NEW YORK — Author and reporter Maia Szalavitz, who writes about substance use and related issues recently spoke with Youth Today and JJIE about her experience and her newest book: “Unbroken Brain: A Revolutionary New Way of Understanding Addiction,” released in April. Here’s Szalavitz’s take on addiction and its complexities, from her own experience and in her own words.
A sin or a learning disorder?
There’s traditionally been two ways of seeing addiction. Either it’s a sin and you’re a horrible bad person and you are just choosing to be a hedonist, or it’s a chronic progressive disease. While I certainly believe addiction is a medical problem that should be dealt with by the health system, the way we’ve conceptualized addiction as a disease is not actually accurate.
I see addiction as a learning disorder, and I can’t imagine there would be any neuroscientists who would say ‘No, learning is not involved in addiction.’ You have to learn that a drug fixes your problem in order to crave it, otherwise your brain wouldn’t know what to crave. That sounds very stupid and simple, but a lot of complexity goes into that. The very definition of addiction that is agreed on by most researchers and the National Institute of Drug Abuse, for example, is that it’s a compulsive behavior that continues despite negative consequences.
So, that basically means addiction is a problem of punishment learning, you aren’t learning from punishment, which is this horrible irony, because if addiction were solved through punishment, which is what we try to do all the time, the condition actually wouldn’t exist as defined.
The learning that occurs in addiction is generally different from the learning that occurs in people when they learn math or something. Addiction is when you fall in love with a drug instead of a child or a lover, and the learning that takes part in that part of the brain is designed by evolution to get us to persist despite negative consequences to do what we need to do. The problem is when that gets misdirected to a drug, and then you can find yourself in some very negative and potentially deadly situations.
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The other reason I think learning is really critical in addiction is that learning is part of development, and we now know through neuroscience again that every mental illness, psychiatric condition, learning disorder, whatever, anything that’s really going on with the brain in some ways, has developmental components to it. So you don’t just wake up depressed from one thing, generally, there’s a whole pattern of things that go into it, your genes influence and the environment influences and your particular stage of development influences.
If addiction is misdirected love, how can that be redirected?
If addiction is misdirected love, and if addiction is compulsive behavior despite negative consequences, the thing people are going to need to get better is love, compassion and respect, not punishment.
Punishment by definition isn’t going to help. So what you need to do to help people to change and recover is to help them find different areas of passion and help them find better ways of coping. Because about 50 percent of people with addiction have a preexisting mental illness, and about two-thirds have had some type of severe trauma during childhood and they are not using to the point where they’re risking their lives because it’s fun. They’re doing something to help them cope.
And so in order for people to recover, we can’t just say ‘love is all we need.’ Love is great and it does help a lot of people, but a lot of people have things like depression or schizophrenia or bipolar disorder or other disorders, all of which will need to be addressed in order for people to stay in long-term recovery.
And so because addiction is a developmental problem, the developmental stage is important, things like employment are important, things like having a sense of purpose, meaning and hope are important, and this is why there’s been so many spiritual cures for addiction, because those things often give people a sense of meaning and purpose. The problem is that we have a First Amendment in the country, and you can’t impose — or you shouldn’t be able to impose a spiritual solution on people — and it doesn’t work. You’re either amenable to that or you’re not, and so this makes it a very complicated problem.
Punishment is not going to fix it.
We should not be putting kids in cages and hoping that is going to fix their psychological problems of any type. Incarceration is as useful for addiction as it is for diabetes — that is, not useful and potentially harmful, particularly for kids.
There’s a lot of data that shows that if a kid gets put into the system — and we’re talking about kids who are selected for the same exact crimes — are way more likely to recidivate than kids who just happen to get away with it or kids who are diverted from the system. And there’s lots of studies on that, cross-culturally. What we’re doing is causing harm now.
For kids who are incarcerated for good or for ill, obviously what we need to do if we’re stuck with that is to provide dignified, respectful, homeopathic care as much as is possible in that setting. You really do need to feel safe and comfortable and hopeful that your life will get better, because if you don’t feel that way, why wouldn’t you get high?
People have just created irrational ideas that we just need people to suffer the most extreme consequences and then they’ll get better, and this whole idea of hitting bottom is not the answer. It’s a great spiritual story of sin and redemption, but it’s not a medical scientific thing.
Let’s say I hit bottom and then I get into recovery and then I relapse, and so now I need a new bottom, and then I cover again and I relapse again. You can’t tell if I ever really hit bottom until I’m dead. So it’s not useful; it’s a retrospective concept that also has been used to do an enormous amount of harm, like suggesting we put kids into prisons or throwing them out of the house.
You know, this whole notion of tough love, where you just cut these people out of your life, completely contradicts what we know. And what’s horrifying about it, particularly with a child, a teenager, is if you put a teenager on the street, you are putting them at extreme risk of way worse outcomes than if they are home with you. And if a child is doing something that is harming other family members or harming you or just putting other people at risk in some way, yes, something needs to be done about that, but don’t think that cutting the kid out of your life will help the kid. That is a real mistake a lot of people make.
Parents really don’t want their kids hanging out with a ‘bad crowd.’ We want our kids with people who have good values and — as best a teenager can be — are doing well. When you put a kid into a system, you are basically putting them into a bad crowd. And I’m not saying the kids in the system are bad, they’re more deviant. And so you’re putting them in a situation like, ‘Wow, I smoked heroin,’ and ‘Wow, I did coke,’ and the kid is saying, ‘Wow, I only did pot, where can I get some?’ And so there’s this contagion of worse behavior.
So, what works?
If you’re worried about a kid and drug use, the safest, best thing to do is individual counseling or family therapy, none of which will expose kids to more deviant or problematic peers, and both of which are proven to be effective. At the very least, they won’t hurt. In a criminal justice setting, it’s very hard to create a therapeutic environment where people do feel safe, but the real important thing to do is to do your best to do that. Because the best outcomes that are seen for therapy intervention and for other psychological interventions is where the therapist really connects and the person really feels understood.
What about marijuana?
We absolutely should legalize marijuana. Marijuana is the least harmful psychoactive substance that we have, with the possible exception of caffeine. Since virtually any teenager you ask can tell you where to get marijuana anyway, it is unlikely that we could massively increase teen marijuana use.
