Drug Mistreatment
Feeding teens to the correctional complex
Boulder Weekly Cover Story (March 2-8, 2000)
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by Jake Ginsky (Editorial@boulderweekly.com)
As he waited for the drug
counselor to return, Bill hunched
his wiry frame forward, his leg
jittering. He wasn't going through
withdrawal-he was just nervous.
He didn't know what to expect
or exactly what the point of this
questioning was. All he knew for
sure was that he needed to enter
a drug-treatment center, or be
kicked out of school.
Minutes earlier, the sandy-haired 15-year-old (whose name has been
changed) had answered a series of questions. Yes, he occasionally smoked
marijuana with his friends-but not on a regular basis, and always in
moderation.
No, he had never tried any other illicit drug and did not drink alcohol.
Bill's drug use, in other words, was by most people's standards nothing
remarkable for an American adolescent, certainly no worse than that of
hundreds of thousands of other healthy, thriving teenagers. But the
counselor at New Bridge Adolescent Treatment Center apparently thought
otherwise.
"She told me I was 'between abuse and dependency,'" the highest level of
drug abuse, Bill says.
The counselor told Bill's mother, Karen (whose name also has been
changed), that Bill would have to attend after-school treatment four times a
week for the next two to three months, and then once a week for the
remainder of the year. Karen herself would have to attend Alcoholics
Anonymous meetings each week, a requirement for all parents with kids
enrolled in the treatment program, one of the several at the Center. She
would also have to remove all alcohol from her house. To top it off, Bill's
father was to administer random urine tests whenever the facility's officials
ordered him over the phone to do so. The program costs $100 a day, of
which Karen's health insurance would only cover half.
Treatment scam
Such intensive treatment for such a relatively minor problem-if one even
considers drug use at Bill's level a problem-may sound extreme, but is
increasingly common across the U.S. Bill is just one of tens of thousands of
adolescents whom a raft of experts say are coerced into entering drug
treatment each year by schools, parents or the courts, despite not having
any serious drug problem.
Over the past 10 years, more than one million adolescents have been
removed from school for drug-policy violations, according to Joel Brown of
the Center for Educational Research and Development, who is currently
studying the effect schools have in forcing youths into treatment. In a great
number of those cases, Brown says, students have only one way to get
readmitted to school: enroll in a treatment facility. No one knows the full
extent of this trend, because no centralized statistics are kept on
drug-related school expulsions. The trend does, however, seem to help
explain why adolescent treatment admissions have shot up by about
two-thirds since 1990, according to a recent study by the federal Substance
Abuse and Mental Health Services Administration.
Brown estimates that "less than 10 percent" of the kids who enter treatment
at the insistence of their schools actually have problems.
"The assumption is that if a kid gets caught in school with drugs, they
automatically have a drug problem, but there's a great number of kids that
are experimenting with substances and still succeeding in school," says
Brown, who stresses that he does not encourage adolescent drug use.
"You know who gets put into treatment? It's the kids who get caught,"
seconds Ernest Drucker of New York's Montefiore Medical Center, who
headed a methadone clinic for 20 years from 1970 to 1990.
Bill says he was pushed into treatment by officials at his school in Northern
California. In January, Bill's principal told Karen that he suspected Bill of
"using" and urged her to have him assessed at a treatment facility.
Karen, in fact, knew that her son occasionally smoked marijuana. She
wasn't happy about it, but she believed he was using the drug responsibly.
But before Karen had a chance to do anything about the principal's advice,
one of Bill's teachers caught him smoking marijuana in the school parking lot
with one of his friends. Karen says she was called back to the school and
given an ultimatum.
"This time, they basically said, 'You either enroll him into a drug treatment
program or we're going to start procedures for expulsion,'" she says.
The principal at Bill's school would neither confirm nor deny Karen's
account.
