Cracking The Habit

This article was written for a health maintenance organization in Honolulu, Hawaii. The Oahu Public Information Subcommittee coordinated the interview with a local member having experience with a specific drug.

Cracking The Habit

Island Scene Online

Beating crack cocaine addiction cost this man an immeasurable price.

By Dave Reardon | Posted: September 24, 2003

He doesn’t remember exactly where and when he took his first hit of crack cocaine. He doesn’t remember a lot of things. He says his bad memory is the result of nearly 30 years of drug use. But there is only one thing he really needs to remember: the desperation and hopelessness he felt when he was on cocaine.

He lost jobs. He lost family. He lost years of his life.

He says what’s important now isn’t the past or the future, but the present. His goal is to get through each day without using drugs — and to help others do the same as a member of Narcotics Anonymous.

We’ll call him “Greg,” because Greg is a common name, and he looks very typical, and much of his story is, too. He’s 47 years old, born and raised in Hawai’i , with two grown children. He works two jobs.

Greg gave up a career he enjoyed and had much experience in just so he could drive a cab. The reason? Cab drivers get paid quickly, and crack cocaine addicts need to be able to get money quickly to support their habits.

All cocaine in Hawai’i is smuggled into the state, but crack is “readily available” after it’s converted, usually an ounce or two at a time, according to a federal Drug Enforcement Administration report. The cost hasn’t changed much over the years, ranging from $10 to $100, depending on the size of the rock.

Greg says crack cocaine or “rock” is not just the drug of the downtrodden, the street people, those who don’t have regular jobs and who lost hope long ago. He says there are many everyday people who smoke the powerful stimulant, and that you probably know some of them. Many are otherwise law-abiding citizens. Some are very good at hiding their habit, like he was. But they are still addicts, just like the ones you see staggering around on the streets or hear about getting arrested for robbery and burglary or prostitution.

Crack is not the first drug of choice in Hawai’i today, Greg says. Not the one that gets the headlines. Crystal methamphetamine, or “ice,” is the state’s most worrisome substance, both because of its growing use and because of addicts’ propensity for violence. Among younger users of illicit drugs, ecstasy is a growing problem. Of Hawai’i 12th-graders in 2002, 10.6 precent had tried ecstasy, but only 4.5 percent had used cocaine (powder and crack), according to a Hawai’i State Department of Health study.

Crack use in the Islands is most prevalent among young adults 18 to 30, according to the Office of National Drug Control Policy. In 2000, nearly 16 percent of adult males who were arrested in Hawai’i tested positive for cocaine, according to a Hawai’i drug threat assessment by the National Drug Intelligence Center. Also in Hawai’i in 2000, there were 364 cocaine-related admissions to publicly funded treatment centers for cocaine abuse, according to the same report.

Greg’s first drug was marijuana (alcohol made him sick). He first tried it when he was around 12.

“I guess it was my older brother and sister and some friends who got me started,” he says. “I don’t know if it was really a conscious choice or just going along with the others. But that’s what we did. And back then it was just accepted. We were just doing what kids did then, smoking pot.

“And I really loved that, for 20 years. But I stopped using it because I progressed to other things.”

At 16, Greg was a pretty typical Hawai’i teenager. His family moved a lot within the state, but other than that it was a normal childhood for the most part, he says. His parents drank some and argued quite a bit, but he doesn’t think that affected him very much. He liked to work on cars and enjoyed water sports.

But 16 was also the age when Greg tried his first snort of cocaine. Thirty years ago the drug was all over the place, easy to find, even for a kid. Especially for a kid with older siblings who knew the right people. In his high school years and early adulthood, Greg used drugs as a social lubricant. “If people around me were doing heroin, I probably would have done that. It was definitely about fitting in.”

It took Greg several attempts to get a buzz from crack cocaine. Then, one time, as he describes it, “It worked.” When Greg placed the rock in the glass pipe, lit and inhaled, the freebase cocaine vapors raced through his bloodstream and slammed his brain with euphoria within seconds.

