THE FUTURE

Not long ago the federal hospitals at Lexington and Fort Worth were the only places an addict could go to when he had made up his mind to seek help. Today, in New York City alone, there are over 40 facilities open to him, and others have sprung up in all parts of the country.

But, in spite of their growing number, all the present facilities together are no more than a few grains of sand trying to stem the vast tide of drug abuse. None has any clearly conclusive answersparticularly to the problem of the addict who does not want to escape from his habit, as many do not, and who does not have what it takes to benefit from even the best treatment and aftercare or from the rugged discipline of Synanon.

On the other hand, the small gleams of success to be glimpsed in several of the approaches now being tried are reinforced by an encouraging phenomenon called "maturing out." Many times, those working with addicts have found that a few — among them some who seem to be hopeless cases may simply grow out of their addiction, leaving it behind them as they achieve greater maturity and emotional balance with time. These few successes provide hope that a way will eventually be found to cure and ultimately prevent the devastating effects of drug abuse.

DRUG ABUSE: A PRIMER FOR PARENTS

The problem of drug abuse, while not new to man's experience, has recently assumed considerable prominence as a major social concern. While this prominence is due, in part, to greater willingness to discuss the issue openly, there are still many who continue to turn their backs on the problem. “Drug abuse," they say, "is someone else's problem, not ours. It can't happen here."

Unhappily, this statement does not stand up under close examination. In today's highly mobile society, with its capacity for instantaneous communication, bizarre ideas—including those disruptive of life become community property, and the means for realizing them provided everywhere.

A case in point is drug abuse. Once largely confined to dismal slum life, it has become today the plaything of the economically and socially advantaged. Drug abuse can be found everywhere-in any social stratum, in any cultural milieu, at any economic level.

Complicating the problem has been the emergence of a number of individuals of impressive credentials who have become the Pied Pipers of drug abuse. By seeking to end legal restrictions on drugs which affect behavior (particularly hallucinogens such as marihuana and LSD), they have become heroes to many of the nation's youth. The positive reaction of some young people to these individuals is, in part, understandable. The spokesmen for unfettered drug abuse use the appeal of personal freedom in stating their case-an appeal that often wins an affirmative response from the young at a time in their lives when it is natural to break away from many restraints.

You, as well as the schools, face an extremely difficult task in convincing children that drug abuse is not smart, is not a sign of maturity, is not freedom. For make no mistake about it, drug abuse, at best, provides only temporary escape from the realities of the moment; it closes the door to personal freedom.

WHAT IS DRUG ABUSE?

In simplest terms, drug abuse is the consumption of chemical substance for a purpose other than that for which it was intended. As generally discussed, abuse may be divided into two major categories: (a) improper use of medicines for nonmedical purposes, and (b) consumption of chemical substances for which no approved medical application exists.

Among the medicines which figure in drug abuse are narcotics (opium derivatives used to allay severe pain), simulants (drugs such as amphetamine used in the treatment of obesity and mild depression), depressants (drugs such as the barbiturates used in the treatment of epilepsy, high blood pressure, and insomnia), and certain tranquilizers (drugs used in combating tension, anxiety, and extreme agitation).

Among the nonmedical substances subject to abuse are the narcotic heroin (an opium derivative outlawed in the United States); the hallucinogens marihuana (usually used in the form of a cigarette), LSD, and DMT (the so-called "mind expansion" compounds); and nondrug substances such as glue (an intoxicant when inhaled).

EFFECTS OF DRUG ABUSE

Recent years have seen the development of powerful new drugs which have had enormous impact on medicine, as in the treatment of mental and emotional disorders where thousands so afflicted have been restored to active, useful lives. But the same powerful drugs, which are safe when properly used under medical supervision can be dangerous when used for nonmedical purposes.

Although various drugs affect in different ways persons abusing them, the problem of "dependency" is common to much of drug abuse. For example, narcotics and depressants, when taken for prolonged periods of time and in stronger dosages than needed therapeutically, can create physical dependence. When this develops, the abuser's body craves the drug and reacts violently with withdrawal symptoms when deprived of it.

