Pubdate: Sat, 18 Aug 2001
Source: National Journal (US)
Section: Health; Vol 33, No 33
Copyright: 2001 National Journal Group Inc
Contact:  http://nationaljournal.com/njweekly/
Details: http://www.mapinc.org/media/1172
Author: Siobhan Gorman

WHY THEY DON'T JUST SAY NO

Andrew, Morris, and Smurf do drugs. One smokes pot, one shoots heroin, and 
one pops pills. Carlings, after a life on the streets, is struggling to 
stay clean. Here are their stories.

Andrew is your typical software programmer. He planned to earn a computer 
science degree at a California university. But during his freshman year of 
college, he started working part-time in the high-tech sector, enjoyed it, 
and joined a local software company. At age 21, he's been in the workforce 
for three years and makes $45,000 a year, plus stock options, at a Seattle 
software company. Clean-cut and a slim 6 feet 1 inch tall, Andrew could 
have stepped straight out of a Banana Republic ad. He likes to snowboard, 
surf, and ride motor cross.

He's also your typical drug user. Andrew, who is white, smoked marijuana 
for the first time six years ago, as a high school freshman in Northern 
California. His best friend persuaded him to try it. "We did everything 
together," he says. "We went out to the woods and smoked way too much of 
the stuff. We had no idea what we were doing." Surprised by the 
unexpectedly strong buzz, Andrew and his friend waited a while before 
trying marijuana again.

Six months later, Andrew smoked marijuana with a few more friends, and then 
did a little drug research on the Internet. "As I learned more, I found 
that it would not really do significant harm." A few months later, his 
parents asked him whether he was involved with drugs. Not accustomed to 
lying, he answered yes. They shipped him off to the family therapist, who 
hypnotized Andrew and told him, "You're walking along a road and you see 
this weed. It's big, it's dirty. You don't touch it." Unpersuaded, Andrew 
asked the therapist whether he had ever tried marijuana. The therapist 
admitted not only to having tried it, but also to using it now. "I think at 
the time if he had said, 'This is evil. This is bad. Never do it again,' 
that probably would have done it."

Andrew's drug use continues today, and seemed to hit new heights last year. 
"There were crazy things going on in the whole software industry," he says. 
"I was thrown into a lot of things I wasn't ready for." To relieve stress, 
he smoked marijuana three or four times a week. He says he has cut back 
this year. A couple times a month, he'll smoke a joint. He recently tried 
Ecstasy: "I can't say I ever had that much fun before."

America's drug users look a lot like America as a whole-but a little 
younger. Their racial profile is identical to the general population's, 
according to the most recent annual National Household Survey on Drug 
Abuse. Most users are under 50 years old. Andrew's age group, the 
18-to-22-year-olds, has the highest proportion of users-19.4 percent. At 
that age, they're newly independent, and they're either making money for 
the first time or living on their own in college. The rate of use spikes 
again among people in their 40s, who presumably were the peace- and-love 
experimenters in the late 1960s and early '70s.

For lawmakers looking to reduce the demand for drugs, however, the real 
question is: Who makes up the drug-abusing population? Drug users tend to 
be young; for many of them, drugs are a passing phase. For those who become 
drug abusers, drug use is different. They see their lives taken over by 
drugs, and they often end up in hospitals or jail.

Drug abusers represent about 20 percent of drug users, but they account for 
about 80 percent of drug demand, said Mark Kleiman, a drug policy expert at 
the University of California Los Angeles. Drug abusers as a group are 
"poorer, darker, and younger than the population at large. They're socially 
marginal or they're rock stars. They use drugs because they're easy to get, 
and the consequences [for them] aren't that great."

The success of America's battle against drug abuse hinges, in part, on 
understanding who's using drugs-and why. Drug experts say that a more 
sophisticated understanding of drug use is the key to improving prevention 
efforts and to recognizing their limitations. (See story, p. 2602.) 
Otherwise, prevention techniques will keep on being about as effective as 
Andrew's hypnosis.

