WHEN KIDS ARE ON DRUGS

I would like to take exception to both the tone and the content of Steve
Twomey's column of Nov. 6, "To Hell and Back."

Tone first. The parents whom he describes as "brutal" in employing a
toughlove approach have not come to their behaviormanagement decisions
without having already tried numerous other strategies over months and
years. This kind of parenting is sometimes absolutely necessary when
other approaches have failed to prevent children from becoming
dangerously involved in the use of illegal substances. Twomey appears to
question the validity of such an approach and at the same time appears
to blame nurturing parents or "marshmallow" moms for having caused
the problem. What Twomey does not do is provide his view of what type of
parenting would prevent or alleviate the problem.

And now, content. Twomey dismisses "treatment" in one short sentence
toward the end of his column, and I believe that this is the greatest
shortcoming of the entire column. He fails to educate his reading public
about facts that were printed as early as 1994 in prestigious
publications such as the Menninger Letter: "The researchers found that
85 percent of the substance abusing adolescents had at least one
psychiatric disorder, compared to 65 percent of nonabusers. In fact, 63
percent of the substance abusers received at least four psychiatric
diagnoses, compared to only 30 percent of other adolescents."

Dr. Alan Leshner, director of the National Institute on Drug Abuse at
NIH, was quoted a year later as saying "the number of patients suffering
from cooccurring mental and addictive disorders in this country is
substantially greater than previously realized. . . . Drug addiction and
mental disorders are, in reality, brain dysfunctions that occur as a
result of changes in brain structure or function."

New knowledge about persons who become dependent on drugs, including the
adolescents whom Twomey calls "addicts or boozers or both," continues
to be discovered. The Brain Imaging Center at the National Institute on
Drug Abuse in December 1996 released PET scans that show dramatic
differences between the brains of those who are hooked on drugs and
those who aren't. Time magazine devoted its May 5 cover and lead article
to "How We Get Addicted . . . and how we might get cured" and concluded
that "psychosocial interventions . . . can and do help" and "cognitive
therapy . . . appears to hold particular promise."

The article went on to quote Dr. David Lewis, director of the Center for
Alcohol and Addiction Studies at Brown University School of Medicine,
who said, "Until now, policy makers have responded to the drug problem
as though it were mostly a criminal matter. . . . In my view, we've got
things upside down. . . . By relying so heavily on a criminalized
approach, we've only added to the stigma of drug abuse and prevented
highquality medical care."

The adolescents whom Twomey writes about live in Annandale, Potomac,
Arlington, Southeast D.C., Upper Marlboro and in the neighborhood of
every Washington Post reader. They are extremely complex kids. Their
problems have many facets.

Twomey needs to sympathize more with the parents of such very difficult
children, respect them more for their efforts to not enable further
their children's addictions and, especially, promote the use of medical
treatment based on the knowledge derived by scans that enable a window
into the brain early on.

Carolyn W. Sanger is president of the Alliance for the Mentally Ill
of Montgomery County Inc.