You don't have to be an alcohol and drug treatment professional to recognize these kinds of headlines that have appeared in the print and broadcast media:
OxyContin Use at an All-Time High Among Youth
Meth: The Crack of the New Millennium
Computer-Savvy Kids Buy Pharmaceuticals From the Comfort of Their Bedrooms
The average citizen undoubtedly has stumbled across such headlines more than once recently. As drug and alcohol professionals, we have a responsibility to use the media to highlight new trends and issues relevant to our world. However, should we think about presenting these trends with an asterisk? Is it possible that while issues such as teen prescription drug use capture headlines, a more insidious issue—marijuana use—continues to fly under the radar?
Focusing on one particular drug use trend while losing sight of other prevalent problems could play into the skewed logic that we have come to associate with the addict's thought process. Most alcohol and drug treatment providers have encountered clients who have substituted one drug for an identified “problem” drug. In this field, we are firm in proclaiming drug substitution's ineffectiveness for avoiding consequences from substance use. In fact, we often argue that substitution either will lead back to the original drug of choice, escalate use of the substitute drug, or both.
Many clinicians assess the attempt to rationalize drug substitution by using the adage, “A drug is a drug is a drug.” But today's headlines about drug trends offer a different message: They scream “differentiation.” In the murky world of the addicted brain, differentiation is linked to numerous defense mechanisms (minimization, rationalization, denial, etc.). How many times will we speak of “gateway drugs” or contribute to the latest sexy headline before we realize that we are perpetuating the very cycle of addiction that we seek to prevent?
Perceptions of marijuana's harm
Most of those professionals familiar with the adolescent population would say that the culture of adolescence already views marijuana as a drug worthy of legalization. Given this cultural backdrop, and knowing that marijuana still represents the biggest slice of the adolescent drug and alcohol treatment pie, do we not need to place an asterisk next to our good intentions linked to informing the public of new trends and data?
More than a small segment of society views marijuana as relatively harmless, relegating it to gateway or “soft” drug status. Adolescents who come to chemical dependency treatment arrive against this backdrop of public opinion. What treatment provider has not had an encounter with an adolescent, a parent, or an adult addict who seeks to differentiate marijuana use from use of “harder” drugs?
Do we educate youths and their parents about the risks that new drug options present, only to realize that this type of information serves as the fuel the addicted brain seeks? One cannot help but think that our discussion in this field tends to move from one discrete drug trend to another, as OxyContin segues to methamphetamine and so on.
The media need to report on new ideas that capture the public's attention. The treatment industry has a responsibility to provide patients and their loved ones with current data. Even as a professional who has worked in the chemical dependency field for 15 years, I would certainly choose to read something new about methamphetamine or OxyContin over a story about teen marijuana use. But if the addict's mentality seeks to differentiate marijuana use from that of other drugs, are we not perpetuating this differentiation by the degree to which we call attention to these other topics of the moment?
Without external stimulation, the addict uses mental gymnastics to make the ongoing use of aberrant behavior seem acceptable. Take a survey of patients and you'll find a high number who reserve the right to smoke weed. Give the same sample of patients the latest data on other drugs of abuse, and see if they rationalize further that smoking weed is acceptable. Indeed, this type of information may offer potent stimulation to an unquiet mind that seeks more complex ways to justify self-destructive behavior.
David Rotenberg is Executive Director of Adolescent Services at the Caron Foundation in Wernersville, Pennsylvania.