Beautiful Boy (16 page)

As many as half of all meth users, and a larger percentage of ice users, tweak. That is, at some point they experience the type of meth psychosis first identified in Japan in the late 1940s. It is characterized by auditory and visual hallucinations, intense paranoia, delusions, and a variety of other symptoms, some of which are indistinguishable from schizophrenia. The hyperanxious state
of tweaking can lead to aggression and violence, hence the following, from a report for police on how to approach meth addicts: "The most dangerous stage of meth abuse for abusers, medical personnel, and law enforcement officers is called 'tweaking.' A tweaker is an abuser who probably has not slept in 3-15 days and is irritable and paranoid. Tweakers often behave or react violently.... Detaining a tweaker alone is not recommended and law enforcement officers should call for backup."

The report includes Six Safety Tips for Approaching a Tweaker, including: "Keep a 7-10 ft. distance. Coming too close can be perceived as threatening. Do not shine bright lights at him. The tweaker is already paranoid and if blinded by a bright light he is likely to run or become violent. Slow your speech and lower the pitch of your voice. A tweaker already hears sounds at a fast pace and in a high pitch. Slow your movements. This will decrease the odds that the tweaker will misinterpret your physical actions. Keep your hands visible. If you place your hands where the tweaker cannot see them, he might feel threatened and could become violent. Keep the tweaker talking. A tweaker who falls silent can be extremely dangerous. Silence often means that his paranoid thoughts have taken over reality, and anyone present can become part of the tweaker's paranoid delusions."

Tweaking or not, meth addicts are more likely than other drug users (with the possible exception of crack addicts) to engage in antisocial behavior. A successful businessman took the drug to work longer hours, became addicted, and murdered a man who owed him drugs and money. An addict shot his wife, another fatally bludgeoned his victim, and another murdered a couple for a car and seventy dollars. A couple, both meth abusers, beat, starved, and then scalded their four-year-old niece, who died in a bathtub. A Pontoon Beach, Illinois, man was under the influence of meth when he murdered his wife and then killed himself. In Portland, a woman on meth was arrested for killing her eighteen-month-old child, strangling her with a scarf. In Texas, a man high on meth, after arguing with a friend, tracked him down and murdered him—shooting him six times in the head. In Ventura County, California, a man under the influence of meth raped and strangled a
woman. Also in California, a meth-addicted mother was convicted of keeping her two young children locked in a cold, cockroach-infested converted garage. An Omaha man was recently sentenced to forty years for murdering his girlfriend's child after shooting meth. The child had been smothered and had numerous broken bones. There have been trials in Phoenix, Denver, Chicago, and Riverside County, California, of mothers accused of murdering their babies because they nursed them while they were on meth. The mother in Riverside, during her trial, said, "I woke up with a corpse."

In addition to crime, methamphetamine causes significant environmental damage in the places where it is made. The manufacture of one pound of methamphetamine creates six pounds of corrosive liquids, acid vapors, heavy metals, solvents, and other harmful materials. When these chemicals make contact with the skin or are inhaled, they can cause illness, disfigurement, or death. Lab operators almost always dump the waste. The implications for the Central Valley in California, a source of a large percentage of America's fruits and vegetables—and much of its meth—are significant. In the early 2000s, hospitals in the valley were treating many children, often of undocumented immigrants, for conditions related to the chemical by-products of meth production. As an FBI agent there told me, "Millions of pounds of toxic chemicals are going into the fruit basket of the United States. The chemicals are turning up in alarming levels in ground-water samples."

The health effects of using meth are disastrous. The drug lands more people in emergency rooms than any other club drug, including ecstasy, ketamine, and GHB combined. (And in a laboratory test conducted at the University of California at Los Angeles, eight out of ten tablets sold as ecstasy at clubs in that city contained meth.) Those who don't overdose on the drug may still die from it. Meth causes or contributes to fatal accidents and suicides. After conducting a survey of suicidal tendencies in drug users, psychiatrist Tom Newton, a researcher at UCLA, concluded that "meth-amphetamine is a uniquely potent drug for inducing depression so severe that people feel like committing suicide."

Many other health risks are related to chronic meth abuse. A
doctor who works at a San Francisco emergency room told me about the stream of meth addicts who come in with "blown-out"—literally ruptured—aortas. Addicts may cough up chunks of the lining of their lungs. Many meth addicts lose their teeth. Chronic meth use can cause Parkinson's-like cognitive dysfunction, including deteriorating memory and mental acuity and physical impairment, including paralysis—results of meth-induced strokes. Onetime use of the drug can be fatal. It can cause the body temperature to sharply rise, leading to lethal convulsions, death from hyperthermia, "arrhythmic sudden death"—the heart no longer has a functional beat—or fatal aneurysms. Serious or fatal conditions may be more likely to occur because of the extended periods of activity that many users engage in. Meth users may not sleep or eat for days. The combination of the drug and fatigue has been shown to contribute to paranoia and aggression. The cycle tends to compound physical, psychological, and social problems; and these all may be further compounded by existing mental health issues, which are common among users.