Virtually all drugs subject to abuse can create psychological dependence. Because they alter mood, the abuser increasingly relies on them to produce emotional attitudes he thinks he needs to function adequately. In time, his need for the drug, in terms of emotional support it provides, renders his habit almost impossible to break. At this point, he is psychologically dependent-even though the drug he abuses may not cause physical dependence.

35-525-70-pt. 2- -26

As for the chemical agents and drugs without proved medical utility, they too have their dangers: Hallucinogens, by distorting reality, can lead an abuser to irrational or dangerous acts, which have, on occasion, led to death. Marihuana and LSD have been known to provoke psychotic episodes. Some cases of LSDinduced psychosis have been irreversible. Solvents, when inhaled, may cause damage to the kidneys, liver, or heart.

While it is true that some individuals have experimented with drug abuse and walked away from it, it is a sad fact that virtually no one who became a hard-core addict ever intended to get "hooked." Once established, the habit of abusing drugs can be a lifelong problem, interfering not only with one's education, but with future employment and family success, too. In addition, the enormous amount of money needed to sustain a habit invariably leads the abuser to criminal acts such as shoplifting, burglary . . . even prostitution.

SPOTTING DRUG ABUSE

How can you know if your youngster is abusing drugs? With frequent abusers, there are definite signs: sluggishness, loss of appetite, indifference to environment, profound mood alterations. But as the same symptoms are common to many nondrug abuse disorders-particularly those experienced by adolescents during the normal course of maturation-one cannot be sure drug abuse exists on the basis of symptomatic evidence exclusively.

However, drug abusers often leave tell-tale clues which are an indication of their activities. For example, you should be alert for the following: Tablets and capsules (particularly barbiturates and amphetamine) missing from prescription bottles in your medicine cabinet.

Quantity supplies of tubes of "airplane cement" or glue-stained plastic bags and ripped open tubes.

Tablets and capsules of unknown origin among your child's possessions. Parents should make it a point to learn about their child's companions, for they often supply an additional clue to the possibility of drug abuse. Are his companions youngsters who seem to have little parental supervision? Are they having discipline problems in school? Drug abuse often finds fertile ground among such persons.

Despite your precautions and concern, your child may still be experimenting with drugs without your being aware of it. This is particularly true of occasional abuse. Whether or not you suspect your child of abusing drugs, it is a good idea for you to initiate discussions about the general problem. During one of these discussions, you might inquire-sympathetically, not reproachfully--if he has ever experimented with drugs. Very often a young person in the initial stages of drug abuse will want to talk about it to ease his conscience. Remember, most drug abuse by youngsters begins in response to pressure from their contemporaries. Accordingly, a young person may be better able to withstand these pressures when he knows he has the sympathetic and understanding support of parents who are aware of the problem. The way in which you react can be very important. Very often, your own sympathetic counseling will be all that is needed. If abuse is extensive, you may need to consult your family physician.

YOUR ROLE

You, as a concerned parent, will want to do what you can to prevent drug abuse. The best way to accomplish this is for youngsters to learn the facts about the problem through regular school programs beginning in the preteens and continuing through high school. More and more schools throughout the country are integrating the topic into classwork, but they cannot do the job alone. The active participation of parents is essential.

Clearly, then, your task is to initiate drug abuse discussions with your children at an early age. If your child is moving into his teens, NOW is the time to begin your discussions. But you must be prepared to discuss intelligently and factually any questions your youngster might raise. Surprisingly, many children already know more about drug abuse than their parents. Therefore, you must learn all you can about the subject; for where drug abuse is concerned, to lecture, admonish, or threaten may have an adverse effect, while reason and sympathetic counseling can often prove the best defense against the problem.

An excellent source for information on drug abuse is the book, Drug Abuse: Escape to Nowhere. Originally published for educators, this factual, enlightening look into the complex world of drug abuse can be used effectively by parents.

Written in nontechnical terms, the book explores the history of drug abuse, the effects of the drugs most commonly abused, and ways in which youngsters can be reached on this vital subject. It is available for $2 a copy from the PublicationSales Section, National Education Association, 1201 Sixteenth Street, N.W., Washington, D.C. 20036 (Stock No. 244-07816).

Mr. BRADEMAS. We are very grateful to you for having come.
Mr. FRAME. Thank you.

Mr. BRADEMAS. Our next witness is Miss Naomi Casa Santa of the United Health Foundation of South Bend.

