DRUGS AND DRUG ADDICTS.

Auckland Star, Volume LX, Issue 134, 8 June 1929, Page 6 (Supplement)

DRUGS AND DRUG ADDICTS.

(By PROF. DR. ALFRED FROEHLICH.)

; (Concluded from last Saturday.) Two Berlin doctors, Joel and Fraenkel, have published a series of interesting experiences with cocaine addicts. A cocainist missed the street car he wanted to take and ran after it for hours through the city. Another, uncommonly (excited, wrote a treatise on the Devil, ■which he called his other self. He would eit nights long before the glass, watching every twitch of his face, making 2jttf&sr*s-painting himself and enjoying thoroughly the pleasure he derived from lis mimicry. But in the day, he would tear about the streets as if posseesed, frightened by ugly faces, he said. A third felt as if he shed great heat from his inner self, and rushed about the Btreets, looking for rats rand mice and jumping over fences like a cat.

Sensorial disturbances of som6 cocainists betray themselves sometimes an the sense of touch; this is essentially absent in other drug addicts. The cocainist will believe that he has worms wriggling under his skin, that beetles, microbes or thorns are crawling or stinging him; that hair or ecales grow on hie tengue. In their intoxication, they scratch themselves with their rails till they bleed or dig with a knife under their skin to get rid of the stinging eensation they feel.

The memory of cocainista in spite of all those mental disturbances remains surprisingly good, although cases are known in which there are complete gr.ps in their recollection of past happenings..

The consequences of habitual inhaling of cocaine are devastating and dar.gerOU6. In the first place, they bring about an alteration of mental capacity and even a disturbance of morality. Intelligence and memory gradually wane. Weakness of will becomes the most important fundamental of the character, and to recover himself, the cbcajnist seeks in a further absorption of the drug to whip up his energy. Like all addicts to drugs, the cocainist will brook at no sacrifice to obtain , the drug he needs; he will lower and humiliate himself to- an astounding degree. This particular hunger for the drug 5s likely in certain persons to. break out in misdemeanours. Corainwts would give their shirt, their fur coat, to procure a small quantity of the drug, when they have no money at hand. A. Sinister Development.

The trade in cocaine as in all other addiction- drugs is of course sternly prohibited and only pharmacists can deliver it on a doctor's prescription, which must be renewed every time. The cocainist knows that he cannot corrupt a doctor or a chemist. Hence, the clandestine trade in "enow" develops more and more.

Further, cocaine addicts suffer greatly from insomnia and have to take other drugs in order to assist sleep, thereby impairing their health all the more. The seediness following intoxication with cocaine makes the addict, often reprove himself for his folly, but he wants more drug to make him acquire a new love for life. If he has no money to buy cocaine ideas of suicide enter his mind which he sometimes carries out. Therefore, the more drug he absorbs, the more he wants to keep up his courage to live, so to speak. In their state of inebriation, cocainists often fall foul of the ,law, .in which cases no doubt their responsibility is abnormal to a certain extent. And after this, they loee their jobs, their business declines, they are ostracised, become poor, and sink lower and lower in, the social ladder.

The habitual absorption of cocaine creates a kind or resistance to. the effects of the poison which is not bo intensive as in the case'of morphia or opium. How fair can this resistance extend is difficult to ascertain; some cocainiste can gradually increase the doses they "sniff," but the fact that they take it by the nose limits to a certain degree the amount of poison that finds its way into the blood stream and becomes absorbed in the organism. Whereas the injection under the skin of three to twelve grains of cocaine may prove a fatal 7 dose> pome cocainieta can consume daily all the*, year round -from 30 to 50 grains, taken through the nose, without fear for their life.""The-high price of the drug and ii;s frequent adulteration prevent them.from exceeding this dose.

"Snow" Cocaine,

The manner in which the drug is- consumed is entirely different from that employed in the absorption of other poisons. Cocaine is very seldom swallowed normally or smoked in a cigarette, or injected under the skin; it is mostly inhaled in the form of a "pinch of snuff, by the nose. It is this fact which has assisted so much in the development of the craving. Morphia must be injected tinder the skin, and as this is not effected without pain, some sensitive people shun it for that reason. Besides, the addict to morphia can never be sure that his skin or the needle used are thoroughly clean, whereby he runs the risk of infecting the wound and of causing abcesses and other infectious inflammations.

The sniffing of cocaine as if it were snuff is, therefore, more agreeable,' and the iinger of intoxication to the extent of causing grievous injury or even death is thereby much reduced. The addict is alive to the immediate influence of the drug and can restrain from absorbing too large a quantity or can extend the enjoyment derived over a longer time by successive "sniffs" of the "snow." Besides, the addict can seldom procure the" cocaine or "snow" as it is called, in the slang of the clandestine trade, in absolutely pure quality; it is generally adulterated with harmless substances for which he pays many times over the real value. The ugly morphia syringe is replaced by a small and pretty snuffbox, in which a little shovel helps to measure out the "pinch."

