Chapter 2
Stimulant Abuse

Although stimulants are the most used drugs in the world, not all of them share the same legal status. Cocaine and most amphetamines have only a few legitimate medical applications; their use for any other reason is forbidden. Methamphetamine is not approved for any type of use. Nevertheless, thousands of recreational users find the appeal of cocaine and amphetamines so strong that they self-administer the drugs in violation of the law.

A Pattern of Abuse

Unfortunately, the federal government's efforts to protect the public from dangerous drugs have not eliminated the problem of stimulant abuse. In the wake of the 1906 ban on nonprescription use of cocaine, cocaine abuse did not disappear. The drug remained popular among thousands of users, and its sales were brisk. Those who elected to keep using it did so in secret to avoid arrest. The public got most of its information about cocaine and its users from wild rumors and sensational stories. As a result, a fear of cocaine users developed in some parts of the country.

Playing into this worry, many newspaper reporters wrote incredible stories about cocaine addicts terrorizing law-abiding citizens. In one 1914 article, Dr. Edward Huntington Williams scared readers across the country with his description of a "cocaine fiend." Williams reported that this violent person was so strong that he could not even be killed with a gun, which is not true. According to the doctor,

The drug produces an exhilaration … that may produce the wildest form of insane excitation, accompanied by the fantastic hallucinations and delusions that characterize acute mania…. But the drug produces several other conditions which make the "fiend" a peculiarly dangerous criminal. One of these conditions is a temporary immunity to shock—a resistance to the knockdown effects of fatal wounds. Bullets fired into vital parts, that would drop a sane man in his tracks, fail to check the "fiend"—fail to stop his rush or weaken his attack.¹⁴

In the late 1920s after amphetamines were introduced, many people were relieved to learn that large numbers of cocaine users were switching to the new drugs. In general, the public believed that amphetamines were safe because they had not been around long enough for people to discover their dangers. Harold E. Doweiko, the author of Concepts of Chemical Dependency, explains that the "dangers of cocaine were well known to drug abusers/addicts of the era, but because the long-term effects of the amphetamines were not known, they were viewed as a safe substitute for cocaine."¹⁵

For the next four decades, the medical community prescribed amphetamines to patients for a variety of ills. However, just as with cocaine, signs of addiction were eventually noted and the drugs were banned. Unfortunately, the pattern of abuse established at the end of the nineteenth century by cocaine was repeated in the last half of the twentieth century by amphetamines. Legislation to regulate the consumption of amphetamines did not deter recreational users; it simply made the drugs more difficult to purchase. Following in the footsteps of cocaine addicts, abusers of amphetamines turned to the black market for their supply of drugs.

The Appeal

There was—and still is—a great demand for cocaine and amphetamines. People who use these chemicals refer to themselves as being "cranked up," "pepped up," "jazzed up," or "hyped." The nicknames for the drugs are self-describing, reflecting either their action or appearance. On the streets, cocaine is known as coke, blow, powder, cane, vitamin C, girl, and crack. Some of the more popular names for amphetamines are speed, crank, powder, ice, tweak, go, uppers, black beauty, pep pills, wake up, and wheels. Methamphetamine is most commonly called meth.

Many young people learn about these substances from friends and acquaintances, and are often introduced to the drugs at parties. Liz is a teen who sometimes attends parties where drugs are common. "You go to parties," she says, "and there will be kids in the bathroom or in a bedroom … doing speed and coke."¹⁶

Why would a young person try amphetamines or cocaine in the first place? People who work with stimulant abusers see three primary reasons. "Curiosity or peer pressure … bring them all in,"¹⁷ says Kevin Boender, a counselor who runs a drug abuse program in Idaho. Young people are naturally curious, and many do not fully realize the dangers associated with experimenting with stimulants. Others are pressured by friends who are trying stimulants and feel that they must join in or risk rejection by the group.

Boender also claims that some girls try stimulants because they have heard that the drugs will make them thin. Since these stimulants speed up the body systems and suppress hunger, abusers do not eat much. For some people, the idea of taking stimulants and losing the desire for food sounds more appealing than consciously dieting and wisely planning food choices.

