Pubdate: Sun, 12 Nov 2006
Source: Tampa Tribune (FL)
Copyright: 2006 The Tribune Co.
Contact: http://www.tbo.com/news/opinion/submissionform.htm
Website: http://www.tampatrib.com/
Details: http://www.mapinc.org/media/446
Author: Jan Hollingsworth, The Tampa Tribune
Bookmark: http://www.mapinc.org/youth.htm (Youth)

GHB A BROKEN MIND

BRANDON - The young wrestler was sitting on the kitchen floor, his 
bloody face illuminated by the early-morning light that streamed 
through a nearby window. In other parts of the world, the shadow of 
the moon was edging across the rising sun, marking the beginning of a 
dramatic and well-publicized total eclipse.  Will Hollingsworth had 
talked of little else for the past four days: the last eclipse of the 
millennium and the apocalypse some believed would follow.  He had not 
slept in more than 100 hours, holed up in his room, paging restlessly 
through a Bible, his television tuned to news of the eclipse.  It was 
a peculiar obsession for a 20-year-old college student who spent most 
of his time training to be a world-class athlete.  Will didn't appear 
intoxicated. To the contrary, he was alert, engaging and 
philosophical, though strangely fixated on current events.  Now this.

On any other day, he would have been out the door - running for miles 
along eastern Hillsborough County's busiest roads, pumping iron at 
the gym, working out with his old high school wrestling team.

But on this August morning in 1999, there was only the inexplicable 
blood and the vacant stare that greeted me when I came to make breakfast.

"What happened?" I asked my only son.

"I've been fighting demons," he replied.

Demons?

"It's true," he insisted, gesturing to his bloody face and filthy 
shirt. "I've been fighting demons all night. And I won."

I followed his gaze through the window into the back yard. There, the 
torn sod and blood-stained patio marked the spot where he had pounded 
his face into the ground as his father and I slept, oblivious to the 
war we were about to wage with an invisible enemy.

Will would battle his demons for the next three years. But he would 
never exorcise them.

GHB had already laid claim to his sanity, and there was no one who 
could tell us how to retrieve it. Dying To Win

Trinka Porrata is all too familiar with the phenomenon of young men 
who speak of mortal conflict with demons - men who pound their heads 
on concrete as they experience the unique and little-known psychosis 
that accompanies GHB withdrawal.

"I can't tell you how many times I've heard about that," said the 
retired Los Angeles narcotics detective. "Some of them try to put 
their heads through plate-glass windows."

Some succeed.

Porrata, founder of Project GHB, has spent seven years throwing a 
lifeline into cyberspace for addicts desperate to escape the grip of 
a nutritional supplement promoted as a safe, non-habit-forming sleep 
aid that claimed to build lean muscle mass.

Most have been athletes or bodybuilders, but GHB use cuts across all 
demographics.

"It's the most unique drug," she said. "We have a lot of senior 
citizens hooked on it thinking it's antiaging. It's big in the gay 
community, big in the gym scene, big in the club scene. Yet it's invisible."

Porrata said she has had more than 1,800 inquiries from GHB users and 
their family members since Project GHB went online in December 1999.

"We were getting: 'I thought I was the only person in the world with 
this problem,'" she said.

Before Project GHB, anyone looking for information on the chemical 
discovered a nest of Internet sites featuring glowing testimonials, 
mail-order supplies and recipes for cooking it at home.

Central Florida, with its fitness culture, was a watershed for the 
craze during the 1990s, before GHB-related products were outlawed.

Tampa had its own cottage industry in the form of Body Life Sciences, 
a now-defunct company that produced and marketed the supplement under 
the brand names Revivarant and Revivarant G.

GHB seemed to offer something for everyone, depending on the dosage: 
sedation, exhilaration, sexual stimulation, weight loss and the 
unsubstantiated promise of massive muscles.

It was readily available at health food stores and gyms, where it 
entered the marketplace as an ostensibly safe, legal alternative to steroids.

In recent years, its ability to induce mild euphoria and amnesia 
attracted a new kind of customer who employed it as a party drug 
associated with overdoses and sexual assaults.

GHB's link to date rapes and all-night raves quickly overshadowed its 
widespread use in the athletic community. Yet it is the athletes and 
bodybuilders, who incorporate it into a daily regimen, who are most 
at risk of becoming addicted.

"It's really the frequency of the dose as opposed to the amount of 
the dose that leads to this very striking psychosis," said David 
Kershaw, a psychologist for Hillsborough County's Mobile Crisis Unit.