I think, obviously, we really want to prevent kids from taking drugs. The best way to minimize this is to minimize harm. We’re never going to prevent every kid from doing something stupid during their teenage years. Your brain is primed to take risks; you’re primed to get into a social scene. [They’re going] to do things that we really don’t want them doing … so we need to reduce harm.
I don’t think there’s a single child who’s ever benefitted from being arrested for marijuana or for underage drinking. This does not solve the problem. It makes worse problems because a) it puts them into the system and b) it gives them a potential criminal record to have to deal with, and it can have consequences for school. The thing we want for all our kids is that they be connected with a learning community, and that they have strong social and familial relationships. If we can do whatever we can do to create that and to reduce bullying and to reduce the kind of pain and shame so many kids feel for so many reasons, that stuff is going to reduce addiction. It may not necessarily reduce use. But, again, 70 percent of my generation used and we created Steve Jobs and [Barack] Obama and [Al] Gore. We have to stop panicking over this stuff.
The worst thing you can do is to make kids so terrified that they’re not going to get into college or that they’re going to get thrown out of high school that when they overdose they aren’t going to call for help.
The most important thing to do is to make sure they stay healthy and alive. Again, that doesn’t mean we should tolerate the older kids teaching younger kids to use drugs ... what we want to do is to reduce the reasons people use compulsively and reduce the harm associated with specific drugs.
We have to think in terms of harm reduction instead of ‘We’re going to get rid of this whole thing,’ because drug use has been with humanity before humanity evolved into humanity. You can see that elephants will get drunk, nonhuman primates will enjoy it, the cats will go for the catnip — it’s built into our biology. So we can either accept that people will seek ways of consciousness alteration and seek to reduce harm, or we can bury our heads in the sand and create more harm with the way we’re trying to stop it.
What about our current drug laws?
The thing about our drug laws is that they’re not based on science. Science could never get you to make alcohol and tobacco legal and marijuana illegal. Only racism can do that. And that’s what we have. We have a system that was devised by racists to create racist ends.
And I know that sounds really extreme, but if you just look at the history, you will find Harry Anslinger [first U.S. commissioner of the Bureau of Narcotics] going on about satanic swing and how reefer will make black people think they’re as good as white people — which to him, obviously, was a very horrible outcome. This is the basis of our drug laws. We have cocaine laws because they thought cocaine would make black people impervious to bullets — if only, right? It’s pseudo-scientific at best. You see this stuff in the New York Times in the early 1900s. It’s not obscure. So once you know the history of our drug laws, you have to say it is just based on nothing.
Do we really want to base our 21st century policy on what the colonialist preferred at a certain time in history, not at all based on health or what the preferences of different cultures might be? That’s just ridiculous. I think our drug laws need to be made scientifically, as best as possible, recognizing that values will always be part of that.
Beyond science, how did your background help form your views?
I don’t have kids, but I’ve often noticed when people first become parents they seem to completely forget their own adolescence and they start to, as their kids become teenagers, try to do the things that didn’t stop them themselves. And I jokingly frame this as: Your brain gets wiped of those memories when you become a parent.
I also had my own addiction to cocaine and heroin in my 20s. I knew that it was driven not by the things the drug workers were telling me; in fact, I couldn’t believe any drug information that was given to me by authorities because I knew from my own experience that it was wrong. So when you’re telling me that marijuana’s going to make me crazy and addicted, and it doesn’t happen, why would I believe you about the other things? And obviously there are greater risks associated with some other things. And the reason I ended up taking those risks, I eventually learned, was not because I was some horrible creature that is evil and bad and wrong, but because I was wired slightly differently, and I found that these substances allowed me to connect socially, allowed me to feel OK and not overwhelmed by my sensory issues and emotional dysregulation. So, having had that personal experience, I knew that a lot of the stuff that we say about these things is just wrong.
Having the personal experience made me understand a lot more. That’s not to say I can speak for everybody with addiction. I think there’s a huge range of experiences.
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Two mothers and a father talk about what it's like to be the parent of a substance user in this affecting piece about frustration and loss.
Troubled kids, powerful drugs
This story was reported and written by Halle Stockton for PublicSource.
Pennsylvania defied an Office of Open Records ruling and took the matter to court to conceal the names of doctors prescribing to kids confined in its six correctional facilities.
The Pennsylvania Department of Human Services insisted the physicians who care for and prescribe for the state’s most chronic or violent youth offenders would be endangered if their names were made public.
PublicSource requested the names of the doctors with whom the state contracts to determine their qualifications, disciplinary history and if they’re taking payments from drug companies.
The request was part of a larger investigation that showed worrisome rates of psychiatric medications prescribed to the residents of the state’s secure youth development centers and forestry camps. Experts say the meds, some of which carry severe health risks, are being used to drug the kids into behaving.
The kids can be dangerous. Most who end up in the rural centers and camps have been in court time and time again. Many have handled guns and drugs; assaults and robberies are among the most common offenses.
But others who work with the same kind of kids found it troubling that there was so much concern over keeping the doctors anonymous.
Dr. Terry Lee, a child and adolescent psychiatrist to adjudicated delinquents in Washington state, said it’s not a good sign.
“Shouldn't it be public knowledge that public dollars are going to someone?” he said. “Shouldn’t you be able to track if they’ve had actions on their medical license?”
Lee also works in a secure juvenile correction facility, called the Echo Glen Children’s Center, about 30 miles outside Seattle.
“I’m not fearful. I tell people where I work,” he said. “They may have very good reasons, but it just doesn’t quite sound right.”
The doctors are the “gateway” to medications. They also have a say in how long the kids, mostly teenagers, stay in the facilities.
Judges sometimes call on physicians and psychiatrists to evaluate their progress, and that can lead to either a release or waiting months before another review hearing.
The Department of Human Services (DHS), which operates the youth correctional facilities, said most doctors only use their last names during appointments with the juveniles.
The department would not release their full names because they say it would expose them and their families to the risk of physical harm.