Freebase cocaine, of which crack is one form, is an efficient way of delivering cocaine to the brain. “Freebase” refers to a process of separating or “freeing” the “base” product using baking soda. There is an initial rush of immensely pleasurable feeling lasting for up to two minutes. This is followed by an intense high lasting for about 30 minutes.

Cocaine acts by increasing the concentration of the mood-enhancing neurotransmitters dopamine, norepinephrine and serotonin in the brain. Research has also shown that cocaine can cause the release of dopamine. These neurotransmitters make everything seem intensely wonderful. To Greg, the rush made him think he could see everything with crystal clarity for a few minutes.

What he didn’t see was that, for the next three years, he would be hooked on crack, and that his addiction would come at a huge cost. In some ways he will always pay.

He worked, but eventually, only with a lot of break time to sneak home and feed his habit, which he helped support by committing petty crimes. His family broke up around him. He lost custody of his children, and contact with them.

By the end, the lowest point, he sat in his apartment in the dark without electricity, without food. His health was going down the tubes, too.

“I think I probably shortened my life, probably did some long-term things to my body that aren’t good that will hurt me later, and my memory isn’t as good as it should be,” Greg says.

Habitual crack users often suffer from a chronic cough that brings up black phlegm. Respiratory ailments like bronchitis can also appear. And along with the sudden rush of smoking crack comes an increased danger of overdose, which can even cause death from heart or respiratory failure, though this is rare.

Greg had a girlfriend who was also using drugs, but his only true companion was paranoia.

“It becomes a very selfish, hiding kind of thing,” he says. “And the first hit doesn’t bring you happiness anymore, it brings you instant paranoia.” His brother also had a drug problem. Whenever they saw each other, they both could tell they needed help, and they talked about it.

“Denial? I probably slept through that phase,” says Greg.

He considers himself fortunate, because he realized he needed to do something before the decision was made for him.

It took three tries, but rehab finally worked for Greg. “The first time I left after six days,” he says.

That was from an outpatient clinic, which he tried a second time, also unsuccessfully. Finally, he made it through a 90-day residential state Department of Health program. But what about follow-up care?

One of the keys to his ongoing recovery as a crack cocaine addict is the steady stream of new addicts he meets at Narcotics Anonymous meetings. This may sound selfish, and Greg admits it, but that’s how it works.

“The newcomers are the most important people to my recovery,” he says. “When people keep coming in, it helps the others of us remember how it was, and how using drugs didn’t work for us. That’s why it’s important. When you’re new and you come in, your comprehending skills are probably pretty low. It takes a while for things to be clear.

“That’s what we don’t want to go back to.”

What does Greg tell the new guys? “Keep coming back to meetings.”

That’s the way Greg beats his addiction. He keeps coming back to meetings — three, four, five times a week. Because the itch comes every day, and he scratches it by going to the meetings and talking and listening, and living in the here and now. It’s kept him clean for nearly seven years.

“It’s not like I’m cured. It’s incurable. The meetings are the medicine for my disease.”

That, and acknowledgement that there is more out there than we can see, hear and touch.

“That was a key for me,” Greg says. “I surrendered to a higher power. I’d never really had that before. We went to church once in a while as kids, but nothing really steady.”

Today, Greg lives a simple life, but it’s fulfilling, and he has recovered some of what he had lost. “I got contact with my children back,” he says. “I have enough money to go on vacations to the Mainland.”

While Greg’s story isn’t the shocking rock-bottom tale of other addicts, his slow, steady descent into drug dependence is still sad. And his story of recovery just as inspiring.

“I lost a lot of years, but being clean has opened up my world.”

For information about Narcotics Anonymous, call (808) 734-4357 on O’ahu, (808) 969-6644 on the Big Island , (808) 242-6404 on Maui , and (808) 828-1674 on Kaua’i.

Island Scene Online is not intended to replace the advice of health care professionals. Please consult your physician for your personal needs and before making any changes in your lifestyle.

© 2003 Hawaii Medical Service Association An Independent Licensee of the Blue Cross and Blue Shield Association. All Rights Reserved.