Health trends go in and out of fashion. Open your mouth and say "aahhh" - if you don't have tonsils, the chances are you're a pre-1970s child. Tonsillectomies were as routine then as tummy tucks are now. Similarly, there's been a radical shift in the thinking about addiction.
Drink-related hospital admissions in England have reached record levels, according to the latest NHS statistics. The numbers of cases of cirrhosis of the liver have risen 900 per cent in men and women under the age of 45 over the past 30 years in the UK. The amount adolescents are drinking, particularly young women, is toxic to their brains just at a time when they should be reaching a cognitive peak. A growing number of experts has become convinced that traditional addiction treatments are not working.
In the 1970s and 1980s the genetic link dominated thinking about addiction. However, the "booze gene" is no longer seen as inescapable destiny. Treatments in the past also focused on the addicted. Now experts are becoming increasingly convinced that addiction should be tackled before it starts by teaching children the skills to cope in life.
Patricia Conrod, a 36-year-old Canadian psychologist, is one of those behind the new approach. "It's the premise that there is nothing we can do to control abuse that I want to change," she says. Conrod is the first research fellow appointed by the charity Action On Addiction, which is funding the Preventure Project, aimed at reducing risky behaviour in young people.
"We teach adolescents how to challenge their thinking and control their 'hot thoughts'," she says during a visit to a school in South London. "Hot thoughts" are not about sex. They are about "how uncomfortable physical sensations and thoughts can control your mood and affect the action you take", Conrod says.
Nicola, one of a group of 15-year old girls, begins by describing her recent hot thought, which was about walking out of a GCSE mock exam to go drinking with her boyfriend because she was bored. "We help them to focus on how their short term behaviour could block their long term goals," Conrod explains. In other words, how their personalities might be making them unhappy.
Personality is the key word in addiction treatment today. The good news is that abuse of addictive substances can be prevented and controlled by encouraging people to take responsibility for self-damaging behaviour.
The Preventure Project is on trial over three years with 4,000 young people, from every socio-economic group, in schools across London. Conrod aims to prove that you can modify how personality influences addictive behaviour. "We're not talking about changing personalities but we know personalities can be managed."
The programme targets four factors - depression, anxiety, thrill-seeking and impulsivity - that are known to lead to increased risk of early-onset substance misuse. Preventure says surveys of the at-risk students it has helped showed the incidence of panic attacks had fallen 45 per cent. During six and 12-month follow-ups, it found that half of the adolescents who received the sensation-seeking intervention stopped binge-drinking altogether.
Leonie Frieda, author of a recent biography of Catherine de Medici, knows much about addiction. "I was tremendously unhappy aged 25," she says. "I also had a tremendous amount of money because I was going out with a billionaire and I happened to sit next to a coke dealer one night at dinner." Within six weeks Frieda had a coke and heroin habit. "I used to drive along the French coast to Monaco at 150 miles an hour and then take my hands off the wheel," she says.
Addiction experts describe her personality as "thrill-seeking" - something that began to manifest itself as severe anorexia when Frieda was a teenager. "Anorexia might as well been heroin because you get such a buzz from it," she says. Frieda had a family history of alcoholism (her mother and two grandparents abused either alcohol and drugs). Does she think being taught to control her negative coping strategies might have made a difference? "God yes. I didn't know the first thing about feelings," she says. "I'm now 50 and on a journey of self-discovery about things I should have learnt as a child."
Conrod catches kids at an age when binge drinking can begin to kick in. The Girasol Foundation, which has been operating in Spain for more than 20 years and is making its first foray into the UK, begins earlier, targeting children as young as seven. "In my view it's a little late by the time they are teenagers," says psychologist Pilar Lillo, one of Girasol's founders. "We like to start when they are building their personalities. We teach a broad life-skills educational programme." She uses a variety of techniques including group exercises, role-playing, relaxation and story telling to increase children's confidence, emotional skills and responsibility before they've had their first sip of alcohol.
"The younger you start the better," says fashion consultant and recovering addict Pandora Delevigne. As a child Delevigne was hyper-anxious and so unhappy that she couldn't sleep at night. "I couldn't cope and felt convinced I was a lunatic. Every time I said anything I was told not to be silly or to grow up."
Delevigne, who is helping to raise funds for Girasol's work in London and Herefordshire schools, says she is lucky to have survived years of drug abuse, which might have been avoided if someone had understood her "depressive" personality as a child. "If someone had spoken to me then about my personality it could have changed my life."
The problem with prevention is that there is little money in it whereas "picking up the pieces" is big business. The recommended primary stay in a private clinic to "dry out" is four to six weeks at a cost of up to £17,000.
"I have lost count of the number of clinics that I went to - maybe about 40," Frieda says. "But I'd come out of rehab and face the same situation." This illustrates why Conrod feels adolescence is the crucial time to learn coping skills. "You might go to a clinic in Arizona," she says, "but you have to come back and know how to cope with every day things."
Carol Woolton is an editor at Vogue magazine
Action on Addiction: www.aona.co.uk