“We have a major personal security issue with that,” DHS spokeswoman Kait Gillis said in a May 2014 phone call about the records requested. “The doctors disclose no personal information to these students. They receive a lot of threats on their physical safety. It would be really detrimental to them to have their personal information disclosed.”
The Open Records office wrote the department did not provide “evidence showing a nexus between the release of the doctors’ names and a risk of harm.”
It also pointed out that the names of public employees are generally part of the public record:
“Here, the doctors at issue receive taxpayer money to perform services for the department, and without disclosure of these names, taxpayers cannot find out the ultimate recipient of this money.”
The department petitioned the Commonwealth Court of Pennsylvania in February 2014 to review the Office of Open Records’ ruling. In June 2014, the court selected the case for mediation.
Before the mediation process could start, the department offered to redact pharmaceutical invoices it previously argued were not public record if PublicSource withdrew its request for doctors’ names.
PublicSource agreed to the compromise so that the project could move forward.
The invoices were used to analyze what prescriptions the kids were actually being given.
(This interactive drug app will allow you to explore the data we received from the state.)
The youth residents were described as threatening, retaliatory and manipulative by the department and doctors.
One physician who had worked in one of the facilities for three years at the time said he fears his name being released to the media would lead to the troubled teens, their family members and gang associates being able to learn his full name and home and office address.
“Because many such persons have violent proclivities, my personal security and the personal security of my family and my neighbors would be placed in heightened jeopardy,” according to the doctor’s affidavit.
The doctor said residents have threatened to rape his daughter and to shoot him.
The physicians attributed substance-abuse issues among the youth as a point of tension. According to affidavits, the residents often request controlled substances and get hostile or make false complaints when denied.
Another clinician, who has done this work for 12 years, wrote: ”The youths are observant and attempt to find out personal information to use against me and my co-workers.”
The affidavits were submitted to the Open Records office by DHS with the doctors’ names redacted, and the state declined all requests for interviews.
Advanced Correctional Healthcare provides medical services at adult and youth facilities in 17 Midwestern states. Deborah Ash, vice president of compliance, said their doctors also only share their title and last name for safety reasons.
“It is still fairly easy to find them even with just a last name,” she said, “but you do the best you can do short of changing your name.”
The company also discourages the use of doctor-specific parking spots to prevent inmates’ families or gang associates on the outside from tracking them down.
Residents of the Pennsylvania facilities have proven to be dangerous at times.
In 2011, three teenagers were charged with attacking a guard at the South Mountain Secure Treatment Unit, according to a Public Opinion article.
According to The Daily Item, a resident of the North Central Secure Treatment Unit in October 2014 punched a staff member after a search of his room; the young man pleaded guilty to the assault in February.
Six staff members were injured in what was called a riot, started by four residents at the Cresson Secure Treatment Unit on Jan. 1, 2015, according to the Pittsburgh Post-Gazette.
PublicSource could not locate any accounts of incidents specifically targeting medical staff, and the department did not identify any in their arguments.
Doctors taking money from drug companies is an inherent conflict of interest, especially when doctors are treating vulnerable kids in institutions where parental consent isn’t always obtained.
The 2010 Affordable Care Act established a federal rule that pharmaceutical companies must disclose what gifts, speaker fees and other payments doctors receive from them.
In Florida, the Palm Beach Post found that one in three psychiatrists contracted by the Department of Juvenile Justice over five years — 2007 to 2011 — had taken speaker fees or received gifts from pharmaceutical companies.
There was at least one obvious instance of a doctor who increased the prescribing of a certain medication at the same time he was paid by the maker of the drug.
The reporters were able to assess this because of Florida’s broad public records law.
Amanda Fortuna, a spokeswoman for the Florida department, told PublicSource that although a list of the doctors is not readily available, their names would not be exempt from the public record.
Pennsylvania doctors received about $143 million from drug and medical device companies from August 2013 to December 2014; only five states had doctors taking more money, according to ProPublica’s Dollars for Docs app.
Meredith Matone, a research scientist for PolicyLab at the Children’s Hospital of Philadelphia, said the prescribing habits of individual doctors isn’t a driving factor in the overall issue of psychotropic medication use.
“There’s a small portion of providers who are probably skewed for their own personal gain,” she said.
For most prescribers, she said, they simply use the medications more once they are educated about them. “They may just look at it as another tool in their toolbox.”
But who’s supervising how they use those tools?
Gail Wasserman, a child psychologist who directs the Center for the Promotion of Mental Health in Juvenile Justice in New York, said it can be particularly challenging to supervise doctors who are contracted to provide services.
“Health care [has] got to have its own supervisory structure,” she said. “Where is that, who does that and how do you make sure it works and it’s accountable?”
The Department of Human Services did not answer several questions posed by PublicSource on the checks and balances for its doctors.
‘The right to know me’
As a judge who has dealt with delinquent youth face to face for more than five years, Allegheny County Court of Common Pleas Judge Kathryn M. Hens-Greco could not relate to the doctors’ fears.
“Well, I would say the youth know my name pretty clearly. It’s on the bench. It’s on the order,” she said. “I don't spend a lot of time worrying about my personal safety. I pay attention a little, but they have the right to know me. I am the one sending them to where they’re going.”
Hens-Greco said she is bothered that the doctors’ names were not released. She could only surmise that it is difficult to attract psychiatrists to the rural facilities, and the state felt they must honor their wish to remain anonymous to retain their services.
Sidney Ornduff, a psychologist in the Memphis area, evaluated hundreds of kids annually as director of clinical services for the Juvenile Court of Memphis and Shelby County for nearly five years.
She was torn when she heard about the state’s decision to withhold the doctors’ names. She said she has been threatened and scared by delinquent youth and their families before. She also said she felt the public has a right to know if the doctors are qualified and in good standing with their professional boards.
“Safety first, yes, but a degree of transparency,” she said.
The importance placed on the anonymity of the psychiatrists was upsetting to Dr. Melisa Rowland, a child and adolescent psychiatrist who is working with New York City’s juvenile justice system to implement multisystemic therapy, a model that works with chronically violent youth within their homes and communities.
“If they really feel that way, that’s probably part of the problem,” she said. “One thing that drives me crazy in my field is they act like they’re sociopaths. I’ve just worked with so many hundreds and hundreds of these kids … I can’t remember the last time I came across a kid that was scary.”
