P is for paranoia

By SCOTT MacLEOD

Andrew Jones has sealed his doors and windows, drawn his curtains and switched off his lights to foil Their surveillance. The Orewa P-addict has darkened his home and erected barricades against the shadowy People he knows are coming to get him.

Jones' fear of Them is almost unbridled. He is exhausted, but terrified of sleep. He knows he must be awake and be ready when They come.

And ready he is. The walls of his home are lined with Molotov cocktails.

The phone rings, unanswered. Only rarely will Jones (not his real name) bring himself to speak. The electronic bugs in the walls and phone-lines see to that.

Through a crack in his curtains, Jones can see Them driving their Fords and Mazdas, or strolling past dressed as housewives and businessmen.

Across the road, linemen from the power company are digging what Jones knows to be his grave. He is sure he can hear gunshots.

With great caution he creeps from his fortress to seek the necessities of life. He notes with fear that each passing motorist, each shop assistant, is eyeing him with evil intent. He scans the shop shelves for meals in sealed packages he hopes are less likely to have been poisoned.

Anybody would think Jones has been smoking P. But he has not had a puff in days. These are merely the withdrawal symptoms.

His battle with P-induced paranoia shows why New Zealand is in the grip of its first A-class drug epidemic. For although Jones is a sick man, he is not unusual. Thousands of P-users are fighting to beat their addictions. Many are struggling with paranoia, near-suicidal depression or extreme lethargy.

The drug has struck New Zealand with such force and speed that the public and lawmakers are still grappling to understand its powerful hold on users. But figures released last month show that New Zealand has rapidly become one of the top three nations in the world for abusing the drug.

The users are well aware of the reasons P has such a strong pull. During the past fortnight more than two dozen P addicts have shared their stories with Herald readers, and one of the most striking features is that many have studied the chemical changes that take place in their brains when they use - and withdraw - from the drug.

But this knowledge does not seem to make their withdrawals any easier. Users have variously described the effect of their first-ever puff as "empowering", "a lightbulb switching on in my head", "a charge", "making me feel bulletproof", or simply "wow".

But after P-users go up, they must come down. These are the "tweaking" and "crash" phases when paranoia, depression and lethargy set in.

The only quick fix is to take more P. Addicts smoke more, then often move on to inject the drug. But most say they can never recapture the feeling of that first high.

Studies into P's addictiveness and mental effects are less comprehensive than for many other hard drugs such as heroin and cocaine, which have swept the United States. However, most psychologists agree that P shares the qualities of other addictive "uppers" in that much of the secret to its pull lies in the tweaking and crash phases.

It is the desperate effort to delay or ease the mental anguish that sends users on binges of three or more days - and can make them crave a fix months after they quit.

At six Hanmer clinics throughout New Zealand, drug-dependency experts are increasingly picking up telephones to find P addicts at the other end.

At the Auckland outpatient clinic at the start of last year, the ratio was one caller in 25. In the first six months of this year, it was one in five.

At Hanmer's residential treatment clinic near Christchurch, one-third of patients admitted for addiction to alcohol and other drugs are now P users.

One of the clinic's top specialists, Rob Brandram-Adams, says P rates at least nine out of 10 for its addictiveness.

"The accelerator's down," he says of the effects of taking P. "You feel extremely good, outstanding, you might have delusions of grandeur."

This is caused by a surge of adrenaline, serotonin and dopamine. The latter two - feelgood chemicals - are released from nerve-endings in the brain and move towards other nerve-endings that hold receptors. P causes a surge in the level of the chemicals being released, flooding the brain and forcing it to adapt its structure so it has more receptors.

When the chemical-producing nerve-endings burn out, there are an awful lot of receptors but very little chemical, Brandram-Adams says. This causes the crash.

"The cravings are caused by this chemical phenomenon. It's a crying out of the receptors' memories of the good effects. "There is acute withdrawal that lasts a few days, and post-acute withdrawal that can last for weeks."

Studies on P-users in the US have linked abnormal levels of dopamine with mental disorders such as schizophrenia. And studies on mice reported by the US National Institute on Drug Abuse found that P can kill dopamine-producing cells and create symptoms similar to Parkinson's Disease.

The institute says tests on monkeys show their dopamine cells are still damaged three years after their last dose of P.

Brandram-Adams' assessment of P as being at the extreme end of the addictiveness scale is backed by Auckland psychiatrist Angela Ryan. She cites figures showing that half of all people treated for addiction to P and its variants have become psychotic or schizophrenic.

Brandram-Adams speaks of a "domino effect" in the brain when a user who has been clean for months takes just one more puff. Total abstinence is the only way to beat P, he says.

At Hanmer, addicts are weaned off P with a daily programme involving psychological, physical and withdrawal assessments, and medication for psychological side-effects.

This starts with a detox - avoiding the drug until the worst of its withdrawal symptoms have passed - then moving into a recovery phase "which is about improving your life" without P.

Staff watch carefully for depression, paranoia, cravings, suspicion and over-tiredness. The 35-day programme costs $10,800 - roughly the cost for a heavy user of smoking P over the same period.

The craving for P can make users do things they normally would not. One addict, an Aucklander in his early 30s who lost his family and a successful business during an 18-month binge, says he was reduced to burgling pharmacies to pay for his addiction.

"I probably became addicted within a week," he says. "Initially it was empowering, but as time went on I could see how focused on it I had become.

"I did whatever it took to get it."

It was only when he feared for his life over drug debts that he retreated to Northland and went cold turkey. When he checked into a treatment clinic near Ohaewai, he was 15kg under his normal weight.

Then there are the effects on relatives. Addicts have told of feeling violent, agitated or suicidal during withdrawal. One woman spoke of kicking in her mother's bedroom door, another of listening to filthy messages left on her answerphone by a P-addicted son.

Sometimes the drug hurts relatives more literally. An Auckland mother of five says she stopped using during her first three pregnancies but could not during the last two.

One of these later children, a 19-month-old boy, has been slow to walk and talk.

American researchers are yet to finish a five-year study into the effects of P on babies, but anecdotal evidence suggests the drug can harm foetuses.

On September 8, California mother Amy Leanne Prien, 31, was found guilty of murdering her 3-month-old son. He overdosed on P in her breast-milk.

As for Andrew Jones, he says he is "nearly back to being a happy, normal human being" after battling through his P withdrawal.

He has survived his fear of Them, with medication and family support.

Jones says he is a regular, down-to-earth New Zealander with a full-time job.

During his withdrawal, he says he was "convinced someone was out to get me" as retribution for some wrong he had committed but could no longer remember.

"I lived hell on earth," he says.

"I fried my brain."

Herald Feature: The P epidemic

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