One Mother’s Story : Hooked and Pregnant: A Time Bomb

The crazy thing was, she’d buy more crack, then throw up as soon as she smoked it. What is this lousy stuff cooked with? she wanted to know.

She bit down on a piece to test it, and the drug numbed her tongue, just as it was supposed to. Everyone else was getting off OK. So how come I’m the only one getting sick?

Girl, you’re pregnant is all, people told her. They snickered and pointed. And maybe they were right. There was every reason to think so. How do I get rid of a baby? she asked them.

Abortion was out. That costs money, and money was better spent for drugs. People suggested that she sit in scalding water or drink turpentine. But why suffer so much just to kill a child?

An Addict’s Logic

Instead, Barbara Colbert smoked even more. If she used enough crack, she’d be high and the baby would be dead. To an addict of two years, that kind of happily-ever-after scheme made pretty good sense.

“Give me a dime rock,” she would tell the dealers, trading $10 for each hit, then smoking it all up and never chipping it into pieces, so that a big dose could get way down to the baby.

But what happened next goes against formula because somehow the crack--a smokable, maximum-strength form of cocaine--did not totally consume Barbara with its usual gangrene of the spirit.

One day she asked for help, something all too rare for an addict. And that same day she got it, which is all too rare for society.

What if the whole besotted mass of them--the hopheads and street pros and petty thieves--swore off drugs and came in for treatment?

The answer is disturbing, for the redemptive moment is easily lost. The resolve to quit crack, like the high itself, comes on so fast and is gone so soon, quick as a shiver.

Programs Overwhelmed

Nationwide, there is only about one treatment slot for every 26 people whose drug use “seriously impairs their health or ability to function,” according to the National Institute on Drug Abuse (NIDA).

A sweeping new national anti-drug strategy, drafted by William J. Bennett--the Bush Administration’s point man on drugs--proposes, among other things, a 50% increase in federal support for drug treatment.

But there is such a long way to go. In Miami, where Barbara Colbert lives, the wait to get into a residential drug program is five months.

In Los Angeles County, the wait can be half a year; federal and state budget cuts have reduced public treatment slots by 25% since 1981, as the number of addicts has multiplied.

“Cocaine abusers come to us in urgency, and there is anger when they can’t get in,” said Irma Strantz, the Los Angeles drug program administrator.

Barbara Colbert understands how that goes. She asks: What would have happened if I hadn’t fought with my mother in the street and my cousin hadn’t come along and taken me right then to the detox center and the door hadn’t swung open?

“What would have happened to Cornelius, to my baby?”

But that is to get ahead of the story.

Scientists have rigged up cages so that laboratory rats can push a lever and get high. Some of the rodents get heroin, some cocaine. Researchers then compare the damage. Cocaine is worse.

While the heroin rats quickly get hooked, they also settle into a stable pattern of use. They keep their body weights up, their fur clean. Few of them die.

Cocaine rats, in contrast, use the drug erratically, unrestrained one day and sparingly the next. They grow thin and motley and fitful. Most die.

In the past few years, entire neighborhoods have become much like the rigged cages of the laboratories. Pellets of crack--made from cocaine, baking soda and water----are as cheap as $1, as easy to get as pushing a lever.

Half a million Americans smoke crack, NIDA estimates. Their bloodstreams rush the drug from the lungs to the brain in about five seconds. “It knocked me right to my knees,” Barbara said. “Cloud 50, way into outer space.”

Small Town Setting

Back in the spring of 1987, crack was just getting acquainted with Florida City, a small town south of Miami where urban blight disappears into vast tomato fields, a junction of migrant and ghetto life.

Barbara Colbert, then 24, lived there, usually with her mother, Joann, who was retired on a pension. Barbara, you ought to be making more of yourself, Joann would tell her.

She couldn’t understand what had happened to the daughter who had run track in high school and made the honor roll. Here she was, drinking so much beer and sniffing cocaine. That’s all any of them do around here!

Barbara had a little boy, Rubin, born of an abandoned romance. Caring for him always seemed to get left to Joann. Is that really fair? the grandmother demanded to know. You leave the boy lying around like an old doll.

But Barbara had her own standards, and she figured herself to be a better mom than most. She had a job over at Bojangles, the fast-food chicken place, and she brought home a paycheck. Why shouldn’t she party whenever she wanted to?

Two friends came over one night with something new. It’s almost a blackout, it’s so intense, they promised. They showed her how to smoke some stuff called crack out of a glass that had foil on top with holes punched around.

Barbara inhaled. This first kiss was magic, though it lasted hardly a few minutes. Her lips jerked and her mouth drooled. Where can I get some more, she wanted to know.

She felt hooked right away, she recalls, and that’s something many addicts say, though there are too many dabblers around for that to be true for all of them.

In an hour she was off to buy an “eight ball,” slang for a round, cookie-sized chunk of crack, enough for 20 dime pieces but costing only $120 or so. She shared, this time.

Days later, she would binge alone. Barbara locked herself in her room and told Rubin to stay away. On a table she set out four Schlitz malt liquor cans, with holes punched in the sides to make them into pipes.