Nancy Echelbarger, who runs Substance Misuse Services in Spokane, Washington, sees many stimulant addicts. She believes that most of her clients are trying to medicate themselves in an effort to avoid dealing with real issues in their lives. According to Echelbarger, "We find no matter what the drug, it is a symptom. Ninety-five percent of both men and women use drugs to cover the memories, pain and anger of a traumatic past, or childhood, or both."¹⁸

A Big Lift

No matter what motivates a person to try—and continue—using stimulants, these drugs have similar effects on all people. They increase energy, inspiring users to take on a flurry of activity. One young woman remembers how energized she felt when she used amphetamines:

When I get Crank, I can't wait to get back home and see how I'm going to channel my energy for the next 10 plus hours. Sometimes I write poems or stories. The first time the writing hit me was on the way back from San Francisco…. We flew out, then drove back a Brady Bunch Style Station wagon. The drive normally takes 2½ days from [California to South Dakota], but we made it in 28 hours. Wide Awake!¹⁹

Coca Long Ago

In early Incan society, coca was originally reserved for royalty and priests. Worshippers believed that the coca leaf was a gift from the gods that was given to the first Inca ruler. With the passage of time, common people were permitted to use the leaves as well. They found that they could work longer and harder in their high-altitude homes if they kept a wad of green leaves in their mouths. Each wad was savored for thirty minutes or so and then spit out.

When the Spanish invaded Peru in 1533, they banned the use of coca leaves. To their shock, they found that the natives were no longer able to work long days in the silver mines. As a result, the Spanish soon reversed their position and provided fresh leaves to the Indian laborers during rest breaks. Spaniards who took up the habit of coca-leaf chewing, meanwhile, were viewed as rebels and treated as outcasts. Spanish chewers were forced to leave the colony and live alone or move in with the Indians.

Indian cultures of more recent times worshipped Mama Coca, a goddess who blessed humans with her power. When a worshipper chewed or smoked coca leaves, Mama Coca's power was thought to enter his body. The worshipper believed that this protected his mind and body against any danger. Many present-day natives have similar beliefs and carry out similar practices.

Amphetamines and cocaine also generate feelings of confidence. One user, Cynric, and his friend Rob kept "bumping," or repeating

hits of meth, to maintain that feeling of confidence for more than thirty hours:

I felt this incredible feeling … like I was king of the world, and I could do anything I wanted…. We decided to … go to a mountain near my place with lots of hiking trails…. When we got to the mountain, we de cided to bypass the hiking trails and climb straight up the rock face with no safety harnesses … which was also odd because I am afraid of heights…. I still have a scar on my leg from where I slammed it into a rock … and I didn't even feel it at the time, I just had this attitude like "whatever, I have to get to the top … I have to climb!"²⁰

In addition to producing a false sense of assurance, meth's effects on the brain can cause an odd and disturbing behavior called getting "hung up." An addict can have the same thought, or carry out the same action, for hours at a time. One person might get hung up cleaning a floor over and over again, another assembling and disassembling a small appliance several times, and still another singing the same song for hours.

Generally, the effects of stimulants are the same no matter how the drugs are ingested. However, the method of use influences how quickly, and how strongly, cocaine and amphetamines affect the body. All are commonly sold as white powders, although meth may occasionally have an off-white or light brown tint. These powders have a strong, chemical odor. They can be swallowed alone or mixed with a beverage or food. Cocaine can also be rubbed on the gums or held under the tongue for absorption though the oral mucus membranes.

Through the Nose

In the powder form, cocaine and amphetamines can also be inhaled. Many users pour their powder of choice onto a mirror, chop it into a fine dust, and sniff it. Inside the nostrils, the drug molecules diffuse across the membranes of the cells and enter the bloodstream. Once blood-borne, they travel quickly to the brain.

The high from snorting cocaine is intense. It begins almost immediately, peaks in fifteen to thirty minutes, and can last a couple of hours. A young woman remembers how she felt after sniffing cocaine: "Everything was brighter; people were warmer. It was an empathic feeling. I was told that I was moving around like a hummingbird for the most part talking a mile a minute."²¹

Many users say that the high from meth lasts much longer than a coke high. First-time users are often surprised to find out that snorting meth gives a high that peaks in twenty minutes, similar to cocaine, but lasts ten hours or more.

Matt Schofield, a reporter for the Kansas City Star, asked Denise Byrd, a young meth user, to tell him about her first experience with the drug. Schofield recounts Byrd's story:

It's early on a Friday night at a friend's weekly poker party. On her right is her host. He bought the drug…. Between hands of poker, her host chops at the stuff with a razor blade.

Quickly she inhales … making the powder vanish. She grabs her nose. "Never again," she tells herself. "I will never do this again."

