Tuesday, October 30, 2007

Women and Steroids

No matter where you go, we are hearing more and more about the use and abuse of steroids in men’s sports. But when multi gold medallist and track super star Marion Jones recently announced that she used steroids after vehemently denying the allegations for years, it sent a shock wave across the country and mixed messages to her friends, family, and fans. This coming on the heels of Barry Bonds record breaking home run season tainted with accusations of steroid use and the recent rumors of talented boxers Sugar Shane Mosley and Jameel McCline’s use of steroids to prepare for there matches. The question most people are asking is why? Why are athletes, especially women athletes, using these illegal and potential harmful substances?

Before I get into the reasons why, let me first explain this class of drugs more correctly called anabolic androgenic steroids (AAS). AAS are the synthetic derivatives of the naturally occurring male hormone testosterone. The ability for steroids to build muscle and strength is the anabolic effect of the drug, while the development of MALE secondary sexual characteristics, like the pitch of someone’s voice and the pattern of body hair describe the androgenic effect of the drugs. AAS have been around since the 1930s to treat a condition in men called hypogonadism in which the testes do not produce a sufficient amount of testosterone for normal male development and sexual function. Other approved medical uses for testosterone include the treatment of impotency, the “wasting” or weight loss seen in persons infected with HIV or cancers, and delayed puberty.

Performance enhancing drugs like AAS are not new to the arena of sports. They date back to the early Olympic Game’s, which started in Greece and has now evolved into a multimillion-dollar industry due to marketing and advertising. As early as 1969, journalist Bill Gilbert was quoted in Sports Illustrated as saying, “The pill, capsule, vial, and needle have become fixtures of the locker room as athletes increasingly turn to drugs in the hope of improving performance.” The desire to win and to gain the edge over one’s opponent is innate, however in the “steroid” culture, there is a phrase used by some professional athletes: “If you are not using steroids, then you are not trying hard enough!” This quest for supremacy at the expense of one’s health has taken over and the all-mighty dollar is more important than health, longevity and loved ones. Steroids have been used and proven to build strength and endurance in competitive athletes for decades; however, AAS are illegal and potentially harmful and considered cheating! These are not the messages we want to deliver to young African American athletes.

The reason women use these illegal and potential harmful substances are very similar to the reasons men use them: to improve athletic performance, to become more muscular, to gain weight, to lose weight, to recover faster from fatigue and injury, and/or to increase speed and endurance. Women who are victims of rape or who have been physically abused also use AAS to improve strength and confidence so that they can protect themselves from future attacks. Muscle dysmorphia, also called bigorexia or reverse anorexia nervosa, is a disorder in which a person becomes obsessed with the idea that he or she is not muscular enough, hence uses AAS to “bulk up”.

AAS have become much more complex as proven by the “designer” steroids used by Marion Jones, some of which are undetectable with the latest technology in urine, blood, or hair samples. Steroids are administered in many ways including pills, needles, patches, or creams. Once in the blood stream they are soaked up my muscle cells and promote the production of protein, which stimulates muscle growth. Athletes will mix different types of AAS to achieve various effects, as there is no accepted medical dosing standard for the use of these drugs for performance enhancement. Side effects of AAS use/abuse include high blood pressure, strokes, elevated cholesterol, nausea, sleep disturbances, acne, increased aggressiveness, and mood disorders including anxiety and depression. Women can experience reduced breast size, increased body and facial hair, a deeper voice, and menstrual problems. In men, reduced sperm count, impotence, breast growth, and decreased testicular size have all been documented. Some of these side effects are irreversible and require surgical treatment.

This is a very unfortunate situation and I am truly saddened as Marion Jones was one of my favorite athletes. I hope that she will turn the negative into a positive and begin to educate young athletes on the only way to become successful in competitive sports while at the same time improving their health: hard work and proper nutrition.

For more information on steroids visit www.nida.nih.gov or visit my website at www.h2doc.com, view the Steroid Man, see a comprehensive list of individuals who have been associated with steroids and shoot me a question or comment at DrRani@h2doc.com. It’s Tha Hip Hop Doc, they call me H2D, come on now lets get Hip Hop Healthy. Peace, I’m out! (c) 2007 Rani Whitfield.

