BABY STEPS BETTER THAN NONE IN KICKING DRUGS, SAYS ER
DOC

Society should lower its expectations of how clean crack and meth
addicts should stay when they're trying to kick their habits, says the
chief of emergency at Kelowna General Hospital.

Jeff Eppler sees up to five drug addicts who need treatment in his
department every day. Instead of expecting total abstinence, he
believes those addicted to crack cocaine or crystal meth should be
applauded for even small accomplishments.

"I figure if someone's off the drug for six weeks, that's a success.
They weren't stealing or prostituting. Six weeks is better than no
weeks," Eppler said in an interview.

"We have to accept that as long as there are drugs around, a certain
proportion of the population will get addicted to them, and there's
nothing we can do to help them."

Crack remains the drug of choice among hardened addicts in the Central
Okanagan. Crystal meth is growing in popularity among the younger
crowd because it's cheap, long-lasting and easy to make, says Carmen
Lenihan, facilitator of the Central Okanagan Crystal Meth Task Force.

"It does such a tremendous amount of damage to the brain chemistry in
such a short period of time," she said.

Crack and meth addicts are proving difficult to treat. You can't put a
patient through maintenance programs like you can alcoholics or heroin
addicts, Eppler said.

"For opiates, you've got the methadone programs, which help a lot of
people. It's a good thing. . . . With alcohol you have Alcoholics
Anonymous, I suppose, which also helps a lot of people.

"For cocaine and crystal meth, it's a different kettle of fish. . . .
It really seems to mess up people's brains more than any other drug.
It's a really profound craving. I don't know what the answer is."

Crack users are sometimes psychotic, Eppler said. They don't withdraw
the way people do from alcohol or heroin, which often leads to severe
cravings and physical withdrawal. They're not usually violent, but
they're often paranoid and fearful. Sometimes they're "wild," he said.

"With cocaine, crack and crystal meth . . . it's mainly psychological
withdrawal. When people use a lot of crack or crystal meth, they can
(have) psychosis. They lose their grip on reality. They become acutely
paranoid."

Patients high on crack or meth are sometimes strapped to a bed so
staff can sedate them. They settle down quickly because they've
depleted their neuro-transmitters from lack of sleep. Staff often
can't rouse them for a full day.

"They need to replenish everything. They're just gone. They end up
tying up a stretcher. They don't have a home half the time," Eppler
said.

The biggest problem with crack and cocaine are the social problems -
homelessness, poverty and crime, he said. Some die from taking the
drugs, but not often from an overdose. It's usually deprivation that
gradually eats away at them.

"And you see these people come in. They just look awful. They're all
really skinny and scabby, and they look 20 to 30 years older than they
really are. They pick at their skin, they get sores on their face, and
it's just tragic," Eppler said.

Lifelong sobriety probably isn't an option for many of them. Experts
should try at least to help them be clean for longer periods of time,
Eppler said. They need life skills, psychological counselling and more
social supports.

"You have to aim low," he said. "People need to stop moralizing about
drug abuse. . . . It's an illness. We have to accept it as such."