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Wednesday, September 2, 2015

Poor Young Men Use Guns to Settle Disputes and Maintain Status

"Many top police officials say they are seeing a growing willingness among disenchanted young men in poor neighborhoods to use violence to settle ordinary disputes.

“'Maintaining one’s status and credibility and honor, if you will, within that peer community is literally a matter of life and death,' Milwaukee’s police chief, Edward A. Flynn, said. 'And that’s coupled with a very harsh reality, which is the mental calculation of those who live in that strata that it is more dangerous to get caught without their gun than to get caught with their gun.'"

(Monica Davey and Mitch Smith. "Murder Rates Rising Sharply in Many U.S. Cities."
The New York Times. August 31, 2015)

What about this mentality that the gun is not only a defense to criminal assault but also a common means of settling disputes?

Captain Mike Sack, a homicide commander in the St. Louis Metropolitan Police Department, cited killings there that had grown out of arguments over girlfriends, food and even characters on a TV show. “Most remarkable is that individuals get so upset over things that I or others might consider petty but resort to such a level of violence,” he said.

“That is not a situation that can be solved by policing,” said New Orleans Police Superintendent Michael S. Harrison. “It speaks to a culture of violence deeply ingrained into a community -- a segment of the population where people are resolving their problems in a violent way.”

Youth in America today have access to, are using, and are being victimized by firearms more than ever before. Dr. Alfred Blumstein, professor at the H. John Heinz III School of Public Policy and Management of Carnegie Mellon University and one of the top experts in criminology and operations, headed research that found the following about youth, guns, and violence:

* The increase in violence in the United States during the late 1980s and early 1990s was due primarily to an increase in violent acts committed by people under age 20. Similarly, dramatic declines in homicide and robbery in recent years are attributable primarily to a decline in youth violence.

* The increase in youth homicide was predominantly due to a significant increase in the use of handguns, which converted ordinary teenage fights and other violent encounters into homicides.

* Several other interrelated factors also fueled the rise in youth violence, including the rise of illegal drug markets, particularly for crack cocaine, the recruitment of youth into those markets, and an increase in gun carrying among young people.

* Youth violence diminished as the crack markets shrank, law enforcement increased efforts to control youth access to guns, youth gun carrying declined, and the robust economy provided legitimate jobs for young people.

(A. Blumstein. "Youth, guns, and violent crime." Future Child. Summer-Fall 2002.)

When we fail to see youth as victims of guns and crime, we deny many means that allow us to correct the problem of youth violence. Many Americans consider all juveniles who commit gun violence thuggish delinquents and gang members. I believe the truth is that most young people with weapons are misguided, unsupervised, angry, rebellious adolescents who see guns as status symbols with a purpose -- "problem-solving tools" for settling arguments.

If we wish to correct this unsettling attitude, we must do much more than point accusing fingers at young assailants in the aftermath of deadly shootings, and, instead, address the violence with strategies that strike at the core of why violent youth possess and use guns. It is evident we must find better means of reaching and helping at-risk youth in their early teens because effective, early prevention measures can keep them from becoming criminal delinquents.

The first thing we can do is be honest and transparent about the hurts of our young people. Poor children in America are under tremendous stress. Yet, in our limited wisdom, we simply tell them they have no excuse to act irresponsibly. What happens when a youth experiences severe mental, bodily, and spiritual stress? Any parent knows that child will act out, often in aggression.

Now, what if this same hurting child is constantly bombarded with the message "you don't matter"?   In his home, his parents are too busy to spend time with him in order to nurture his dreams and aspirations. In fact, he is likely from a one-parent family where money and supervision are often lacking. In a dysfunctional setting, he is often yelled at, scolded, and told that he is only good at doing wrong. Soon, he sees this as a self-fulfilling prophecy, so he begins to hone the skills that contribute to misbehavior and to acquire every available tool for aiding violence.   

And, of course, he channels the frustration he feels at home into a much broader community as he enters school. Here, even though zero tolerance is essential to safeguard innocent students, his school labels him a likely "trouble maker" and soon has "proof" as it runs him through the gamut of disciplinary measures as he finds added social pressures push him to commit so many unruly behaviors that he becomes suspended time and again, and eventually expelled. Claiming "we can't deal with him," his school pushes him out of the education institution that might have been his savior and allows him to take another step closer to entering the prison population.  

And, guns do become commonplace tools for these young people. They are used as machismo symbols for gangs, used for youth crimes, and used for youthful self protection. The Rochester Youth Development Study (RYDS) is a longitudinal study investigating the development of delinquent behavior, drug use, and related behaviors among a group of urban adolescents. It is used by the U.S. Department of Justice. Here are some findings from 2001:

"Overall, boys who owned guns for sport look more like those who didn’t own guns at all than those who owned guns for protection. Compared with boys who did not own guns at all, those who owned guns for sport did have significantly elevated levels of gun carrying, gun crime, and drug selling. (For street crime and gang membership, the differences were not statistically  significant from zero.)

"However, boys who owned guns for protection were significantly and substantially more likely to be involved in delinquent behavior than either those who did not own guns or those who owned guns for sport. For example, 70 percent of protection owners carried their guns, whereas only 11.1 percent of sport owners did so, and only 3.2 percent of those who did not own a gun had carried a gun in the past 6 months. 2 In other words, a protection owner was six times more likely than a sport owner to carry a gun.

"Further, protection owners were eight times more likely than sport owners to commit a gun crime, 3.5 times more likely to commit a street crime, nearly five times more likely to be in a gang, and 4.5 times more likely to sell drugs -- all statistically significant differences.

"One should not necessarily infer from this analysis that owning a gun for protection leads to criminal activity. The opposite may be true: involvement in criminal activity may lead to the need to own a gun for protection. For example, a drug dealer may obtain a gun to ply his trade, rather than ply his trade because he happens to have a gun. However, one thing is certain: boys who own guns for protection have adapted to the dangerous associations and circumstances that surround criminal activity."

Table 1: Percentage of Boys Involved in Delinquency, by Gun Ownership Status

Gun Ownership Status (%)

Type of Delinquency No Gun Owned (n=548)   Gun Owned for Sport (n=27)  Gun Owned for Protection (n=40)

Gun carrying                  3.2                                   11.1                                          70.0
Gun crime                      1.3                                     3.7                                           30.0
Street crime                 14.8                                   18.5                                           67.5
Gang membership        7.2                                    11.1                                           55.0
Drug selling                   3.5                                     7.4                                            32.5

What does the mantra of personal responsibility mean to a child who has a pitifully insufficient support system? Sure, success stories of children beating the odds are celebrated and held up as wonderful models of behavior. But, when we face reality, we find success without major support is very rare and failure is the predominant outcome.

