DRUG COUNSELOR: MORE NEED TREATMENT

In his more than 20 years as a certified addictions counselor, Larry
Kosloski has seen a lot of people and their families ravaged by their
inability to stop using drugs or alcohol.

But the treatment director at Anderson/Oconee Behavioral Health Services,
formerly the Drug and Alcohol Commission, also has seen treatment turn
lives around, and he believes in the case of treatment, more is definitely
better.

His belief is underscored by the 2001 National Household Survey on Drug
Abuse released earlier this month by the federal Substance Abuse and Mental
Health Services Administration.

7.1 percent nationwide use drugs

The annual snapshot of the drug abuse problem in the United States
indicates that significantly more people would benefit from addiction
treatment than previously believed and that too many drug users, more than
4.6 million, don't recognize they have a problem.

The survey relied on the responses of 70,000 people 12 and older to
questions about their own experience with drugs.

Almost 16 million people nationwide - 7.1 percent of the 2001 population -
were estimated to be illicit drug users, based on the number of
interviewees who said they used illicit drugs in the month prior to their
interview. Throw in alcohol abuse or dependence, and the number climbs to
16.6 million people, about 7.3 percent.

The fastest growing population of drug users is young adults between 18 and
25. Their rate of abuse or dependence increased from 16 percent in 2000 to
nearly 19 percent in 2001. There was no significant change in drug use
among adults 26 and older.

South Carolina and Upstate residents probably have the same degree of drug
and alcohol problems as elsewhere, Mr. Kosloski said.

"Generally, I'm sure we follow right along with national trends," he said.

Alcohol by far is the most commonly abused drug, followed by marijuana,
cocaine and other amphetamines (including methamphetamine), and
anti-anxiety drugs such as Xanax.

Heroin and other opiates also are used locally, but users who seek help
tend to wind up at methadone clinics or inpatient rehabilitation facilities
such as AnMed Wellspring in Williamston, Mr. Kosloski said.

That center treated 65 people over the past 12 months, Director Joe Feleppa
said. People come to deal with addictions from alcohol, opiates such as
heroin, painkillers such as Oxycontin, and anxiety drugs such as Xanax.

The number of people needing help for Oxycontin addiction rose sharply last
year, from one or two in previous years to about a dozen.

"A lot start out using it for medical purposes, then it gets out of hand,"
he said.

Progress Made

The nation has come a long way from the peak days of drug abuse in the late
1970s when Mr. Kosloski was in college.

"When I was in college, there was no such thing as alcohol awareness," he
said. "I don't remember people talking about substance abuse. It is
different now. Even the issue of drinking and driving: it was illegal then,
too, but now it's a social taboo."

Officialdom also has experienced an attitude shift about drug use, more
often using mandatory treatment instead of jail and fines or breaking up
families, he said.

"I believe that the court system and probation office and DSS and employees
are doing the right thing in offering treatment in lieu of being fired or
going to jail or losing your kids permanently," he said.

Mental illness and drug abuse

The national survey for the first time also gathered information about
mental illness. The nexus of substance abuse and mental disorders has
caused tension between local agencies trying to decide who should treat
which patients.

Among adults with serious mental illnesses in 2001, 20.3 percent were
dependent on or abused alcohol or drugs, compared with 6.3 percent of
adults without mental illness, the survey showed.

The opposite is not true, Mr. Kosloski said.

"Most people who are alcohol and drug dependent do not have mental health
disorders," he said.

To make scarce financial resources stretch farther and to reduce tension
between agencies, top level officials in the departments of Mental Health
and Alcohol and Other Drug Abuse Services have been meeting this year to
find ways to collaborate.

The most recent accomplishment is a working definition of a person with
"co-existing disorders." For purposes of agency collaboration, it will mean
someone with a diagnosed addiction and schizophrenia or other psychotic
disorder, a depressive disorder, bipolar disorder or an anxiety disorder,
said John Hart, the alcohol and drug abuse agency's legislative liaison.

"What's at stake for us is access to services and quality of care," Mr.
Hart said. "Everyone would agree with that. The difficulty is having people
bounce back and forth."

Future treatment may include integrated groups led by staff from both
agencies, he said.

Making of an Addict

Most alcohol and drug users seek help when they hit rock bottom. They've
had a frightening medical emergency or their life starts falling apart, Mr.
Kosloski said.

Different people are motivated at different levels of crisis, he said.

"I've seen people who have been nearly dead three times over and arrested
so many times, and they have still never gotten help," he said. "And other
people have gotten a DUI one time and said that's as bad as they want it to
get."

Addicts are rich and poor, black, white and other races, male and female.
There are two key predictors, however:

a.. The younger a person is the first time they use alcohol or a drug, the
more likely they will develop a problem, because youths are mentally and
physically vulnerable to addiction. b.. If a person has a family member
with a substance abuse problem, they are more likely to also develop one.

Also, the more educated a person is, the less likely they will abuse drugs,
Mr. Kosloski said.

More people are more aware of the dangers of drugs and alcohol, but addicts
continue to be created.

"There's a difference between the getting information and (changing
behavior)," Mr. Kosloski said. "There are still people who are going to do
risky things."

He said his job would depress him if he didn't see people getting better.
Fortunately, he does.

"A lot of recovering people put their lives together without using drugs or
alcohol," he said. "It gives me a lot of hope."