'Public health' approach to drug abuse Solomon favors approaching drug abuse as a disease.

December 13, 1991|By Sue Miller | Sue Miller,Evening Sun Staff

The chairman of the Governor's Drug and Alcohol Abuse Commission says he will push for statewide implementation of a "public health" approach to substance abuse prevention and treatment because "it is one of the most effective programs for the dollars spent."

Dr. Neil Solomon, the chairman, said the commission has $1.7 million in federal funds to pump into the public health approach, which recognizes that alcoholism and drug addiction are preventable diseases and that these diseases have reached epidemic proportions.

"This is an approach that has been successful in combating other epidemics, such as heart disease and lung cancer," he said yesterday at a briefing held at the Door in East Baltimore, which he described as an exemplary program serving high-risk youth.

Risk factors and protective factors must be identified and the public made aware of them, he said.

"In heart disease, we identified smoking, excess weight, stress and high levels of cholesterol as risk factors, and regular exercise and a healthy diet as protective factors," he explained.

"Heart disease has been reduced significantly because people listened and they modified their behaviors," he said.

Research shows that the more risk factors young people face, the more likely they will be to abuse drugs. Similarly, the more protective factors, the less likely young people will be to abuse drugs, he said.

Risk factors that have been linked to adolescent substance abuse include:

* Academic failure.

* Early anti-social behavior.

* A weak social bond to conventional society.

* Association with drug-using peers.

* Parental drug use or a family history of alcoholism.

* A family's low expectations for their children's success.

Protective factors are such things as:

* A strong social bond to family, school, positive peers and the community.

* Commitment to conventional values, beliefs, norms and expectations.

* Recognition by and involvement with groups and individuals who do not use or sanction drugs.

* Skills to resist social influences, solve problems, make decisions and participate in productive group activities.

Solomon said that the next step is to provide prevention activities that help people reduce or eliminate the risk factors and develop and strengthen protective factors.

He said research indicates the most effective prevention efforts will target more than one risk or protective factor, will intervene early before behavior stabilizes, will bond youth to family, school, positive peer groups and community and will involve a home-school-community partnership.

Experts say the public health approach addresses "the root causes of substance abuse rather than the symptoms."

The public health approach is being used successfully in Oregon and Washington, according to Larry Dawson, who has been involved in drug- and alcohol-abuse work for 20 years and is now the commission's executive assistant for prevention services.

Solomon said Maryland "has made a dent in the problem of substance abuse, but it's not a significant dent."

That, combined with evidence that continued heavy use of alcohol and crack cocaine can be expected to continue, demands a more widespread use of "risk-focused" programs, he said.

The November 1991 version of Maryland's Drug and Alcohol Abuse Control Plan, which was released by Solomon at the meeting, notes that heroin problems also are expected to increase.

In Maryland, heroin use is rarely found among students or the general population. Recent law enforcement seizures indicate there appears to be a market for heroin developing in areas other than Baltimore, initiated by aggressive new traffickers, the report said.

Law enforcement officials and researchers have found a strong correlation between drug and alcohol abuse and crime, according to the report. A recent study, it further said, showed that a person's crime rate increased six times when heroin addicts in Baltimore were using the drug heavily.

Solomon stressed the need for a statewide grand jury that would have subpoena power across all jurisdictions of the state "so we could tap into the drug kingpins' hidden assets." Those are "millions and millions of dollars that we could put back into treatment and prevention programs," he said.

But Solomon said he will not seek legislation in the upcoming General Assembly session to establish a statewide grand jury, similar to those already operating in neighboring Pennsylvania and Virginia, because "we do not have a consensus for it at this time."

But, he promised not to let the idea die. "I'm going to spend this coming year talking about it to the people who are not fully convinced this is the way we should go," he said.

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