Wednesday, October 24, 2007


I love wearing my throwback jersey’s, especially those from the Negro baseball leagues. These jerseys symbolize so many things: pain, suffering, success, fun. But most importantly they represent hard work that the individuals who wore them endured so that other African American players could achieve the American Dream: baseball, hot dogs, apple pie, and Escalade’s!? I wonder how my now 2-year-old daughter will feel about wearing the throwback jersey of the greatest player to ever play the game of baseball, Barry Bonds. Despite his success in this sport, his name and his records have been tainted with the accusations and stench of steroid use and his athletic prowess has come in to question. The “clear and the cream”, substances given to Bonds by his personal trainer who failed to inform him of what they contained, where actually illegal substances used to enhance performance. But why is this steroid thing such a big deal? Why is the home run record that Bonds now holds in question?

Simply stated, steroids are illegal, potentially harmful, banned in most professional sports and college, and is considered cheating. Among athletes on the elite level, some feel that if you are not using steroids, then you are not trying hard enough. Steroids can build muscle and increase an athlete’s speed and strength. That has been proven. The problem is that penalties are placed on athletes found to be using them and if used for long periods of time the side effects can be embarrassing and potentially life threatening. In women, the side effects of steroids include facial and body hair growth, male pattern baldness, deepening of the voice, reduced breast size and menstrual problems. In men, reduced sperm count, impotence, breast growth, and decreased testicle size have all been documented. All individuals who use steroids are at risk for high blood pressure, strokes, high cholesterol, nausea, sleep disturbances, acne, increased aggressiveness, and mood disorders including anxiety and depression. Some of these side effects like the breast development in men and voice changes in women are irreversible. It amazes me that I get continue to get request from athletes in my private practice for steroids.

Hip-hop has had its bout with accusations of steroid use. LL Cool J was rumored to have used steroids to transforms his body into that of a Greek god. He has denied using steroids as well as plastic surgery to improve his physique in his book LL Cool J’s Platinum Workout.

Whether it is to win at any and all cost or to look good and ripped in a shirts, success and vanity out weigh life and longevity in the psyche of steroid users; that is until something bad happens like being banned from your sport, having a heart attack, or not able to “get it up” when the time is right.

The road to success in sports is hard and education on proper nutrition, exercise, and rest is of the utmost importance. Commitment to the sport on all levels is the only way to be successful. Is Barry Bonds guilty; unfortunately some believe he is, despite being the greatest player to ever play the game of baseball. My advice to him and any young athlete is to never take or rub something on your body without knowing exactly what it is that you are taking or rubbing on you. (c) 2007 Rani Whitfield. This article was published October 2007 at http://allhiphop.com/.

Tuesday, October 23, 2007

Depression and Hip Hop: Are they related?

Images of strength have dominated hip-hop since its inception in the early 1970’s. MC’s often professed superiority over other MC’s with lyrical wizardry and dominance on the microphone. Weakness was not an option, especially outward signs of weakness. However, when it comes to saving your life or the life of someone you love, we have to admit that hip hop artist and those who love hip hop are at risk for one of the most common medical problems seen in the doctors office: Depression. Not that hip-hop itself has any direct relationship to this disease, but you must realize that no one is exempt and we must all be aware of the signs and symptoms of this treatable disease.

The untimely death of hip-hop DJ David “Disco D” Shayman is only a testament to this issue. I never met Disco D and I don’t know all the circumstances surrounding his death, but one thing I can tell you is that depression, left untreated, can lead to loss days of work, destruction of families, and in its worse form, SUICIDE! The old saying that suicide is a permanent solution to a temporary problem is very true. Once a person commits suicide, the opportunity to resolve issues and make amends is gone. Disco D will be missed, and I’m sure he would want those who loved his music to learn more about this problem. So, lets define depression, its signs and symptoms, and options for treatment.

