Pubdate: Thu, 24 Feb 2000
Source: Tampa Tribune (FL)
Copyright: 2000, The Tribune Co.
Contact:  P.O. Box 191,Tampa, FL  33601
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Contact:  Mike Stobbe

COCAINE ONE OF THE MOST ADDICTIVE DRUGS, EXPERTS SAY

TAMPA - Darryl Strawberry's drug problem highlights the potent effects
of cocaine use.

When he heard baseball star Darryl Strawberry had again tested
positive for cocaine use, Ken Thompson wasn't shocked.

``Not a surprise,'' said Thompson, medical director at the Florida
Recovery Center at the University of Florida in Gainesville.

``The relapse rate for cocaine is very high,'' he said.

Indeed, cocaine is regarded as one of the most addictive of all drugs,
by both the clinicians who treat addicts and the chemists who study
how drugs affect the brain.

``People say, `Why doesn't this guy stop? Look at all the things he's
got to lose?' '' Thompson said. ``But maybe he can't stop.''

Experts say a person who is years into apparently successful recovery
can suddenly start sweating, aching and yearning for cocaine.

The reaction can be triggered by something as simple as the sight of
the addict's old dealer, or the smell of a perfume worn by a
girlfriend with whom the addict used to smoke crack.

Studies have shown that just the sight of cocaine can raise an
addict's body temperature and blood pressure.

``You don't see that with other drugs,'' said Robert Neri, director of
clinical services for Phoenix House of Florida, which runs a 165-bed
treatment center in Ocala and a 15- bed re-entry facility in Tampa.

Cocaine addicts drop out of treatment at a higher rate than the
addicts of any other substance, Neri noted.

Cocaine's power comes from how it disrupts brain chemistry, scientists
say.

People feel pleasure or happiness through the release of certain brain
chemicals, including dopamine. A good joke or sex can trigger the
release of dopamine, which is then picked up by brain cells, processed
and recycled for future release.

Cocaine can start a flood of dopamine, prompting a sensation of
unparalleled pleasure, scientists say.

But the brain apparently doesn't want too much of a good thing and
takes steps to preserve a chemical balance, some researchers say. For
example, after repeated use, brain cells may stop taking in dopamine.

The result: Recapturing that initial high or even feeling pleasure at
all becomes more difficult.

``You feel so good, and then you need it to get up from feeling so
bad,'' Neri said.

The dopamine reception problem is only one theory.

In an article published in September in the journal Nature,
researchers noted that a protein called delta-FosB appears in the
brains of cocaine addicts. Scientists believe repeated cocaine use
throws a genetic switch that causes production of the protein. They
think that enhances sensitivity to cocaine and may contribute to
cocaine addiction.

``There's a lot of chemistry we don't know about,'' Thompson
said.

Of course, there is more to addiction than chemistry. Experts say
pre-existing depression can be a factor, as can social stress or loss
of a job or spouse.

Neri said he was not familiar with the specifics of Strawberry's case.
But generally speaking, professional athletes who have used cocaine
feel a greater attraction to the drug at certain times in their lives.

First, Neri said, drugs appeal to an athlete when he enters a
professional sport and is dealing with the new monied lifestyle.
Second, an athlete can be tempted after suffering a confidence-shaking
injury. Third, an aging athlete can seek drugs to help him deal with
the reality of having to retire soon.

Strawberry has faced all of these stages, including a dramatic rise to
stardom with the New York Mets in the 1980s and a struggle with colon
cancer in 1998. As he reported to spring training this month with the
New York Yankees, he was only a month from his 38th birthday.

Here's another challenge facing Strawberry and other athletes: The
pressure to return to the lineup makes it difficult to go through 10
or more months of uninterrupted drug treatment, Neri said.
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