Instead of initiating proactive measures to help all children feel valued -- even delinquent individuals, the much of the public prefers to ignore largely this poor population and expect them to somehow miraculously "pull themselves up by their own bootstraps." The result is often "pulling themselves" toward the criminal crowd, accessing guns as tools of their trade, and using them in violent confrontations.  

I constantly hear seemingly everyone profess to their strict beliefs in equality, yet talk costs nothing and requires no commitment and effort. Put a gun in the hand of a poor, young Afro-American, and a large segment of public is quick to blame his race for his penchant towards violence. How many people are willing to count all youth as valuable members of society no matter their economic status, their race, or their creed?

Given the disproportionate damage gun violence is having on communities of color, the NAACP has
advocated for a number of sane, sensible gun laws which will do a lot to eliminate the damage caused by gun violence.

Specifically, the organization is calling for a permanent, nation-wide ban on the sale, transfer, importation, and manufacturing of all high-powered military style semi automatic assault rifles and pistols (assault weapons) and the ammunition clips; a federal law requiring universal background checks for all gun purchases; and that the federal government do more to require states and federal agencies to submit information about disqualified individuals, including mentally ill and other dangerous people for inclusion in the National Instant Criminal Background Check System.

The NAACP is also opposed to proposals which have the potential to increase gun violence or may unnecessarily, disproportionately criminalize African American youth or other youth of color. Specifically, we have asked for an increase in federal resources for more comprehensive security measures and technology in areas surrounding schools and for counselors in schools to help stop all types of violence, rather than some proposals which have called for police officers or armed security personnel to be placed in schools across the country or to arm teachers or administrators.

There exists a body of literature that argues that police in schools, sometimes referred to as Resource Officers, has the result of criminalizing non-violent student behavior such as class skipping and other acts of defiance and pipelining kids into the juvenile justice system rather than in-school counseling and discipline. Rather than criminalizing children or adding more guns into the school environment, the NAACP believes the nation should focus on providing resources so that more counselors and mental health professionals can be hired and placed in public schools to help assist, monitor and prevent these types of tragedies.

(Hilary O. Shelton, Director, Washington Bureau. "Stopping Gun Violence; Urging Strong Support for Safe, Sane, and Sensible Gun Violence Prevention Laws, Policies, and Programs." National Association for Advancement of Colored People. January 15, 2015.) 

An Effective Program in Chicago

According to the University of Chicago, 7,000 students have missed more than 40 days of school and are enrolled in schools within communities that have homicide rates more than twice the national average. These youth are at a greatly elevated risk for violence involvement.

To combat this, a program titled Becoming a Man (B.A.M.©) is being implemented and funded by local foundations, corporations, and the federal government. The program is being expanding to reach 2,000 students in Chicago in the coming school year.

B.A.M. is a dropout and violence prevention program for at-risk male students in grades 7-12. B.A.M. offers in-school programming, in some cases complemented by after-school sports, to develop social-cognitive skills strongly correlated with reductions in violent and anti-social behavior.

Each session is built around a lesson designed to develop a specific skill through stories, role-playing and group exercises. Participants learn about and practice impulse control, emotional self-regulation, reading social cues and interpreting intentions of others, raising aspirations for the future and developing a sense of personal responsibility and integrity.

The after-school sports component reinforces conflict resolution skills and the social and emotional learning objectives of the in-school curriculum. The goal of this program is to help youth learn to compete within the confines of a sport, and to help them learn self-control and accomplishment. The program hopes that through sports, the youths will learn “soft skills” that will help them avoid criminal behavior and succeed in school and the labor market.

A randomized controlled trial by the University of Chicago Crime Lab has demonstrated the positive results of B.A.M. These include the following:
  • Reduced violent crime arrests by 44%
  • Reduced weapons crime and vandalism by 36%
  • Reduced the likelihood of attending school in a juvenile justice setting by 53%
  • Increased future graduation rates by 10-23%
The return on investment was found to be up to 31 times the participant cost from reductions in crime alone in one year, and additional societal benefits of nearly $50,000 to $120,000 per participant from increased lifetime earnings, tax payments and lower public benefit use.

Surely programs like Becoming a Man will strike significant positive changes while aiming at the heart of the problem of youth gun violence. The roots of a young person's feeling the need to pack a gun is based on fear, yet that fear stems from many different reasons for gun ownership ranging from the need to survive to the need to use deadly force in criminal activities.

The death rates are abhorrent. It is time to work on respecting humanity while limiting the violents' ability to kill innocent people and each other. Shooting back in retaliation will never change the mentality of violence present today.

Only when we care enough about saving all lives will America commit sufficient resources to solving youth gun violence. And, one thing that must be striken from the equation of youth violence is the all-too-efficient and effective tool of mayhem -- the loaded gun in the hands of a scared and angry young man who lacks a sensible means to cope with disputes.

Saturday, August 29, 2015

Rebekah Bolser: Welcome To Portsmouth

At the age of 11, Rebekah Bolser was convinced she could change the world. So, when she viewed a public service announcement featuring actress and singer Selena Gomez, who at 17 became the youngest UNICEF ambassador ever, Bebekah became motivated to join and begin her career of activism.

19-year-old Bekah, as she is affectionately known, says, "I don’t think there’s ever been a time when I doubted my ability to take on a project just because of my age." And, although she has been described with the girlish platitude of "sugar, spice, and everything nice," she already has a strong track record of activism while rocking campaigns and important movements.

Bolser is a 2013 graduate of Hamilton High School. She has just completed her freshman year at Miami University in Oxford, Ohio where she is pursuing a bachelor's degree in Diplomacy and Global Politics and a second major in Strategic Communications.