Depression or a depressive disorder is a disease that affects the entire body. It is by no means a sign of weakness and does not have to be prompted by the death of a loved one, divorce, or losing your job, although these situations can be a factor. Depression is an extreme form of sadness that a person cannot pull himself out of or resolve easily with out help. There are several types of depression including major depression, dysthymia, and bipolar disorder. We will focus on major depression. Symptoms of major depression include problems sleeping (insomnia or oversleeping), loss of interest in things one normally does, feelings of guilt, decreased energy, decreased concentration, changes in appetite (not eating at all or overeating), decreased sex drive, and thoughts of suicide. If you have a family history of depression, this also increases your risk of getting the disease. These symptoms usually have to be present consistently for more than two weeks.

In general, women experience depression about twice as often as men, however, men with depression are 4 times more likely to commit suicide than women. There are also studies that show there may be an increased risk of heart disease in both men and women who are depressed.

Once the diagnosis is made, treatment must begin immediately! There are medical problems that can cause depression, such as thyroid disorders and viral infections, but once they are ruled out, the usual course of treatment includes consultation with a psychologist or psychiatrist, medications, and group or one-on-one therapy. Do not let depression take you out of the game. If you or someone you love is exhibiting any of the above signs or symptoms, seek help right away! It could very well save your life. (c) 2007 Rani Whitfield. This article was published October 2007 at http://allhiphop.com.

Monday, October 22, 2007

HIV/AIDS: An Epidemic in the African-American Community

When the media announced that Eric “Easy E” Wright had full blown AIDS in 1995, I grab my Straight Outta Compton CD and head nodded for a few. Four years prior to his announcement, Magic Johnson shocked the world with a similar message… “I have the HIV virus…” It hit me like a rock as my best images of Magic and Eazy E came from the times when they where young and hungry for success. I believed that only gay men got the disease, not realizing that a second cousin moved to California after being diagnosed with an unknown illness and died a lonely death. HIV/AIDS was once thought to be a problem for gay white men only and was defined as the Gay Related Immunodefeciency Disease or GRID. However, ten days after being admitted to the hospital with pneumonia, a common complication of AIDS, Eazy E was dead. The HIV/AIDS epidemic was real and one of gangsta raps pioneers fell prey.

Today, African Americans are facing its greatest health challenge and the numbers reported by the Centers for Disease Control are staggering: African Americans make up only 13% of the United States population, yet we represent 50% of the cases of HIV/AIDS in this country; African American women are the fastest growing population of HIV positive people in the United States; and of the 1.2 million people in the US believed to be infected with HIV, 200-300,000 are unaware they are infected. In the month of October I personally diagnosed eight African American women of child bearing age with HIV- all but one, 25 years old or younger, was incarcerated. This unfortunately comes as no surprise when individuals like Elidor Kersaint (club promoter in Miami), Nikko Briteramos (former college basketball player), and Nushawn Williams (former drug dealer from Brooklyn) have knowingly spread the disease to women.

What was considered a gay white man’s disease has now become one of black and brown brothers and sisters. Debates continue on the origins of the HIV and the emphasis focuses on treatment, not prevention, immunization, or a cure. The bottom line is that the HIV, which is spread by blood and body fluids, is here!

Abstinence, wearing condoms, getting tested, dispelling the myths and educating ourselves about HIV are the only cure. Intravenous drug use (IVDA), promiscuity, men having sex with men (MSM), is the primary modes of infection among African Americans. The southern states have been hit the hardest and my hometown of Baton Rouge ranked number 6 in the country in AIDS cases followed by New Orleans. In 2005, Miami had the highest rates of new AIDS diagnoses in this country. Hip-hop has made several attempts to raise and help eradicate this illness from our communities. When hip-hop was “founded” in the early 1970’s, it was the result of crime and violence that brought about the movement to positively change things. “Coochie Bang” by Queen Latifah and “Go See the Doctor” by Kool Moo Dee, although not specifically addressing HIV, did address condom usage and sexually transmitted diseases. But as you know, the culture has evolved, the game has changed, and the call to do things not necessarily hip-hop is upon us. Rappers, MC’s, and DJ’s have been summoned to speak on politics, injustice, and health. "Hip-hop as a culture is getting a lot of backlash right now for its lyrics, for its public image, and the people are crying out for more responsibility," said KRS-One at the 2007 BET Hip Hop Awards. I applaud Common and Ludacris in their recent efforts to bring more awareness to the issue of HIV/AIDS. We need more of a collaborative effort, however, and I support KRS One for pulling MC’s together to “stop the violence”, but we need some love on the medical battlefield. The messages must be consistent and reinforced on and off the stage. The use of hip-hop as a tool for empowerment has been proven. Lets us use it to educate about health issues as well.

