Clinical Pediatrics

"One purpose of this paper is to define, as precisely as possible, patterns of drug use in one subculture of the youthful population. Another of its purposes is to emphasize the distinction between "drug use" and "drug abuse." Among the patients in our clinic the taking of drugs is al most universal; abuse, on the other hand, is of a much lower order of magnitude. Admittedly, imprecisely defined criteria separate these practices. Furthermore, separation of drug use from drug abuse does not imply acceptance of the one and rejection of the other."

Forty-seven patients who were physically addicted to opiates completed extensive questionnaires. Among the observations was that the typical heroin addict starts with glue sniffing and taking cough medicines in early adolescence; later takes amphetamines, barbiturates, and mari juana; and finally uses heroin. Younger addicts use a greater variety of drugs than older ones, and start out on glue far more frequently.

Drug abuse is abused in that current approaches largely fail to recognize drug abuse as a symptom of underlying disease. The concerns of medicine, religion, and the state have been to correct the symptom, rather than to attack its causes, as our rapidly changing technologic society progressively deprives us all of several needs basic to our well-being. One response has been drug abuse, often arising from the hunger for love, understanding, and a meaning to life in our increasingly dehumanizing culture. Essential ingredients in the development of identity are religion and ritualization; if healthy, normative sources are unavailable or unattractive, drugs may be chosen. "In this paper I should like to discuss some lesser-realized aspects of drug abuse in a special group of our youth, to stress some root causes of the problem." Medicine and religion must communicate with and educate our youth and ourselves, and become advocates of youth's plight and needs. Details are given.

Natural and synthetic glucocorticoids, in use for 21 years, have outlived the phases of over-optimism regarding cura tive actions and over-pessimism over side effects. Some of the side effects can be evaded, as in alternate day therapy; others can be taken advantage of in the management of specific conditions as shown in the summary Table 3.

Growth studies which compare children from upper and lower socio-economic groups in the same population and geographic environment can offer an indication of optimal growth. Hence assessment of physical growth in children becomes an impor tant index of health and nutrition for a given population. But deviations from United States' standards should never be labeled as deviations from Normal, on the assumption that improved environmental factors would result in children from other countries reaching United States means for height and weight.

From personal observations and reports on record the authors point out that the same exanthem may be associated with penicillin as well as ampicillin, and sug gest that this may not be a persistent hypersensitivity.