Series: Part 2 Of 5

DRUG CRAVING LATCHES ONTO BRAIN - AND GROWS

Editor's note: Abuse of alcohol and drugs is a Utah epidemic. One out of 20
Utahns has a substance abuse problem needing treatment. The Deseret News
examines addiction in a five-part series focused through the eyes of former
and current addicts as they run the gamut of political, social, economic
and medical factors associated with those addictions.

Second In A Series

The buzz was big in Hollywood five years ago about Terry H. but not as big
as the mixture of heroine and crack ringing in his own head that eventually
drowned out everything else.

Before the highs and before he was 20 years old, Terry had produced two
albums for an arena-level band. A debut album as vocalist, guitar and bass
player with his own group was praised by one reviewer as "alarmingly fresh"
and comparable to the venerable Kinks and the Replacements. He is the only
person his producer ever knew who simply walked into Los Angeles and got a
record deal.

It's all gone now - the live shows, the stacks of Marshall amplifiers, the
fat paychecks, even the original gold Gibson Les Paul electric guitar - all
of it literally pawned and huffed away.

"I ended up with a mattress and a book on the Beatles," says Terry, now in
Salt Lake recovering and clearly buoyed by gratitude that he is no longer
that "skinny and tweaked-out guy hidden under all that ugliness.

"It got so bad and out of control that I would pick up the phone, dial 9-1
then fire up the pipe, and if I felt like I was going to pass out I would
hit the other 1." He watched a buddy give a homeless guy his Jeep and 50
bucks on the promise of a score. He would rent cars and wake up three days
later not remembering a thing, with no idea where he was and the car with
no gas. "I probably just let it sit there and idle out and not know it. It
was the perpetual lost weekend."

Terry, 27, doesn't laugh when he tells those stories. They make him feel
embarrassed and guilty that he used to be "utterly thrashed" on drugs. "I
can't tell you how great it feels knowing when I wake up in the morning my
biggest worry is getting the newspaper and a cup of coffee."

Turns out your brain on drugs really is something like an egg burning in a
frying pan.

Depending on the form and dose, drugs in a way fry the brain's pleasure
center. They chemically and sometimes permanently singe the circuits. Each
little wave of drug ultimately amounts to a cascade of neurobiological
changes over time, ranging from nearly indescribable euphoria when it is
first ingested to excruciating illness at withdrawal.

"The high that drugs give you is like taking the best feeling, emotional
and physical, and times-ing it by at least a thousand," says recovering
addict Roger Ashworth, who was doing "the high of highs" for seven years -
injecting heroin and cocaine simultaneously. "But you ultimately pay for
that feeling, either by kicking it or dying."

Ashworth hasn't done speedballs for a couple years, and he hasn't been sick
since that day he threw up 120 times ("I counted") when his addiction was
at its worst.

He's says he's gotten control and is starting to get his life back with a
daily dose of methadone.

Although some critics - including Alcoholics Anonymous - say that the
synthetic narcotic just replaces one illegal drug for a mostly legal one,
Ashworth and dozens of others who take methadone through Discovery House in
Salt Lake City say it is the only reason their lives have finally taken on
an even keel.

"This is the first time I've been clean my whole life," says Kim, 45, a
hairdresser from California who ultimately became a prostitute in Salt Lake
City before she found God and methadone "in that order" and got her life back.

"I was so naive that I didn't even realize I was hooked until I told my
boyfriend one day that I was feeling like I had a really bad case of the
flu," Kim said. "He said, 'You are so stupid. You don't have the flu,
you're a junkie.' I wouldn't believe it. But he came over at lunch, and 20
minutes later I was feeling fine. I cried and cried. But I didn't stop using."

She couldn't. Her brain had begun chemically craving the drug. It wasn't
just coaxing her to get some, it was making her physically sick in order to
get it.

Kim's brain and those of others who are hooked on any psycho-active drug -
from nicotine to caffeine to alcohol to narcotics - became diseased. In her
case, without heroin, any kind of pain was practically debilitating. The
nausea would be constant and deep. She would sweat and even start to shake.

"My high had turned into an ugly monster," she said. "I had four choices:
I'd go crazy, I'd die, I'd be institutionalized - meaning jail - or I'd
have to kick it."

Methadone calms an addict's frayed circuits that are inducing the spate of
unpleasant physical side-effects when their usual drug is taken away. It
targets the same chemical receptors in the brain that a narcotic does but
acts so slowly that users don't get high. It's a little like someone who
has a deep craving for a double cheeseburger managing to satisfy the
hunger, for a while, with a bowl of soup.

"The sensation is much different," says Steve Davis, who became addicted to
painkillers after breaking his leg hiking in southern Utah. "It doesn't
make you high, but it quiets the craving enough that you stop obsessing
about getting the drug and can get on with your life."

As anyone who has gotten a bad headache without their morning coffee or
their daily Big Gulp of Diet Coke can attest, drugs aren't done with you
just because the increased sense of energy or well-being or even an acute
high have passed.

