“What… Me?”

       “You think I have a problem with [fill in the drug(s)-of-choice here: alcohol/prescription pills/cocaine/methamphetamine/marijuana]?

       “Me?”

       “You gotta be kidding!”

       Cyndi Collier, who’s been a drug treatment counselor for 25 years, says one of the things in the field that hasn’t changed much over the past quarter-century is that “denial remains one of the biggest hurdles to seeking help for your addiction.”

       Collier, who’s now a counselor in the Betty Ford Center’s 90-Day Program, says something that has changed is the demographic breakdown of the patient population. “Now, so many of our patients are younger women,” she says. “In the past, women generally would start using excessively at a later stage, say in their 50s and 60s, and the disease would come on later in life.”

       But, she adds, “It’s not unusual now for kids to start drinking alcohol, smoking pot, at age 11. By their late teens, by the time they’re 20, they’re full-blown alcoholics/addicts. We’ve seen, I’m sorry to report, a marked increase in the number of women patients who are in their 20s.”

       Cold statistics back up Collier’s observations. One-third of all women in the U.S. have their first alcoholic sip before they enter high school. Almost half of high-school girls drink, and more than a quarter binge-drink.

       And college? “The rate of drinking is astronomical,” says Jon Morgenstern, a professor of psychiatry and Vice President of the National Center on Addiction and Substance Abuse. “College is really a training ground for becoming an alcoholic.”

       Here’s a frightening statistic: At all-female colleges, the rate of frequent binge-drinking increased by 124% between 1993 and 2001.

       According to the Betty Ford Center’s Collier, “The drugs – besides, or in addition to, alcohol – that these young women [who enter treatment] are using and abusing reflect our `go-fast’ society. That helps explain, I think, the popularity of methamphetamine and cocaine as drugs of choice. They work fast. The problem is, of course, dependence on those drugs happens fast, too. You become addicted – fast.

       “A sad by-product of the `go-fast’ society is that many young people who’ve become alcoholics/addicts are deep in denial and they look at you with disbelief when you tell them about the true nature of the disease, and that recovery means abstinence – period.

       “I’ve heard so many times, `What do you mean, I can never drink again?’ Or, `What do you mean, I can never smoke dope again?’ They’re so used to living life on their terms. They’ve been living life under the illusion that they’ve been in control of their life – and now we’re telling them they have to surrender control. It’s like a death sentence to many of these women.

       “Believe me, when your mindset’s like that, it takes time to make the major adjustment – in your head and in your lifestyle – that’s required.”

       Cyndi Collier says denial isn’t just a roadblock many prospective patients have to overcome before they get to treatment – it often remains an issue after they get into treatment.

       But, she says, there is hope.

       “One of the amazing, positive benefits of 90 days of treatment is that it gives us – the treatment professionals – and the patient a real opportunity to break through the denial barrier.”

       Collier adds, “You know, most every alcoholic/addict worth her salt can put on a brave face – I call it a `smiley face’ – for about six weeks after they get here. It’s only then that the smile starts to crumble. It’s only then the patient starts to really tackle the deep-below-the-surface trauma and grief and loss issues that are haunting her.”

       Cyndi Collier points out that in the 90-Day Program, patients start to do a lot of things on their own after the first month or so, things like driving a car, shopping for groceries, going to coffee shops, going to AA meetings. “That’s when,” she says, “layers upon countless layers of denial start to peel away.”

       And the picture that emerges, she says, is usually not pretty. “As a matter of fact, confronting the truth is often devastating. But if you don’t tackle the root causes of your disease – why, you’re not going to really heal. If you never get beyond the `smiley face’ stage, you’re putting band aids on open sores, not healing those sores.”

       Denial, says Collier, is just as acute as it ever was for women alcoholics/addicts. And denial, she says, “is a barrier that must be overcome – to some extent at least -- before a person seeks treatment. But then when the woman is in treatment, we have to keep chipping away at that huge boulder in the roadway.

       “The beauty of the 90-Day Program,” she adds, “is that it provides the twin gifts that just keep on giving: time and introspection.”