Close-up: cocaine.

Big White Lies

At first, cocaine made Miguel feel powerful. But the drug's promises turned out to be lies.

If you'd met Miguel Flores when he was in junior high school, you'd have met a young man who listened to his mother and did well in school. If you'd met him in high school, you'd have met a different person--a teenager who cut classes and got left back, a son who screamed obscenities at his mom. Drugs changed him.

When we talked to Miguel, he was a resident at Odyssey House, a drug treatment program in New York City's East Village. Now 19, he told Scholastic how he got there.

When Miguel started high school in Brooklyn, New York, he fell in with a new crowd--the wrong crowd. To make a long story short, he started smoking marijuana, drinking, and failing classes. Finally, he got arrested and spent a night in a crowded cell on Rikers Island, a New York City jail.

NOT READY TO STOP

Given a choice by a judge between jail and getting help, Miguel opted for an outpatient drug treatment program. But he clearly wasn't ready to commit to the challenge of staying off drugs. In fact, it was during the time he was legally bound to this program that he began using cocaine.

Cocaine is a stimulant and a powerfully addictive drug. Derived from the leaves of the coca plant, it has many names on the street, including coke, C, snow, flake, and blow. Coke comes in the form of white powder and is generally inhaled or snorted.

Miguel joined only a small percentage of his peers when he snorted the potentially deadly powder. According to a 2002 NIDA-funded study, only 3.6 percent of 8th-graders, 6.1 percent of 10th-graders, and 7.8 percent of 12th-graders have ever tried cocaine.

"I wanted to see how it felt," he said. "It was a different kind of high. Cocaine makes you feel like you have a lot of power. It makes you feel invincible."

"Feelings of being powerful and invincible are not only typical, but were some of the earliest reported effects of cocaine," says Dr. Steven Grant of the National Institute on Drug Abuse [NIDA]. But such feelings are short-lived.

For Miguel, they only lasted about 20 minutes. The high faded away, and he began to feel like he was "nobody." He vowed not to take cocaine again. He'd heard that cocaine could make him have a stroke. He'd also read articles about people dying of cocaine overdoses.

MOM'S TEARS

In other words, Miguel knew that cocaine was dangerous. But less than two months after he first snorted coke, his resolve weakened, and he snorted the white powder again--and then again and again.

The stimulant took its toll. Miguel's heart pumped hard. He was nervous and paranoid. He even became violent.

"The more you use cocaine, the less high you will get, but it becomes more likely that you will experience these unpleasant effects," says Dr. Grant. What Miguel experienced, he explains, is because of changes in the brain that happen in response to repeated exposure to cocaine.

But more painful to Miguel than any side effect is the memory of seeing his mom cry when she discovered the truth about his cocaine use.

REAL STRENGTH

Drug users often must go through several treatment cycles before they are successful. When Miguel's mandatory urine tests repeatedly came up positive, he was again given a choice--this time between jail and a residential treatment program. He chose Odyssey House, and although it's been difficult, he has stuck to his commitment. When we spoke, he'd been clean for 10 months.

If you meet Miguel today, you see a young man who feels "strong," but not because there's cocaine in his body. He feels strong because he's resisted drugs. You also see that the respect for his mother has returned. In fact, he credits her with his recovery. "I did it for my mom," he says. Someday, perhaps he'll realize that he really did it for himself.

COCAINE & YOUR BRAIN

Cocaine interferes with the brain's normal handing of dopamine, a brain chemical, or neurotransmitter, involved with feelings of pleasure.

Like all neurotransmitters, dopamine travels from one brain cell, or neuron, to another by crossing a synapse, or gap, between cells. It then sends its message by binding to a dopamine receptor on the next cell. When finished, it returns into the synapse, where a transporter carries it back to the first brain call for reuse.

Cocaine binds to and blocks dopamine transporters, preventing them from picking up dopamine for recycling. "The transporter us like a pump in a swimming pool that recycles water to keep the water at a certain level," explains NIDA's Dr. Grant. "Cocaine clogs the pump, allowing dopamine levels to rise to abnormally high levels, just like a clogged water pump will make a swimming pool overflow and produce a flood."

Scientists believe that this dopamine "flood" is behind the cocaine high. And just like a literal flood, it can cause a lot of damage. With repeated exposure to cocaine, the brain becomes unable to process dopamine normally. "Many cocaine users report that they have less ability to experience pleasure in life," says Dr. David Gorelick of NIDA. To try to feel good, they return to the drug, again and again, while the joys of real life pass them by.

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COCAINE KILLS

Remember Chris Farley? The Saturday Night Live comedian wan found dead in his luxury New York City apartment on December 18, 1997. He was only 33 years old. The cause of death was a morphine-and-cocaine-induced heart attack. Cocaine played a role in the death of this talented comic, and the drug has had a hand in many other deaths. Cocaine can trigger fatal heart attacks and strokes--even in healthy young people.

Here's how cocaine can cause a heart attack: "Cocaine Increases the amount of oxygen needed by the heart because it stimulates the heart to beat raster and stronger," explains NIDA's Dr. Gorelick. "At the same time, cocaine is decreasing the amount of blood flowing to the heart muscle, or blocking blood flow completely." This is because the drug constricts blood vessels.

Dr. Gorelick also explained how cocaine induces strokes. "In one type of stroke, blood flow is stopped because the blood vessel is constricted and or blocked," he says. "In another type, the blood vessel leaks or bursts, and blood no longer flows beyond the point of damage."

In 2001, there were 193, 034 hospital emergency-department cases involving cocaine nationwide, or 10 percent more than in 2000 (according to the Drug Abuse Warning Network, 2002). The irony is that some young people try cocaine for thrills and excitement. How exciting is it to end up in the emergency room ... or dead?

Don't Be "Shaky" on the Facts!

Cocaine is just one of many stimulants that can do a number on your head and heart. Stimulants are drugs that speed up activity in the central nervous system (brain and spinal cord). They make the heart beat faster and cause blood vessels to narrow--which can make you feel nervous and jittery. The caffeine that gives your latte its kick is a stimulant. Any stimulant--even caffeine, to a mild degree---can become addicting. Other dangerous stimulants:

* Crack is cocaine in a form that is smoked.

* Amphetamines are pills that have some legitimate medical uses only when prescribed by doctors. They're also called "speed."

* Methamphetamine is a long-acting and highly addictive stimulant. It comes in many forms including crystals ("crystal" or "ice") and powder (called "crank").

* Ecstasy, or methylenedioxymethamphetamine (MDMA), usually taken in pill form, is part stimulant and part hallucinogen. (Turn the page for an article on hallucinogens.)