In the book Dirty, Meredith Maran examines the issue of
teenage drug use by tracing the lives of three teenagers
though courts, jails, and treatment centers. The subtitle -
"A Search for Answers Inside America's Teenage Drug
Epidemic" - speaks to her own search for meaning: her son
was a heavy drug user, and though he is now clean and a
drug counselor for troubled youth, Maran remembers and
relates her encounters with court-mandated treatment and
visits from the police. She brings a surprisingly
level-headed approach to this emotional topic, questioning
the benefits of jails, the quality of treatment centers,
and even whether treatment is needed in every case where a
teenager chooses to use drugs.
Her cases are diverse, and while she hides the identities
of her underage subjects, she does not disguise the
treatment facilities, drug courts, or jails. She meets
Mike, who does meth along with any other drug he can get
his hands on, who makes his own pipes from test tubes with
glass-blowing skills he taught himself, whose only
motivation for becoming clean is the chance to go on a
book tour with Maran: "he got clean without a drug program
because he had a reason to. Not anyone else's reason; his
own" (p 288). She meets Tristan, an introspective and
intelligent boy who uses mushrooms and peyote for
spiritual reasons, who refuses to believe that his
spiritual quests are criminal, and who can only accept the
existence of a higher spiritual power (the first step of
AA) because of a vision he had on a drug trip. She meets
Zalika, a prostitute since age twelve, who sells crack even
when she doesn't use it herself, who escaped her
upper-middle class life to live with the money, diamonds,
and respect that only her different pimps could offer her.
She questions the use of the AA program for teenagers (p
233). Specifically, it's difficult to imagine a teenager
admitting that she has no control over her actions and
that she must give herself over to a higher power
(requirements of the 12-step program). Adolescence is a
time of asserting control and independence, and the AA
model may not work for these teens. Further, she explains
that the illegality of drugs puts parents in a difficult
position if their child decides to run from treatment. As
Maran says, "They can (1) lose track of their kid, (2)
harbor a fugitive, or (3) have their kid arrested. Unable
to count of their parents' 'loyalty,' many kids run away
from home when they run away from treatment... - the last
thing they, or their families, need" (p 269).
My only complaint is the subtitle. "America's Teenage
Drug Epidemic" implies that drug abuse is a disease and
that it can spread like a disease, like influenza. But
not all drug use is bad, Maran admits, having used illegal
drugs herself and having watched one son smoke pot
throughout his teenage years without problems. Drug use
may be beneficial for some teens, either by relaxing them,
helping them concentrate, or giving them access to a
spirituality they couldn't get through their normal lives.
But some teenagers abuse drugs; Maran's first son is one
of these. But even for abusers, drug use must begin with
a choice. Many of these kids have problems that could
lead to drug abuse, like poverty, or affluent parents who
substitute gifts for love, or drug-using parents, or
learning disabilities, or profound boredom. But none of
these implies "disease."
The word "epidemic" implies a disease that can be treated.
And drug abuse can be treated, but not with a
"one-size-fits-all" approach like tuberculosis. Treatment
needs to be selected deliberately for the patient, argues
Maran and many of the drug counselors she interviews. So
the word "Epidemic" on the cover is misleading, as Maran
does not argue drug abuse is an epidemic.
But this is a trivial complaint about an otherwise
impressive sociological study. Her fieldwork is
impressive, and her ability to get to know the teenagers
she works with is probably unparalleled in the literature.
She knows these kids, and she cares about them. This is
due, in no small part, to her own son who was addicted to
drugs and went to many different treatment centers. But
however she did it, Maran has written a heartful,
realistic look at teenage drug use that addresses abuse
but does not dwell on statistics. She tells the stories
of real teenagers, and she makes it clear that there is no
easy answer to any of the questions she raises, despite
the vociferous arguments of pundits and politicians.