The influence of cocaine after it has been sniffed can be described under three distinct stages. First, there is a feeling of elation, exuberance and well-being, ■which manifests itself in speech and gestures. A patient who had .made an abusive use of the drug stated that immediately after sniffing a pinch he had the feeling that he must take the world in his arms and forgive all his enemies. The excitement produced vents itself in verbose ramblings; the cocainist indulging also frequently in the writing of numerous letters. In this state, the addicts reveal all tlieuv secret thoughts, and simply bubble over with words, to the great surprise of their hearers. No doubt there is a loss of the responsible control over mental processes, but the control of movement is not impaired. It is even claimed that fa.otoiist& g*&>

DELUSIONS OF, THE COCAINE VICTIM.

acrobats acquire under the influence of 'cocaine a peculiar feeling of security, 'and artists often take the drug in order to combat stage fright. A cashier admitted that he took cocaine in order to acquire the courage to burgle a safe. The excitement produced by the drug is of little value in creative work, according to the observations of scientists and authors. The celebrated Italian writer Mantegazza found that although his pen was impatient and could not write quickly enough he ne.er was able, under the influence of the drug, to formulate new ideas, nor even to bring his Avork to a form of any value. "An American doctor admits that his personal observations made under the influence of cocaine bear out this statement. He wrote endless pages of manuscript; the ideas were correctly expressed, but there was no association between them. That the cocainist considers this feeling of elation as most agreeable, is expressed in his features. Many addicts are restless, constantly fighting one another, screaming or dancing, such as people would be when strongly under the influence of alcoholic intoxication. Consequent Delusions.

After this,first .stage, come the aftereffects of cocaine- intoxication, which usually take the form of sensorial disturbances in which the. addict suffers from delusive impressions concerning his environment. The agreeable feeling of elation is followed by depression. The nerves controlling the senses are for the most part in a state of high sensibility; in the first place, the most affected being those of hearing. When in this stage the addict hears a- slight rap, he takes it for a loud bang; human voices sound for him, as if they were violent trumpet noises: approaching footsteps -will be th/ 3 tramp of marching troops. A slight noise of which he cannot discern the cause will convey to his brain the idea of burglars breaking into his room; he imagines himself surrounded by threatening people, thieves, murderers. He will imagine a white handkerchief to be a ghost, or that he is burning alive; one man will shopt at his servant, or fancy himself in a swarm of furious bees which he will fight with all his might, although admitting that he cannot feel the slightest sting. One addict walked about the streets with a huge tortoise, which he led by the front paw, and with which he wanted to seek some refuge underground.

Another addict stated: "I saw my bed-cover heaving like sea-waves, and the curtains took all sorts of shapes, as if they had been people dressed in costumes of the past who were fighting to get hold of the cocaine, and they finally crumpled up on the floor and vanished." Another said that chairs, tables, curtains and clothes took the shape of fantastic animals; the walls were riddled with many holes through which spies were watching him. He tried hard to stop up all those holes. In the street he thought everybody was looking at him. A friend bid him to come into a restaurant and have some lunch; he was greatly surprised to find he had to pay for it; the "friend" was a perfect stranger; the incident was a complete hallucination caused by cocaine intoxication.

Through hearing his own voice, the cocainist is also subject to delusions with regard to himself; he applies everything he hears to himself, owing to the feeling of anxiety which possesses him. He will imagine, for instance, that voices underneath the carpet are warning him of danger, and in his mind he will wage violent discussions with his own thoughts which he hears practically as spoken words.

Some of the delusions are very strange; a cocainist would not go to bed after, entering a hospital, because he thought the bed was on fire. Once when walking in the woods around the city, lie had imagined the trees were burning, and he threw himself in a pond near by, where he swam for hours to keep away from the flames. Another addict had the delusion that some enemy blew chloroform vapours at him through a hole in the wall. Many who believe that their life is menaced will wait for hours, revolver in hand, for their imaginary foes. Soldiers addicted to cocaine will give false alarms when on sentry duty. Yet they are more or less conscious of what they are doing, as if they were in a day-dream.

Many persons are also subject to another peculiar form of delusion—the eearch mania. With all the* signs of real anxiety they will search in all their pockets for their pocket-book, and even when they find it they do not believe it is their own. They will look everywhere for their hat, although it is under their very eyes. In the street, the addict will search for cocaine or money to buy the drug with, and he will bend to pick up all kinds of things, papers, rags, etc., in the gutters or dustbins.

The Fight Against Abuse. It is difficult to reduce the craving for cocaine; it would be necessary to organise a severe watch over doctors, chemists, and the clandestine trade, but in order to obtain some results, arrangements would have to be made, between all the Nations of the world with a view to curtail the production of cocaine to the mere quantity necessary for medicinal purposes and to penalise any trespass that would infringe on regulations. The League of Nations is the only institution that could undertake this task. And pitiless penalties against smugglers and people dealing with the drug clandestinely would probably render their business less profitable.

The cocainist can be cured even if he is in the highest etate of mental and physical illness, provided he is sent at once to a medical institution and the doctors rightly diagnose his case. The cure can only be obtained by complete severance, that is to eay by entirely depriving the addict from the drug. In the first stages of the cure,.the addict is ordered to bed for a.complete rest, which can be assisted by calming or sleeping draughts. After a while, the oocainists develop a most ravenous appetite, and the quantity of food they can eat is sometimes extraordinary. It is possible through the influence of hypnotic sleep to bring about the desired repulsion for the drug. But as soon as the erstwhile cocainist has recovered his taste for work and mixed again amongst his fellow men, a careful watch.must be kept .over him for a long time to prevent him from returning to the habit. Many cured cocainiete unfortunately fall again in their evil ways when they meet their old boon companions. The end is mental and moral decay, physical breakdown, despair,' poverty misery and death.—