Then the high hits. She feels strong. Incredibly strong. So strong that she looks around for something to lift, something heavy. But she feels too wired to think about that for long. Now she wants to talk. "I mean," she tells herself, "this is the stuff! This is real."²²

Slamming Is Serious

Stimulant abusers who want a more intense response from drugs than the one they can get by snorting opt to inject themselves with a needle. This is called slamming. All of the powdered stimulants can be dissolved and injected directly into a vein. The high from injecting is powerful, and it hits immediately, but it is not as long-lived as the high from snorting. Some users compare the instant adrenaline rush from slamming to the feeling one gets while bungee jumping or parachuting.

Injecting stimulants into veins is a dangerous and often difficult process, especially if users have already damaged their veins. Journalist Conrad Evarts interviewed a stimulant addict, identified as Addicta, about her habit of injecting meth under her fingernails and into her neck because the veins of her arms and legs had collapsed. Addicta explains that "It's hard to find my veins. I used to always shoot in my left arm, or my right arm and I can't even hit myself there no more because I've ruined that vein. So under your fingernails is a good place to hit yourself." When Evarts asked how she could get to a vein there, Addicta replied, "I don't know they did it for me, 'cause I couldn't do it for me." She also used her jugular vein:

I was out here at my friend's house in Nowheresville and my arms were really bad bruised and my friend said, "Well Addicta we can hit you in the neck in your jugular vein." And I said no way. 'Cause all you got to do is do somethin' wrong in that vein and you could die. She had used hers before. Her jugular veins, and my cousins have used theirs. And that's scary though … I did [use it]. It didn't matter to me. I just wanted to get high.²³

Up in Smoke

Stimulant users are continually developing new ways to get drugs into their bodies. Smoking is a relatively recent technique. Because cocaine powder, or cocaine hydrochloride, is very sensitive to heat, it cannot be smoked without first converting it into a different chemical form, which is a very dangerous process,

especially for amateur chemists. According to drug abuse expert Doweiko,

When cocaine hydrochloride became a popular drug of abuse in the 1970's, users quickly discovered that it is not easily smoked. The high temperatures needed to vaporize cocaine hydrochloride also destroy it, making it of limited value to those who wished to smoke it. Dedicated cocaine abusers of

the 1970's and 1980's knew that it was possible to smoke the alkaloid base of cocaine; they also knew that transforming cocaine hydrochloride into an alkaloid base was a long, dangerous process. This made the practice of smoking cocaine unpopular before around 1985.²⁴

Enterprising drug producers knew that if cocaine could be smoked easily, they could sell more of it. Eventually, they came up with a formula that worked. By heating a mixture of cocaine hydrochloride with a few household chemicals until crystals formed, they created a form of cocaine called crack. The cracking sound the crystals made cooling in the cooking pot inspired the drug's name.

Users heat the crack crystals and inhale the vapors. The intense euphoria, known as a flash high, starts in less than ten seconds and lasts three to five minutes. It is followed by ten or fifteen minutes of milder euphoria. Because the effects wear off so quickly, crack users must repeat doses more often than cocaine users in order to maintain the high.

Since smoking cocaine proved to be popular, few were surprised when a smokable form of meth appeared on the streets in the late 1970s. Called ice or crank, this crystallized meth is a colorless, odorless chip of pure methamphetamine. Crank or ice is to methamphetamine what crack is to cocaine. By heating and inhaling the vapors, crank users receive an instant high that lasts a long time, up to eight hours.

Carlos Perez, a former crank smoker, compares the thrill of crank to the rush associated with scary or exhilarating experiences:

You feel fabulous because by taking crank your brain becomes super-active, making your whole body feel euphoric and ecstatic. And you feel all this by not doing anything but ingesting the drug. Unlike dropping off the top of a roller coaster or diving from a high cliff into the ocean, where you are consciously aware of what you did to feel that rush.²⁵

Treacherous Treats

Meth has one more face, and it is an innocent-looking one: Tablets called Yaba, a Thai word meaning "crazy medicine," are becoming increasingly popular in the United States. These brightly colored, sweet-tasting pills are more commonly found in the western half of the country than anywhere else. Some are small, about one-quarter the size of an aspirin, and can be easily concealed in the end of a straw. Others are larger because they are mixed with caffeine or other stimulants.

The attractive, candylike appearance of these drugs is what appeals to some young people, which worries both former drug users and drug abuse experts. "Candy drugs, of course, I would be on that in a second,"²⁶ says Alyssa, a seventeen-year-old meth addict.