Kershaw has seen his share of GHB addicts in withdrawal - beginning 
in late 1999, when the county's mental health center saw a rash of 
cases involving muscular young men suffering from hallucinations and paranoia.

One believed he had an invisible tape recorder fastened to his leg. 
Another saw a swarm of flies covering his body. All were regular users of GHB.

"The irony is that despite the fact that they wouldn't deliberately 
pollute their bodies like that, they get sucked into using it," 
Kershaw said. "The people I see are all athletes, all concerned with 
being as healthy as they can be."

One of them was Will. The Runner Stumbles

Will's descent into madness was swift and seemingly irreversible.

The first sign that something was amiss came one night in the spring 
of 1999, when he called to ask his father to come help him change a 
flat tire. It turned out the tire was flat because Will had drifted 
off an exit ramp on Interstate 75 and into a tree.

Weeks later, another late-night call - this one from an 
ex-girlfriend, who said she had received an urgent message from Will 
asking her to pick him up at a gas station near the University of 
South Florida.

When she arrived, she found the car, with the engine still running, 
the driver's door ajar, but no sign of Will. He turned up at another 
nearby gas station - incoherent, with no memory of how he got there.

His father and I were mystified. Will seemed as bewildered as we were.

"I keep making mistakes, and I don't know why," he said.

He never made the connection between the potion he bought at the 
local health food store and the bizarre things that happened when he 
stopped using it.

We didn't know he was using GHB. There were a lot of things we didn't know.

The Will we knew was exceptionally bright, responsible, hardworking 
and honest. A good student, a loyal friend and - most striking - a 
gifted athlete with a passionate dream to be the best of the best - 
at something.

He was, at one time, the fastest boy in Hillsborough County - 
sprinting and jumping his way through a medley of track-and-field 
titles during his middle school years.

There was a charisma about the sturdy blond boy whose blistering 
speed brought stadium crowds to their feet as he entered the homestretch.

When he earned a place on the Brandon High School wrestling team - 
one of the premier prep athletic programs in the nation - he told a 
sports reporter what it meant to soar with the Eagles.

"I feel there is no limit to where I can go," he said in a 1997 
newspaper interview. "It is a great team and I don't think my life 
will ever be the same." Death And Detox

About the time the young wrestler was beginning to unravel in 
Florida, bodybuilder Mike Scarcella, a former Mr. America, was 
arrested in Texas, charged with felony possession with intent to 
distribute GHB.

The U.S. Food and Drug Administration had banned the supplement in 
1990 but left loopholes that allowed its analogues - chemical cousins 
that turn into GHB after ingestion - to be sold for another decade.

By all accounts, including his own, Scarcella had been using the 
supplement for years - first as a muscle-building nightcap, then as a 
morning pick-me-up. Eventually he was sipping capfuls throughout the 
day, a classic pattern among athletic users that can lead to physical 
dependence in a matter of weeks or months.

Scarcella was hooked. His May 1999 arrest, which resulted in 10 
years' probation, was not enough to pry him from the grip of GHB.

The 1992 Mr. America continued to use and sell the drug, even as he 
tried to kick the habit - first on his own, then in hospitals, where 
doctors had no experience with the bizarre hallucinations and raging 
psychosis of GHB withdrawal.

Even with a doctor's help, withdrawal can be deadly.

Stroke, heart attack and suicide are among the consequences for 
addicts in withdrawal, which can start within one to three hours of a 
missed dose.

Anxiety, restlessness and insomnia can progress quickly to delirium, 
muscle tremors and delusions.

"They think they're on fire. They're moving, thrashing, screaming," 
said Karen Miotto, a University of California-Los Angeles addiction 
psychiatrist who helped develop a GHB detox protocol.

"I think GHB is probably harder to get addicted to than some other 
drugs," she said. "But once people get addicted, it is far harder to 
get off than any drug I've seen."

Scarcella's battle ended in August 2003, when the 39-year-old 
bodybuilder was admitted to a Texas hospital feeling the first 
effects of GHB withdrawal. By the 10th day, he had become delusional 
and suffered what the medical examiner termed "sudden cardiac death."

Doctors and psychiatrists have been slow to recognize GHB withdrawal. 
Most know little beyond its reputation as a date-rape or club drug 
with the potential to deliver a swift, deadly knockout punch.

Emergency room physicians have become familiar with the unconscious 
overdose patients - generally youthful partiers - who are often 
treated and released.

But they rarely consider GHB use in the muscular, hallucinating 
patients who are delivered in four-point restraints.

"ER doctors don't really know what to look for," Kershaw said.