Four cans were better than one because she wouldn’t have to stop when a hole clogged up. A big $15 rock was enough for breathing in three good hits, and she put one piece on top of each can.

She smoked methodically but without hurry. Then she relaxed on the bed, and her thoughts were serene and frightless.

Those were great days, she says. But they didn’t last. Soon after, whenever she climbed for a big high, she made it up fewer stairs all the time.

She knew she needed to get ever bigger amounts--either that or to cut back--and the first choice was always the easier. Was she lost to crack by then?

Yes and no, Barbara says. She was still able to work. She rarely missed a day. She would grind up some crack and lace it across a reefer she could smoke on the job when no one was looking.

She remembers baking biscuits in the Bojangles kitchen. She had put the flour and lard and milk in a huge metal bowl and was ready to mix it. She puffed at the reefer, glancing around from time to time.

Suddenly, the boss was coming. She dropped the drugs into the batter and folded it in, nonchalant as she could be, with her heart thumping.

Then there was nothing to do but slice the dough, grease the cookie sheet and put it all in the oven. And hope nobody tasted a thing.

Scientists are not sure exactly how cocaine works on people, though there seems to be a consensus that it makes the brain chemistry go tipsy. Dopamine is one of the chemicals in the brain that regulates feelings of pleasure.

One theory has it that cocaine--especially in big, quick doses of crack--causes extra amounts of dopamine to surge into the brain’s pleasure centers.

With repeated use the dopamine supply is depleted, so much so that it would take months to catch up. Users only make it worse by smoking more. No matter what, they feel anxious and depressed.

As time went by, Barbara came to understand this in her own way.

Before, it was as if she were two compatible people, her off drugs and her on. It was all right either way.

But now there was an unhappy separation. The more basic Barbara was the one who was high, and the other, waiting to get up, felt awful and incomplete. “After a while, you’re just getting high to get normal,” she says.

She discarded her job, and when she found work again, the jobs discarded her. Her mother threw her out. Barbara took Rubin and moved in with her father in nearby Goulds. The granddad liked the boy.

Goulds was much like Florida City. It seemed easier to find people on crack than off. Who’d even mess with you if you weren’t on drugs? she says.

On the streets, someone was always running up, shouting, What do you need? Then three more would make it a crowd: Mine is better than his!

Soon, she knew all the dealers, the ones who sold the good stuff and the ones who peddled “dummies” with cocaine on the tips and wax inside.

Days sped away amid the curling smoke in crack houses, where the entrance fee was a chip off what she had just bought. There was a “quick hit room” for those in a rush--and sofas and beds for those with time.

The water was usually turned off and the toilets stunk, but the lights worked. A TV was always playing, and people stared listlessly, comfortable in their common decline, limp in their chairs like wilted plants.

When Barbara thought of it, she’d remember to bring a dollar to Rubin. The boy wanted a mother. He had a Parent’s Day at school and she promised to go, but the hours eddied away from her and never came back.

Money became a problem, and she was too scared to steal. Her body was the only thing she had to sell, and it seemed sensible to do so, this commodity easily traded away and yet never used up.

The cars moved slowly along 220th Street. Barbara was cheap. Do whatever and just go, she told the men. Or maybe she said friendlier things--and just felt that way.

The profits went too often for crack and too seldom for rent. She quarreled with her father, and he and his lady friend kicked her out, too.

She wandered at night into abandoned houses. She held a match in the air and searched for shapes in the darkness, her eyes shuttling from side to side. If the rooms were empty, she’d curl up on the floor.

Pregnant and Sick

Where did she get pregnant? She does not know--maybe in Goulds or back in Florida City or a place in between. She hated the baby who was on the way and prayed it would die. She was sick most every day.

Barbara was no longer a bargain on the streets. She smelled. Her clothes were dirty. Her hair was nappy and her face sunken.

She begged her mother for help. The two argued. “She told me I wasn’t her mother any more, and I said I didn’t care,” Joann recalls.

But Barbara did get back into the house, off and on. She promised to reform. And, one weekend last November, Joann even left her pregnant daughter with $250 rent money.

Barbara spent $10, then more and more, until, finally, it was almost gone. Joann found her on a street corner, trying to catch a bus back to Goulds.

Where is the money? she demanded. And the two wrestled against a car, until a cousin pried away the choke hold that had been closed around Barbara’s neck.

Each year, thousands of newborns--estimates go as high as 375,000--suffer damage from their mothers’ use of drugs. At Jackson Memorial, the public hospital in Miami, doctors project that cocaine affects about one in eight births.

That is scary. The placenta acts more as a sponge than as a shield. Many of the “crack babies” will be born seizure-prone and irritable and hyperactive. Some will have deformed limbs and hearts and lungs.

Such children are overburdening the nation’s child welfare systems. They require special care and education, and some school systems--Los Angeles among them--are setting aside classrooms just for such cases.

Already, the youngsters are being spoken of as a lost generation. They were lost in the womb, where crack, booze and other drugs left them a mile behind at the startling line.