Bekah's long list of credentials include the following:
    * Working with OneCommunity, an art exhibit that challenges elementary school students to create artwork that depicts issues within their community including racism, discrimination, and immigration.
    * Founding Teens Against Teen Suicide at 14 years old, an organization dedicated to raising awareness on issues surrounding teen suicide and depression and began "teen on teen counseling" groups at local high schools where students could seek tutoring, advice, and mentorship from their classmates in an open, inclusive environment.
    * Establishing the Pocahontas Project in 2013, a locally based project that seeks to teach students about environmental sustainability through art.
    * Starting EveryGirl, a scholarship fund and leadership immersion forum dedicated to giving incoming college freshman girls the resources and skills needed to become leaders on their campuses.
    * Currently serving as the USA Chapter Chairperson for the International Youth Council, a civil society organization founded at the Youth Assembly at the United Nations, where she works to create national and global programs that encourage young leaders to get involved with issues surrounding the Millennium Development Goals, Post2015 Agenda, and the role of young people in creating these policies. Her current initiatives also involve comprehensive sex education and reproductive justice.
    * Acting as director of the Student Voice Project in which she oversees student representatives of Ohio and also serves as the chair for the Congressional Youth Council Implementation Committee. * Publishing frequently for several sources including the Huffington Post, ProgressWomen, and GenYNot.
Bolser says her time is recently divided between two projects very dear to her heart. This year, she was selected to attend the Clinton Global Initiative University, which has catalyzed her work with women of low-income backgrounds. The other project is called “A Seat At the Table,” and it has her working with a team of young people to create civic education programs for local high school students that focus on youth policy and what youth-friendly communities look like while building stronger relationships with their local city council representatives.

Bolser claims her favorite quote is “The duty of youth is to challenge corruption.” (Kurt Cobain). She believes when young people raise their voices and stand together, they can make positive change in their communities. She is very passionate about several issues and topics including gender equality, safe water access, and education. Bolser will be studying International Development and Social Change and hopes to continue empowering young people throughout college and beyond.

Rebekah Bolser has graciously accepted an invitation to come to Portsmouth and take part in the Scioto County International Overdose Awareness Day event at the Fastop Market, 1735 8th Street on Monday, August 31 from 10AM-3PM. The Portsmouth City Health Department is extending an invitation to all to attend and hear Bekah share her comments about the day.

Bolser recently lost her Uncle Josh to the Ohio heroin epidemic. She wrote an article on July 7 for the Huffington Post titled "On Heroin, Ohio, and Storytelling for Change" describing her loss. She said:

I feel like there's a lot of fear and anger surrounding the Ohio heroin epidemic. And that sometimes these emotions can get in the way of recognizing the lives being lost, the stories behind those lives, and communities where these issues come from. My uncle overdosed and passed away in May and I've had a hard time talking about these issues and his life, but I've decided to work through it in the best way I know how: by writing about it and sharing his story, and my story.

I've been surrounded by drugs since I was very young and I think that communities like Hamilton (specifically the part of Hamilton where I grew up) are often dismissed when discussing these issues. And the first step to addressing these issues is talking about them within the context of the communities where these issues develop.

I constantly miss Josh and writing this hasn't changed that, but I felt like this is something I have to talk about and I couldn't do that without centering around his life and his passing. Rest in peace, Uncle Josh. I love and miss you every second.”

By all indications, Rebekah Bolser is destined to be an invaluable human resource for America as she continues to mature and to accept many leadership roles. Her voice is wise beyond her years, and one must certainly marvel at how many marvelous accomplishments she has achieved at such a young age. Perhaps most importantly, her complete commitment to action legitimizes her ability to help enact needed change.

Please come August 31 to help welcome Bekah to Portsmouth. The health department is so happy that she can attend the local International Overdose Awareness Day event.

Gun Control: Respect and Support for Alison and Andy Parker

"Andy Parker's resolve to fight for gun control formed in the hours after his daughter Alison, a promising journalist killed while doing what she loved, was shot and killed on live television.

"'This will be my mission,' he told reporters. 'I've got to do something going forward that makes her life meaningful and will always be with me. And this is the way to do it.'

"'There are too many guns in America and there are clearly too many guns in the wrong hands. So we're going to continue to do what we can.'

"While his articulate Southern voice renews a push for gun restrictions, winning such measures has proved nearly impossible in the U.S., even after other high-profile tragedies garnered sympathy across the country and elicited similar pledges of activism from victim's relatives."

(Jonathan Drew. "After TV slaying, reporter's dad finds voice on gun control."
Associated Press.
I believe we all must respect this father's impassioned mission. No, I must go even further in my belief: I believe we all must demand our lawmakers make an honest and diligent attempt to draft and to pass legislation that will stiffen gun laws representing an acceptable compromise between gun advocates and gun control supporters.

Parker did gain a strong supporter in Virginia Governor Terry McAuliffe, a gun-owner himself, who has promised to help fight for stronger background checks for gun buyers. Small steps will lead to miles of understanding and reform.

Andy Parker, like so many U.S. citizens, said he's not against gun ownership in general, but stricter background checks are needed to keep guns away from mentally ill people. He wants to close loopholes for buying guns at gun shows. He also doesn't see why civilians need assault weapons. He says, "Who the hell needs a machine gun to go hunt?"

The absolute refusal of the gun lobby to consider any kind of much-needed control, particularly opposition by the NRA, one of the most powerful political action groups in the nation, is simply stubborn will based on some shaky arguments. Here are two prominent ones I hear all the time:

* At the most basic tenant of gun advocates is the Second Amendment as written in the Bill of Rights in the U.S. Constitution. They insist it exists to protect an individual's right to own guns for the purpose of self-defense.

* The mantra of the NRA is their slogan "Guns don't kill people; people kill people." This is an answer to the argument under consideration that clarifies, when it comes to murders, people are the ultimate cause and guns are merely proximate causes -- the end of a causal chain that started with a person deciding to murder.

I believe that simple, absolute thinking is seriously flawed. And, the refusal of gun advocates to consider control because they are convinced that any step to reform opens the door to the government seizing all guns is ludicrous.

It is also logical to consider an opposing view on the Second Amendment, a gun advocate's sacred document to own and to wield a plethora of weapons.

The amendment states:

"A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed."

The ACLU takes the position that he Second Amendment protects a collective right rather than an individual right. What questions are left unanswered, even in the Supreme Court's 1939 United States v. Miller decision that was widely understood to have endorsed that view?

There are many unresolved questions, including what firearms are protected by the Second Amendment, what regulations (short of an outright ban) may be upheld, and how that determination will be made.

The Supreme Court held, in District of Columbia v. Heller (a 5-4 decision in 2008) that the 2nd Amendment guarantees an individual right to possess a firearm in the home for self-defense. Simple? Not exactly. Since Heller, courts nationwide have found a wide variety of firearms laws constitutional because they can help prevent gun deaths, injuries, and crimes in communities across the country.

