997 that most youths in treatment "are either court mandated or
what we call 'mommy mandated.'" At such facilities as the Hazelden
Foundation in Center City, Minnesota one of the largest treatment
centers in the country relatives accounted for nearly half of all
youth admissions in 1998.

"C.D.", a Connecticut teenager who recently completed treatment at an
outpatient center in Connecticut says that most of the teenagers were
placed in the program by their parents, often against their own will.
"Some of them were forced into it by threats by their family," she
says, estimating that only "50 percent" of the kids in the program had
real drug abuse problems.

"Parents are scared shitless about this," says Stanton Peele, a New
Jersey psychologist and author who specializes in addiction. "They're
afraid their kids are going to end up like David Kennedy and die of
heroin or something."

Just ask Al Levesque, who says his mother forced him to enter three
separate rehab clinics in Connecticut over a three year period,
beginning at age 14. He was admitted for marijuana use every time,
despite the fact that he used the drug moderately. His mother, he
says, saw him as an "out of control teen."

"I don't think that I ever did or do have a drug problem. I've
always been a good student, and I've always been very productive,"
says Levesque, now 23 and finishing his last semester at Western
Connecticut State University.

Levesque literally spent years in treatment at his mother's bidding.
Most of his stays consisted of outpatient treatment in which the
client is not hospitalized but attends day sessions but he often
spent "every waking hour of his day" at the treatment facilities. In
one instance, he was required to attend treatment 40 hours a week for
nine months.

The results of his "rehabilitation"? Levesque continued to use
marijuana responsibly, and has not moved on to regular use of harder
drugs. He is currently vice president of the WCSU chapter of the
National Organization for the Repeal of Marijuana Laws.

Of course, many in the federal government and the treatment industry
heartily approve of the increase in adolescent treatment, saying the
trend parallels an overall increase in teen drug use over the past
decade.

"We know that drug use remains very high [among teenagers], and we're
working to lower that," says Bob Weiner, spokesman for US drug czar
Barry McCaffrey.

Drug use among teens increased after 1990, but has begun declining
again in recent years, according to school surveys. But the only
significant increase has been with marijuana use, which rose
substantially from 1991 to 1999, according to the NIDAfunded
Monitoring the Future Study. In 1997, marijuana was the primary
substance of abuse in about half the treatment admissions for people
younger than 20. The use of all other illicit drugs, including cocaine
and heroin, has increased by only a few percentage points.

Carol Falkowski, a senior researcher at Hazelden, says the rise in
marijuana admissions is justified. "More kids are being exposed to a
more potent form of [marijuana] at a younger and younger age," she
says. "Kids are running into real problems."

But, says Drucker, an increase in use does not necessarily lead to an
increase in abuse, particularly in the case of a drug that has never
been proven addictive and is considered by many to be safer than alcohol.

"How the hell do you treat somebody for using marijuana?" he asks.
"Frankly, there's no evidence of an effective form of treatment for
those who do have problems with marijuana."

By definition, however, the federal government's "zero tolerance"
policy considers virtually any drug use, regardless of the type of
substance or frequency of use, as "abuse." The result, say critics, is
a "onesizefitsall" model of drug treatment. This model is based on
complete abstinence, which many criticize as simplistic, even some
whose job it is to advocate abstinence based treatment.

"If teenagers use drugs at all, they've already met the criteria [for
drug abuse]," says Pat Harrison, manager of health care research at
the Minnesota Department of Human Services. "We can't teach safe and
responsible use to minors because of the zero tolerance policy. So
you're left with no choice but advocating total abstinence, which
isn't particularly effective."

The scarce statistics the government keeps on frequency of drug use by
teens entering treatment seem to support the notion that many of them
do not belong there. According to the federal government's Treatment
Episode Data Set for 1996, the year in which teen marijuana use was at
its most recent peak, close to 30 percent of the kids who were
admitted for marijuana use reported "no use in the past month" upon
entering treatment. Another 15 percent reported using only "one to three
times in the past month." Only 32 percent reported daily marijuana
use.

Meanwhile, while kids with minor drug problems fill treatment slots,
others with serious addictions are left out in the cold.

According to a July 1999 report by the California Legislative
Analyst's Office, only 10 percent of adolescents who are estimated to
need publicly funded treatment receive it. Nearly 2,000 wards of the
California Youth Authority are waiting to get into drug rehab
programs, according to a recent Los Angeles Times article.

Access to treatment often depends on being able to afford it, says
Brian Greenberg, a psychologist who is vice president of the Walden
House Adolescent Treatment Center in San Francisco. For many low income
families, says Greenberg, the only adolescent treatment available is
through the juvenile justice system. This puts the parents of many
young addicts in a tough spot. "If a family doesn't have health
insurance, sometimes they will err on the side of calling the police
when their kid gets into trouble because it's the only way to get
treated," he says.

"Ironically, the kids that are labeled 'at risk' by the government
[often] don't get any of the help that they need," Brown says.