For more information on HIV visit http://www.blackaids.org/. (c) 2007 Rani Whitfield. This article was published October 2007 at http://allhiphop.com.

Sexual Enhancement

In the pursuit of sexual success and fertility, the moon, and everything under it, has been touted as an aphrodisiac by some person or culture. Love potion peddlers stop at nothing to sell their sexual wares. "I'll make you the same promise that my wife made to me," says Theodore Maximillian in the provocative brochure for his "Maxim" product. "I'm going to cure your impotence immediately!" Maxim "acts as a potent aphrodisiac," according to the advertisement.
An aphrodisiac is a food, drink, drug, scent, or device that, promoters claim, can arouse or increase sexual desire, or libido. A broader definition includes products that improve sexual performance. Named after Aphrodite, the Greek goddess of sexual love and beauty, the list of supposed sexual stimulants includes anchovies and adrenaline, licorice and lard, scallops and Spanish fly, and hundreds of other items.

According to the Food and Drug Administration, the reputed sexual effects of so-called aphrodisiacs are based in folklore, not fact. In 1989, the agency declared that there is no scientific proof that any over-the-counter aphrodisiacs work to treat sexual dysfunction.
Countering Cultural Views

FDA's findings clash with a 5,000-year tradition of pursuing sexual betterment through use of plants, drugs and magic. Despite FDA's determination that OTC aphrodisiacs are ineffective--and sometimes even dangerous--people continue the optimistic quest for drug-induced sexual success.

Several principles help demystify some cultural views about aphrodisiacs. Sometimes the reason for an item's legendary reputation is obvious. It's easy to imagine how the sex organs of animals such as goats and rabbits, known for their procreativeness, have achieved their esteemed status as love aids in some cultures.

Chilies, curries, and other spicy foods have been viewed as aphrodisiacs because their physiological effects--a raised heart rate and sometimes sweating--are similar to the physical reactions experienced during sex. And some foods were glorified as aphrodisiacs based on their rarity and mystery. While chocolate was once considered the ultimate aphrodisiac, the reputation wore off as it became commonly available.

Many ancient peoples believed in the so-called "law of similarity," reasoning that an object resembling genitalia may possess sexual powers. Ginseng, rhinoceros horn, and oysters are three classical examples.

The word ginseng means "man root," and the plant's reputation as an aphrodisiac probably arises from its marked similarity to the human body. Ginseng has been looked on as an invigorating and rejuvenating agent for centuries in China, Tibet, Korea, Indochina, and India. The root may have a mild stimulant action, like coffee. There have been some experiments reporting a sexual response in animals treated with ginseng, but there is no evidence that ginseng has an effect on human sexuality.

The similarity of the shape of the rhinoceros horn to the penis is credited for its worldwide reputation as a libido enhancer. The horn contains significant amounts of calcium and phosphorus. The addition of the food to a deficient diet could improve general physical vigor and possibly lead to an increased sexual interest. But in most Americans' diets, which are usually not lacking calcium or phosphorus, the small quantities usually consumed would not affect physical performance.

Because Aphrodite was said to be born from the sea, many types of seafood have reputations as aphrodisiacs. Oysters are particularly esteemed as sex aids, possibly gaining their reputation at a time when their contribution of zinc to the nutritionally deficient diets of the day could improve overall health and so lead to an increased sex drive.

Shortage of Studies
There is no proof that ginseng, rhinoceros horn, or oysters have an effect on human sexual reaction. But might some foods and OTC drugs eventually be proven to affect sexual appetite? Some big obstacles exist to answering this question. The placebo effect is one scientific stumbling block.