Some experts say many school officials are encouraged to offer the
treatment-or-expulsion ultimatum by the example set by the federal
government's hard-line policy on drugs. The federal government cannot
require schools to follow a set drug policy, but the Department of Education
does offer "model program" guidelines emphasizing a pro-active approach
to drug prevention and intervention, according to DOE spokeswoman
Melinda Malico.
School drug policies vary by state and district. Schools usually have
discretion to suspend or expel students who are caught with drugs. Some
simply require a student caught with drugs to go in for an assessment. But,
as Bill's situation reveals, it does not take much to be diagnosed as an
"abuser."
Guilt by association
Consider these unassuming questions from the New Bridge Foundation's
self assessment for teens: "Do you sometimes hang out with kids who
drink/use? Have you had anything to drink in the last week? Have you ever
felt guilty or bummed out after drinking/using?"
Such vague questions, many researchers say, help to explain how kids
without real drug problems end up thrown in as hard-core addicts.
Though schools are a primary culprit in pushing youths into unneeded
treatment, parents do their share too. Alan Leshner, director of the National
Institute on Drug Abuse (NIDA), told the Dallas Morning News in 1997
that most youths in treatment "are either court-mandated or what we call
'mommy-mandated.'" At such facilities as the Hazelden Foundation in
Center City, Minnesota-one of the largest treatment centers in the
country-relatives accounted for nearly half of all youth admissions in 1998.
"C.D.," a Connecticut teenager who recently completed treatment at an
outpatient center, says that most of the teenagers were placed in the
program by their parents, often against their own will. "Some of them were
forced into it by threats by their family," she says, estimating that only 50
percent of the kids in the program had real drug-abuse problems.
"Parents are scared shitless about this," says Stanton Peele, a New Jersey
psychologist and author who specializes in addiction. "They're afraid their
kids are going to end up like David Kennedy and die of heroin or
something."
Three years, three clinics
Just ask Al Levesque, who says his mother forced him to enter three
separate rehab clinics in Connecticut over a three-year period, beginning at
age 14. He was admitted for marijuana use every time, despite the fact he
used the drug in moderation. His mother, he says, saw him as an "out of
control teen."
"I don't think that I ever did-or do-have a drug problem. I've always been a
good student, and I've always been very productive," says Levesque, now
23 and finishing his last semester at Western Connecticut State University.
Levesque literally spent years in treatment at his mother's bidding. Most of
his stays consisted of outpatient treatment-in which the client is not
hospitalized but attends day sessions-but he often spent "every waking hour
of his day" at the treatment facilities. In one instance, he was required to
attend treatment 40 hours a week for nine months.
The results of his "rehabilitation"? Levesque continued to use marijuana
responsibly, and has not moved on to regular use of harder drugs. He is
currently vice president of the WCSU chapter of the National Organization
for the Repeal of Marijuana Laws.
Of course, many in the federal government and the treatment industry
heartily approve of the increase in adolescent treatment, saying the trend
parallels an overall increase in teen drug use over the past decade.
"We know that drug use remains very high (among teenagers), and we're
working to lower that," says Bob Weiner, spokesman for US drug czar
Barry McCaffrey.
Pot-smoking teens
Drug use among teens increased after 1990, but has begun declining again
in recent years, according to school surveys. But the only significant
increase has been with marijuana use, which rose substantially from 1991 to
1999, according to the NIDA-funded Monitoring the Future Study. In
1997, marijuana was the primary substance of abuse in about half the
treatment admissions for people younger than 20. The use of all other illicit
drugs, including cocaine and heroin, has increased by only a few percentage
points.
Carol Falkowski, a senior researcher at Hazelden, says the rise in marijuana
admissions is justified. "More kids are being exposed to a more potent form
of (marijuana) at a younger and younger age," she says. "Kids are running
into real problems."
But, says Drucker, an increase in use does not necessarily lead to an
increase in abuse, particularly in the case of a drug that has never been
proven addictive and is considered by many to be safer than alcohol.
