Such perceptions are changing with the appearance of cocaine in a more menacing, smokable "freebase" form. Called "crack" or "rock," it is potent, conveniently packaged and cheap enough to attract even teenagers on an allowance. From the big cities, it already has invaded the suburbs.
As director of adolescent treatment at Stony Lodge Hospital's Outpatient Recovery Center in Ossining, N.Y., Ellen Morehouse has seen the crack problem grow. A graduate of Cornell and New York Universities, she is also executive director of the Student Assistance Services, whose alcohol-and-drug use prevention program for New York's Westchester County is serving as a model for schools elsewhere in the U.S. and Canada. Morehouse, 36, who lives with her attorney husband and 2-year-old son in Westchester, spoke with reporter Jane Sugden on the social roots of the new cocaine epidemic among teens.
How fast is cocaine use spreading among young people?
In a 1975 University of Michigan study, 9 percent of high school seniors surveyed said they had used it at some time in their lives. Ten years later that number was up to 17 percent. The survey in 1985 also found cocaine use up among all groups of teens—males and females, college bound or not, urban and rural—and in every region of the country except the South.
Isn't cocaine expensive?
The idea that cocaine is just for the rich is a myth. It's like pocket calculators—expensive when they first appeared, but now anyone can afford them. In New York City a gram of coke—enough for 10 good-size lines, or doses—goes for $80 to $120 on the streets. Most teens know where to get cocaine, and a group might pool their money on Friday night to get high. Our research in Westchester County found no difference in the pattern of cocaine use between those in the poorest and richest high schools. It is an equal-opportunity epidemic.
How did cocaine become a "drug of choice" with kids?
Adolescents by definition are trendy. In the late '60s it was "in" to look poor, to be earthy, natural, to wear worn-out jeans with patches. Marijuana became popular then; smoking pot made you mellow. But now materialism is back. Money is okay, success is great, the more designer labels the better. Cocaine fits the mood of the 1980s. It's a high-performance drug associated with movie stars, athletes, the rich and glamorous.
Is it easy to get hooked on cocaine?
Let's face it: Coke really works, at least at the start. When a person first uses it, he gets a feeling of well-being. He can stay up later, work longer. Sexual performance may be improved, initially. In the case of teenagers who may not be socially confident, coke gets them where they want to be. They become part of the group, and, unlike heroin, there's neither the stigma nor the dangers from the use of needles. Coke is a white powder, which makes it seem more socially acceptable.
What exactly is crack?
It's a kind of dealer-prepared cocaine freebase, in which powdered coke is mixed with baking soda and water to form a paste. After the concoction hardens, it looks like off-white granulated sugar; it is broken into chips or tiny lumps.
What is the advantage of crack?
Crack is easier to use. Lots of people find it distasteful to snort powdered cocaine. But crack is pure; it can be used in a cigarette or smoked in a pipe. It's cheap and convenient. A two-dose vial of crack costs about $10.
Is crack dangerous?
Smoking cocaine freebase is a much more potent and very dangerous form of coke use. In snorting the powder, it takes up to five minutes for the user to feel the effects. But in smoking freebase, it takes only eight seconds. The high is almost immediate, the euphoria more intense. The heart starts beating at a very fast rate, blood pressure often rises, and heart-lung problems and seizures can occur. The terrifying thing about crack is that a youngster could become addicted in a matter of weeks.
What is the pattern of cocaine use?
Cocaine users develop a tolerance for the drug. The euphoria is never the same as it was at the beginning. They might use four times more cocaine and still never repeat the original high. But the addict so craves the ultimate rush that he lets everything else go and assumes great risks to get cocaine.
How do addicted youngsters support their growing drug habits?
Many begin to steal—from parents, relatives, friends. They might rip off car radios, turn to prostitution—anything for the ultimate high. Some become drug dealers themselves.
Why are youngsters so reluctant to heed warnings about cocaine?
There's a natural tendency among kids to experiment. They tend to do dangerous things without considering the consequences. Kids often ignore adults' warnings. One youngster I know bought crack, got into his car, put one of the rocks in his pipe, lit up, inhaled, stepped on the accelerator and passed out. He hit a phone pole but miraculously survived.
Have parents contributed to this casual disregard of cocaine's dangers?
If an adolescent sees his parents as heavy drinkers or users of drugs—even such things as sleeping pills—he will think it is an acceptable way to get rid of problems, a way to feel better. And a lot of today's parents grew up in the Vietnam era and used drugs. They saw movies like Reefer Madness, but they believed that pot did not hurt a lot of them. So they don't believe cocaine is dangerous, either. They won't take it seriously. Parents say to me, "I know my child is going to experiment, and I don't mind. I just don't want him to use too much." This is tragic. Before they know it, their kids are hooked.
If parents suspect their child is on cocaine, what signs should they look for?
Dramatic weight loss over a relatively short time is one sign, especially with crack. Sometimes they cough up a black mucus. One kid lost 16 pounds in a month. It often takes parents a while to see the changes in a child's life patterns. He used to be interested in his girlfriend, sports, his homework; now he isn't interested in much of anything. His grades skid. After every high there is a crash, so another early sign is the youngster's staying in bed. Kids on cocaine sometimes sleep 14, 16 hours because they are so exhausted after the high.
How can youthful addicts be helped?
The first step is to stop the use of cocaine, or any mood-altering drug, immediately and completely. Sometimes this requires hospitalization to break accessibility to the drug. Even without that, there must be urine screening at least twice a week. Parents must get involved in the recovery; the family must be educated about the addictive process. The kids should understand that recovery is going to be hard, but it is easy to relapse. They must participate in the programs of such groups as Narcotics Anonymous or Cocaine Anonymous or even Alcoholics Anonymous. The schools can provide support through counselors. Exercise is important: It also is a stimulant, but a natural one. Our program of abstinence and life-style change lasts generally six to 12 months, but we look on cocaine addiction as a lifelong illness.
Can the cocaine epidemic be stopped?
The cocaine-prevention battle really starts with cigarettes and alcohol. Not everyone who smokes or drinks turns to cocaine, but there are very few cocaine users who did not first use tobacco, marijuana or alcohol. More broadly there is the whole psychology of drugs. Our society must see that we are far too much a drug culture. Changing attitudes in any profound way won't come easily, but there's hope. Smoking, for example, is no longer the vogue. There has been some decrease in alcohol consumption, and marijuana use is down somewhat, too. We must make cocaine unchic. We must deglamorize it before it's too late.
For years cocaine largely escaped the grim and sordid reputation reserved for other illicit drugs. While hardly anyone argued that coke was completely harmless, the social threats posed by "the champagne of drugs" seemed sufficiently remote to most American families. Experts did warn that coke snorting could result in disorders ranging from inflamed sinuses to psychosis, but few thought it to be relentlessly addictive. Cocaine might be a problem for celebrities and fast-trackers, many parents reasoned, but not for neighborhood kids.