The Court's Heller decision included:

"Like most rights, the Second Amendment right is not unlimited. It is not a right to keep and carry any weapon whatsoever in any manner whatsoever and for whatever purpose: For example, concealed weapons prohibitions have been upheld under the Amendment or state analogues. The Court’s opinion should not be taken to cast doubt on longstanding prohibitions on the possession of firearms by felons and the mentally ill, or laws forbidding the carrying of firearms in sensitive places such as schools and government buildings, or laws imposing conditions and qualifications on the commercial sale of arms. Miller’s holding that the sorts of weapons protected are those “in common use at the time” finds support in the historical tradition of prohibiting the carrying of dangerous and unusual weapons."

And ...

In dissent, Justice John Paul Stevens stated that the court's judgment was "a strained and unpersuasive reading" which overturned longstanding precedent, and that the court had "bestowed a dramatic upheaval in the law."

The dissent concludes, "The Court would have us believe that over 200 years ago, the Framers made a choice to limit the tools available to elected officials wishing to regulate civilian uses of weapons.... I could not possibly conclude that the Framers made such a choice."

(D.C. v. Heller opinion. (at Cornell Legal Information Institute). Also available as *Heller Decision, United States Supreme Court web site)

Since the June 2008 ruling, over 80 different cases have been heard in lower federal courts on the constitutionality of a wide variety of gun control laws. These courts have heard lawsuits in regard to bans of firearm possession by felons, drug addicts, illegal aliens, and individuals convicted of domestic violence misdemeanors.

Also, cases have been heard on the constitutionality of laws prohibiting certain types of weapons, such as machine guns, sawed-off shotguns and/or specific types of weapons attachments. In addition, courts have heard challenges to laws barring guns in post offices and near schools and laws outlawing "straw" purchases, carrying of concealed weapons, types of ammunition and possession of unregistered firearms.

The courts have upheld most of these laws as being constitutional.

(Adam Winkler: The New Second Amendment: A Bark Worse Than Its Right.
Huffington Post.  January 02, 2009)

Consistently since the Heller ruling, the lower federal courts have ruled that almost all gun control measures as presently legislated are lawful and that according to UCLA professor of constitutional law Adam Winkler: "What gun rights advocates are discovering is that the vast majority of gun control laws fit within these categories."

Good Luck, Mr. Parker

Andy Parker has taken on one of the most formidable opponents in the country. The gun lobby is a monstrous force in politics. Yet, Parker is now trying to use his voice to do something about the staggering toll of 88 Americans killed with guns every day and hundreds more injured.

Richard Martinez, who lost his only child, Christopher Ross Michaels-Martinez, in senseless gun violence in May of 2014 -- a well-documented story about a horrific shooting spree near the University of California, wrote Andy Parker a letter about becoming a new member of an awful group no one wants to join.

Christopher, like Alison, was cut down by a disturbed individual who got his hands on a gun -- despite many troubling red flags in his history -- and shot and killed innocent people. Here is part of the text:

"So from one grieving father to another, Andy, I share your grief and mourn your loss. I know what you are feeling. You are not alone. Welcome to the heartbreaking club that no one wants to be a part of.  Christopher was killed I made a pledge that “Not One More” son, daughter, father, mother, brother or sister should have to grieve a loved one’s death because of preventable gun violence. I committed my life to sparing other parents the phone call that I got on May 23, 2014. The phone call that you, Andy, received yesterday."

In a short time, Richard has become an important spokesman and a determined activist. He has helped do the following:

* Fought the NRA as they unsuccessfully pushed for bills in New Hampshire and 15 other states to repeal the permit requirement for carrying concealed, loaded handguns in public. And they lost fights to pass bills that would force universities to allow guns onto college campuses in Florida, Nevada, Montana, and a dozen other states.

* Helped to defeat bills that would have repealed the requirement that all handgun sales require a background check in Colorado, Iowa, and North Carolina.  Sixty gun lobby backed-bills have been defeated in legislatures around the country so far in 2015.

I wish Andy Parker and Richard Martinez good luck and Godspeed. As Martinez said to Parker ...

"Your words will inspire thousands of people to do 'whatever it takes' to make sure that 'Not One More' family has to experience the pain that we have endured. It’s painful to welcome another father into this club, but I know that together we can keep up the momentum. Too many have died. We can save lives."

(Richard Marinez. "Andy Parker, welcome to the parents of children killed by guns club."
USA Today. August 29, 2015.)

Friday, August 28, 2015

Got Tats? What Ya Gonna Do When Your Kids Want Them?

Tattoos, tattoos, tattoos -- they are everywhere in every style depicting seemingly anything imaginable while proudly proclaiming the "body art" sensation. A 2012 Harris Poll found that 21 percent of Americans (one in five) has a tattoo, up from 14 percent in 2008.

Yet, how about tattoo remorse? In the poll, 86 percent of people claimed to not regret the tattoo, yet, according to another study reported by The Huffington Post in 2012, close to one-third of people who have gotten a tattoo regret it.

In fact, tattoo removal, both painful and expensive, is becoming commonplace. Laser tattoo removal procedures increased 32 percent from 2011 to 2012 according to one survey, with "employment" often cited as the reason. And although tattoo removal involves many months of laser treatments tailored to the wavelength of the pigments, chemists from several laboratories, including the government's National Center for Toxicological Research, said the fading tattoo becomes more like a toxic chemical dump. The laser removal process, which demolishes the pigment by scorching it with heat, triggers chemical reactions that generate carcinogenic and mutation-inducing breakdown products, which are then absorbed by the body.

And the bigger the tattoo, the greater the toxic release. This can only make one wonder whether it's better to let the sleeping paint lie, walled off by the body's own protective devices.

(Michael Yaremchuk, M.D., Chief of Craniofacial Surgery, Massachusetts General Hospital. "Beyond Tattoo Regret: The Public Health Dangers of Ink. Huff Post "Healthy Living."
March 07, 2013)
(Bernadine Healy, M.D. "The Dangerous Art of the Tattoo. U.S. World and Health News.
                                                                       July 25, 2008)

My question is despite the popularity of tattooing, what will parents say to the younger generation when their offspring demands to be inked with tattoos similar to Mommy's and Daddy's? Even with the "safeguard" of modern tattoo removal technology, scar tissue takes the place of the "removed" ink. Are parents willing to condone the practice for their loved ones?

The risks of getting a tattoo -- stigma, social embarrassment, job-related restrictions, and medical problems -- must be weighed carefully as people decide whether any gain exceeds the exposure to harm.

