Louis Marsit began stealing bottles of beer from his father when he was nine years old. This was followed by repeated episodes of drug abuse, brushes with the law and suicide attempts. By 18 he had dropped out of school, and eight years later he was in jail. At his court hearing, he asked the judge to send him to a therapeutic drug and treatment center in Maryland called Second Genesis. A year later Louis is free of drug addiction and a working member of his community. Speaking at the opening ceremony of a new treatment center recently, Louis expressed his firm belief: "If it wasn't for Second Genesis I know I would not be here today. I would be dead." Louis's poignant story is similar to that of millions of former drug and alcohol abusers who credit their extraordinary rehabilitation to one of the thousands of therapeutic communities that have been set up in the United States and around the world during the past decade. One measure of their success in the United States is the fact that the number of people abusing drugs has declined dramatically-from 23 million in 1985 to less than 13 million today. There are about 700 therapeutic communities in the United States, providing treatment to all classesof people and all age levels.Treatment programs can last anywhere from three months to three years. After drug users have completed their treatment programs, they often need extra time before they feel confident to go back to their families or to liveon their own. To help them in this intervening period, many American cities have set up halfway houses. For example, Kansas City, Missouri, has nine Oxford Houses (above), where these people can live for as long as they like. As these houses are run by former drug addicts, occupants receive strong moral support from kindred souls. Therapeutic treatment centers, says Robert Martinez, director of President Bush's Office of National Drug Control Policy, instill the kind of tough, meaningful values that are largely responsible for the decline in drug use. "Many if not most successful treatment programs are based on an ethos of personal accountability, adherence to tough rules, personal sacrifice, and sanctions for misbehavior," he says. The therapeutic community employs community-imposed sanctions and penalties as well as earned privileges as part of the recovery process. Members of the community are part of a "family group," not patients in an institution, and they playa major role in managing the community and acting as positive role models for others to emulate. David Deitch, vice president of Day top Village in New York, says the therapeutic community model is based on the notion that drug dependence is a problem of the whole person. Attention is thus given to social, moral, psychological, educational, and family issues. "The model insists on the ideas that new behaviors are possible, no matter what," Deitch says, "and we will use community life as a way of fostering that change." Day top is the largest nonprofit therapeutic community in the world, treating as many as 3,000 people and providing dozens of programs to meet the educational, emotional, and psychological needs of participants.
"While we do have a hard pocket of regrettably large chronic drug users who need to be treated, we have seen a slow reduction in the spread of drug use that was occurring in the late 1970sand early 1980s," Deitch says. "That's a critical point. Treatmentdoes work, and that's one way it's been demonstrated. " Studies show that more than 90 percent of those who completed treatment remained drug-free afterward. One of the major factors behind the success 0 ftrea tmen t centers is their ability to rekindle an individual's self-esteem, says Andrew Mecca, president of California's Policy Council on Alcohol and Drugs. "That self-esteem is promoted within an environment to which somebody feels they can belong, that makes them feelsignificant, acknowledged for their efforts and recognized for their competence," he says. Another factor behind their success is psychiatric intervention for many drug abusers. Studies have shown that one-half of the people with a substance abuse problem have a diagnosed mental illness and that 28 percent of those are afflicted with depression or manic-depressive syndrome. Researchers have also found that the use of illicit drugs serves as self-medication for many of these people, because they can't deal with their everyday environment, an environment often filled with poverty and hopelessness. Benny Primm, administrator for treatment improvement at the U.S. Alcohol, Drug Abuse and Mental Health Administration, says, "If we can recognize the need for strong psychiatric intervention early in the treatment process, perhaps we can change the face of addiction in society." Getting to the ca-sual or recreational user of drugs is the key to stopping the spread of drugs, according Herbert Kleber, deputy director for demand reduction at the Officeof National Drug Control Policy. "The hard-core addict is not the role model," he says. "No one wants to be the stumbling drunk, the psychotic cocaine user, or the burnt-out heroin addict. The role model is the individual who can use drugs, get high and still keep hisjob, family, health, and possessions." But this role model is a myth, he says. It can only be broken by experts demonstrating the dangers of drug use and by the example of "unfortunate public role models" whose lives have been wasted by drug use. The highly publicized death of a University of Maryland basketball star from a cocaine overdose in 1986sparked intense public education efforts in the United States. Another myth, according to Kleber, is that most drug addicts in America are poor and unemployed. He says that 68 percent of drug users are employed and that 70 percent or more belong to majority, rather than minority, groups. According to the U.S. Chamber of Commerce, drug abuse iscosting American employers more than $60,000 million a year. To curb drug use and reduce accidents in the workplace, 28 percent of the largest companies, according to a study by the Gallup organization, now use drug testing. Two-thirds of these companies also offer drug treatment 0 programs for their workers.
Help ...and Hope