Cocaine Highs Leaving Behind Social Hangover

Last week a teen-age girl, who was a chronic cocaine user, was brought to a Tustin hospital’s emergency room because she had lacerated both arms attempting during a hallucination to remove insects and bugs she believed were crawling and biting just under the surface of her skin.

Earlier this month, a young upper-middle-class Orange County businessman watched as the body of a “coke buddy,” who had fatally overdosed during a cocaine party, was wheeled out of the house by the coroner; he was filled with guilt, rage and fear of his own death. Last week, friendless, jobless and penniless--except for handouts from his father--he checked himself into the CareUnit in Orange in an attempt to put back together what remained of his life by undergoing treatment for addiction to cocaine.

Usually the Matrix cocaine addiction outpatient clinic in Beverly Hills--whose clients on average earn $25,000 a year--receives 25% of its public hot-line calls from South-Central Los Angeles, one of Southern California’s poorest areas. But at the first of the month, the number of calls from South-Central Los Angeles jumps to 75%, when mothers on welfare have spent their entire checks on two-day cocaine binges and now are suicidal because they don’t know how they’re going to feed their children for the rest of the month, Matrix director Richard Rawson says.

Usually the Matrix cocaine addiction outpatient clinic in Beverly Hills--whose clients on average earn $25,000 a year--receives 25% of its public hot-line calls from South-Central Los Angeles, one of Southern California’s poorest areas. But at the first of the month, the number of calls from South-Central Los Angeles jumps to 75%, when mothers on welfare have spent their entire checks on two-day cocaine binges and now are suicidal because they have no way to feed their children for the rest of the month, clinic officials said.

Once toasted as the “champagne” drug of the ‘70s, cocaine has left the ‘80s with a massive hangover, according to speakers who gave these casualty accounts at a “Cocaine Update” seminar conducted last weekend by UC Irvine Extension.

In Orange County alone, 20 chapters of Cocaine Anonymous have sprung up since 1982, said Jeff Fortuna, a professor of health education at Cal State Long Beach. He also is director of Orange-based Drug Education Consultants, which provides therapeutic services and drug prevention advice to hospitals, companies and schools.

Some chapters only have about 10 members, while others have memberships exceeding 100, added Fortuna, who explained that the organization, modeled after Alcoholics Anonymous, seeks to help recovering cocaine addicts by providing group and individual support.

“There have been more fatal cocaine overdoses (300) in California in the last three years than in the other 49 states combined in the last 10 years,” Fortuna told the 45 nurses, psychologists, marriage, family and child counselors, and former cocaine users who each paid $88 to attend the seminar.

Yet the leading cause of death among cocaine addicts is suicide because the chronic use of cocaine results in extreme depression, said Richard Rawson, a clinical psychologist who is director of the Matrix outpatient cocaine addiction treatment program in Beverly Hills.

Seminar coordinator Ruth Stafford, an Orange County clinical psychologist specializing in treating addictive disorders, said, “Cocaine addiction is reaching epidemic proportions, accounting for up to 40% of admissions to many chemical dependency programs.”

This epidemic stems partly from the widespread belief that cocaine provides a safe, non-addictive high, Rawson said. But that benign image is fast eroding. The National Institute on Drug Abuse last year declared cocaine to be a “powerfully addictive” substance--and researchers have linked its use to cardiac arrests, seizures, respiratory ailments and other serious health problems.

In the late ‘70s at UCLA, Ron Siegel, a psychopharmacologist, conducted research on monkeys and rats in which they were injected with cocaine every time they pressed a bar. Videotapes of the monkey experiments show them ignoring food, water, a willing sex partner--and even painful shocks accompanying the cocaine injections--to repeatedly press on the bar for more cocaine injections until they fell over dead.

“Until 1980 about the only ones in this country who knew that cocaine was addictive were Ron Siegel and his monkeys at UCLA,” Rawson said.

“Cocaine is by far the most addictive drug,” said Dr. Joseph Pursch, who from his office in the Orange CareUnit serves as corporate medical director of Comprehensive Care Corp., which operates one of the largest chains of substance abuse hospitals in the nation. After cocaine, in declining order of addictive potential, Pursch listed heroin, barbiturates, alcohol and marijuana.

The deleterious effects of cocaine occur amazingly fast, Rawson noted. Before becoming director of Matrix two years ago, he operated a drug rehabilitation program in which heroin addicts made up 80% of the caseload.

“While people tend to be addicted to heroin for 10 to 15 years before they seek help, cocaine addiction lasts, on average, only three years before people come in for help,” Rawson said.

“Cocaine addicts seek help not because they’re afraid of going through withdrawal or going to jail, as is the case for those on heroin; 70% say they’re coming in for treatment because they’re out of control,” Rawson said. “They’ve got careers, currently are working, make about $25,000 a year, have families--and are afraid of losing it all. They can’t understand what’s happened to them.”