The health risks alone may be the most powerful argument against tattooing. Even though tattoos are increasing in popularity and taboos against them are decreasing, these factors do not mean that tattoos are extremely safe even for those who visit a well-respected tattoo artist in a sterile setting.

A 2012 New England Journal of Medicine article looks at the public health issues resulting from nontuberculous Mycobacteria (NTM), a bacterial infection caused by contaminated tattoo ink -- ink that was contaminated before distribution to the parlors. The research stated that "even if a person receives a tattoo at a tattoo parlor that maintains the highest standards of hygienic practice, there remains a risk of infection from the use of contaminated ink. People who get tattoos must be made aware of this risk and should seek medical attention if lesions consisting of red papules or a diffuse macular rash develop at the tattoo site."

According to the FDA, efforts to identify these cases nationwide revealed that there were outbreaks of tattoo ink–related nontuberculous mycobacterial infections that were associated with multiple brands of ink, occurred in other states, and involved multiple species of mycobacteria (e.g., chelonae, fortuitum, and abscessus).  have been linked to four brands of ink.

The FDA found 19 cases of skin infections in New York State that were traced to the same pre-mixed (tap water or distilled water) and tattoo ink mixtures. In addition to the cluster in New York, cases were confirmed in Colorado, Washington, and Iowa.

The FDA concluded: "M. chelonae, one of several disease-causing NTM species, can cause lung disease, joint infection, eye problems and other organ infections."

(Pamela M. LeBlanc, M.P.H., Katherine A. Hollinger, D.V.M., M.P.H., and Karl C. Klontz, M.D., M.P.H. "Tattoo Ink–Related Infections -- Awareness, Diagnosis, Reporting, and Prevention.N Engl J Med. September 13, 2012.)

The infection caused by Mycobacterium chelonae, which is related to the same germs that cause leprosy and tuberculosis usually don’t cause a problem for people with strong immune systems.
But, injecting the ink under the skin to make a tattoo bypasses many of body’s natural defenses and can allow these germs to set up shop. Once established, mycobacterial infections are stubborn. They often require months of treatment with antibiotics to clear.

Linda Katz, director of the Office of Cosmetics and Colors at the Food and Drug Administration, said people should be aware that the FDA has never approved a color or pigment for injection into the skin. Many colors are approved for other uses, such as automobile paint or printer’s ink. Inks don’t have to be tested for safety or purity before they’re sold to consumers. Katz warned: “Tattooing poses a risk of infection to anyone, but the risk is particularly high for those with pre-existing heart or circulatory disease, diabetes or compromised immune systems.”

Delaware Valley College chemistry Professor Ronald Petruso has found what he says are potentially carcinogenic substances manufactured solely for car paint in a yellow-orange pigment he tested. And traces of lead turned up in ink samples analyzed by a Northern Arizona University colleague, Jani Ingram.

"It just boggles my mind that the federal government has never set regulations for anything like this," Petruso says. Experts believe these materials are being mixed into ink because they endure. "Look at your car—the color is there for 20 years," says Wolfgang Bäumler, assistant professor of experimental dermatology at the University of Regensburg in Germany. His own study of some 40 inks revealed that most contained potentially hazardous chemicals.

(Lindsay Lyon. "If You're Considering a Tattoo, Read This." U.S. News and World Report.
April 15, 2008.)

Allergic reactions have occurred with some of the many metals put into tattoo inks. Nickel being one of the most common metal allergies. Others have reacted to the mercury in red cinnabar, to cobalt blue, and to cadmium sulfite when used as a yellow pigment. Some inks were found to have high levels of lead, some contained lithium, and the blue inks were full of copper.

Henna tattoos that contain the dark brown dye para-phenylenediamine (PPD) can cause a delayed allergic reaction and subsequent PPD hyper-sensitization that may permanently prohibit one from using sulfa drugs, PABA sunscreens, benzocaine and other anesthetics, and hair dyes. Fragrance sensitization may occur, and in some cases, the reaction will include skin necrosis, scarring, and hypo-pigmentation. Analysis of henna dye used on persons who reported allergic reactions has shown the presence of toxic chemicals from hair and textile dyes, in addition to PPD.

(Julie Genser. "The Truth About Tattoos: Health Risks, Toxicity and More." Natural News.
 September 28, 2007.)

University of Bradford researchers using an atomic force microscope (AFM) that allows them to examine skin with tattoos at the nano-level (the first to use an AFM to examine tattoos) found evidence that suggests the tattoo process remodels collagen (your body's main connective tissue).

One nanometer is one-billionth of a meter, which is a measure so small it's absolutely useless as a reference point. To get some idea of just how small these particles are, consider that a human blood cell is 8,000 nanometers, and a human hair is 80,000 nanometers wide.

Nanoparticles from tattoo ink were found to exist in both the collagenous network of the skin as well as around blood vessels. This suggests that the ink particles are leaving the surface of your skin and traveling elsewhere in your body, where they could potentially enter organs and other tissues.

(Joseph M. Mercola."Nanoparticles in Tattoos May Cause Cancer."
November 20, 2013.)

This is problematic because tattoo inks are largely unregulated and known to contain cancer-causing compounds. The researchers believe the issue could become a significant public health concern given the rise in tattooing in the last decade, noting:

"We need to do more work, but there is no question that these substances can be toxic. It takes a long time for the multi-step nature of cancer to show its face and I don't think we should wait to see if there is anything wrong with these ingredients."

And, while, so far, incidences of skin cancer appearing on tattooed skin has been considered coincidental, it is largely unknown whether the inks may be contributing to cancers, or other health problems, elsewhere in the body. It's known, for instance, that some tattoo pigment may migrate from your skin into your body's lymph nodes. According to Dr. Samuel Epstein, a well-respected professional in cancer prevention:

"… the evidence which we've accumulated so far, is largely restricted to the fact that they (nanoparticles) get into your bloodstream and reach organs throughout your body. And as far as the brain is concerned, we have actual evidence of entry into the brain and producing toxic effects -- lesions, small lesions, toxic effects in the brain."

(Joseph M. Mercola."Nanoparticles in Tattoos May Cause Cancer."
November 20, 2013.)

Evidence suggests that some nanoparticles may induce toxic effects in the brain and cause nerve damage, and some may also be carcinogenic. In 2011, a study in The British Journal of Dermatology revealed that nanoparticles are indeed found in tattoo inks, with black pigments containing the smallest particles (white pigments had the largest particles and colored pigments were in between).