Most physicians and mental health professionals also fail to 
recognize the early stages of withdrawal, when careful detoxification 
using the right medications might head off a spiral into psychosis.

"It really means that the only time they're going to get help is when 
they've reached the state of hallucinating," said California 
addiction specialist Alex Stalcup. By then, their condition may be 
far less treatable.

"It's just heartbreaking." Jesus' Son

The angels appeared in September 1999, shortly after the eclipse that 
marked the end of life as we knew it.

These were not benevolent guardians, but mute, shadowy creatures only 
Will could see.

What was their purpose? I asked him.

"They're here to watch us," he said.

Not as protectors but observers. They were neither dangerous nor 
benign. They just WERE, he said.

Six weeks had passed since the morning of Will's bloody battle with 
the backyard demons.

His father and I had spent the first week taking turns staying home 
from work with him as he slept round-the-clock, sedated by a physician.

The sleep deprivation that preceded the incident was enough to cause 
hallucinations, according to a psychologist friend. Perhaps sleep 
would bring him out of it, she suggested.

We knew by this time that GHB had played some role. Will had 
acknowledged taking the supplement in the week before the eclipse. 
But he had stopped about three days before, he insisted.

When Will finally woke up by week's end, the crisis seemed to have passed.

He returned to his part-time job as a waiter at a Brandon restaurant 
and began his junior year at USF. With his sights set on the Olympics 
since high school, he resumed his regular workouts - and, according 
to his off-campus roommates, resumed his GHB use.

"It takes you to a place you never want to come back from," Will said.

On Labor Day, he was back home, reading the Bible around the clock. 
He stopped attending classes, didn't report for work and did not 
return to the apartment he shared with three other students. He had 
stopped taking GHB.

He also had ceased his workouts and stopped eating. He claimed he was 
going to fast for two weeks - "like Jesus."

Once again, his father and I took turns working from home, watching, waiting.

He was, by law, an adult and could not be forced into an evaluation 
unless he proved to be a danger to himself or others. He didn't meet 
that criterion - not yet.

His father took his car keys, just in case.

Sept. 17, 1999. It was my turn to watch over Will.

I worked on a news story from my laptop on the dining room table, 
just outside his bedroom. Each time I checked on him, he was sitting 
on his couch, reading his Bible. He had not eaten since Sept. 6.

Shortly before 6 p.m., Will wandered out of his room and pulled up a 
chair across from me. My fingers froze on the keyboard as I met his gaze.

"What are you working on?" he asked.

I knew he couldn't possibly be interested, but it was the first time 
in weeks he had made any effort to engage in conversation. I began to 
explain the story I was writing.

Then I saw it, so plainly that for a moment I thought I was the one 
losing touch with reality.

Will's gray-green eyes, the windows to his troubled soul, suddenly 
transformed into black pools of blazing madness. And for the first 
time, I understood the concept of possession.

I was still answering his question when he cut me off in midsentence.

"You don't know who you're dealing with, do you?" hissed the suddenly 
dark, dangerous creature.

"No," I replied, cautiously. "Who AM I dealing with?"

He rose from his chair and took a step toward me, his fist clenched, 
his face contorted with rage.

"I am the Lord Jesus Christ, and I want my car keys."

I glanced at the clock. His father was due home any time now.

Will's lips smiled, but his eyes still glittered with that dark madness.

"He's not going to save you," he said, as though he had read my mind.

The phone rang. Will answered.

"Yeah, Dad. She's right here," he said, handing me the phone, still 
smiling that frightening smile.

Whatever I had seen in Will's eyes, his father heard in his voice.

"Can you talk?" he asked me.

"No."

"Something is wrong?"

"Yes."

"Get out of the house," Will's father told me. "Get out NOW."

Clearly the time for watching and waiting was over. His father dialed 911.

That night, the angels made their first appearance as Kershaw and his 
mobile crisis unit came to commit Will for 72 hours of psychiatric 
observation under Florida's Baker Act - the first of nearly a dozen 
hospitalizations over the next 30 months.

It wasn't a tough call. Will was in "florid psychosis" and claimed 
alternately to be God, Jesus and Jesus' son.

Then there were the angels, who would, in time, become Will's 
constant companions.

Kershaw was among the few professionals we encountered over three 
years who took serious note when we told him of the GHB link.

"Will's case prompted me to educate myself on this," he said. "If I 
have someone who's got psychotic symptoms, and they've got a history 
of being a fairly well-functioning athlete with no history of mental 
illness, one of the first things I think of now is GHB." Spontaneous Combustion

GHB was the last thing David Johnson thought of as he searched the 
Internet for information about Enliven, a supplement his 28-year-old 
son, Tyler, purchased at a health food store near his home in Beebe, Ark.