"The mind is the most potent aphrodisiac there is," says John Renner, founder of the Consumer Health Information Research Institute (CHIRI). "It's very difficult to evaluate something someone is taking because if you tell them it's an aphrodisiac, the hope of a certain response might actually lead to an additional sexual reaction."

Because the psychological complications are absent in animals, some studies have been done on the effect of certain drugs on animals' sexual activity. One substance that was tested extensively in animals is yohimbine. Obtained from the bark of an African tree, yohimbine has been used for centuries in Africa and West India for its supposed aphrodisiac properties. It supposedly works by stimulating the nerve centers in the spine that control erection. FDA called the res ults of preliminary animal studies "encouraging," but animal studies cannot be relied on to show the effectiveness of the drug in humans.

In people, the only available evidence is anecdotal and subjective. To scientifically measure sexual stimulation, a valid human study would have to be performed in the laboratory, comparing a placebo (an inert pill with no active ingredients) to the test aphrodisiac. Preferably, neither the researchers nor the patients would know who was getting the test substance. Because of cultural taboos, few such studies have been undertaken.

A second obstacle to obtaining proof of aphrodisiac effects is that some drugs may not actually have specific sexual effects, but may change a person's mood and therefore seem to be an aphrodisiac. For example, alcohol has been called a "social lubricant." People drink for many reasons, including to relax, reduce anxiety, gain self-confidence, and overcome depression. Because sexual problems can be caused or worsened by psychological stress, moderate drinking might seem like a sexual enhancer. In fact, it merely lessens inhibitions.

Alcohol is actually a depressant, and so, as the porter in Shakespeare's Macbeth observed, it "provokes the desire, but it takes away the performance." And drinking too much actually decreases desire.

No Quick Fix
Despite the lack of scientific evidence of safety and effectiveness, the fraudulent OTC love potion industry thrives to this day. Marketers use a "blatant snake-oil approach," according to CHIRI's Renner. He estimates that the aphrodisiac sellers, who do much of their business by mail-order, take in revenues in the hundreds of millions of dollars a year.

The FDA sends warning letters to companies that make aphrodisiac claims, stating that the agency may take further regulatory action if the violations continue. "In the health fraud area, when they get a warning letter, most people take their profits and run," says Joel Aronson, director of FDA's division of nontraditional drugs. "They don't want to get into a legal battle with the agency becau se it could involve protracted, expensive litigation."

Aphrodisiac experimentation isn't just a rip-off--it can be deadly. Spanish fly, or cantharides, is probably the most legendary aphrodisiac--and the most dangerous. Made from dried beetle remains, the reported sexual excitement from Spanish fly comes from the irritation to the urogenital tract and a resultant rush of blood to the sex organs. But Spanish fly is a poison that burns the mouth and throat and can lead to genitourinary infections, scarring of the urethra, and even death.

To avoid being taken for their money or their lives, individuals with sexual problems should seek a physician's advice. A lack of sexual energy or ability in men or women could be caused by something as simple as stress or a medication one is taking, or as serious as an underlying condition like diabetes or high blood pressure.

A doctor can diagnose a sexual problem and recommend treatment. If necessary, a doctor can prescribe a drug to treat sexual dysfunction. Testosterone replacement therapy is one prescription option for men whose natural testosterone level is not within the normal range, but its serious potential side effects cal l for a physician's supervision. For those with an impotence problem that isn't caused by low testosterone levels, the new "Caverject" injection may be the answer.

"People will continue to have false hopes of finding easy ways of resolving their problems," says Aronson. And so the hunt for the elusive love drug persists. A universal aphrodisiac may never be found, but experts agree that what's good for your overall health is probably good for your sex life too.

A good diet and a regular exercise program are a more dependable path to better sex than are goats' eyes, deer sperm, and frogs' legs. A good mental state is equally important.
Maybe the wishful search for a cure-all drug should be abandoned in favor of an easier, more reliable mechanism: the erotic stimulation of one's own imagination. To quote renowned sex expert "Dr. Ruth" Westheimer, Ed.D.: "The most important sex organ lies between the ears."
Tamar Nordenberg is a lawyer with the Office of the Director in FDA's Center for Drug Evaluation and Research.

