Why do so many Americans turn with such regularity not only to the medicine chest, but also to the street, for their ''highs?''
As with any perplexing social ill, explanations ring out like frantic shots in the dark: boredom, loneliness, peer pressure, stress, low self-esteem, availability. . . . Says one physician, ''People simply like the feeling,'' and don't think ahead about addiction, loss of motivation, and other problems. Other observers say that health-conscious Americans are also continually looking for an easy and safe ''high.'' When a drug's harmfulness becomes apparent, people simply switch to another drug rather than seek drug-free alternatives.
Still others say chronic drug-taking is symptomatic of deeper societal ills. The impersonal and technological nature of society, the competitiveness of American life, and pressures on the traditional family, are offered as more complex reasons - and, perhaps, more painful for a society to confront.
But as Margaret, an ex-heroin addict insists, ''You need to find out why you get high. You develop a long-term psychological dependency on heroin (or any drug) and you're really just running away from yourself. . . ''
The dark-haired daughter of a New York loan shark, she used to burgle houses to support her four-year-old habit. But Margaret now is two years into her new marriage and is successfully holding two jobs. She is not totally weaned away from drugs, since she is still gradually withdrawing from heroin by substituting methadone, a controversial synthetic narcotic. Still, she says, ''I'm better now than I ever thought I could be.''
Although Margaret is happy with herself now, she expresses concern for young people who are deeply into drugs. ''They say they don't know why they're into (drugs).'' But Bob, who dabbled in drugs during his Florida high school years, disagrees. ''Just because I was taking drugs didn't mean that I wasn't a functioning, thinking person. If you're going to 'cure' drug abuse, you must understand why (people take drugs). . . ''
Locating high school age kids who will discuss their drug problems with candor is difficult. As one student now off drugs admits: ''I didn't think I had a drug problem.'' But a four-year-old juvenile rehabilitation center in St. Petersburg, Fla., called Straight Inc. is getting kids to face their drug problems head on. Self-honesty is part of Straight's rigorous, if slightly controversial, program, which insists on family involvement and strong peer counseling.
Using Alcoholics Anonymous-like tactics of confession, Straight encourages its largely teen-age participants to face their reasons for drug-taking and learn to cope with their lives without resorting to chemicals.
One of the oldest traps people have fallen into when rationalizing drug abuse has been to blame a poor home and family life as the culprit. ''That has been a terribly crippling message,'' says one drug expert, Dr. Robert DuPont, ''that says if your kids are into drugs, then there is something wrong with your family.''
A quick poll among five high school students attending Straight Inc. reveals a half-and-half situation. Says one boy, ''Our house was like a hotel - no communication between my mom, my stepfather, and me. There was lots of violence, lots of broken things.'' But another girl who was equally involved with drugs says, ''My parents didn't even smoke or drink. We went to church regularly and spent an hour at the dinner table each night talking about our days.''
If definitive answers are scarce as to why drug-taking begins, answers as to why people stop taking drugs are even more elusive. For those who successfully pull themselves out of drugs, some of the answers have a very similar ring: ''My kids''; ''I don't ever want to hurt my family like that again''; ''I couldn't see putting my parents through that again''; ''I think it all comes down to family''; ''You can do it if you really want to.''