Tyler, who had graduated weeks before from the University of 
Arkansas, became restless and "fidgety" on the night of July 15, 
2000. His pulse raced, and he began to say things that didn't make 
sense, Johnson said.

Unknown to Johnson, the young bodybuilder had been taking Enliven for 
about a year. Now, engaged to be married and about to begin law 
school, Tyler had decided to stop taking it.

That night, he showed his father a bottle of the supplement, labeled 
as a "100% Pure Cellular Recovery System" that "Renews the Body Naturally."

What it didn't say was the active ingredient - 1,4 butanediol, better 
known as BD - is a solvent that converts into GHB once ingested.

Johnson didn't know it, but Tyler was in GHB withdrawal.

"I wanted to take him to the hospital, but he told me he was all 
right and he went to bed," Johnson said.

The next morning, shortly after dawn, a neighbor discovered Tyler's 
body on the Johnsons' front lawn. He had shot himself in the head.

Suicide is an all-too-common outcome in cases of GHB addiction, 
though the true numbers will never be known.

Porrata has seen it over and over.

"It's like spontaneous combustion, not like they pondered it. They 
just shoot themselves in the head," she said.

Detox from GHB can take at least two weeks.

"I think one of the most dangerous periods is after detox, where they 
are suffering depression, anxiety, and it becomes this protracted 
withdrawal state," said Miotto, of UCLA.

GHB anxiety is malignant - the frightening dreams at night, the 
terror during the day as the central nervous system tries to deal 
with the legacy of a little-understood chemical assault on the brain, 
said Stalcup, the addiction specialist.

"If I had to go through what I see people going through, I don't know 
if I could do it," he said.

Perhaps the harshest irony, Porrata said, is the people who become 
addicted to GHB in the pursuit of health and fitness and end up 
turning to street drugs to counter the effects of withdrawal.

Black-market Xanax, Valium and similar drugs tend to be the ones of 
choice. Alcohol, cocaine, Ecstasy and even crystal methamphetamine 
aren't far behind.

"They all say that GHB leaves a hole in your soul," Porrata said. 
"They say it's the worst drug there is: 'I could get off of heroin. I 
couldn't get off of G.'" Of Dreams And Nightmares

In the weeks and months that followed Will's first Baker Act, life 
took on a rhythm of sorts - but not the sort we envisioned.

By day, Will continued to run, lift weights, wrestle and pursue his 
athletic dreams.

By night, he battled the demons that invaded his sleep.

The boy who once was a designated driver for friends retreated to his 
room, alone, to drown the delusions in rum and vodka.

His circle of friends shifted from students and athletes to dropouts 
and drug dealers who could ensure a steady supply of sedatives and 
anything else that might quiet the voices and visions.

I purchased a dreamcatcher and hung it beside his bed, hoping the 
mystical Indian legend would offer some comfort.

But nothing could banish the nightmarish images that appeared when he 
closed his eyes.

"You can't imagine what is happening in the world," he told me.

"Yes, I can." I had to look no further than the gaping hole in his soul.

Laced with antipsychotics prescribed by his doctors, supplemented by 
a pharmacopia of his own invention, Will struggled to hold down a job 
and tried to complete his junior year.

He teetered for months on the brink of madness, alternately 
stabilizing, then disintegrating into a series of forced hospital stays.

We didn't know whether he continued to use GHB or whether the drug 
had permanently rewired his brain.

"With Will, when I saw him again and again, I wasn't sure if the GHB 
had triggered more of a chronic process with him," Kershaw said.

Each time Will was committed, we asked the nurses and doctors to flag 
his chart to reflect his GHB use - a request that often was received 
with blank stares and dismissive waves.

Will continued to slip from our grasp, trapped in a world inhabited 
by demons and angels, a world defined by the absence of light or joy.

We wondered how long he could survive in such a dark, hopeless place.

It didn't help that he had come to believe he possessed the gift of 
prophesy and claimed to have seen his own death many times.

He wouldn't tell us when this was to occur. All he would say was that 
it involved fire. Drowning In Cases

In the beginning, the addicts who flocked to Project GHB for help 
tended to be young men in their late teens and early 20s.

Today, Porrata is seeing older men who have been using for five to 10 
years. Most are 30 to 55 years old.

"It's not the party kids," she said. "It's the man in midlife crisis 
who starts going to the gym and wants to lose a few pounds, look a 
little better, rekindle things - and someone introduces him to G."

