CRAVING CRACK, THEN 'FACING THE ROAR'

Selling For Only $10-$20 A Rock, It Can Own The Addict's Soul

"It replaces everything. It's your relationships, your love affairs, your
food, your companion, your life."

Lenoria Davis, nurse and former crack addict, has worked in drug
rehabilitation clinics for the last 11 years, putting her visceral knowledge
of crack and other drug addictions to use as part of her own way of "just
saying no." It has been a difficult journey. Davis used to watch an
anti-drug TV commercial in which a seductive voice-over was supposed to be
the voice of a drug.

Sounding like a resonant and teasing lyric in a Barry White love song, the
voice asked, "Would you steal for me? Leave your home for me? Die for me?"
Davis listened to those intended warnings and, like Nancy Reagan's worst
nightmare, she didn't hesitate: "Yes, yes, yes. The answer to all those
questions was yes."

Like actor Robert Downey Jr. and County Commissioner Michael Hooks, Davis
finally confronted her addiction. Hooks confessed his addiction last week at
a County Commission meeting in which he said he is "a Michael Hooks that I
don't know, that most of you don't know and that I'm not particularly proud
of."

He then disappeared into a rehabilitation program, where the outcome is not
always certain. But Davis and other drug counselors say that, while an
addiction to cocaine or crack is among the hardest to overcome, it can be
done. Withdrawal is what Davis calls a "frightening" experience and what
others call "facing the roar."

Her drug use began a little at a time. Alcohol and marijuana with friends.
Demerol as a prescription for lower back pain. Then, through access as a
nurse, Demerol stolen from patient supplies at a hospital where she once
worked. And finally crack. It was the worst. It led her to the streets to
buy drugs. It cost her a child and led her to prostitution to help pay for
"rocks" of crack cocaine.

Davis, 55, now works at Grace House, a state and federally funded
not-for-profit drug rehabilitation program for women. There, executive
director Sharon Trammell says the treatment model is the same as the 12-step
program used by Alcoholics Anonymous.

The public sometimes has the perception that crack addiction, like
antiquated notions about "reefer madness," means little chance of recovery.
Trammell says government funding means government guidelines requiring her
to track patients after recovery. Trammell says the program is averaging
about an 80 percent success rate after two years for patients who complete a
six-month primary treatment program with a six-month "halfway house"
followup.

The program once had a higher success rate but now is getting more clients
formerly on welfare, without work histories and with little to return to
when they leave.

The drug that brought them to rehab is almost always crack. "Ten years ago
we saw almost no crack addicts here. Now 90 percent of our clients are crack
clients," says Trammell. It is a pattern that repeats itself in almost every
rehab center and in the courts. General Sessions Judge Tim Dwyer, head of
the Shelby County Drug Court, says the majority of cases "by far" are
related to crack.

Most short-term rehab facilities have lower success rates than Grace House,
and some government studies indicate as few as half of addicts will remain
abstinent after initial treatment. But it can be done.

"Crack is not a death sentence. We have plenty of people who are in
recovery. It takes vigilance, but so does any kind of recovery if you're
addicted," says Elaine Orland, clinical director at Grace House.

At Harbor House, a government-funded rehab center for men, alcohol and drug
counselor Armstead Chavers says addiction to crack is the same as addiction
to cocaine. "The only difference is how it's brought into the system.
Cocaine is inhaled or snorted or, sometimes, taken intravenously. Crack is
smoked."

Government studies are looking at possible drug regimens to interfere with
crack and cocaine receptors in the brain. Traditional treatment is immediate
withdrawal, intense therapy and support-group sessions using 12-step models.
"It's not a step-down sort of thing. It's a determination that starts with
now," says Chavers.

Unlike severe alcoholics, who face detoxification and possible "DT's"
(delirium tremens), crack addicts face intense cravings - the roar. "People
can die from alcohol withdrawal, but crack addiction is a mental obsession.
Once removed from it, the situation abates."

Counselors say crack addiction is often related to and complicated by social
conditions. "A lot of people have had events in their lives that were
painful. They feel deprived. They feel they can enhance the pleasurable
aspects of their lives with drugs," says Abbott Jordan, director of Lakeside
Behavioral Health System Outpatient Services, Cresthaven.

