Because almost two-thirds of high school seniors have taken an illicit drug in the past year, quite a few adolescents could conceivably be targets for such interventions. But disease-based treatments are not reserved for those thought to be abusing drugs. Successful therapy means patients must accept that constant relapse is the only alternative to remaining in treatment and abstaining the rest of their lives. Therefore, acceptance of therapy and its disease message almost guarantees relapse, because there are few adolescents who will abstain forever. It is based loosely on findings of enhanced genetic liability for alcoholism among children of alcoholics.
Addiction is always an expression of a whole life-style and an accumulation of behavioral steps.
Vaillant's cautious tone is entirely lost on those administering disease-oriented therapy and prevention programs for the young. Administrators of such programs currently favor recommendations of permanent abstinence for those they consider to be at risk. As a result of a renewal of intense prohibitionism toward both drugs and alcohol, recommendations of abstinence are not restricted to those with family or personal histories of substance abuse. Unfortunately, offering children increasingly dire warnings about the dangers of these substances has not yet caused many to avoid them. Such scare tactics, moreover, may be counterproductive.