(T. Høgsberg, K. Loeschner, D. Löf, and J. Serup. "Tattoo inks in general usage contain nanoparticles." British Journal of Dermatology. November 24, 2011.)

Since black ink, which is common in nearly every tattoo, may contain a significant amount of nanoparticles, it is likely that such toxins could find easy entrance into the bloodstream, perhaps worsening their effects. Writing in Experimental Dermatology, researchers highlighted the dangerous potential of tattoo inks (particularly black) even beyond nanoparticles:

"Black tattoo inks are usually based on soot, are not regulated and may contain hazardous polycyclic aromatic hydrocarbons (PAHs). Part of PAHs possibly stay lifelong in skin, absorb UV radiation and generate singlet oxygen, which may affect skin integrity."

(Cameron Kennedy. "Sarcoidosis presenting in tattoos." Clinical and Experimental Dermatology. April 27, 2006.)

Kristina Chiprean, Director of the McLaughlin Health Center said ...

“Because tattoos weren’t as popular 30 years ago as they are today, it isn’t as easy to monitor the effects. Watching people who are 20 now over the next 50 years, that’s when we’re really going to figure out the long term effects of tattoo ink.

“Often times a tattoo gets infected because bacteria moves through the holes in the skin, not from an allergic reaction to the ink,” Chiprean said. “What people don’t realize is that skin is our largest organ, and by putting holes in it we open ourselves up to invasive bacteria.”

(Catie Clark. "Black tattoo ink may carry long-term health risks." September 21, 2012.)

The Friends of the Earth – a global network of grassroots groups – is among those now calling for proper regulation of tattoo inks amidst the new findings that they may contribute to cancer. In the meantime, it may be wise to "think before you ink," as the FDA recommends, at least until further research is completed (and remember that permanent makeup is also a form of tattoo).

And, The Kids?

I've heard it said that "one person's art is another person's graffiti. The permanence of tattoos is overwhelming to many who consider that their tattoos may be considered by others as beautiful "body art" or as "tramp stamps." Youthful decisions about fads and risks often come back to bite the integrity of parents who preach "Do what I say, not what I do."

I believe a timely discussion about the health risks of tattoos is necessary in proactive parenting. Perhaps a thorough review of the research will convince many young tattoo enthusiasts that skin is more beautiful, and exceeding more healthy, without ink. For those parents who are looking for a lesson plan to help them explain all about tattoos, here is a site to click for one such aid:

"Health Risks Of Body Art"

Thursday, August 27, 2015

Paying More: Trash Collection, Water, and Sewage In Portsmouth

Oh, the wheel of fortune: Around and around and around she goes; where she stops NOBODY knows. Now, it's a lose/lose situation again for the taxpayers of Portsmouth as two more money-grabbing issues -- higher trash collection fees and increased water charges -- are thrust upon us. And, let's not forget, these added payments are on the heals of recent passages of income tax increases said to be needed to "keep the City government afloat" -- Portsmouth passed a 0.6 percent income tax increase in 2011 and a 0.5 percent in 2015.

No one at city hall seems to know where the proverbial "buck" stops or how to account for it after it hits the city coffers.

Trash Talk

Sanitation rates are going up. How much? At this time, it's all speculation -- 50 cents, 75 cents, or $1.00 a month? Why? Citations. The city discovered they will now be on the hook to the Environmental Protection Agency for an annual fee estimated to be between $75,000 and $85,000.

To add to the confusion, at a recent city council meeting, reference was continually made to someone who, when they learned of the city’s citations from the EPA, failed to inform City Manager Allen about it.

Frank Lewis of the Daily Times reports ...

"Third Ward Councilman Kevin E. Johnson said: 'Our employees answer to you (City Manager Allen). There is no reason why you shouldn’t have known about this. We’ve asked a lot of the citizens of Portsmouth and they have stepped up and I think we need to step up and I think that these kinds of things just don’t need to happen. If they (EPA) were there that many times. If they advised us that many times and they put it in writing because we have copies of it, you of all people, should have known.'”

To which, Allen replied: "'In order to not diminish the amount remaining in the Sanitation Fund, which currently has a $414,000 balance, the only option is to raise rates for consumers. The last thing I want to do is send another $75,000 out the door... While the EPA believes it is a simple step to just add the $4.75 fee per ton to that agency, it is not that simple.'"

(Frank Lewis. "City sanitation rates to increase." Portsmouth Daily Times. August 25, 2015.)

It may be true that nothing about explanations for increases seems "that simple." But, Allen said the only solution is to raise the monthly bills of city residents. Passing ever-increasing fees and taxes onto the public seems exceedingly straightforward for city government.

Water Wonderment

Portsmouth residents thought they were getting a much-needed break as their new monthly utility bills were less than what would have been equal to one-third of their regular quarterly bills. Of course, this was just too good to be true. It was all just another goof-up at city hall. Math is hard, and nobody understands fractions, right?

After investigating the billing practices, City Manager Allen now says residents of the city of Portsmouth have been getting under-billed for their water and sewer bill service. He says the problem was "a math error," so "for the past five months everybody’s bills were about a third of what they should have been.”

In a rather convoluted explanation Allen explained the numbers snafu. Again, Frank Lewis of the Daily Times reports on the city hall confusion ...

“'There was a minimum charge they said was charged every quarter and that was to be split by thirds, so it doesn’t go up,' Allen said. 'You’re just paying a third of your minimum charge every month. The staff cut the rates by a third, so the minimum bill didn’t change, but all the rates were lowered by two-thirds.'"

But, hallelujah, citizens did get a break because of this "two-thirds error." Allen said despite the rates being lowered by two-thirds, Portsmouth is not going to go back to residents to collect what is owed the city.

“'We are going to send a letter out notifying everybody that we made a mistake and we hope (with) the summer of celebration, we’re just going to chalk it up to the celebration of our bicentennial,' Allen said. 'Everybody got reduced water bills all summer. But that will be in a letter that explained what happened in the next utility bill.'"

(Frank Lewis. "Allen says residents have been under-billed."
Portsmouth Daily Times. August 26, 2015) 

Allen claimed "some of the staff didn’t understand how the city was billing or what they were billing for.” This makes one wonder if what we have here is a failure to communicate as well as some basic grade school math deficiencies. At any rate, soon taxpayers will be paying much larger water and sewer payments.

It's Only Money?