Reach Halle Stockton at 412-315-0263 or email@example.com. Follow her on Twitter at @HalleStockton.
Illustration by Anita Dufalla and video by Ryan Loew.
A report released by the American Civil Liberties Union (ACLU) earlier this week found that in 2010, African-Americans were approximately four times more likely than whites to be arrested for marijuana possession -- this, despite that fact that national data indicates the two populations use marijuana at nearly the same rates.
Furthermore, in several states, including Illinois, Iowa and Minnesota, the ACLU said African-Americans were busted for pot at rates from 7.5 to 8 times higher than whites.
Regardless of region, the ACLU reports that these discrepancies in arrest rate by race remain consistent. “In over 96 percent of counties with more than 30,000 people in which at least 2 percent of the residents are black,” the report reads, “blacks are arrested at higher rates than whites for marijuana possession.”
Overall, New York, Texas, California, Florida and Illinois were found to have the highest rates of marijuana possession arrests. In almost half of all states, the ACLU found that possession offenses accounted for more than 90 percent of marijuana arrests. The rate fell below 80 percent in only seven states, while just two states -- Minnesota and Massachusetts -- had possession arrest rates lower than 65 percent of all statewide pot offenses.
With police data collected from all 50 states, the new ACLU report is one of the most comprehensive analyses of marijuana arrests in the nation ever compiled. According to the new data, 88 percent of the more than 8 million marijuana arrests tallied up from 2001 until 2010 were for possession. With costs stemming from policing, adjudicating and incarcerating individuals for violations, the ACLU claims that states squander an estimated $3.6 billion a year in enforcing marijuana laws.
In 2010, the ACLU states that more than half of all drug arrest in the nation were for marijuana; that same year, the group estimates that police officials made a marijuana arrest every 37 seconds.
In addition to discovering major racial discrepancies in national marijuana arrest rates, the new report appears to reveal similar discrepancies regarding the ages of those arrested for pot. Sixty-two percent of individuals arrested for marijuana possession, the ACLU reports, are under the age of 24, while more than a third of the nation’s marijuana possession arrests can be attributed to teenagers, the latest data indicates.
Additionally, the ACLU calls for police departments to end “stop and frisk” and other racial profiling policies, while similarly placing a lesser emphasis on COMPSTAT (comparative statistics) policing, which they argue unfairly targets minority communities.
According to the authors of the report, the most sensible approach to curb marijuana-related incarcerations is to completely legalize the drug, nationwide.
“Legalization would, first and foremost, eliminate the unfair race- and community-targeted enforcement of marijuana criminal laws [and] help reduce over incarceration in our jails,” the report states.
“At a time when states are facing budget shortfalls, legalizing marijuana makes fiscal sense,” the report continues, arguing that the licensing and taxing of marijuana would allow states to save millions in annual expenses and allow communities to potentially reinvest education and substance abuse treatment alternatives to imprisonment.
“The aggressive enforcement of marijuana possession laws needlessly ensnares hundreds of thousands of people in the criminal justice system, crowds our jails, is carried out in a racially biased manner, wastes millions of taxpayers’ dollars and has not reduced marijuana use or availability,” the report concludes. “It is time for marijuana possession arrests to end.”
His book "Stickup Kids: Race, Drugs, Violence and the American Dream," published by the University of California Press last month, chronicles the downfall of the drug trade and the young Dominican men from his childhood neighborhood that tried to make an often dangerous living in it.
It’s a personal story for Contreras. As teenagers, Contreras, now 41, writes that he and his friends grew up seeing the flashy Dominican drug dealers making money hand over fist and desperately wanted to be like them.
“I saw a lot of drug dealers living the high life,” he says. "It was time to make it, to achieve this grand American dream."
But by the time they were old enough to take part, the market had dwindled. Contreras didn’t make it as a drug dealer, so he turned to academia. His work brought him back to the South Bronx to research what happened to his friends that stayed and made a go for it.
Much of the time covered in the book was when Contreras lived in the area, off the 4 train’s 167th street stop, a few blocks from the new Yankee stadium. The area is full of public housing, industrial businesses and empty parking lots that fill up on game days. New attempts to bring the area to its former glory have included putting in playgrounds and park areas, but windows are still barred, graffiti and trash are at every corner and police are an omnipresent force. The book focuses on two friends and a few others — under the aliases Pablo, Gus, Neno, Topi and David — in their circle from this neighborhood and traces their drug careers from the start to the present day.
The crack trade peaked in New York between 1987 and 1989, so Contreras and his peers, who he calls "tail enders," teenagers in the late 1980s, were a little too young and too late to the game to be successful drug dealers. Soon robbing major drug dealers, despite the increased risk, became the lucrative move.
Contreras disagrees with other sociologists, specifically mentioning Jack Katz, a UCLA professor who contended in his book “Seductions of Crime: Moral and Sensual Attractions of Doing Evil” that people get into crime for the emotional allure, the thrill that comes with it. Contreras says while the thrill was part of it, it didn’t necessarily have to be crack. If teenagers thought they could grow up to be lawyers, the thrill could have come from arguing a court case. But crack dealing was what seemed possible for the neighborhood kids, and more importantly, it was a way to earn good money.
“If crack hadn't risen, there is a good chance they wouldn't have participated in the drug market,” he says. “Crack gave more opportunity for the youth to participate."
The South Bronx was built up for middle class families in the 1920s but by the time Contreras came of age it was becoming increasingly run-down with high-crime, low-employment and problem schools, and grinding down the population.
“The South Bronx was still on fire," he says.
The neighborhood still had plenty of people working legally, but the jobs were low-waged and dead end.
"They understood, intuitively, that they had little opportunity," Contreras says.
The Dominican drug dealers were a major exception to the trend, highly visible men that inspired envy. They had the nicest clothes, expensive cars and plenty of women. The dealers were the embodiment of the American Dream for the local children, Contreras said.
So even as the crack market started to shrink, the appeal of material wealth didn't fade. The city's officials might have celebrated the decline in crack, but it wasn't over for everyone.
"Once you get use to the high life," Contreras says. "It's hard to let it go."
