SPOTLIGHT ON YOUNG ADDICTS

Still, Too Many Get Inadequate Or No Treatment

With her bright pink nail polish, pancake makeup and darting,
penciled eyes, Sarah looks older than 16.

But being too old has never been her problem - not since the age of
11, when she sought help from a California drug treatment program for
adolescents and was turned away for being too young.

By then, she had already been smoking crystal meth for at least a year.

Ineligible for a program "developmentally targeted" for teens, an
adolescent Sarah fell through the cracks.

Although a social worker from Child Protective Services, familiar
with her case, offered alternative counseling, it was years before
Sarah quit, and then it was on her own terms.

The overwhelming fact is that of the 1.6 million young people between
the ages of 12 and 18 with serious alcohol and drug problems, fewer
than one in 10 receive treatment.

Of the estimated 175,000 who do, only about 25 percent stay in
treatment for three months, as recommended by the National Institute
on Drug Abuse; less than 50 percent stay for even six weeks,
according to the Office of Applied Statistics in 2005.

And there is virtually no continuing care for teenagers who struggle
to stay straight once back in circulation.

A 2002 study in the Journal of Substance Abuse Treatment found almost
80 percent of teenagers relapse within a year of treatment.

Today, the field is moving from an uninhabited backwater to a
state-of-the-art discipline, with dozens of new federal grants,
hundreds of published studies, promising new interventions and -
finally - evaluated program outcomes.

Recovery schools

One of the most telling developments is the rapid growth of recovery
high schools and colleges - some with waiting lists - whose main
focus is abstinence and recovery for students after treatment.

In Madison, Horizon High School opened its doors in a church basement
in 2004 and graduated a class of five last June.

Its mission is to foster emotional, social and academic growth for
students who want to learn in an environment free of alcohol and
drugs, said director Traci Goll.

Now housed at 29 S. Mills St., in Neighborhood House Community
Center, Horizon High has openings for students in grades 9 through
12. Tuition is $12,000 a year, or $6,000 per semester.

"That sounds expensive," Goll said, but for families that have
financed rehabilitation, several other schools, therapy and perhaps
legal expenses, it's well worth it.

"So many kids get sent away, but it would be so much better if they
could stay with their families and get the help they need," she said.

At the high school level, there are 30 of these schools for abusers
around the country, each built on a 12-Step model, offering
mentorship and concrete rules for staying straight, as well as the
sort of peer bonding that reinforces new patterns of positive
behavior, something that generally isn't possible in a typical high school.

"To think a teenager is going to go for treatment for 30 days and
then come back to his old environment - where he bought his drugs,
where his peers are using and where he was seen as a drug user . . .
that's not realistic for the vast majority of kids," says Andrew
Finch, executive director of the Association of Recovery Schools,
which represents the 30 recovery high schools, from Alabama to Alaska.

"For them, school is a danger zone," Finch says. "It's like an adult
alcoholic being required to go to work in a bar."

Tony Landecker, 23, now sober and a sophomore at Augsburg College in
Minneapolis, was in treatment for alcoholism at 14. He managed to not
drink for more than three years but during senior spring break he
went to Florida. Landecker and friends promised to drink only once.

But that quickly turned into four or five nights and didn't stop when
he returned home. It would be two more years before he got help.

Finch says the high school programs work: Between 20 percent and 30
percent of the young participants relapse, but that's a substantial
improvement over the national norm of 80 percent.

Lots of new knowledge

The field is exploding with new knowledge about adolescence and
substance abuse.

It is now understood, for example, that the vast majority of teen
substance abusers - more than 80 percent of girls, according to some
recent academic studies - have been sexually, physically or emotionally abused.

With that in mind, many experts have put out a call for routine
screening for sexual abuse when young drug and alcohol users show up
for treatment.

"The issue of traumatic victimization is an unspoken elephant in the
counseling rooms," writes Michael L. Dennis, a research psychologist
at Chestnut Systems, a research and treatment center in Bloomington,
Ill., and author of well-regarded drug assessment tests. "Physical,
sexual and emotional abuse is the norm."

Many adolescent substance abusers - federal estimates say 70 percent
- - also have a mental health problem, such as attention deficit
disorder, bipolar disorder or post-traumatic stress disorder.

Slowly, local public agencies across the country are responding, some
even consolidating mental health and substance abuse agencies into
single entities, its counselors expected to be trained to deal with both.

Philosophical split

For those who can get to private treatment, many youth programs are
now moving away from the classic 12-Step model, as embodied by
Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). A
philosophical split has emerged among the treatment specialists, with
some on-the-ground programs endorsing alternatives to 12-Step and its
insistence on total abstinence.

"Many treatment programs are using new evidence-based practices that
meet youth where they are with their current substance abuse and help
them make a decision what they're going to do about it," says Randy
Muck, lead public health advisor for Adolescent Treatment Programs at
the federal Substance Abuse & Mental Health Services Administration.

Many experts argue that the language of 12-Step programs, with their
starting point of sobriety, grew out of a therapeutic model aimed at
adult males. Its requisite call to a "higher power" is often a major
sticking point with teens who, in the words of one probation officer,
often "think they are the higher authority."

"For years, the problem we've encountered is that treatment for kids
is basically treatment for adults repackaged," says Scott Reiner,
program development manager in the Virginia Department of Juvenile
Justice. "They changed a couple words, perhaps, but never addressed
the developmental needs of kids."

About this series

More than 22 million Americans age 12 and older are addicted to drugs
and alcohol, but nine out of 10 fail to get the treatment they need.
This five-part series by Public Access Journalism and distributed by
McClatchy-Tribune News Service explores the latest research on
addiction and treatment and personal stories on the road to recovery.

MONDAY: New drugs and new treatment methods fuel hope. TODAY:
Addiction treatment for adolescents becomes a state-of-the-art
discipline. WEDNESDAY: Different approaches helping female addicts.
THURSDAY: Overcoming the seemingly insurmountable cost of treatment.
FRIDAY: Advocates work to drum up moral, financial support.