I guess I shouldn't be concerned about mistakes and gaffes at city hall. After all, even city fathers are human and prone to make errors. Still, the confidence rating for city government continues to fall as one little cost after another is passed directly to taxpayers amid clouds of confusion. These "surprises" strike deep when a crisis of deep mistrust for political allies already exists in Portsmouth.

So many have questioned the equality of justice dealt by enforcement and court officials in the city. Money, power, and affiliation are factors people believe drives this inequality -- those things and an air of indifference for common people. When the public questions management decisions or procedures, so often those who inquire are ridiculed and/or told half-truths (lies) to discourage their honest search for justice.

Like the old, dirty, ill-kept city building itself, city government begs for proper maintenance that is crucial to developing trust and pride. Instead, some of those in charge prefer to ignore the obvious cleanup and maintain the conditions that cause steady decay inside and outside the walls of the edifice. I worry about increases in payments, but I worry about increases in political alliances much more.

We pay precious dollars for needed services. We pay increased fees for mistakes. We also "pay" for ineptness in all positions. When can we expect better service by our public servants to be exchanged for the skyrocketing costs we incur?

Wednesday, August 26, 2015

Childhood Trauma Increases Potential For Drug Addiction

For a long time now, research has confirmed an established link between childhood trauma and psychiatric symptoms in adulthood and also evidence to suggest a link between such early life experiences and substance misuse.

(J. Briere, J. and M.  Runtz. "Childhood sexual abuse : long term sequelae and implications for psychological assessment." Journal of Interpersonal Violence, 8. 1993.)

Contemporary psychoanalytic theories of addiction also emphasize the relationship between experience of early life trauma and later substance misuse, proposing that drug use is an attempt at self-medication, or a chemical means of inducing a dissociative state, so often apparent in victims of child abuse. Researchers find that substance misuse offers an external means of discharging painful internal states, through immediate action.

(L. Wurmser. "The role of superego conflicts in substance abuse and their treatment." International Journal of Psychoanalytic Psychotherapy.10. 1984.)

(J. McDougall. Theatres of the Body : A Psychoanalytical Approach to Psychosomatic Illness. London. 1989.)

Why is understanding this information so important for those concerned about stopping addiction and overdose? I believe it is vital to examine all risk factors for addiction. For example, in schools, counselors, psychologists, and Human Service officials work together to identify and treat trauma and psychiatric disorders suffered by students. These people must stay up-to-date on findings related to their clients.

Proper attention and timely intervention for children who live with trauma not only can prevent their drug addiction but also can save their lives. Understanding how severe stress and trauma can lead to addiction and other mental illnesses should ultimately help lead to better treatments. 

Much research now confirms that severe trauma can lead to drug addiction.

One study of children who attended the 10 middle and high schools closest to the Twin Towers at 9/11 ground zero found that the greater the number of trauma-inducing factors children had experienced, the more likely the kids were to increase their use of alcohol and other drugs. These factors included their knowing someone who had died, being personally in fear for their life or that of their loved ones during the attacks, and how close their school was to the towers. 

Compared to those with no exposure factors, teens with one were five times more likely to increase alcohol and other drug use, and those with three or more factors were a stunning 19 times more likely to increase their alcohol or drug use. The youth who increased their use had more difficulty with their schoolwork, lower grades and more behavior problems, suggesting that they weren’t just using drugs but had developed drug abuse or even potential dependence.

(Claude M. Chemtob, Yoko Nomura, Louis Josephson, Richard E. Adams and Lloyd Sederer. "Substance use and functional impairment among adolescents directly exposed to the 2001 World Trade Center attacks." Disasters, 33. July 2009.)

The Adverse Childhood Experiences (ACE) study, which includes some 17,000 participants in California’s Kaiser Permanente insurance program, found multiple, dose-dependent relationships between severe childhood stress and all types of addictions, including overeating.

Adverse childhood experiences measured included emotional, physical and sexual abuse, neglect, having a mentally ill or addicted parent, losing a parent to death or divorce, living in a house with domestic violence and having an incarcerated parent.

Compared to a child with no ACEs, one with six or more is nearly three times more likely to be a smoker as an adult. A child with four or more is five times more likely to become an alcoholic and 60% more likely to become obese. And a boy with four or more ACEs is a whopping 46 times more likely to become an IV drug user later in life than one who has had no severe adverse childhood experiences.

The type of adverse experience doesn’t make a large difference in the results, according to Dr. Vincent Felitti, head of the study. What seems to matter most is the cumulative effect of multiple types of stress. For example, having been both physically abused and neglected is worse than having been physically abused alone.

One factor does stand out, however. “I would have assumed before we looked at it that probably the most destructive problem would be incest—but interestingly it was not, it was co-equal with the others,” says Felitti.

Instead, he notes, The one with the slight edge, by 15% over the others, was chronic recurrent humiliation, what we termed as emotional abuse,” citing examples like parents calling their children stupid and worthless. (The study did not look at bullying by peers, but other studies have found that such abuse can haver similarly negative health effects.)

Among other of the most negative stress response are the following:

* The feeling of being helpless, combined with ongoing "emotional abuse,"
* Chronic neglect,
* Caregiver substance abuse or mental illness,
* Exposure to violence, and
* The accumulated burdens of family financial hardship -- without adequate adult support.

Ironically, humiliation is a common theme in addiction treatment, where tough confrontation to “break” addicts remains a frequent practice, despite research showing its ineffectiveness and harmfulness. Some so-called therapeutic-community programs, for example, place people on a “hot seat,” where they are confronted about their personality flaws and other negative qualities, sometimes for hours on end. Other programs force people to wear humiliating signs or even diapers. Indeed, people traumatized as children can actually be re-traumatized by this form of treatment, exacerbating both post-traumatic stress disorder and addiction.

Felitti insists that the best way to treat addiction is with empathy and compassion. “I would argue that the person using [drugs] is not using them to have a problem, they’re using drugs to find a solution,” he says.

Nearly 3 million U.S. children experience some form of maltreatment annually, predominantly by a parent, family member or other adult caregiver, according to the U.S. Children’s Bureau. The American Academy of Pediatrics in 2012 identified psychological maltreatment as “the most challenging and prevalent form of child abuse and neglect.”

A growing body of research, including a new study published by the American Psychological Association, concludes that children who are emotionally abused and neglected face similar and sometimes worse mental health problems as children who are physically or sexually abused, yet psychological abuse is rarely addressed in prevention programs or in treating victims.