The decline of crack use had the unintended consequence of driving up crime, even if it didn't show up in police reports. The stickup kids would hold up major drug dealers, the wholesalers, to keep up their lifestyles. Drug dealers, for obvious reasons, do not always report being robbed of their wares to the police.
So these stickup kids -- the ones who aren’t in jail or dead as they enter adulthood -- instead of aging out of crime like most men do as they enter their late-20s, found new opportunities to make money through violence. Still, Contreras says the violence was not nearly as bad or frequent as when they were selling drugs themselves.
Even when his subjects tried to start aboveboard businesses with the money earned from robbing dealers, there were problems. A criminal record and no experience in business frustrated most attempts at making a go at an honest living. One of his subjects he calls "Pablo" wanted to start a company, but asked Contreras to take a major role and become the face of the business. He wasn't comfortable with public speaking. The business fell apart and Pablo went back to drug dealing.
"They become self-destructive," Contreras says of his subjects as they grew up and got stuck in the violent rut they found themselves in.
Contreras compared their growing up to be stickup kids to high school sports stars, who peak early with no later in life success. Instead, it’s a cycle of violence and lock-up and no major material wealth as they start families of their own.
“It’s almost disorienting,” he says. “They can't make sense of their new lower status.”
His subjects’ outlooks are not bright, highlighted by the fact that he is unwilling to discuss them in detail with a federal investigation ongoing.
In his book, he summed up his observations of the rise and fall of the drug cycle New York went through in the late 1980s and 1990s as a Greek tragedy, unfolding in three acts.
“When a drug market rises, a struggling college student becomes a drug dealer; a tough kid, an enforcer; a poor building superintendent, a lookout; and a dishwasher, a drug kingpin. When a drug market expands, a mother mourns her dead dealer son; a dad laments his drug-using daughter; a child visits a parent imprisoned by the state. When a drug market peaks, an ill-affected sibling becomes a social worker; a storefront preacher, a community organizer; a stay-at-home mom, an after-school volunteer.”
And when that market starts to decline, the lingering aftermath in the community proves to be an improvement for few.
The book continues, “When a drug market fades, an ex-con is perpetually unemployed; a recovering female addict, forever humiliated; a New York City mayor, despite doing nothing special, applauded and praised.”
Via a popular online service, cocaine, prescription pills and heroin may just be a mouse click away from reaching your child
There is a scene in Steven Soderbergh’s 2000 film Traffic in which a teenage girl says something that has become, for the most part, a generally recognized truth about high school.
“For someone my age,” the character says, “it’s a lot easier to get drugs than it is to get alcohol.”
Indeed, typing the term “easier to get drugs than alcohol” into a Google search box returns more than 12,000 pages, with thousands upon thousands of Internet users stating what many parents fear - that for their children, obtaining illegal drugs is anything but a challenge.
What most parents are unaware of, however, is how the Internet is potentially making it even easier for youth to obtain drugs. In the 21st century, teens do not necessarily have to seek out dealers to procure marijuana or cocaine; in fact, scoring illicit substances these days could be as simple as turning on a monitor and making a few mouse clicks.
At first glance, the Silk Road - a popular online marketplace - looks like any other website; just passing by, one likely wouldn’t be able to distinguish the service from eBay, Craigslist or any of the myriad other electronic bazaars on the Internet.
But a closer look at the site reveals that the Silk Road is anything but just another Amazon clone. Marijuana, cocaine, party drugs such as ecstasy, heroin and even some illegal weapons can all be traded, bought and sold on the site - which, fundamentally, can be accessed by anyone technologically savvy enough to find it.
Dr. Monica Barratt of Australia’s National Drug Research Institute said that - even for the ordinary Internet user - discovering how to locate the service isn’t too difficult a task.
“I think that anyone with average Internet and computer skills could work out how to access the site within half an hour or less,” she said.
“However, it is one technical hurdle to access the site and another entirely to work out how to purchase drugs, and importantly, how to purchase drugs in ways that do not leave behind a trail of evidence.”
The Silk Road, a service beloved by techies and loathed by federal officials, is every bit as enigmatic as it is controversial. As with the nameless, faceless constituency of Anonymous - the world famous cadre of hackers that frequently target government and corporate websites - even the FBI’s most skilled trackers can have trouble fingering exactly who is operating the service, let alone where the physical location of the Silk Road’s mainframe actually is.
“I don't think that anyone except the owner/s know where Silk Road is being hosted,” Dr. Barratt said. “Silk Road is a lucrative enterprise for the owner/s who take a commission from all sales, so I can only speculate that the owner/s would take great care to protect the site by continuing to mask the location of the hosting and any infrastructure involved.”
To many, the mystery of the Silk Road’s ownership is irrelevant; what’s important, they say, is that the site - somehow, someway - gets shut down.
The service, once called the “Amazon.com of illegal drugs” by National Public Radio, was a major bull’s eye in the crosshairs for legislators backing - and justifying- this year’s failed Stop Online Piracy Act (SOPA), with New York Sen. Charles Schumer describing the site as the “most brazen attempt to peddle drugs online” he had ever encountered.
The identity of who actually runs the service remains a mystery. Periodically, an administrator with the username “Silk Road” will post “official” statements on the Silk Road forums, and occasionally send what are essentially press releases to the media. According to the site’s apparent “admin,” what he or she (or potentially, they) provides is a relatively harmless service.
“Over 99 percent of all transactions conducted within the escrow system are completed to the satisfaction of both buyer and seller, or a mutually agreed upon is found,” the site’s administrator has posted on the Silk Road forums. Even so, the operators of the service do seem to have their limits as to what can be sold or exchanged on the site.
“Please do not list anything who’s purpose is to harm or defraud, such as stolen credit cards, counterfeit currency, personal info, assassinations and weapons of mass destruction,” one admin post reads.
Attempts to shut down the Silk Road, however, have proven incredibly difficult for U.S. agencies. While officials shut down MegaUpload - a Hong Kong-quartered file-swapping service frequently accused of promoting online piracy - earlier this year, United States officials have had little luck in their efforts to yank the site down, or even in determining who is running the service.
