Pubdate: Sat, 18 Sep 1999 Source: Toronto Sun (Canada) Copyright: 1999, Canoe Limited Partnership. Contact: http://www.canoe.ca/TorontoSun/ Forum: http://www.canoe.ca/Chat/newsgroups.html Author: Jean Sonmor CRACK OF DOOM CLAIMS ANOTHER The end could not have been more pathetic. A big man running around in circles in a parking lot, chased by security. His crime? Stealing a few boxes of Enfalac and Heinz baby cereal for heaven's sake ... But minutes later, Patrick Shand Jr., 31, known to police for his record, for his crack addiction and for his "fair" ways, died. Face down in a supermarket parking lot in a puddle of blood and urine. A lot has and will be said about the application of force by the security guards; about Shand's piercing cries for help; about his loving family, his long ago "straight-A" grades and how he was once a force for good, helping neighbourhood kids choose the right path. But a lot more should have been said about the drug that, one way or another, killed him; the drug that took hold of his life and shook him into a grim degraded world he likely barely noticed in his quest for the next high. "I see it all the time," says Mike Naymark, the manager of cocaine services for the newly merged Centre for Addiction and Mental Health. "They come in here and they talk about getting involved in things they would never have imagined possible -- crime, sexual acting out, all kinds of things." Naymark has seen thousands of crack addicts. His centre is an amalgamation of the old Clarke Institute, The Queen Street Mental Health Centre, The Donwood and The Addiction Research Foundation. As the manager of the cocaine programs, what he hasn't seen in Toronto's crack scene doesn't exist. He admits it's a huge problem but shies away from the word "epidemic." Still we haven't seen the falling off of crack use that has been reported in the U.S. In fact one-quarter to one-third of all the requests for addiction help at the centre are for cocaine or more particularly crack. If anything, the numbers are growing. And the outrage isn't there. We seem to have relegated crack to the status of white noise, no more than background buzz that doesn't quite penetrate until a story like Shand's hits us between the eyes. But think about where you've heard about crack lately. Everywhere. - - A 70-year-old man cruising down a street in Oakville is picked up for trafficking with $4,000 worth of crack in the trunk of his car. - - Oshawa police stop a car to find a loaded handgun in the front seat, $50,000 worth of crack in the trunk and a baby in the backseat. - - The lovely Darryl Strawberry says he's trying one more time to kick his habit and admits sadly that when he looks in a mirror he sees "the enemy." - - Twenty-year-old Eton- and Oxford-educated Lord Frederick Windsor, 28th in line for the British throne and buddy to Prince William, admits to snorting coke at at New York party and adds, "It's pretty hard to avoid getting into this sort of thing." And even harder to get out of it. Patrick Shand had sought help several times. Once, a court had ordered him to live in residential treatment centre. "He had a problem and we were trying to help him," his heartbroken younger brother Colin told the Sun's Jason Botchford. But treatment rarely if ever works the first time -- or the second. Relapse is expected, Naymark says. "Crack's addictive potential is very high. ... It's very different from alcohol addiction, for example, because one moves from recreational use to addiction much more quickly, and the intensity and persistence of the craving remains long after the use has stopped." That's the part that few seem to understand. There's a lot of moral outrage around about the weak losers who give in to crack. And along with that comes a huge stigma. The prevailing wisdom is that crack is for out-of-control-people ruled by their desperation. Lots of people showing up at the Donwood for the six-week, cocaine-specific program have told their families they're in trouble with alcohol. They don't want to say that cocaine got them. Few acknowledge the changes in brain chemistry that have been talked about since the early '90s when Michael Kuhar, a Toronto doctor, first discovered the link between dopamine and cocaine addiction. Ironically, on the same day that Patrick Shand died, a breakthrough was announced that scientists were calling "brilliant" and "elegant." Researchers at the Yale school of medicine had shown for the first time that cocaine addiction causes a build-up of Delta-Fos-B, a protein that works like a molecular switch in the brain, creating a craving for cocaine. Now they know how to attack the problem -- figure out how to turn off the switch. Tragically, it's too late for Patrick. - --- MAP posted-by: Richard Lake