STATEMENT OF NAOMI CASA SANTA, UNITED HEALTH

FOUNDATION OF SOUTH BEND, SOUTH BEND, IND.

Miss SANTA. I am Naomi Casa Santa, patient service director of the United Health Foundation of South Bend.

The opportunities offered by H.R. 9312 are necessary to effectively implement a strong drug education program. It is important to develop curriculum to deal with use and abuse of drugs. It is equally vital to direct community educational facilities toward people who already have a problem with drugs.

I would urge and support grants for specialized training of competent social workers to function within the structures of the educational system.

I also support provisions for social service projects designed to acquaint the school system with the medical and social problems involved with drug usage.

In summary, I support the bill, with special emphasis on grants for rehabilitation programs to be executed within the educational

agency.

Mr. BRADEMAS. Thank you very much, Miss Santa. Would you give us any comment on any information you may have concerning the availability within the public schools of this county, for example, of instruction in the field of drug abuse?

Miss SANTA. I think that you know, there is a wide-open field for real competent instruction courses. We have family programs and give away programs, where you go into classrooms and go through this.

I think there are some excellent movies available for classroom usage. I have seen a couple of them. They are available through our school system. It has been my opinion that they are effective in the junior high schools.

Mr. BRADEMAS. I note that you support with special emphasis on grants for rehabilitation programs to be executed within the educational agency. Could you explain that sentence a little more in detail? Miss SANTA. Well, our agency mostly sees the individual after he has had the problem, you see. And I have for a long time had the feeling that our answer to almost any social problem that existed within the school system was to suspend the youngster from school and out of sight, out of mind.

I feel that while you have the youngster in some kind of a controlled environment within the school, a program directed towards counsel or rehabilitative measures, within the school structure, possibly would reach a youngster once he does have a problem.

Mr. BRADEMAS. I have just one other question. To what extent does the United Health Foundation cooperate with the local public school system in this field? Do you have any coordinated programs?

Miss SANTA. We provide educational material when it is requested. We have upon occasion been called by school teachers, or by school personnel to help with a young person who has this problem. They do this in a spirit of extreme confidence, with the knowledge we are not going to go back to the school officials with this information.

Mr. BRADEMAS. Your work is not directed in effect to the preventive area?

Miss SANTA. We have an all around program, actually. We have not developed a preventive program. We are working on it in conjunction with the other agencies.

Mr. BRADEMAS. Thank you very much. Mr. Reid.

Mr. REID. Thank you very much. You say in your final summary sentence, "I support the bill, with special emphasis on grants for rehabilitation programs to be executed within the educational agency."

Do you have anything that would be equivalent to a halfway house, and do you think that would be good?

Miss SANTA. We have a halfway house for returnees from mental hospitals, but not returnees from either alcoholism or drug addiction. Mr. REID. What do you do with those that become addicted to drugs? What kind of treatment is available in the area, in the rehabilitation sense?

Miss SANTA. I don't think very much. This is my big problem. Mr. REID. Thank you very much. That is all I have.

Mr. BRADEMAS. Mr. Meeds.

Mr. MEEDS. Thank you, Mr. Chairman.

Miss Casa Santa, could you tell me a little about the United Health Foundation? What does it do? What is its purpose?

Miss SANTA. I would be glad to. The United Health Foundation is a United Fund Agency. It is the health arm of the United Fund. By this I mean any health problem that comes to the attention of the United Community Services is eventually brought to our attention and we work in a variety of health areas.

Mr. MEEDS. So that you have in effect your board meeting unit for the health activities of the United Fund?

Miss SANTA. Yes.

Mr. MEEDS. And you receive information from the various agencies of the United Fund about health problems in this area?

Miss SANTA. Yes.

Mr. MEEDS. And in such procedure you are in pretty good condition to know what the health problems in your area are, I would say! Miss SANTA. I think we are, yes.

Mr. MEEDS. Would you describe the drug and narcotic problem in this area to be a serious problem

Miss SANTA. I think it is. I would particularly stress at the college level. We have a lot of colleges in this area and it has been my observation that there are few parties in this age group in which there isn't some pot involved. I don't mean every youngster there, but I mean there is some pot involved.