One reason it has been difficult to track down the physical source of the service is because, technically, the site isn’t part of the World Wide Web most Internet users are familiar with. Instead of entering a URL into a search box, the only way users can access the Silk Road is through the use of an anonymity network. The most popular of these is called Tor. This network masks browsers’ Internet Protocol (IP) addresses, which are specific numerical sequences that correspond to fixed geographical locations.
Essentially, when users hook into an anonymity network, their actual locations are hidden from all but the most advanced analytic software, making third party tracking extremely difficult if not impossible.
Andrew Lewman, executive director of the Tor Project, said that his company simply provides a service and the applications users find for IP maskers is something they have no control over.
“Silk Road is just a website that happens to use Tor’s hidden services,” he said. “Tor’s hidden services just give you an address, sort of like an IP address or a street address. What you do with the address is up to you.”
He said that the “deep web” - the portion of the Internet where sites such as The Silk Road are hidden - is a difficult concept to define.
“People think of the deep web like an iceberg,” Lewman explained. The average Internet user, he said, only sees the part above the water line, but the iceberg—the whole of the Internet—continues on deep under the surface of the water, hidden from view. “We generally call it the hidden web,” he added.
But Lewman is quick to point out that much of the deep web—the bulk of the iceberg under the water—is hidden for good reason.
“Things like your bank account are included in the hidden web,” Lewman said, “because you put a username and password in front of it—probably because you don’t want Google” to add your bank account to its index of websites.
Additionally, Lewman said that IP masking software has many security applications, especially for business data and journalists wishing to insure anonymity for sources.
“The majority usage of Tor is by just normal people, looking to protect their privacy online,” he said. “It’s sort of unfortunate that the press and media seem to jump all over the negative uses far more than the positive uses.”
To insure optimal levels of user anonymity, the Silk Road service uses a transaction system that sounds like it was lifted from a science-fiction novel. Silk Road customers do not exchange physical money on the site, nor do they exchange goods via credit cards or other online banking services, such as PayPal. Rather, Silk Road users pay for items listed on the marketplace with a form of electronic currency called Bitcoins.
“There are a number of ways that Bitcoins can be obtained and some of these ways differ between countries,” Dr. Barratt said. While Bitcoins can be purchased online through credit cards and bank accounts, she said many users prefer to use throwaway credit-cards or gift cards to make their purchases more anonymous. After Silk Road users obtain Bitcoins, they deposit them into accounts, which are then filtered through a tumbling service built into the site. Although this makes transactions more difficult to trace, Dr. Barratt said that the process still isn’t a completely anonymous one.
“Bitcoins can be used relatively anonymously, like cash, but can potentially also be used in traceable ways,” she said. “For example, if one bought Bitcoins with their credit card and then transferred the same amount into their Silk Road account to buy drugs, it may be possible to link these transactions through piecing together the amounts [and] the times of the transfers/transactions.”
While the computer know-how required to access the site and engage in commerce is most likely beyond the skill set of most juveniles, there is a possibility that more technologically adept youth could use the service to procure illegal goods. And even those lacking advanced technical knowledge don’t have to search the Web for too long to find information on how to access the Silk Road, as a number of how-to tutorials are available and easy to find on video hosting sites such as YouTube.
“I think that a teenager with modest technical skill would be able to access Silk Road, though it may be a bit more difficult for them to access Bitcoin in order to actually make a purchase,” Dr. Barratt said. “There are no age restrictions on Silk Road, not that age restrictions ever stopped teenagers from accessing other websites with restricted content.”
Dr. Barratt said that although the packaging used for Silk Road deliveries are usually intended to fool mail delivery systems and law enforcement agencies, she believes that the ultimate safeguard against the service may be mom and dad themselves.
“Of course, the drugs then need to be sent to an appropriate postal address,” she said. “For teens living at home, it can be a little harder to control who opens your mail.”
For further reporting on this story, check out our previous coverage.
Heavy marijuana use among teens has increased drastically in recent years, with nearly one in 10 sparking up 20 times or more each month, according to a new survey of young Americans released this morning.
The findings represent nearly an 80 percent increase in past-month heavy marijuana use among high school aged youth since 2008.
Overall, the rate of marijuana use among teens has increased. Past month marijuana users, or teens that have used marijuana in the month prior to the survey, increased 42 percent, to 27 percent of teens, compared to 2008 findings. Past-year and lifetime use also increased, but not as drastically, at 26 percent and 21 percent respectively.
Marijuana use has not been this widespread among American teens since 1998, when the past-month usage rate hovered around 27 percent, according the survey conducted by The Partnership at Drugfree.org and the MetLife Foundation.
“Heavy use of marijuana – particularly beginning in adolescence – brings the risk of serious problems and our data show it is linked to involvement with alcohol and other drugs as well,” Steve Pasierb, President and CEO of The Partnership at Drugfree.org, said in a press release. “Kids who begin using drugs or alcohol as teenagers are more likely to struggle with substance use disorders when compared to those who start using after the teenage years.”
The use of marijuana is becoming normalized among teens, too, according to the survey of 3,322 teen-aged students in grades 9-12 and 821 parents. Seventy-one percent of teens said they have friends who use the drug, up 64 percent from 2008, and only 26 percent agreed with the statement, “in my school, most teens don’t smoke marijuana.”
Still, while the number of teens who have used marijuana in their lifetime is on the rise, less than half of high school aged students have actually used the drug. The rate of teens who disapproved of their peer’s use of the drug remained unchanged since 2008, with more than 60 percent disapproving of the practice – and 41 percent who said they “strongly disapprove.”
Heavy users are drastically more likely to use other drugs such as cocaine, Ecstasy and prescription drugs, compared to their peers who reported not using marijuana in the past year, the report found.
Teen boys, especially Hispanic males, have led the increase in the past year. Heavy usage by teen boys usage increased at nearly twice the rate of their female counterparts. Hispanic high school males are more likely to have used marijuana in the past year compared to their peers. Fifty percent reported using the drug in the past year, compared to 40 percent of black and 35 percent of white teens.
