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In the quintessentially suburban San Fernando Valley of Los Angeles, David, 21, was not reduced to stealing from his family to support his five-gram, $750-a-week habit. Instead, during six months last year, he embezzled $20,000 from the camera store where he worked. His thefts were discovered just before Thanksgiving, but the police were not called, and David's father repaid the $20,000. David cannot figure it. "I was the all-American kid who had never been in trouble," he says. "I was popular. I taught religion classes at the synagogue. How could a well-brought-up kid like me get into something like this?"
A few years ago, cocaine users were a rarity at Phoenix House; today a third of the people seeking help say cocaine is their main problem. At Northwestern University on Chicago's North Shore, Dr. Sidney Schnoll, the director of the chemical dependence program, says that in 1979 one or two of the patients were being weaned from coke; today, as in New York, about a third are. Between 1979 and the end of 1981, the number of cokeheads admitted to federally funded treatment programs rose by more than half, from 1,961 to 3,393.
Sometimes it is purely psychological wounds that drive cocaholics to therapy. But diehard users can be prone to high-pitched anxiety, irrational fears, paranoia and even, reports Harvard's Grinspoon, "out-and-out cocaine psychosis:" Violence is not rare. When Nicky's wife finally smashed his free-basing pipe, he threw furniture and chased her from their suburban house. "I went ape," he says. Mike, the son of a well-to-do South Carolina lawyer, is a patient turned counselor at Charleston's Fenwick Hall drug-treatmeat center. He carried a gun during his cocaine madness. In 1980, as he was being arrested for the last time (for jumping into Charleston Harbor to "hunt sharks"), he kicked out the windows of a police squad car. Fortunately, according to Haight-Ashbury's Dr. Smith, cocaine psychosis can be moderated with antipsychotic drugs (like Haldol), and the hallucinations usually stop two to four days after the last dose of coke.
Specialized treatment regimens are proliferating. Dr. Richard Miller has run 50 people through his "cokenders" spa (one week, $900) in the countryside north of San Francisco. During the week of therapy he offers the recovering overusers a toot of cocaine to test their resolve. In Los Angeles, new Cocaine Anonymous groups draw 700 people to weekly meetings. At South Miami Hospital, a coke-treatment program (four weeks, $6,300) has been discharging more than 300 patients a year.
Medical research is still sketchy. The commonest cocaine-related ailment, a breakdown of nasal membrane, "is the least of one's worries," according to Dr. Pollin of the National Institute on Drug Abuse. Chronic cocaine use kills the appetite and so regularly results in severe weight loss. In a three-year study, Gerald Rosen, a Duke University pharmacologist, has found that metabolized cocaine destroys dangerous numbers of liver cells. Researchers at Massachusetts General Hospital, among other places, have seen evidence of serious lung damage in free-basers, who may