The front cover of Newsweek shouted the words: "Crack and Crime."

The back cover featured an advertisement for Old Grand-dad Bourbon.That is the peculiar duality of the message Americans send youths about substance abuse and addiction. The odd message echoes through our advertisements, our lifestyles and our decisions, according to Dr. Beny J. Primm. Americans talk about the dangers of substance abuse while touting ads that make alcohol and cigarettes looks elegant and desirable.

Primm, associate administrator of New York's Alcohol, Drug Abuse and Mental Health Administration and director of the Office for Treatment Improvement, was the keynote speaker Tuesday at the 12th annual Conference on Substance Abuse in Park City. The conference runs through Thursday.

The doctor, also renowned for HIV and AIDS research, said that most theories of drug addiction embrace both biological and environmental factors, like peer pressure and poverty. Clearly, he said, substance abuse is more prevalent in lower socioeconomic classes.

"The greater the environmental risk and the greater the biological vulnerability, the greater the severity (of addiction)," Primm said. "But I think the true common denominator for substance abuse in our society is stress, which is defined as a non-specific response of the body to any demand."

There's a clear relationship between drug use and employment, Primm said. People who do a lot of drugs don't work. People who are unemployed are more apt to turn to drugs. Those without jobs are more apt to be poor as well, "and poverty predisposes young children to selling drugs."

An issue of the Nation discusses "Kids Who Sell Crack," which it calls the "newest and most frightening jobs program."

Selling drugs, particularly crack, can seem like an answer to people who don't have hope. "We don't worry about tomorrow. It's something to worry about only if it comes," Primm said. "It's very hard to get people into treatment if they have to think about food and shoes and clothes."

Statistically, nationwide, a black family of four earns slightly less than a single woman, who earns a lot less than a single man. Despite that disparity, Primm said women are catching up with males in needing drug treatment when they're arrested.

Mental health, alcoholism, drug abuse and stress are interlocked. Anxiety is the leading reason people are admitted to mental-health institutions. Alcohol and drug abuse rank second. Alcohol is a common factor in traffic accidents, murder, drownings, child abuse, rape, assault and suicide. In fact, Primm said, "at any given time, 40 percent of all drug users are in the prison system. But we don't utilize this captive audience" by bringing treatment programs and changes into place. "Detoxification in itself is not a treatment, although it can be a bridge to treatment."

Primm warned professionals to stop arguing about methods of treatment and start treating. Substance-abuse treatment must become part of mainstream medicine. There's too much of it. "The outhousing of drug treatment programs has to stop."

The answer, he said, may only be found in a "social earthquake" that destroys an environment where drugs thrive.


Substance-abuse statistics

Dr. Beny J. Primm, keynote speaker at the 12th annual Conference on Substance Abuse, said that nationally:

- Two of three adults consume alcohol, but 10 percent of those who drink use half of all the beer, wine and liquor consumed.

- Two of three high school seniors had a drink within the past month.

- Five percent of high school seniors drink daily.

- Drug-related, non-HIV medical problems include hepatitis, renal disease, non-viral liver disease, skin ulcers, endocarditis, seizure disorders and sexually transmitted diseases like gonorrhea and syphilis.