“The latest findings showing an increase in marijuana use among teens is unsettling and should serve as a wake-up call to everyone in a position to prevent unhealthy behavior,” said Dennis White, President and CEO of MetLife Foundation, who contributed to the report. “While it may be difficult to clearly understand just how dangerous marijuana use can be for teens, it is imperative that we all pay attention to the warning signs and intervene anyway we can.”
The findings are part of the 23rd annual Partnership Attitude Tracking Study, a yearly gauge of teens’ and parents’ attitudes toward issues that affect their lives.
Photo credit: Ryan Schill/JJIE
The Substance Abuse and Mental Health Services Administration (SAMHSA) and the John D. and Catherine T. MacArthur Foundation have teamed up for a new $1 million project to divert youth with behavioral health conditions away from the juvenile justice system and into community-based programs and services.
According to SAMHSA, 60-70 percent of youth in the juvenile justice system have a mental disorder and more than 60 percent suffer from a substance abuse disorder. Many of these youth, SAMHSA says, wind up in the juvenile justice system rather than receiving treatment for their underlying disorders.
Up to eight states will be selected competitively to participate in the new collaborative initiative. If selected, states would receive support to develop and initiate policies and programs to divert youth away from the juvenile justice system early.
"This innovative effort will help ensure that fewer at- risk young people fall through the cracks and into an overburdened juvenile justice system that is very often unable to address their underlying behavioral health problems," SAMHSA Administrator Pam Hyde said in a press release. "This initiative focuses on helping divert these youth whenever possible to community-based behavioral health services that can actually turn their lives around for the better."
The program will combine SAMHSA’s Policy Academy initiative and the MacArthur Foundation’s Models for Change Action Network and will emphasize reducing the overrepresentation of youth of color with mental and/or substance use disorders in the juvenile justice system while incorporating mental, substance use and co-occurring screening and assessment practices throughout the juvenile justice system recognizing the important roles of evidence-based practice, treatment, and trauma-informed services.
The National Center for Mental Health, Juvenile Justice at Policy Research Associates, Inc. and the Technical Assistance Collaborative, Inc. have agreed to coordinate the proposed initiative.
“The states selected will have access to leading experts in the field and the latest research and information on front-end diversion policies and programs for youth with co-occurring disorders,” said Laurie Garduque, Director of Justice Reform for the MacArthur Foundation. “With the seamless integration of SAMHSA’s and MacArthur’s demonstrated strategies for effective training and technical assistance, we will promote broader diffusion and new adaptations of models of best practices to states committed to systems reform.”
At the National Collegiate Recovery Conference Wednesday at Kennesaw State University, Michael Fishman, Director of the Young Adult Program at Talbott Recovery Campus in Atlanta, neatly summed up everything he had learned in 22 years of treating addiction in young adults. The recurring theme of his keynote address: It’s complicated.
“Most young adults are generally poly-substance abusers,” he said.
They aren’t just using marijuana; they’re also drinking, Fishman says. It’s not just opioids, it’s opioids and anti-depressants or any other combination. And that complicates the picture for doctors trying to get to know their patient’s true diagnosis.
“The drugs and alcohol may mask the underlying pathology,” Fishman said. Withdrawal symptoms, he added, “cloud the picture,” as do toxicity and detox.
Additionally, many young adults suffering from addiction are also suffering from mental illness of some kind, what Fishman calls “dual-diagnosis.” Depression and anxiety are common in substance abusers and the addiction may begin as an attempt to self-medicate, which Fishman says doesn’t work.
“Ask any young person who self-medicates how that’s working out for them,” he said with a laugh.
The three-day National Collegiate Recovery Conference was hosted by Kennesaw State University's Center for Young Adult Addiction and Recovery and featured addiction specialists from college campuses across the country.
At a separate address Thursday, John F. Kelly, Program Director of the Addiction Recovery Management Services at Massachusetts General Hospital, echoed Fishman’s assessment.
“Young adults,” he said, “have the highest rates of co-occurring psychiatric problems.”
According to Kelly, who is also a consultant to the White House Office of National Drug Control Policy, this is a serious cause for concern because of the impacts not only on the patient, but also on society.
“Drugs and alcohol account for more than $500 billion in economic impact,” he said. “It costs more than heart disease.”
In fact, he said, excessive alcohol consumption alone costs the nation $2 per drink, citing a 2011 report from the Centers for Disease Control.
“Alcohol use disorder is associated with abnormalities in the pre-frontal cortex,” he said, the part of the brain responsible for decision-making and moderating social behavior.
Additionally, he said, “drinking at an early age impairs maturation.”
When asked by the audience which drugs he saw abused the most, Fishman said opioids — prescription drugs such as Oxycontin, hydrocodone, and roxicodone and illicit drugs such as heroin.
“Eighty percent of what I see is opioid dependency,” he said. “It’s rampant.”
He added that often young people become addicted to prescription opioids but when they become too expensive they seek out cheaper alternatives, such as heroin.
Abuse of prescription drugs by young adults, he added, “is an epidemic right now.”
Treatment is imperative and should include a specific and consistent structure, Fishman said. Also important is family involvement.
“Parents are often afraid if they set boundaries they [their children] will run away,” Fishman said. Young adults “need a sense of family support,” not the “potential for sabotage.”
NEW YORK -- Getting shot was probably a critical turning point in Ray Tebout’s life, he says. It was 1990. Tebout had just turned 16 and was living on the streets of the South Bronx, selling drugs and doing his best to survive. And then some guy had to go and shoot him in the foot.
The day of the shooting Tebout was on the corner selling drugs when “a guy wanted something from me,” he said. “I gave it to him but he decided he wanted something from someone else.” The man got angry and walked away but then — suddenly — he turned around and shot Tebout.
“Getting shot in the foot may not sound like much,” he said, “but it’s pretty horrible.”
Homeless, with his foot in a cast and walking on crutches, Tebout was mostly immobile, at least by the standards of drug dealers in the South Bronx.
“Losing your mobility in such a predatory environment was tough,” he said. You can’t sell drugs, he added, because you can’t run from the cops or the thugs.
He may not have been able to walk, but this was still the first step toward turning his life around. But it was only the first, very tiny step and it would be years, spent in and out of prison, before his life would be truly stable; before he stopped burglarizing stores because he was starving, homeless and desperate.