In the hospitals, the mothers arrive in labor. They are often malnourished, unkempt, lacking any prenatal care. Some have used crack to try to kill the fetus--and some to hasten delivery.

Crack has overwhelmed the maternal instinct. Or just about: “If they can get crack, it’s the hell with the baby,” Dr. Estelle Whitney said. “But most say: Keep me away from the drugs. If I’m around it, I’ll use it. Help!”

Barbara Colbert, three months pregnant, wanted help. Somehow, she began to think of the baby inside her. Maybe that baby could really become something.

Timing is important. Any drug use threatens the fetus, but doctors have found that use after the first trimester is significantly worse.

A Miami treatment program, the Family Health Center, is one of the few in the nation devoted to pregnant crack users and the babies they bear. It has only 15 spaces, but there was an opening. Barbara got it.

She was hesitant. The vibes were bad. They had lots of rules. Ask them why, and they always said it was to help you and not hurt you. Well, that kind of talk is for school kids.

“I sort of wanted to get help and I sort of didn’t,” Barbara says. “I wanted to be taken care of and I wanted to be left alone.”

The truth is, there are no magic regimens for treating crack addicts. No one has a drug to take its place, like methadone instead of heroin. And no one has a two, four or six-month plan to clean people up for good.

The one command is abstinence, and programs usually combine that with a lot of structure. Keep the addicts busy. Convince them drugs are bad. Teach them how to cope with what they meet up with on the streets.

Crack has found a market among the rich and poor--black and white. Experts say the toughest people to help are those with the least to lose, those with no job to go back to and no family to stand beside them.

Some drug programs try to be job programs as well: teach the addicts basic skills, make them study for their high school diploma, find them work. After all, what chance do people have if they walk out the door jobless and homeless?

Dropout and relapse rates vary, depending on the program, who is in it and how well those in charge keep track. It is not unusual to hear that crack wins out over treatment 70% of the time.

Barbara Colbert quickly found out it would not be easy. Crack was home to her, and treatment felt almost like jail. They were making her do up her bed military style, with the sheet so tight she could bounce a coin on it.

And they wanted her attending one stupid meeting after another, where people confessed their troubles like at some kind of revival.

Late at night, Barbara would sneak a cigarette, rocking in a chair and listening for what the dark had brought into the alley outside her window.

Sometimes, she could hear people stumble by at 2 or 3 a.m. She guessed they were addicts, scouring the ground to see if anything useful had been dropped.

Who else could they be? she reasoned. And she envied them.

Cocaine withdrawal is a shock to the brain, but the first days without it are more a mental blow than a physical one. Crack addicts are usually overtired and hyper and depressed. But craving is not severe.

Researchers are trying various anti-depressant drugs and even acupuncture to help addicts get past the first week--the “detox.” Some say the results are promising--and some say no.

Anyway, the hardest part of treatment is not the initial days, but the long haul. Cravings come and go. Often, the addicts think they have put the worst behind them only to find it up ahead.

Dr. Richard Rawson of the Matrix Center in Beverly Hills says the roughest period of recovery is that time between six weeks and four months. He calls it “the wall.”

Temptation Lurks

Boredom and languor have set in. Concentration is weak. A single hit of crack, then, comes to seem both necessary and harmless. Give me a beer or a joint or anything for a jolt.

Researchers say that crack--because of the speed and wallop of the high--leaves an enduring stamp. Craving is triggered by the simplest of cues: money, a song, that certain smile on a drug-sated face.

In a therapy session, Barbara squirms when she sees a crackhead in a public service ad on TV; a Just Say No poster is enough to get her anxious. And this may always be so.

Still, something has changed. Six months ago, her focus shifted from herself alone to her and her baby together. Cornelius was born and he seems for now a healthy child, with no immediate effects from the drug.

Barbara dotes. Is the baby cold? Is he hungry? Does he want to be held? She goes to parenting classes and has learned to do things she never did for Rubin, to wash a baby’s ears and powder his skin and change his bedding.

Counselors at the program say she finally is making progress through the stages of recovery. Next month they will help her find work. Then later, she will move from the program’s shelter into an apartment.

“I’ll be out on my own with my baby and a job, and I’ll get Rubin from my mother and it’ll be OK . . . ,” Barbara says.

Oh sure, there will be temptation: “I know one day I’ll see all my old get-high buddies, and they’ll say, ‘Hey, we thought you was dead. Here, you want a hit?’

“And then I’ll say no, I’m off it. And they’ll say, ‘Get away from me, you square. Get away!’

“And that will hurt.”

Barbara Colbert knows that much. The street will test her. Has she beaten the drug for good? Her answer is honest enough. Even after nine months in treatment, she is not sure.

One night some weeks back, she dreamed she won the lottery. There was plenty of money to buy a big house. It was beautiful. She walked through.

One room was nicer than the rest. It was set up for smoking, and on a round table were pieces of crack in a huge pile.

When Barbara awoke from this dream, she was shaking. And the taste of the drug--real as ever--was fixed in her mouth.

Researcher Anna M. Virtue contributed to this story.