But still it is the athletes who concern her the most.

"Any place you see steroids, GHB is right in the shadows," she said. 
"The sports world won't admit this drug. It's like their secret drug, 
and they won't give it up."

Unlike steroids, there is no evidence GHB enhances physique or 
performance. Still, users subscribe to the myth.

"What makes GHB so attractive to athletes is it's very difficult to 
detect. They pass all the routine urine drug screens that you do," 
said Tampa addiction specialist David Myers.

One of Myers' patients - a Major League Baseball player - sipped GHB 
from a small mouthwash bottle during his games. He told Myers and his 
team managers that GHB use was widespread in pro sports, including 
among his teammates.

"He relapsed," Myers said. "There was no support from team 
management, and it was clear they were not interested in tackling GHB issues."

There is some speculation that stepped-up enforcement has limited the 
drug's availability. But despite a major Drug Enforcement 
Administration sting that netted 115 Internet distributors in 84 
North American cities in 2002, followed by a $7 million bust this 
year in Scotland, there is plenty of GHB to go around.

With Project GHB and other Internet sources supplying information 
that wasn't available to addicts six years ago, many users are taking 
matters into their own hands, Porrata said.

They try to detox at home. They try to self-medicate, becoming 
addicted to other drugs in the process.

"They'll die from other drugs," she said. "And we've had so many 
suicides - so many." The Three Demons

Will's final Baker Act took place Jan. 18, 2002.

His slide into psychosis began as it always did: He stopped eating.

This time he said he planned to fast until Easter.

When he entered Memorial Hospital's psychiatric unit that day, he had 
been fasting for two weeks and had lost nearly 30 pounds.

A public defender assigned to Will's case blocked every effort to 
give him intravenous fluids and nutrients.

If he wanted to starve himself, it wasn't our business, or his 
doctor's, she said.

By February, Will was still fasting and began walking into walls. He 
fell and hit his head.

Then something remarkable happened: After three years of inexplicable 
madness, someone finally decided to take a look at Will's brain. A 
nurse requested a CT scan.

It was then that we finally met his demons.

There were three of them: inoperable brain lesions whose nature and 
origin doctors couldn't even guess at.

Will was transferred to the medical floor, and for the first time in 
nearly two months, he received IV fluids and nutrients. Too late.

The neurological collapse began with involuntary flickering of his 
eyelids, which grew more pronounced each day. His hearing began to 
fail. He started to lose the use of the right side of his body.

Still he would not eat.

"Don't worry," he said. "I'll be fine."

"All you have to do is start eating, and they'll let you out of 
here," I pleaded. "Isn't there someplace you'd rather be?"

"Heaven," he said.

On Easter, Will broke his fast with a Cadbury egg.

He was transferred to a physical therapy unit, then sent home.

The brain scan was sent to Johns Hopkins University in an attempt to 
identify the lesions.

The young wrestler, once the fastest boy in Hillsborough County, 
could not get from the bedroom to the bathroom without a walker. His 
balance was gone, his hearing severely impaired. And his flickering 
eyes couldn't focus on a television screen, much less a Bible.

But he could kneel, and he could pray. And that is what Will did each day.

"Everything will be fine," he kept saying. "I've seen the future, and 
I'll be wrestling."

One of the saddest things about GHB, UCLA's Miotto said, is the way 
the drug affects the mind.

"They don't grasp the level of their impairment," she said.

But the saddest thing about Will's experience was his ability to 
grasp just that.

Despite his irretrievably broken mind, he knew what he had lost. He 
knew it all along.

Will had always felt a particular affinity for the homeless. In the 
years he struggled with GHB psychosis, he actively sought them out to 
give them money as they picked through garbage bins.

"That could be me someday," he said.

Despite his intermittent delusions of grandeur, his goals were humble.

"What do you want from life?" I asked him shortly before that last Baker Act.

"I just want to be able to take care of myself," he said. "To drive a 
car. To have a place of my own."

Weeks after Will's release from the hospital, his doctor evaluated 
him. He checked his eyes, his ears, his balance. This, he told him, 
was as good as it was going to get.

As for the three still-unidentified brain lesions - things could get 
worse, he said.

Four days later, on June 3, 2002, my son took a gas can from the 
garage to the back yard. He doused himself and lit a match.

A young man approached me after the memorial service. He said his 
name was Brandon and that Will had persuaded him to seek treatment 
for cocaine addiction.

"I'm two years clean and sober now," he said. "Will saved my life, 
and I just wanted you to know."

Researcher Mike Messano contributed to this project.
- ---
MAP posted-by: Beth Wehrman