Under normal circumstances, cells in the area of the brain that deal with feelings of pleasure fire electrical impulses at about three times a second.
Compare that to one of life's most thrilling moments, such as sky diving, when those impulses are being fired at up to 40 times a second.
But even that barely approaches the effects of cocaine, which can cause brain cells to fire impulses from 40 to 200 times a second, until the cells sending out those signals have used up all their reserves of neurotransmitters, leaving the recipient cells crying out desperately for more.
"It's very, very difficult to 'just say no' when the brain is saying, 'More! More! More!' " says Dr. Jeffrey Fortuna, director of Drug Education Consultants in Orange and staff consultant for the Chemical Recovery Services unit at Healthcare Medical Center in Tustin. "There is no drug that depletes the brain of chemicals faster than cocaine.
"We can't save everyone, but there are a lot of kids we can reach with education that is scientifically accurate, not moralistic," he told a group of more than 400 doctors, nurses and other health care professionals last week at a daylong conference on cocaine dependency sponsored by Healthcare.
Cocaine abuse is a serious problem in Orange County, Fortuna said, although not so much the kind that shows up so often on television. Instead of crack, the cheap, readily available form of the drug that has caused so much havoc in the inner cities and generated intense media interest, Orange County cocaine users are more likely to use freebase, the most potent form of the drug.
In freebasing, cocaine is heated in a pipe and reduced to its purest form, instead of being combined with other chemicals as it is in crack (cocaine bicarbonate) and cocaine powder (cocaine hydrochloride). "It's 100% pure, and then it's absorbed through the lungs, so it takes effect in a matter of about eight seconds," he said.
Injected cocaine starts working in about 13 seconds, according to Dr. David E. Smith, founder and director of the Haight-Ashbury Free Clinic in San Francisco, who also spoke at the conference. "Snorted cocaine takes about three minutes, and when it's ingested (swallowed), it takes about 25 minutes."
"And it's everywhere, absolutely everywhere in Orange County," Fortuna said. "No community is immune. "The only thing that fluctuates is the price. In Santa Ana, it's about one-fifth the price in Corona del Mar."
The more than 900 addicts that Fortuna has dealt with range in age from 14 to 45, but he calls 18- to 35-year-olds "the real high-risk group in terms of hard-core use."
Fortuna said cocaine "is indeed the most addictive substance on the planet, if you exclude sugar."
Most of what is known about cocaine dependency and other addictions is so recent that health-care professionals are racing to keep up with new developments by reading scientific literature and attending continuing education conferences such as this one. "There has been more learned about brain chemistry and addiction in the last 25 years than in the entire history of society," said Smith, who founded the Haight-Ashbury Free Clinic during the legendary "Summer of Love" in 1967 and has been treating drug addicts ever since.
The most common reason that people use cocaine, Fortuna said, is "to produce a competitive edge. They want to be brighter, faster, quicker and wittier than anyone around them. It's sort of a defensive reason, 'so that people do not see me as I really am.' "
The second reason on the list: to elevate mood. Only 5% to 8% of the adult population in general suffers from clinical depression, Fortuna said, compared with 58% to 64% of those who take drugs. And cocaine will work for a while until the brain's chemical reserves are depleted. "Then the individual will become even more impressed. The most severe depressions I've ever seen in my life are in cocaine addicts," he said.
Appetite suppression is the third most common reason, Fortuna said, and some people take cocaine to increase pleasure. "These are the true hedonists," Fortuna said. But perhaps, surprisingly, "these people are very rare. Most hedonists are also addicted to other drugs," he said. The fifth reason: To shelve anger and fear, Fortuna said.
After cocaine has used up the brain's supply of neurotransmitters, abstinence and good nutrition are "the only two factors that will bring them back," he explained.
"I truly believe that life should be a pursuit of goose bumps," he said. "And there are plenty of goose bumps to be had without the assistance of chemicals."