In early February, Tebout sat on a panel discussing prisoner reentry during the second day of the John Jay College/Guggenheim Symposium on Crime in America held here. His words held an added resonance as he was the only speaker on the panel to have actually been to prison. But now Tebout stands on the other side of the wall, counseling former inmates like himself and proving that a prison sentence doesn't preclude you from becoming a leader in your community. Tebout is now director of counseling at College Initiative, a reentry community organization in New York City that helps the formerly incarcerated transition into college.
Tebout was born in Manhattan in 1974 but spent his youth travelling the country with his family, finally landing in the Bronx when he was 12. All those years of travel isolated him from other kids, leaving him with very limited social skills.
“I was a misfit there,” Tebout said. “I was decently educated, but not socially educated. I read well but I had zero social skills.”
Suddenly he was an awkward suburban kid dropped into a “hostile urban environment.” It wasn’t long before he was committing petty burglaries and selling drugs.
“My first criminal activity was to fit in,” he said. “It gave me something to bond over with folks. When you are interested in engaging in criminal activity you find the people involved in criminal activity.”
It was an important step in the wrong direction, but Tebout says, “It took me out of the position of least powerful in my social group.” And eventually, he says, his petty crimes became more violent.
Tebout’s father had sent him to a number of good schools, but he struggled with authority and got kicked out of them all. “That didn’t work out,” Tebout said simply. Frustrated and facing his own troubles with addiction, Tebout’s father kicked him out. He was 16.
Tebout lived on the streets of the Bronx for 10 months, selling drugs to survive. But he soon realized there was an easier way, he said, and he started looking for people to rob.
“It was a lot easier to rob people than it was to stand on a street corner and sell drugs,” he said.
But then he was shot, left defenseless in a dangerous place and was soon arrested for burglary.
“I was hungry, it was cold and I needed something to eat so I burglarized a store with a couple of guys,” Tebout said. “They got away and I didn’t.”
Tebout was soon back on the streets, his case dismissed and sealed.
When he was 18, in 1992, everything fell apart once and for all when a late-night robbery went sideways. Tebout wanted to make some money. His sister was struggling and he wanted to help her out.
“I was already robbing people,” he said, “so I decided to go out and look for somebody and at the end of the night in a quiet subway station I found a guy.”
Tebout's target pulled a gun on Tebout and tried to shoot him but he managed to wrestle the gun away from the man. Then Tebout pistol-whipped him.
Tebout says he still feels remorse for the attack.
“That was probably one of the worst things I have ever done,” he said. “I think about what that man must have gone through and it’s horrifying. I feel really terrible about it.” Having been attacked himself, Tebout said, he knows the pain the man must have gone through.
He was convicted and sent to prison for 11 years. His time there, Tebout says, was horrible.
“I think I only slept, ate and fought for the first year,” he said. Soon he got involved with gangs on the inside. Tebout is a big guy, tall with a shaved head, and intimidating, but everyone can use protection.
“In some ways [gang members] were essential to helping me out with my time,” he said.
But his first seven years in prison weren’t moving him any closer to rehabilitation. Tebout was actually adding more time to his sentence.
“As I stayed in prison my time got increasingly violent,” he said. “I got an additional one and a half years. It was escalating and escalating.”
Tebout appeared lost, a young man who only knew violence and crime. But his grandmother, like so many grandmothers, knew her grandson better. She wrote Tebout in prison and asked him simply to be a good citizen. He listened.
However, his rehabilitation wasn’t overnight. His criminal behavior faded away slowly, partly out of necessity.
“For gangs that means your defenses are down,” he said. “You are vulnerable and I had to be careful.”
He didn’t stop getting in trouble, he says, but he was more thoughtful and stopped being reckless.
But one day, he says, he prayed and then he was done.
“I’m out,” he says he thought at the time. “I’m not going to put my hands on anybody. I’m going to go out and be a good citizen.”
His good behavior didn’t go unnoticed by prison administrators and they offered him spots in rehabilitation programs telling him his participation could lead to an early release.
Tebout went along with it, mostly because he wanted to get out of prison faster, he says, but eventually he saw they were helping.
“The value of those programs to me,” Tebout said, “was that it started me thinking differently.”
One program defined criminal thinking as the lazy, easy way out and helped Tebout identify the steps to stop him thinking like a criminal.
“I needed to start pursuing the longer, harder road,” he said.
And he did, becoming part of the 33 percent of ex-offenders who do not recidivate according to an offender reentry report for Congress.
Speaking on the same panel as Tebout at the February symposium at John Jay College, attorney Margaret Love described some of the difficulties many former inmates face.
"There are more and more laws that exclude people with convictions from a variety of benefits," she said. "There are upwards of 35,000 laws."
Even harder to deal with is the social stigma, she says.
"Most people who are convicted are not a public safety threat," she said. "But the pervasive backgrounding and the fear that has overcome us since 9/11 has made it very easy to exclude people who have characteristics we fear."
Tebout was released from prison when he was 29. He has $170 in his pocket and the support of some positive friends. Tebout is still proud that he didn’t land in a homeless shelter upon release and instead stayed with an old friend from high school.
He started working in restaurants and used the money he earned to put himself through culinary school. He cooked professionally for two years but he said, “I realized I was doing more counseling in the kitchen than cooking.” So he switched gears and moved into human services.
He continued to work hard, earning credentials in substance abuse counseling and entrepreneurship teaching all while working as a counselor at the Fortune Society, a social service and advocacy group that supports successful reentry into society after prison. He later joined College Initiative and enrolled in the John Jay College of Criminal Justice where he is pursuing a bachelor's degree.
His work has done more than just keep him out of prison, it’s given him a purpose.
“No one was addressing the needs of those being released from prison,” he said. “It’s very rewarding.”
According to the Reentry Policy Council, many communities have few, if any, reentry assistance programs. Through his counseling work, Tebout is working to change that.
Tebout brings a lot of personal experience to his counseling work and says he knows how to approach teenagers in danger of travelling the same path to prison that he did. It’s all about choices and Tebout can’t make decisions for them.
“I’m not here to tell you what to do,” he tells his mentees, “but here are your options.”