Research shows the best way to get addicts off drugs and keep them off is to provide treatment programs. But only one in four drug abusers receives treatment, and the number of drug treatment programs around the country, including those aimed at youthful users, is dwindling, according to a study by the University of Kentucky and the University of Pennsylvania School of Medicine.
“Access (to treatment) has shrunk in the last decade,” said lead author Marjorie Gutman of the Treatment Research Institute at the University of Pennsylvania School of Medicine in the study published in the American Journal of Health Promotion.
“Capacity falls far short of need and may be shrinking under managed care,” Gutman said, because managed care providers often carve out mental health and substance abuse programs from physical health services, she said.
Treatment alternatives aren’t simply dwindling. “They are deteriorating in range, professionalism and duration of services,” said Gutman, citing national and local data.
Part of the solution is to catch potential drug users early, before they become adults, researchers said. But while school-based programs have become more sophisticated and nowadays encompass parents, media and community, programs such as the Drug Awareness Resistance Education program, or DARE, sponsored by police in more than half the nation’s school districts, have shown little, if any, effect, researchers said.
“There is a huge gap out there in knowledge from how kids go from nonuse to use to dependence on alcohol or drugs,” said co-author Richard Clayton of the University of Kentucky Center for Prevention Research. “A one-size-fits-all approach like DARE, or peer mediation is not going to work for kids at risk for drug addiction or already on drugs.”
One solution, Clayton said, is to identify children most at risk early on — as early as kindergarten or first grade — and provide both academic and social-skills help for them, rather than applying broad drug prevention programs in fifth grade, when it may already be too late. “We’ve got everything backward. I think we know, early on, who will be the problem kids,” Clayton said. These children, he said, are likely to have behavioral problems and/or learning disabilities that, if not addressed, lead to rejection by their peers and teachers later on.
The cumulative effect of this, according to Clayton, is antisocial behavior that may lead to drug use. “If we could access these kids early and select them out to get intervention to make them functional and competent at school, I believe they are less likely to be rejected by teachers and peers. And by the time they reach fifth grade they are more likely to hear the messages that programs like DARE have to offer.”