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Posted November 30, 2003 

Dirty
A Search for Answers Inside America's Teenage Drug Epidemic
By Meredith Maran
NY:HarperCollins:2003

Reviewed by Lon Woodbury

The author is a journalist, and the mother of a son who went through all the trauma that accompanies having an out-of-control teen, complete with drugs and arrests, moving from program to program, and failure after frustrating failure. When the worse seemed to be behind her, she started looking for answers by exploring the adolescent treatment industry.

Focusing on three young people she met in various treatment facilities, she gained their trust and shadowed them through their trials, failures and successes. This book is a chronicle of her experiences, and what she learned.

The mark of a good writer is the ability to describe people in a believable manner, and after finishing the book, the reader will feel they have actually met these young people in all their frustrating contradictions. As a parallel theme, through flashbacks, the author shares her own experiences with her own son, sometimes using that to point out the inappropriateness of some of the viewpoints asserted to her by professionals.

What she describes is not a pretty picture. First, she captures the fear, anger, manipulation and ongoing frustration of the young people who are caught up in the legal and rehab systems. She also captures the inadequacies of the system in its attempts to help these young people. For example, she notes several times that half or more of the young people in drug rehab do not have drug use as their central problem, but the focus of their treatment is drug addiction. Where there is this kind of misdiagnosis, failure becomes certain, along with a tremendous waste of resources.

Another problem is the reluctance to prevent children from leaving programs. All children in the programs she looked at can run away, and they know that. The author asserts this manifestation of children's rights is a major contributor to the ineffectiveness of attempts to help out-of-control children.

This book is a good dramatic presentation of the hell some parents and children go through while official attempts to help are under funded, undermanned, and often miss the real needs. It is a good read for the person who wants to see the tragedy of the actual children who are behind the statistics of juvenile drug use and crime.

In a summary, the author asks two questions, and provides the answers as she has learned them.

Why do teenagers abuse drugs: Because it's fun, because they have no hope, and because they don't believe us.

What should we do to keep teenagers from abusing drugs: Support good parenting, support healthy communities, revamp the school system, revamp the juvenile justice system, and revamp the adolescent drug-treatment system.

Although this is an insightful book, from the perspective of this newsletter, which is devoted primarily to private residential resources for these children, the book was disappointing. Although the author mentions private wilderness programs, therapeutic boarding schools and emotional growth programs, her only description is a caricature that sounds like how manipulative adolescents would describe programs they didnít buy into. She states that their prices range from five to forty thousand dollars a month, though actually we work with many quality programs that are less expensive than that. Her description of a wilderness program outside Bend Oregon that one of the three subjects attended emphasized a stern insensitive staff operating in miserably cold conditions. She dismisses them with no investigation.

Her opinions do a disservice to the private programs that are of good quality that actually benefit these youth. But as an investigation into the majority of mainstream attempts to help these children, her critique is very good. She makes a good case for a major rethinking of what we are doing for/to our vulnerable young people who are making very poor decisions.

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