"How the hell do you treat somebody for using marijuana?" he asks.
"Frankly, there's no evidence of an effective form of treatment for those
who do have problems with marijuana."
Zero tolerance
By definition, however, the federal government's "zero tolerance" policy
considers virtually any drug use-regardless of the type of substance or
frequency of use-as "abuse." The result, say critics, is a
"one-size-fits-all"
model of drug treatment. This model is based on complete abstinence,
which many criticize as simplistic, even some whose job it is to advocate
abstinence-based treatment.
"If teenagers use drugs at all, they've already met the criteria (for drug
abuse)," says Pat Harrison, manager of health care research at the
Minnesota Department of Human Services. "We can't teach safe and
responsible use to minors because of the zero-tolerance policy. So you're
left with no choice but advocating total abstinence, which isn't particularly
effective."
The scarce statistics the government keeps on frequency of drug use by
teens entering treatment seem to support the notion that many of them do
not belong there. According to the federal government's Treatment Episode
Data Set for 1996-the year in which teen marijuana use was at its most
recent peak-close to 30 percent of the kids who were admitted for
marijuana use reported "no use in the past month" upon entering treatment.
Another 15 percent reported using only "one-to-three times in the past
month." Only 32 percent reported daily marijuana use.
Meanwhile, while kids with minor drug problems fill treatment slots, others
with serious addictions are left out in the cold.
According to a July 1999 report by the California Legislative Analyst's
Office, only 10 percent of adolescents who are estimated to need publicly
funded treatment receive it. Nearly 2,000 wards of the California Youth
Authority are waiting to get into drug rehab programs, according to a recent
Los Angeles Times article.
Follow the cash
Access to treatment often depends on being able to afford it, says Brian
Greenberg, a psychologist who is vice president of the Walden House
Adolescent Treatment Center in San Francisco. For many low-income
families, says Greenberg, the only adolescent treatment available is through
the juvenile justice system. This puts the parents of many young addicts in a
tough spot. "If a family doesn't have health insurance, sometimes they will
err on the side of calling the police when their kid gets into trouble because
it's the only way to get treated," he says.
"Ironically, the kids that are labeled 'at risk' by the government (often) don't
get any of the help that they need," Brown says.
This article was originally published by the MoJo Wire
(www.motherjones.com), Mother Jones magazine's online counterpart.
Nabbed from home
Lily, a University of Colorado student, was a typical high school teen. She
experimented with drugs, broke a few rules and argued with her parents.
But it was the '90s, and her working parents had no idea how to cope.
Pamphlets, brochures and school counselors assured her the child was
"troubled." If she's tried illegal drugs, the parents were told, Lily (not her
real name) needs professional help. If she seems lonely, withdrawn or
rebellious, she needs help.
So as the 17-year-old slept one night, a man in commando gear entered her
room and carried her away. This was no kidnapping. The parents had paid
the man $10,000 to take the girl to a lock-up boarding school for
treatment, where she would have no contact with the outside world.
At age 18 she left the boarding school, only to live on the streets for the
next two years. Today, she's an adult living, working and studying in
Boulder, decrying her wrongful teenage imprisonment.
Lily's story is among many others like it a new book titled An American
Gulag-Secret P.O.W. Camps for Teens, written by Alexia Parks, a
longtime Boulder resident. Parks, who has become something of an online
"Dear Abby" for teens who've survived the Gulag, was recently chosen by
Newsweek as "one of the 50 people who matter most on the Internet." The
book, slated to become a TV movie, was published by The Education
Exchange and will soon be available at all major book stores (or at
www.teenliberty.org).
"Behavior modification and youth treatment programs have become the
second fastest growth industry in the country, right behind the prison
industry," Parks says. "There are hundreds of programs out there that
survive by identifying kids as troubled in order to get to the parents' money.
The more money your parents have, the longer your stay and the worse the
abuse."