First Impotence Drug
For the 10 million to 20 million American men who suffer from impotence, the Food and Drug Administration's July 6, 1995, approval of Upjohn Company's prescription drug Caverject (alprostadil) may prove to be life-altering. Caverject is the first prescription drug approved for impotence, and is expected to successfully treat 70 to 80 percent of patients.
The drug provides an alternative to devices previously approved by FDA. A vacuum device involves placing a cylinder-like device and attached pump over the penis. By using the pump, blood is drawn into the penis, creating an erection. A constriction band is then placed at the base of the penis to maintain erection. A second treatment option, the penile implant, involves the surgical placement of cylinders in the penis and is available in a variety of designs. (See "Inflatable Penile Implants Under Scrutiny" in the January-February 1994 FDA Consumer.)
FDA approved Caverject to treat impotence caused by neurological, vascular or psychological dysfunction. While psychological factors such as anxiety and depression can lead to sexual dysfunction, more than 85 percent of impotence cases have a physical cause, according to the Impotence Institute of America. A complete physical examination is important so that any underlying condition can be diagnosed and treated. Some common causes of impotence are diabetes, arteriosclerosis (hardening of the arteries), and high blood pressure. Also, impotence has reportedly been caused by 16 of the 200 most commonly prescribed drugs, including drugs for high blood pressure, heart disease, and depression.

Caverject is self-injected into the penis shortly before sexual intercourse. The drug creates an erection by relaxing the smooth muscle tissue and dilating the major artery in the penis, which enhances the blood flow to the penis.

The drug's most common side effect is penile pain. Other side effects include bleeding at the injection site and an unhealthy, prolonged erection of four to six hours. (c) 2007 Rani Whitfield. This article was published October 2007 at http://allhiphop.com/

Steroids: Just Don’t Do It!

At 38 years of age I continue to exercise regularly despite a very busy schedule. While traveling for business, and rarely on vacation, the search for hotels with gyms and nearby training facilities is at the top of my list. I have a very competitive spirit and love to win especially when it comes to sports. What a great accomplishment it would be if I where victorious at the 2008 USA Track and Field Masters 400 meter run I am currently training for? I would do anything to win that race…well just about anything.

Modern sports and the media’s obsession with fame, fortune and the “win at any cost” attitude have created an environment for the abuse of the controlled substances called steroids. Anabolic androgenic steroids (AAS) are the correct name for this class of drugs and many athletes are using them in professional sports today. These substances, once only used by the elite, have spilled over in to mainstream America as we now see weekend warriors and non-athletes using steroids for cosmetic purposes, i.e. weight loss and increased muscle mass. The questions I’m often asked are why people use these illegal and banned substances, what are the benefits of use, and what are the side effects?

AAS are synthetic versions of the male hormone testosterone. The ability for steroids to build muscle and strength is the anabolic effect of the drug, while the development of MALE secondary sexual characteristics, like the pitch of someone’s voice and the pattern of body hair describe the androgenic effect of the drugs. The reported benefits of AAS include: improving athletic performance, increased muscle mass, weight gain, weight loss, faster recovery time from fatigue and injury, and increased speed and endurance. Pills, creams, and needles have been substituted for hard work, nutrition, and adequate rest as ways to gain the edge over the opponent.

In 1997, Sports Illustrated interviewed a group of elite Olympic athletes and one of the questions was: "If you were given a performance enhancing substance and you would not be caught and win, would you take it?” 98% of the athletes responded "Yes". The more chilling question was: "If you were given a performance enhancing substance and you would not be caught, win all competitions for 5 years, then die, would you take it?” More than 70% said, "Yes". Are these the messages we want for our youth?

The side effects of steroid use/abuse described in the medical literature include liver damage, kidney and liver tumors, high blood pressure, strokes, elevated cholesterol, mood disorders, acne, increased aggressiveness, nausea, sleep disturbance, increased body and facial hair, male pattern baldness, breast development in men, reduced sperm count, and decreased testicle size. The user who typically will take ten times or more the recommended medical dose and/or combine them with other substances, like human growth hormone, to enhance the effects of AAS, increases the potential for these health related problems. Furthermore, the integrity of these substances comes in to question as they are often purchased via the Internet, black market, or unregulated pharmacies.

