The Star Talks To: Dr. Mitchell Rosenthal Of Phoenix House

In 1962, just 2 percent of Americans had experimented with hard drugs. Within 20 years, that number would soar to 38 percent, altering not only the priorities of law enforcement but the national psyche.

One of those concerned early on about the meteoric rise in the number of addicted Americans - and a man who could do something about it - was a child psychiatrist, Dr. Mitchell Rosenthal.

What he did, in 1967, was to help found Phoenix House, the country's largest nonprofit substance-abuse agency. Today, Phoenix House is a $50 million-a-year operation treating some 3,000 adults and adolescents, on any given day, most of them poor, at 26 residential, educational, and outpatient centers in New York, New Jersey, Texas, and California.

Prison Costs Far More

Sitting by a fire on a chilly day last week at his spacious house in Northwest, the dark-haired, dark-eyed physician, speaking softly but intensely, said Phoenix House had the best success rate in the business.

Of 70,000 patients treated in three decades, he said, 60 percent, even though they may not have graduated, are "fine."

As important, he stressed, is the fact that for a cost of $18,000 to $20,000, Phoenix House's 12 to 18-month residential program beats, hands down, the expense of a prison bed, estimated at $100,000 to build and $35,000 to maintain annually.

New York City's Rikers Island costs taxpayers as much as $60,000 per prisoner, per year.

Need Is Rising

Besides, said Dr. Rosenthal, who is now Phoenix House's president, prisons have been shown to be ineffective in curing addiction, or its underlying psychological problems.

A recent report of the National Criminal Justice Commission, called "The Real War on Crime," noted that sentencing judges generally must choose between overused probation services and prison, a dilemma the report compared to seeking a physician's help for a headache and being given the choice of a baby aspirin or a lobotomy.

And the need for drug treatment continues to rise. A University of Michigan study found that 40 percent of the nation's 12th-graders have used illicit drugs in the past year, up 13 percent since 1992.

Potent Marijuana

Smokable heroin, too, poses a significant new threat, as does a more potent form of marijuana that has become available just when government opposition to drug use, from the Federal level down, seems to be on the wane.

"Disordered, asocial children are bankrupting our society - financially and morally," declared Dr. Rosenthal. "New York State is spending more on prisons than on higher education . . . on both a state and national level, we need major dollars for treatment."

Many adolescents at Phoenix House, he said, are "abused, unwanted kids" who have experienced a "pathological absence of parenting." They need "habilitation, education, and socialization."

Synanon And A.A.

Dr. Rosenthal is the author of "Drugs, Parents, and Children: The Three-Way Connection," considered the seminal work on the role families can play in preventing adolescent drug abuse.

He did his basic clinical research on the "therapeutic community" - the method he endorses - in the '60s, when, as a Navy doctor in Oakland, Calif., he treated Vietnam veterans who were drug abusers. He drew inspiration, he said, from the California-based drug rehabilitation center Synanon, and from the precepts of Alcoholics Anonymous.

He found great satisfaction, he added, in "forging bonds with people personally; that created wonderful feelings for me, and I saw tremendous effectiveness."

"I learned a different way to use myself."

In the therapeutic community, a residential "immersion program," a patient in a group of, say, 50, "takes a cruise with 49 other co-therapists," he explained. Reliance on one another becomes key in a mutual self-help process, as patients who had formerly denied or minimized their self-destructive behaviors recognize and grow beyond them.

A prescribed code of behavior prevails, characterized, the doctor said, by honesty and accountability in the residential setting. "Everyone works and/or attends school, and everyone helps make the ship sail."

The program is similar to Daytop Village in the city, and to APPLE, A Program Planned for Life Enrichment, on Long Island. Unlike A.A. 12-step meetings, which discourage responses, or "cross-talk," Phoenix House residents confront one another, though verbal abuse is taboo.

Group Leverage

Dr. Rosenthal likened the process to a "therapeutic Pony Express" - no one carries the mail the whole way.

The group exerts "enormous therapeutic leverage, and progress is much faster," he said, than in individual psychotherapy. The community is "very ambitious for its members," he noted.

"The caricature of these groups is that they are too tough," Dr. Rosenthal said, while acknowledging that such therapy is "not for everyone." Only about a fifth of those who begin the residential program graduate. But, he emphasized, "those who are successful know it's real - especially in a [psychotherapeutic] world which uses extensive euphemisms."

Supporters point out that the majority of recovering addicts-in-residence have not chosen the program; many, if they are nonviolent, have been sent there by the courts.

American Ambivalence

Dr. Rosenthal thinks New York State should more than triple its 7,000 long-term residential treatment beds. "We have the means to fix the problem," he insisted.

He believes, however, that Americans are "deeply ambivalent" about drugs. The nation is "all for law and order," he said, but lacks "the political will" to help those who are most affected: poor people and minorities.

"The middle class isn't afraid yet," he said, reminding a visitor that in the late '50s there were some 600,000 beds available to Americans stricken with tuberculosis.

Not surprisingly, Dr. Rosenthal is resolutely opposed to legalizing marijuana. "If we make another powerful mind-altering drug available, we have so many people prone to mental illness, we'll have a vast increase in the socially disabled."

"Forty percent of the kids are in residential treatment because of pot," he said. "They can't function in school, and they live a secret, antisocial" existence.

Dr. Rosenthal, who ran New York City's rehabilitation programs during Mayor John V. Lindsay's administration, likes the city's present Mayor, Rudolph W. Giuliani, who last week proposed a major antidrug initiative.

"It's sound public policy," he said.