Research is showing that the more you take an addictive drug, the more
neurotransmitter receptors you wipe out as the brain reacts and tries to
quiet an overactive reward center, says Glen Hanson, a University of Utah
neuroscientist, co-founder of the Addiction Research and Education Center
at the U. and the acting director of the National Institute on Drug Abuse
in Washington, D.C.

As a result, a kind of law of diminishing returns kicks in, and the amount
of drug that used to bring pleasure has no effect and doses have to be
bumped up, Hanson says.

And because the effect of the drug doesn't feel like it used to - people
say things such as "the beer doesn't taste the way it ought to" and things
like that - "they believe the only option is to do more," Hanson says. "So
that initial desire to have an immediate and acute high becomes over time a
constant chase to find the drug to avoid acute and relentless physical and
emotional despair."

It is a disease that may have begun as a willful act in the beginning, much
like heart disease is often a condition of willfully eating a high-fat diet
and choosing not to exercise.

"But it is the result of literal and probably permanent alteration of brain
structure and brain chemistry," Hanson says. "And for people to tell
addicts it's their fault is like telling someone it's their fault they got
cancer. And just telling them to stop is like telling someone with
Parkinson's disease not to tremor."

Davis says he has thought about just stopping the methadone and going
through being sick for a few days. If he did that, as awful as it would be,
wouldn't he come out the other side cured of his addiction?

"White-knuckling it doesn't really work," he said. "It's not that I don't
think I could do it. I went through a lot of pain climbing back up that
cliff with a broken leg. I think I could take it. The problem is people
almost get a high after coming through that and then a day later they are
in a deep depression. Besides, I've got five years of problems I've created
because of my habit. Methadone is giving me the time to deal with those and
maintain my life."

The other insidious aspect of narcotics, besides doing their job really
well, is they create whole new appetites and cravings, says Charles Walton,
the consulting physician at Discovery House and director of the state
Recovery Assistance Program with the state Department of Commerce.

"It's like having deep new hungers that can't ever be satisfied again," he
said. "You know you can't feed them, or you'll be back in that crazy cycle
again, yet your brain never forgets how good it felt to use them."

It's like people who love chocolate can easily recall how good it is and
can even salivate thinking about it and then being told they can never have
it again."

If there are certain people who have addictive reactions to taking drugs
and there are definite neurobiological changes as a result of use, are some
people simply wired to be more willing to try drugs?

Genes can reduce the risk of addiction, and some people seem to have
built-in reactions such as palpitations and other unpleasant side- effects
that don't make them attracted to drugs.

Research has also shown that human beings, for whatever reason, have always
sought to alter their state of consciousness. In fact, the oldest written
recipe is purported to be a Sumerian beer formula on tablets about 10,000
years old.

Ancient civilizations often sanctioned hallucinogenic drugs, usually within
the context of religious ceremonies.

Modern society has a virtual cornucopia of drugs to choose from, most
highly addictive and neurologically destructive.

"I was a good kid, but I was always willing to seek a thrill," Ashworth
says. "The only thing I can equate (doing drugs) to for people who haven't
tried it is sky-diving. It's like you go up to that open door and you may
back away a few times, but you want that thrill, you've heard about it and
so you eventually jump."

"Some people tend to just want to try things," says James Gibb, U. research
center director and U. College of Pharmacy professor, noting that figuring
out decisionmaking processes that go into drug use - why some do and some
won't - is one key areas for research at the center.

"We don't expect that more research will alter human nature," he said. "But
while we all know the widespread effects of these addictions, we still know
very little about what makes one person a non-user or moderate user and
what sends another into oblivion."

Mickey had always eschewed drugs, even as a teenager when her friends were
experimenting. She didn't even like to take legal drugs prescribed by her
doctor.

Her mantra was simple. "I had to feel things for myself, to experience
things as they were without the effects of drugs clouding my mind," she said.

Mickey, a recreation and mental health therapist, often worked with drug
addicts, and she saw firsthand the devastating effects of addiction.

"Never ever in my life did I think I could do drugs of any kind," she said.

That resolve withered when a back injury left her with pain so severe she
contemplated suicide. "I wanted to swim with the blow dryer," she said. "Or
open a vein."

Doctors treated the pain with powerful prescription pills, but the pain
never went away. In fact, it was getting worse, and so was her depression.
Suicide was always on her mind.

In desperation, Mickey, now 39, turned to a young woman living across the
street for help. Mickey knew the young woman had access to heroin from her
dad's stash. Her neighbor was glad to help.

"For the first time in five years I was pain free," she said. "I was
ashamed, but I could function."

Mickey kept her heroin secret from all who knew her. Not even her closest
friends suspected, nor did her employers, who were happy to have her on the
job and functioning. But she was spiraling out of control and she knew it.

"One day I told myself I would quit or die," she said. "And I laid in bed
and wanted to die."

Her roommate took her to Discovery House, a methadone clinic where she has
now been heroin-free about eight months. The methadone kills the back pain
and dulls her cravings for heroin.

"I thank God for methadone," she said. "I am able to live again."

Tomorrow: Addiction's crimes and punishments.