The chemistry of addiction is usually the same, regardless of a user's drug
of choice. Crack, amphetamines, alcohol or other mood-altering drugs
increase the activity of a chemical called dopamine in the brain, producing
a sense of euphoria. Jordan says some users seem to become addicted the
first time they try a drug, especially crack with its immediate and "very
high euphoria." Others become addicted after repeatedly turning to a drug as
an escape or as a substitute for something missing in their lives. "And if
you use a chemical over enough time, the brain becomes a little lazy. It
depends on external chemicals rather than creating them on its own."

Compared to cocaine, crack is relatively inexpensive. It is a form of cheap
cocaine cooked down with other chemicals and making a cracking sound as it
crystallizes into small "rocks" in the bottom of a saucepan. Jordan and
nurse Lenoria Davis say the price has remained relatively constant through
the years at $10 to $20 a rock.

But crack is demanding. "The first use is the best, and people try to repeat
that feeling. So the amounts go up, and the frequency of use goes up," says
Jordan.

Davis says the drug meant more to her than simply euphoria. "It takes away
inhibitions. It takes away trauma. It's a freedom from emotional bondage
momentarily."

Growing up near Atlanta, she was sexually abused as a child and was part of
a family in which several relatives not only drank but distilled their own.
"When we're traumatized as little people, we grow up not knowing how to take
care of ourselves. Some people kill themselves. You can spell relief any way
you want to."

The "energizing" effect of the drug made her feel she could perform at a
high level. "It seemed to enhance my thinking process. I was more alert,
more energized. I would do more things. And it curbed my appetite, so I
could keep a figure."

But when she got pregnant, she couldn't give up the drug. "I couldn't
control the craving. It's overwhelming, devastating. It's out of control,
and it's like nothing you can do about it." In one climactic week, she was
fired from her hospital job when missing Demerol was traced to her. Then she
had a miscarriage, which she blames on her crack habit. "I had taken a life.
The fact that it was a secret (her drug use) made it even worse."

A year later, she got pregnant again. Living with her mother, she managed to
stay off drugs except for an occasional beer throughout the pregnancy. "My
mom knew by then (about her drug use). She was very supportive and
nonjudgmental. She kept faith in me."

But, as soon as the baby was born, Davis returned to drugs. "Then I started
realizing this was a hopeless situation. I thought, 'Do I want to die, or do
I have the courage to reach out?' I'm a very independent woman, and I don't
ask for help easily." She turned to what was then known as Charter Lakeside
Behavioral Health System, a for-profit treatment center.

Because she had no insurance, she was referred to Grace House, where Davis
says she was finally able to unburden herself about the sexual trauma of her
childhood.

She found people with secrets worse than her own. Within two weeks, she
says, physical cravings began to diminish. But, like veterans of Alcoholics
Anonymous, she still treats recovery as a one-day-at-a-time prospect. "You
will stay on the verge of relapsing, and you will relapse frequently if you
don't deal with the issues that you use to make you relapse." Each person
has his own "triggers," the issues or incidents that can lead to relapse.

Or relapse can occur through another drug that may be part of a dual
addiction. "A typical relapse pattern for a cocaine addict is to relapse
through alcohol," says Jordan. He compares the addiction to skydiving. "It's
thrilling, euphoric, a rush. You can't tell you're falling at 100 mph
because you're so far up there. Then you notice things getting bigger. If
you pull the rip cord early enough, you can land safely. If you're too late,
you can die. And, unfortunately, we do have people who die or develop very
serious secondary health problems."

Cocaine or crack constrict blood vessels, causing high blood pressure that
can lead to heart attacks or stroke. With high doses, users can become
delusional or paranoid or experience acute toxic psychosis with
hallucinations and perceptual distortions, says Jordan.

When a person finally seeks help, Orland says, it's "good news." When it's a
well-known person or someone in a position of power, it's even better news,
she says. "The truth is that's the chance they've got. And it loosens it up
for other people to say, 'OK, maybe it's OK for me to ask for help too.'"

Davis, who has been free of crack for 12 years, says people like Robert
Downey Jr. and Hooks have "all my support and love." Even now, if offered
crack, she says, "I would entertain the thought. I would feel the feelings.
Then I would remember where it would take me and that I wouldn't be able to
stop.

"At least now I know who I am and where I'm going. Before, I was just
going."