New heroin
Successful programs build on key principles

Just saying no is one way to fight drug abuse, whether it's addiction to
marijuana, cocaine or heroin. But serious work must occur before some
teens and adults can just say no.

At least, that's what many experts say. The National Institute on Drug
Abuse outlines several principles that successful drug prevention
programs embrace. Those suggestions focus on getting both children and
their parents to make good choices about their lives, not just drugs.

Good prevention programs emphasize techniques that build strong social
abilities. The institute notes that such programs train young people to
communicate with their peers and to build solid relationships with
others. Similarly, they teach children how to assert themselves in
groups, so they won't be bullied into bad behavior.

Lifeskills Training Program, which was developed by a Cornell University
professor, is one effort that employs this approach. About 20,000 kids
are involved in a Lifeskills Training Program in more than 500 schools
nationwide.

Baltimore's Lombard Middle School is a school that uses the program to
fight drug addiction. Lombard Principal Robert Hopkins says Lifeskills
may employ some "selfevident" ideas. But they are not so evident to a
12yearold or 13yearold, he says. The Lifeskills curriculum helps
impressionable teens learn "how to deal with various situations," Mr.
Hopkins notes.

The National Institute on Drug Abuse also says that successful drug
prevention programs focus on the long term, not just instant
turnarounds. And they involve parents, so they can reinforce what a
child is learning in a program.

The Strengthening Families Program offers a unique approach to parents
and children. It involves both drug abusers and their children. In fact,
the program grew out of a Salt Lake City heroin treatment center.

Parents addicted to heroin asked the center's leaders to help them
discover ways to keep their kids straight. They did not want their young
ones to make the same tragic choices.

A 14week program was developed. Over time, it has been used in cities
like Detroit and Denver. The program's mission is to equip parents and
children with important personal skills. Those newfound abilities
include learning how to resolve family conflicts and manage stress.

Seattle's Focus on Families Program has a similar origin and approach.
Born of a Seattle heroin treatment program, it likewise centers on
family development.

About 95 percent of the program's clients are heroin addicts, who
participate in a 32week program. The program attempts to get parents to
better manage their families and their own lives. Children also are
involved, especially in homebased sessions where family members learn
to resolve differences.

The program has yielded positive results over the last two years. Focus
on Families data show that 54 percent of parental participants in the
program's two Seattle locations have stayed off heroin and other drugs.

Those successes confirm that heroin addiction can be treated. But it is
a difficult journey from detoxification to longterm abstinence and
recovery. Physical withdrawal from opiates like heroin can be more
severe than withdrawals from stimulants. In the past, opiates such as
methadone were most commonly substituted for heroin. Because methadone
stayed in the user's system for several days, addicts did not have to
get daily injections. That helped hold costs down. There still are more
than 100,000 recovering heroin addicts participating in publicly funded
methadone programs.

But most treatment programs now use other medications, including milder
opiate substitutes like Darvon, to detoxify and taper the habit. Yet
even after detoxification, the desire to use again can be triggered by
environmental cues such as white powder. Former addicts usually need
ongoing help from support groups or counselers.

Treatment for the newer heroin abuse may present different problems
because of the younger age of abusers and the polydrug addictions of
youngsters who graduate from cigarettes to marijuana to cocaine and
heroin.

Cities, schools and communities would be wise to start focusing now on
holistic programs for prevention and treatment that help whole families
make better decisions. There must be a constant drumbeat about the
downside of drug abuse. There must be caring advice on how to build
strong personal skills. Youngsters can learn to say no, but they need
coaching.

Fifth in a series