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Home > Research Articles > Tailoring Treatments for Teenage Drug Users

The New York Times

Wednesday, January 08, 2003

By HOWARD MARKEL

In many respects, Michael Lagana is a typical 17-year-old. A junior at Dundalk High School in Maryland, he carries a full load of courses, loves playing football, and works after school selling newspaper subscriptions.

He began smoking marijuana at 14. At 16, he was smoking three fat marijuana cigarettes a day or drinking a couple of 40-ounce bottles of malt liquor.

Donna Lagana, Michael's mother, began to worry last June when she discovered some marijuana among Michael's things. He assured her then that it was "not a problem."

But Michael's drug and alcohol use only escalated. In September, after he drank a fifth of brandy in less than an hour, he passed out and was taken to the emergency room for acute alcohol poisoning.

Although Michael steadfastly refused to see a drug abuse counselor, his parents worried that he might pose a threat to himself or others.

As a result, Mrs. Lagana petitioned the Baltimore County Circuit Court to order him to undergo a substance abuse evaluation. The court agreed, and within a few hours, Michael was picked up from school and taken to a local hospital.

There he was examined by an addiction specialist and was soon admitted to Mountain Manor, an alcohol and drug treatment center for teenagers in Baltimore. It was, Mrs. Lagana recalls, "the hardest day of my life."

"How could I have not noticed it before?" she asked.

Last month, researchers at the University of Michigan reported that the use of alcohol, nicotine and marijuana among high school students across the nation was declining. Nevertheless, levels of teenage drinking and drug use remain stubbornly high.

At least 53 percent of all American adolescents have tried an illicit drug by the time they have finished high school, according to the Michigan researchers.

The Centers for Disease Control and Prevention reported last week that from 1993 to 2001 the rate of binge drinking episodes among drinkers 18 to 20 increased by 56 percent, compared with an increase of 35 percent for all American adults. Binge drinking was defined as five or more drinks at a sitting, with the intention of becoming drunk.

To highlight the continuing problems, a number of doctors who treat substance abuse among adolescents will give a report to all members of Congress and every state governor on Thursday. The report, by a group called the Physician Leadership on National Drug Policy, describes teenage alcohol and drug abuse as a national public health problem.

Dr. Aaron Hogue, a psychologist and a researcher at Columbia University's National Center on Addiction and Substance Abuse, said that last year's reported decline in drug use by teenagers did not mean the problem was going away.

"I am not sure that these general trends, as important as they are, speak directly to those kids who have the most severe substance abuse problems and are in the greatest need of treatment services," Dr. Hogue said.

Also, because the brains of teenagers are still developing, many experts believe they are at greater risk for becoming addicted. A number of studies have shown that teenagers who begin using illicit drugs before they are 15 are eight times as likely to develop substance abuse problems as those who start at 18 or later.

Anna Joseph, a 15-year-old who lives in Ann Arbor, is among those who have avoided drugs. "I don't feel I need them to have a good time," she said.

For her, a major deterrent has been seeing other teenagers at school whose lives became messed up because they were dependent on drugs.

Philip Anderson, a 17-year-old from Ferndale, Md., who began using drugs at 10 and has abstained for over a year, explains that young people try drugs for a lot of reasons. "I got into drugs because I thought it was fun," he said. "Some kids see their parents using them. Others see their friends using them and feel pressured to do the same. Some are just curious."

Dr. Marc Fishman, a psychiatrist at Mountain Manor and a faculty member at Johns Hopkins, said: "Many adults trivialize how bad these drugs really are. They say it's just pot or booze, what's the big deal? But it is a big deal when it involves children."

Still, many experts say more treatment programs tailored to teenagers are needed.