Another reason for the spread of addiction is that cocaine is no longer the “rich man’s drug,” Fortuna said. A worldwide glut of cocaine has brought prices down sharply, increasing the numbers using it and its frequency of use.

“In ’83 a gram cost about $100, but now it averages $50 to $55,” Fortuna told the audience during a session on the social and cultural implications of cocaine addiction. “At prices like this your average blue-collar worker can afford it.”

Even at these reduced prices, cocaine addiction can prove a financial drain, Fortuna added. He noted that an addict typically snorts a $50 gram within 30 minutes. “He’s probably snorting four grams every day, which means he has a $1,400-a-week habit.”

According to U.S. government estimates, 25 million Americans have tried cocaine and 5 to 10 million use it at least once a month.

In Southern California, Rawson said, an estimated 2 million people have tried cocaine since 1980, and it is projected that a quarter--or 500,000--of them will become addicted to cocaine--if they have not already.

“With cocaine, for the first time in the history of drug addiction in this country, we are seeing addiction to a drug move from the upper and middle classes to the lower classes,” Rawson said.

Citing statistics on overdoses, driving impairment arrests, admissions to hospital chemical-dependency programs and partial surveys, Fortuna said that he and most other drug-abuse consultants believe there has been a 300% increase in cocaine use in Orange County in the last two years.

Most of this increase, Fortuna said, has come among those age 18 to 25, although its use is not limited to any one age group.

However, “a lot of patients are older alcoholics who became cocaine addicts when they were 40 or 50,” said Pursch, who has treated celebrities such as former First Lady Betty Ford and former Dodger pitcher Steve Howe for various chemical dependencies.

While most people begin using cocaine because of peer pressure or for social factors, the reason people become chronic users--using it three or more times a week--is because they become physically addicted to it, Fortuna said.

What makes cocaine use so enticing? Fortuna said that after an individual ingests cocaine--generally by snorting it through the nose, intravenous injections or “free-basing” it by smoking cocaine water pipes or cigarettes--it travels in seconds directly to the pleasure center of the brain. The user experiences a feeling of increased status, energy, sexual functioning, confidence, work output, popularity, thinking ability and euphoria, Rawson said.

“The individual becomes higher than high--godlike,” Fortuna added. “Because the individual is so euphoric, elated and confident, he or she becomes very talkative, alert, challenging of others and competitive.”

The cocaine high lasts relatively briefly, Fortuna said. He explained that the high of shortest duration--five minutes--is obtained by those who free-base while the longest-lasting high--30 to 45 minutes--is obtained by those who snort cocaine. The ensuing “crash” to a state of depression occurs within just 12 minutes of last use by free-basers, while for those who snort cocaine, the “crash” is delayed until 90 minutes after last ingestion, Fortuna said.

“This depression is so intolerable that the individual immediately uses cocaine again,” Fortuna said.

And to achieve these highs, Fortuna said, the user is gradually depleting the brain’s supply of noradrenaline, dopamine and serotonin--the three neural transmitters most responsible for controlling whether you feel happy or sad.

Depression Cited

In a frantic attempt to remain constantly happy, a chronic cocaine user--who increases the frequency and amount of use--goes through his brain’s supply of those neural transmitters in a matter of months, leaving the user constantly depressed and suicidal, Fortuna said. And the brain’s supply of transmitters can be replenished only by complete abstinence from cocaine in conjunction with a regimen of therapeutic drugs and nutritionally sound diet for a year or more, he added.

Inpatient treatment of cocaine addiction at CareUnit in Orange lasts four to six weeks, depending on the severity of the addiction, and costs from $10,000 to $12,000, depending on the length of stay. Pursch said patients are placed on a variety of drug and nutritional regimens and receive intensive individual, group and family therapy.

A similar regimen is followed at Rawson’s Matrix program, which is believed to be the only outpatient program in Southern California that solely treats cocaine addicts. Matrix’s six-month program costs $1,500.

Cure Rate Low

Whether inpatient or outpatient, cocaine treatment programs do not have a high cure rate, their proponents acknowledge, blaming the relative newness of the programs. For cocaine addicts, the in-hospital successful rehabilitation rate is no better than 40 to 50%, said Pursch. In contrast, he said, the in-hospital rehabilitation rate for alcoholics ranges from 70% to 85%.

However, Rawson reports a 66% successful rehabilitation rate for Matrix patients. He believes Matrix is more successful than in-hospital programs because it is tailored specifically just for cocaine addicts rather than attempting to treat people with various types of drug dependencies.

Both Rawson and Pursch encourage their patients to follow up their treatment by participating in such support groups as Cocaine Anonymous or Alcoholics Anonymous.