Hooked On Heroin

Many drug abusers look like "Morris." He's quite presentable-tall and 
clean-shaven, with an olive complexion and a medium build. As a precocious 
teenager growing up in a New England suburb in the late 1960s, he fastened 
on beatnik writers, not rock stars, as his role models. Morris, who asked 
that his real name not be used, fell in love with the notion that drugs 
would help him explore new areas of his mind. "I saw myself as an outsider. 
I saw myself as a drug user before I used heroin. I was very interested in 
it. As long as I can remember, I was interested in altered states of 
consciousness. I was interested in the limits of human experiences."

He was also interested in a girl. In 1968, when he was 15, Morris traded 
some marijuana for morphine. "I could have swallowed [the morphine 
tablets]. I could have sniffed them, but I had a crush on this girl who 
shot drugs. I thought that since I had this drug that could be used 
intravenously, it was a way to talk to her."

Surprised that the injection didn't hurt, he continued to shoot morphine 
with his crush. Several months later, he got hold of some heroin. "There is 
a 19th-century novelist whom nobody remembers: Edward Bulwer-Lytton. He had 
said that the experience of taking opium was like having one's soul rubbed 
down with silk. For me, the sensation of heroin was very much like that."

After he went from using heroin monthly, to biweekly, to daily, Morris 
began to realize he was dependent. He tried therapy, but it didn't work. He 
graduated from high school and cultivated a bohemian persona. He took some 
classes at a local college, but he didn't want a degree. "I liked [my 
lifestyle] very much," he says. "Women were attracted to me generally until 
they realized I had some problems that were rather serious, like using 
heroin. Aside from that, I had a lot of girlfriends."

In the mid-1970s, he was arrested on a drug charge. Awaiting trial, he 
found methadone. With his life more in order, Morris enrolled in college. 
But when Morris graduated in 1980, his doctor said that he'd been on 
methadone too long, and took him off it.

Morris returned to heroin, but he managed to enroll in a doctoral program 
in history at an Ivy League university. His use accelerated in 1982 when 
his sister, with whom he was close, died of a cocaine overdose. "I would go 
to a bar in the inner city-in the city I was living in-with my work. And I 
would sit in a stall, doing my grad work, waiting for the heroin dealer to 
show up." By 1985, heroin had become more important than his graduate 
studies. He began selling heroin to support his habit. Arrested twice, 
Morris served just under a year in a medium-security prison. When he got 
out, he met his daughter, who was born just after he entered prison.

Though unmarried, Morris was in a committed relationship and wanted to take 
on his new responsibilities heroin-free. He got a job with the national 
AIDS demonstration project as an outreach worker, and he eventually went to 
work for his city's public health branch, where he is still employed.

Morris relapsed into heroin use in 1997 when he had surgery and used 
painkillers during his recovery. "I probably wasn't as vigilant as I should 
have been." For a while, he was doing heroin at work, and that almost cost 
him his job. Now, at 47, he's back on methadone and does heroin and cocaine 
on the weekends. He doesn't expect to stop using heroin. He says, "It 
doesn't make my life chaotic, and it isn't hurtful to anyone."

In The Inner City

Carlings, a 46-year-old resident at the Clean and Sober Streets 
substance-abuse treatment center in Washington, has been clean for almost 
two years. He has a scar on his right cheek-from an injury sustained while 
playing Superman as a child. His gentle demeanor conceals his 
more-than-30-year battle with drugs, violence, and incarceration.

"I used drugs, I shot drugs, I snorted drugs, I sold drugs. I did 
everything that a person would do on drugs. I lied, I stole, I made 
enemies, I made friends. It got me to the point where my family wouldn't 
accept me," he says. "The low point was when I realized I had to sleep in 
abandoned cars. I didn't have a job; nobody cared. I went to McDonald's and 
washed up in there. I got on methadone. I got off of methadone. I used 
again. I got on methadone again. I got off of methadone." That was how 
Carlings spent his 30s.

