The Most Deadly of All Sins. . .

33 Presentation THE MOST DEADLY OF ALL SINS. LUCILLE PEREZ, M.D. Associate Director for Medical and Clinical Affairs Office of Substance Abuse Prevention Alcohol, Drug Abuse and Mental Health Administration Rockville, MD 20857 To quote Secretary Louis W. Sullivan today, no domestic issue captures the attention of the American public to the extent that drug abuse does. From the morning papers to the evening news, we are updated daily about health and social problems that are caused by the use of dependency-producing drugs. Whether they be illegal (cocaine and marijuana) or legal (nicotine and alcohol), there is no question of the pervasiveness of their use. One in three Americans have used an illicit drug sometime during their lives. Research on biological and social factors continue to show us that dependency -producing drugs, even those with legal and social acceptability, extract too high a price on our nation's health and well-being. Two of our nation's most often quoted surveys on drug abuse, The National Household Survey and The Senior High School Survey, indicate that the rapid increase in drug abuse of the past two decades has been reversed. Abuse of almost all categories of drugs has decreased sharply from their epidemic levels in the 1970s. Most of the 72.5 million Americans who have used illicit drugs no longer do so. I cite these surveys because they can give us a sense of security. We can begin to lean back and relax, assuming that things are getting better. Quite the contrary. In fact, on a local black-owned radio station, I heard a mother state that she was happy that her son was smoking marijuana instead of cocaine. Obviously , this mother did not know that marijuana was the gateway to illicit drug use. Another skewed perception: during the month of August 1989 in my practice in Wood Hall Hospital, North Central Brooklyn, 60 percent of the live births tested positive for drugs and approximately 40 percent of those required placement in the neonatal intensive care unit (NICU). Many of those babies Journal of Health Care for the Poor and Underserved, Vol. 3, No. 1, Summer 1992 34 The Most Deadly of All Sins... became wards of the state because their mothers and fathers could not get it together enough to take them home. What do these statistics mean? They mean that for specific populations, specific socioeconomic classes with certain environmental factors, certain populations are at risk for alcohol and other drug dependency. The influence of alcohol and drugs in the black community is not something we can deny. It is clear that it has had a negative impact on both children and adults. Media attention has helped create a public urgency for action through its graphic coverage of widespread drug-related crimes and violence. We must be concerned , however, about the extent to which the black or African-American community, and black children specifically, particularly young black males, are being stigmatized by these reports. We all know the image of black male drug dealers— the jeep, the overdosed in gold (ODG) look, the silk pants with no socks, the classic walk, the haircut. The impression that this image gives is that all drug dealers are young African-American males. Finally, the community is expressing resentment towards the media and the journalists who launch their careers on sensationalistic accounts of universal drug abuse in the Af rican- American community, without attempting to present a more balanced picture of the community. I gathered my own collection of pictures from the most recent riots in Brooklyn in the 1970s and showed my children the differences between these images and journalistic portrayals of young African-Americans. It was from this display that the Office of Substance Abuse Prevention (OSAP) launched a new project to look at urban AfricanAmerican males and females between the ages of nine and 13 in 12 areas. The number of Af rican-American adolescent substance abusers are low in both the high school and household surveys. Illicitdrugusedecreased from 12.1 percent in 1985 to 7.3 percent in 1988 and 6.4 percent in 1990. Although these are national data, there are urban pockets where these...