(Joseph Spinazzola, PhD. "Psychological Trauma: Theory, Research, Practice, and Policy."
APA Journal. 2014)

Although some addicts have no apparent childhood trauma, at least half have suffered at least one form of severe childhood stress and many have experiences multiple exposures. Among people with the most severe addictions, trauma histories are ubiquitous. And emotional sensitivity, which varies widely with genetics, may make experiences that would not be traumatic for most children intensely traumatic for some.

(Maia Szalavitz. "How Childhood Trauma Creates Life-long Adult Addicts." Study by Vincent Felitti. September 25, 2011.)

(Vincent J Felitti MD, FACP, Robert F Anda, Dale Nordenberg MD,  David F Williamson MS, PhD, Alison M Spitz, Valerie Edwards, Mary P Koss. "Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults." The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine. 1998.)

One study found maltreatment caused actual changes in children's brains. Researchers at the University of Texas studied 32 teens, 19 of whom had been maltreated in childhood but did not have a current psychiatric disorder.

The researchers defined child trauma or maltreatment as any type of significant abuse or neglect lasting six months or longer, or a major traumatic experience like life-threatening illness, witnessing domestic violence or losing a parent before age 10. The other 13 participants in the study served as the control group, having no history of major child trauma or psychiatric problems.

Using a brain-imaging technique that measures the integrity of the white matter that connects various brain regions, the researchers looked for any differences in the teens’ brains when they were first enrolled in the study, before they had developed any psychiatric problems.

This is what the admittedly small sample study found:

"The scans showed that kids who had been maltreated showed connectivity problems in several brain areas, including the superior longitudinal fasciculus (SLF), which is involved in planning behavior and, usually on the left side of the brain, in language processing.

"Another affected region was the right cingulum-hippocampus projection (CGH-R). This tract helps connect the brain’s emotional processing regions with those involved in more abstract thought, ideally allowing the person to integrate both types of information and to regulate their response to emotional stress.

"The teens who developed depression had the most significant reductions in white matter in their SLF; those who developed drug problems were more likely to show greater white matter loss in the CGH-R. These changes suggest that depression-specific vulnerability may be linked to rumination and processing of language that is focused on the negative, while addiction susceptibility may be linked to an inability to regulate emotions more generally."

(Hao Huang, Tejasvi Gundapuneedi, and Uma Rao. "White Matter Disruptions in Adolescents Exposed to Childhood Maltreatment and Vulnerability to Psychopathology." Neuropsychopharmacology, 37. 2012)

Data from the National Survey of Adolescents and other studies indicate that one in four children and adolescents in the United States experiences at least one potentially traumatic event before the age of 16, and more than 13% of 7-year-olds -- one in eight -- have experienced posttraumatic stress disorder (PTSD) at some point in their lives.

(D.G. Kilpatrick, B.E. and Smith, D.W. "Youth Victimization: Prevalence and Implications." U.S. Department of Justice, Office of Justice Programs,
National Institute of Justice. 2003.)

Most, if not all, young people have access to a wide range of psychoactive substances that can both dull the effects of stress and place teens at increased risk of experiencing trauma. It is estimated that 29% of adolescents -- nearly one in three -- have experimented with illegal drugs by the time they complete 8th grade, and 41% have consumed alcohol. 

For many adolescents, such early experimentation eventually progresses to abuse of -- or dependence on -- illicit drugs or alcohol. Every year, approximately one in five American adolescents between the ages of 12 and 17 engages in abusive/dependent or problematic use of illicit drugs or alcohol.

(Substance Abuse and Mental Health Services Administration. Results from the 2006
National Survey on Drug Use and Health: National Findings. Rockville, MD: Department of
Health and Human Services. 2007.)

(J.R. Knight, S.K. Harris, L. Sherritt, S Van Hook, N. Lawrence, T. Brooks, et al. "Prevalence of positive substance abuse screen results among adolescent primary care patients." Arch Pediatr Adolesc Med, 161. 2007.)

There is also evidence that youth who are already abusing substances may be less able to cope with a traumatic event as a result of the functional impairments associated with problematic use. In one study, investigators found that even after controlling for exposure to trauma, adolescents with substance abuse disorders were two times more likely to develop PTSD following trauma than were their non-abusing peers.

The researchers suggested that the extensive psychosocial impairments found in adolescents with substance abuse disorders occurred in part because they lacked the skills necessary to cope with trauma exposure.

(R.M. Giaconia, H.Z. Reinherz, A.C. Hauf, A.D. Paradis, M.S. Wasserman, M.S., and D.M. Langhammer. "Comorbidity of substance use and post-traumatic stress disorders in a community sample of adolescents." Am J Orthopsychiatry, 70. 2000.)

Of course, physical abuse is a trauma that is a major contributing factor to substance abuse. Women who are sexually abused during childhood are at increased risk for drug abuse as adults, according to NIDA-supported research conducted at the Medical College of Virginia Commonwealth University.

(K.S. Kendler. "Childhood sexual abuse and adult psychiatric and substance use disorders in women: An epidemiological and co-twin control analysis." Archives of General Psychiatry, 57. 2000.)

Trauma and Substance Abuse: Myths and Facts:

MYTH: Since most adolescents who use drugs and/or alcohol have experienced some kind of trauma,
there is no need to treat trauma as a unique clinical entity.
FACT: Although not all youth who experience traumatic events develop PTSD, it is important to be
prepared to address the multiple ways youth respond to trauma. Traumatic stress and PTSD are
associated with unique (and challenging) symptoms that require targeted, trauma-informed treatment
to optimize recovery. (For more information, see Understanding Traumatic Stress in Adolescents: A
Primer for Substance Abuse Professionals.) Effective treatment approaches and interventions have
already been developed for patients suffering from traumatic stress and PTSD. Making use of these
techniques as part of a comprehensive treatment plan offers the greatest hope of treatment success
for adolescents dealing with the effects of substance abuse and traumatic stress.

MYTH: When dealing with an adolescent who has a history of trauma and substance abuse, you need to treat one set of problems at a time.
FACT: Because the symptoms associated with traumatic stress and substance abuse are so strongly
linked, the ideal treatment approach is to address both conditions. Unfortunately it is not uncommon
for substance abuse programs to deny admission to patients with PTSD, and for trauma treatment
programs to deny admission to patients who have not achieved sobriety. The decision about which
symptoms and behaviors to address first therefore requires a careful assessment of the relative threat
that each condition poses to a youth’s safety, health, and immediate well-being.