The industry is so desperate for warm bodies, Parks says, that a teen who
borrows the car without asking-or experiments once with alcohol or
pot-may be successfully coerced into expensive in-patient treatment.
"We are criminalizing children for minor offenses," Parks says. "The system
is very similar to multi-level marketing. Professionals who have contact with
teenagers-attorneys, psychologists, school counselors, principals-may
receive referral fees for getting teens into these programs."
The book, which doesn't officially go on sale until March, has already
caught the attention of Amnesty International and the American Bar
Association.
"It's time for Americans to ask 'What is our government doing about this?'"
says Howard Davidson, director of the Bar Association's Center on
Children and the Law.
Christine Doyle, lead researcher for Amnesty International, says she's
familiar with the for-profit abuse of teens, and frightened by Parks' new
book.
"I've come across these stories and, trust me, they're absolutely horrific,"
Doyle says.
-Wayne Laugesen
Girl interrupted
At age 14, Danielle Jackson went through a short stage of rebellion. It was
the summer after her eighth grade year at Casey Middle School. Bored, she
joined hundreds of other students and loitered on the Pearl Street Mall,
napping under trees with people who bang on drums all day.
On three occasions, she experimented with crystal meth, a synthetic drug
similar to cocaine. The experience frightened her so much that she told her
mother about it.
"It completely, totally freaked her out," says Jackson, 18.
The next morning, Jackson was awakened at home by five of her mother's
adult friends. Several Boulder cops waited outside, ready to haul her away.
Jackson was taken to Mapleton Center at Boulder Community Hospital,
and a few days later transferred to Devereux Cleo Wallace, an adolescent
psychiatric organization in Westminster. It would be home for the next year
of her life. Her mother's efforts to have her removed from the hospital were
thwarted by social services officials, who insisted the girl needed treatment.
"I was not a drug addict, and I am not a drug addict to this day," Jackson
says. "I experimented with drugs, like every other teenager who hangs out
on Pearl Street. I was so worried about my experience that I voluntarily
told my mother about it."
She was finally released to her father, who lived in Florida. When Jackson
turned legal age, she returned to Boulder. Today, she works the parking
booth at Norwest Bank and attends Front Range Community College.
"I gained nothing of value from my imprisonment at Cleo Wallace," she
says. "I did not belong there."
But Mike Montgomery, executive director of Cleo Wallace, takes issue
with the assertion that teens end up in long-term treatment for minor bouts
of teenage rebellion. The center treats about 300 children and adolescents
at a time, with facilities in Westminster and Colorado Springs.
"Under managed care these days, there is a very stringent review process
that takes place before someone can be admitted for extended treatment,"
Mongomery says. "The operative term is 'medical necessity.' If it's not
medically necessary, insurance companies don't pay."
Bogus, says Alexia Parks, a critic of what she calls the fast-growing
behavioral modification and youth treatment industry. Parks doesn't criticize
Cleo Wallace, but says some treatment centers have their own doctors on
staff who gladly attest to the medical necessity of ongoing treatment. Then it
may become difficult, she says, for a parent to have a child removed from
treatment.
"It becomes the parent vs. the expert," Parks says. "Frequently the expert
wins."
Montgomery says it's true staff physicians determine whether treatment is
medically necessary, but their opinions are subject to outside review.
"If a physician working for the managed care provider disagrees with the
medical necessity of treatment, then you have doctor-to-doctor review. The
managed care physician discusses it with the facility physician and the
facility physician does not always win those debates."
Parks says some treatment facilities, without medical doctors on staff, may
turn to outside experts for referrals in order to establish "medical necessity."
Some outside experts, she says, may be paid referral fees or receive other
benefits in return for their opinions.
"I am unaware of any such practice," Montgomery says. "We certainly
engage in no such practice."
-Wayne Laugesen
© 2000 Boulder Weekly. All Rights Reserved.