In an interview with NBC 4 reporters, Alyssa and teenagers Cory and Kerry talked about using meth tablets. Yaba has become Cory and Alyssa's favorite, because as Cory points out, "It's a lot easier to eat a piece of candy than to smoke a pipe [or] sniff a line."²⁷ He has been abusing Yaba since he was thirteen years old.

Kat

Kat, or methcathinone, is a strong stimulant derived from the plant Cathula edulis, a native of parts of Africa and Arabia. Kat affects the body in much the same way as amphetamine. In the 1930s and 1940s, pharmaceutical companies tested methcathinone to see if it had any medical uses. It was concluded that the risks and side effects of kat were unacceptable, and further research was abandoned. However, during the research process, scientists learned how to synthesize the drug.

In 1989 a student at the University of Michigan came across the formula for making kat. By 1990, the student began manufacturing the pure extract of kat and selling it in northern Michigan. Its popularity quickly spread to other states.

Kat is now a common street drug. Short-term effects of kat are similar to those of cocaine or meth: increased heart and respiration rates, a sense of euphoria, and increased alertness. Long-term use causes problems much like those brought on by other powerful stimulants, including paranoia, delusions, anxiety, convulsion, and irregular heart rate. After a binge, users often report feelings of severe depression and ideas of suicide.

Kerry compares the high to snorting meth: "The rush was so intense. I had a broken foot at the time [and] I didn't use the crutches at all that night 'cause I didn't feel anything—it was so amazing. [Sniffing] crystal meth doesn't do anything compared to this."²⁸

Bingeing and Crashing

Whether they consume, inhale, or inject the drugs, stimulant abusers often binge, staying high for several days without sleep. They maintain a binge by taking drugs each time their euphoria begins to fade. Bingeing is most common with meth. Meth users, often called tweakers, have been known to stay awake and high for a week or more. Without rest or food, their bodies become worn out and their minds get confused. Steven, a twenty-eight-year-old meth addict, remembers when his habit got out of control:

My speed use escalated to daily use when I started smoking it. I lost my jobs. Soon I disassociated with my party friends who were weekend users and started running with a new set which consisted of "all the time tweakers," … up for 4 days, down for 3 with depression and blackouts for 2 of those 3 days…. Most often I was miserable, but I was hooked. I loved speed more at that time than I loved myself.²⁹

It seems that all things come at a price, and that philosophy certainly applies to cocaine and amphetamines. After the high, while the body is still processing the drug out of its system, users experience a period often called the "crash." It is most often characterized by sore muscles, exhaustion, and depression. Some users are so sad during the crash that they contemplate, or even commit, suicide.

In his report for the Kansas City Star, Matt Schofield recounts Denise Byrd's experiences when her meth began to wear off:

What Denise and many other novice users don't realize is that meth is a roller coaster ride, and the downside is always just over the next hill. Denise crashes a couple of hours past dawn Saturday, the firestorm in her brain finally out. She wakes just after 4 p.m., way past her usual time for breakfast at Mom's.

Her nose is raw. She rolls her neck. She flops her torso over her legs, hoping a gentle tug on her back muscles will ease the soreness. She caresses her feet, trying to massage out the knots. Her muscles had been tense, quivering, tingling, throughout the high. Now she feels as if she has run a marathon and then been in a prize fight.

"Who beat me up?" she wonders momentarily, before remembering the meth.

All this from a 2-inch line? But banging around in her brain like a kid with a toy drum is the thought: "More. You want more of that. You need more of that."³⁰

Kerry, a teen user, points out that although he loves the high, he hates meth when the high comes crashing down: "You feel really nasty…. I mean your bones start to ache, it starts to rot your teeth. It's evil, pretty much, the way it made me feel is just like pure evil." Alyssa, another teen, adds, "Your hair becomes very greasy. Acne, white face, dilated eyes, your fingernails will be extremely

dirty under them. You cannot hide them. You can take a million showers, they will be dirty. You sweat a lot. You're impatient, you're frustrated."³¹

The Products of Time

In the nineteenth century, scientists extracted the active ingredient from the natural stimulant coca, making cocaine available in a concentrated form. Fifty years later, work on another natural stimulant led to the synthesis of amphetamines, producing another powerful drug. This alchemy has dramatically changed the roles that some stimulants play by creating potent, highly desirable drugs of abuse. Today people often find that the continued use of such drugs causes serious problems.