The use of AAS is not only harmful, but it is illegal and considering cheating! We must teach young brothers to place more emphasis on participation and competition not merely winning. Hard work, proper nutrition, combined with hydration and rest are the keys to competitive success. I may not win my event in 2008, but I can promise you I will not use steroids to achieve success. My life and my family are much more important to me.

(c) 2007 Rani Whitfield.

Wednesday, October 17, 2007

Crack Cocaine

Being affectionately known as “Tha Hip Hop Doc” by the younger generation is an honor and I wear that title with pride. However, “Thug Doc” or “Gangsta Doc” is two other names I am frequently called by the inmates at the East Baton Rouge Parish Prison. Believe it or not, these are terms of endearment and respect as I work at the prison everyday and see many of the inmates, mostly African American, at the two substance abuse clinics where I work as well. The majority of these individuals are African American men who live well below the poverty level and have long histories of substance abuse. The drug of choice for most of them is crack cocaine.

Cocaine is not new to the world as it has been around for hundreds of years. The leaves of the cocoa plant, from which cocaine is derived, where chewed like tobacco by tribes in South America to ease pain, stimulate or suppress appetite, and combat altitude sickness. It was noted by the tribesman that not only could they work longer but they also felt “happy” and euphoric. In the 1880s pure cocaine was used as a local anesthetic for nose, eye, and throat surgeries due to its abilities not only to provide anesthesia, but also to constrict blood vessels and reduce bleeding. And it is true that cocaine was one of several ingredients in the original Coca-Cola only to be removed in 1929 when the harmful side effects of the drug where noted. Some actually thought that cocaine would be the “miracle” drug of the future.

What was thought to be the wonder drug used in elixirs and tonics later became a drug of the rich and famous in the late 1970s. Snorting cocaine was considered to be in vogue and in some social circles were acceptable and fashionable. However, it wasn’t until the mid-1980s that crack cocaine emerged on to the scene. This cheap and relatively easy to make variant of powder cocaine got its name from the crackling sound it makes when it is heated and its vapors smoked. There was nothing in vogue about crack’s introduction to the United States and the initial impact was felt in poor African American communities.

The 2005 National Survey on Drug use and Health (NSDUH) stated that approximately 7.9 million Americans aged 12 or older reported trying crack cocaine at least once during their lifetimes. Adult’s ages 18 to 25 years old have a higher rate of cocaine use than those of other age groups and men have a higher rate of current crack cocaine use than do women. Crack cocaine has a strong correlation with HIV/AIDS, crime, incarceration, and homelessness. The question that I often ask the inmates and individuals in drug rehab is why? Why is this drug becoming an epidemic in our society?

If you only remember one concept from this article, remember that crack cocaine is highly addictive. There are two main forms of cocaine: the hydrochloride salt or powdered form which dissolves in water and can be injected into veins (intravenous use) or snorted (intranasal use); and the freebase form or crack which is when the compound has not been neutralized by an acid to make the hydrochloride salt. Because it is smoked, the user experiences a high in less than 10 seconds that causes an intense and immediate feeling of euphoria, which according to addicts, is indescribable. Crack is inexpensive to both produce and to buy making it the drug of choice for the poor. Even more alarming are the potential medical complications of crack cocaine abuse: high blood pressure, strokes, heart attacks, headaches, hallucinations, addiction, and even sudden death. Substance abuse, in general is linked to illness liked HIV because when one is under the influence of a drug they make poor decisions like having unprotected sex or using IV drugs.

Inpatient and outpatient substance abuse rehab are a must for individuals who have used crack cocaine. As a result of its highly addictive potential, long-term treatment that includes counseling and group therapy are paramount. We must also look at the laws and how individuals are prosecuted once convicted of cocaine use and ingestion. Crack cocaine, despite what some think, continues to be a big problem in our country. Effective drug policies need to be in place and support for the communities under attack by the drug lord are the only remedies for this problem. And in the words of the late Rick James: “Cocaine is a hell of a drug!”

(c) 2007 Rani Whitfield. This article was published October 2007 at http://www.eurweb.com/