His drug use started as a way to earn respect and money, and to escape 
inner-city life. In 1971, drugs felt like the norm, and Carlings was 
curious. A father at age 14, he started selling drugs, in part, to support 
his son. "School wasn't too good for me at the time, because I had too much 
business selling drugs. I dropped out in the 11th grade. Things were kind 
of like on the up-and-up, and I found myself meeting people, I was really 
popular with people, because I had the drugs." His using and selling began 
with marijuana, but by the time he was 17, he had graduated to LSD, PCP, 
cocaine, and heroin. And by then, he also had a daughter.

As Carlings used and sold more frequently in his early 20s, the environment 
around him began to change. "It was more the gangster type of atmosphere, 
where people supported their habits, and it was like an illness-you would 
get sick if you didn't have it." Confusing a drug order earned him six 
bullets, one of which remains in his left hip. "I was too caught up in it," 
he says. Carlings later lost his first son to "the life," as he puts it. 
Carlings Jr., shot 17 times in a gang-related drug deal, died at age 26.

When Carlings was in his mid-30s, he was arrested in a crack house and 
charged with dealing cocaine, heroin, and marijuana, as well as with gun 
possession. He went to prison for four and a half years. "Gettin' locked up 
was probably the best thing in the world that happened to me. I got a 
little bit of a sense of what was going on. When I got out, I started to 
work again."

Carlings, then 40, took a job as a janitor at a neighborhood Baptist 
church. But the mother of his two younger children had just died, and the 
children were placed in foster care. He was grieving, battling addiction, 
and fighting for custody of his children. He relapsed-cocaine, heroin, 
crack, marijuana. "I figured maybe I'd use some drugs to feel a little bit 
better about things."

Within two years, he quit his job because he couldn't face work every day. 
After an overdose landed him in the hospital, Carlings went to a homeless 
shelter. His condition improved, and he got another job. With the job came 
cash, and with the cash he bought crack.

At last, at age 44, he checked himself into Clean and Sober, which was next 
door to the homeless shelter. "I knew that if I really wanted to get these 
kids back, I needed to stop playing and face the truth about it-that I have 
a drug problem." Now, almost two years later, he's a cook at Georgetown 
University and has a stable income. As soon as he finds a place to live, he 
says, he'll win custody of his children.

Party Girl

  Her club name is Smurf. Her real name is Kristina, and she lives in a 
suburb of Salt Lake City, Utah. She first tried Ecstasy this past New 
Year's Eve. She'd turned down chances to try it before, because she didn't 
know what it would do to her. But her friends talked her into it. "I was 
scared at first, but my friends were like, 'It's really fun.' "

In fact, Kristina was the one to make the buy. She and her friends had 
driven to a nearby town in the afternoon, to the parking lot of Albertson's 
grocery store. They picked Kristina to seal the deal. Her heart beating 
fast, she walked over to another car, where a friend of a friend was 
waiting. She paid him $125, and he handed her five pills.

That evening, about 30 minutes into the hour-long drive to a downtown club, 
Kristina and her friends each took one of the pills. Before long, "my 
friend turned around, and she started laughing," Kristina, a slim, 
blue-eyed, flirtatious blonde, recounted with a giggle. "She said, 'You 
have a Perma-grin!' I just started laughing, and I started rubbing my hands 
together, and I couldn't stop." Her hands felt like gummy bears, she says.

At the club, Kristina and her friends danced until 2 a.m. Her favorite 
activity was to have her friend pick her up and swing her back and forth 
like a pendulum-"I felt like I was floating." Back at a friend's house 
after the club closed, Kristina professed her love to everyone there. "You 
like to be touched. You hug people. You say the 'L' word a lot."

She was a convert. Having dropped out of high school a year earlier, 
Kristina began taking Ecstasy a couple of times a week. She then started 
selling the pills to support her emerging habit, which was costing her 
between $50 and $250 a week. It wasn't hard, however, to hide her habit 
from her parents. "I had my own cell phone, so all the phone calls I needed 
to make, I could do from that. I just told them I was going dancing."

Within a couple months, her friends talked her out of selling. "They didn't 
want to see me get thrown in jail or something like that." Now, she has cut 
back to once a month, and she's working toward her GED. Why doesn't she 
stop completely? "I'm working on it," she says.
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MAP posted-by: Beth