Nic has used meth. In spite of his protests and promises, I increase my pleas for him to go into rehab, but he will not yield. I learn that now that he is over eighteen, I cannot commit him. If he were a threat to himself or someone else, there's a complicated process by which I could commit him for a brief evaluation at a mental hospital, but a parent concerned about a child's drug use doesn't qualify. Had I seen this coming, I would have forced Nic into rehab when I still could have made the decision for him. There is no way to know if it would have helped—he may not have been ready to hear the message of rehab—but at least it may have slowed him down. Now he has to go in on his own.

He sleeps for as much as twenty hours a day for the next three days. After that, he is depressed and withdrawn. Then, without warning, on a cold spring afternoon, he disappears again.

With Nic gone, and our old car with him, I once again call hospital emergency rooms. I once again call the police to see if he has been arrested. When I explain that my son is missing, a police dispatcher, before passing along the phone number for the jail, tells me that if Nic shows up I should send him to a boot camp where children, roused and shackled in the middle of the night, are taken by force. I have been reading about one of these—a boot camp in Arizona near my parents'. A boy died there over the summer. At the boot camp, children were beaten, kicked, starved, chained, and deprived of water in the 114-degree desert.

I talk to other parents who have gone through versions of this and I am bombarded by their advice, too, much of it familiar and much of it familiarly contradictory. Once again, one says that if Nic shows up, I should kick him out. It makes no sense to me because I know where he would go, to his unsupervised friends' homes or perhaps to the squalid and treacherous lairs of his drug dealers. That would be that. All hope for him would be lost. One mother recommends a lockup school where she sent her daughter for two years.

Nic has been gone for six days, and my desperation has built to a frenzy. I have never experienced grief like this. I spend frantic hours on the Internet reading harrowing stories of children on drugs. I call parents who know parents who know parents who have
been through this. I try and try to understand what drugs mean to Nic. He once told me, "Every writer and artist I love was a drunk or an addict." I know that Nic uses drugs because he feels cleverer and less introverted and insecure, and he also carries the dangerous—and fallacious—idea that debauchery leads to the greatest art, whether by Hemingway, Hendrix, or Basquiat.

In his suicide note, Kurt Cobain wrote, "It's better to burn out than to fade away." He was quoting a Neil Young song about Johnny Rotten of the Sex Pistols. When I was twenty-four, I interviewed John Lennon. I asked him about this sentiment, one that pervades rock and roll. He took strong, outraged exception to it. "It's better to fade away like an old soldier than to burn out," he said. "I worship the people who survive. I'll take the living and the healthy."

The living and the healthy.

I do not know if my son can be one of them.

Somehow I never fall apart around Jasper and Daisy. I do not allow myself to; I don't want to worry them any more than they already are. To the kids, Karen and I acknowledge that we're concerned about Nic and, in doing so, try for a delicate balance. We don't want to scare them, and yet we don't want to pretend that everything is fine when they know—how can they not?—that it isn't. I'm convinced that failing to acknowledge this crisis will be more confusing and more damaging than the truth.

When I am alone, however, I weep in a way that I have not wept since I was a young boy. Nic used to tease me about my inability to cry. On the rare occasions when my eyes welled up, he joked about my "constipated tears." Now tears come at unexpected moments for no obvious reason, and they pour forth with ferocity. They scare the hell out of me. It scares the hell out of me to be so lost and helpless and out of control and afraid.

I call Vicki. Our acrimony since the divorce has been pushed aside by our shared worry about Nic. It is with relief that I come to see her not for what separated us but for what unites us. We both love Nic in a way that only parents love their children. It's not that Karen and Nic's stepfather aren't worried about Nic, but in long
telephone conversations that no one else can be part of, his mother and I share a particular quality of worry—acute and visceral.

Meanwhile, Karen and I go back and forth switching roles. When I collapse, she reassures me.

"Nic will be all right."

"How do you know?"

"I just know. He's a smart boy. He has a good heart."

Then Karen will lose it, and I console her.

"It's all right," I say. "He's just mixed up. We'll figure this out. He'll come back."

And he does.

On a still, cold, and gray afternoon, a week later, he shows up at the house. Like the time I went to find him in the alleyway in San Rafael, he is frail, ill, and rambling—a barely recognizable phantom.

I just stare at him standing there in the doorway.

"Oh, Nic," I say. I gaze at him and then lead him by the arm to his room, where, still dressed, he lies on his bed, wrapping himself up in a comforter. I am glad that no one else is home so that, for the moment, I don't have to explain.

I stare at him.

If all that therapy didn't help, then what? Rehab. There is nothing else. "Nic, you have to go into rehab. You have to." He mumbles and falls asleep.

I know that I must do everything possible to get him into a drug rehab program. I call counselors and other specialists for recommendations. Nic's therapist now agrees that rehab is essential, and contacts some of his colleagues who specialize in drug and alcohol addiction. My friends call their friends who have been through this.

Nic sleeps.

I call the recommended facilities in our area, inquiring about their success rates for treating meth users. These conversations provide my initial glimpse of what must be the most chaotic, flailing field of health care in America. I am quoted a range from 25 to 85 percent, but a drug and alcohol counselor familiar with many
programs says that the figures are unreliable. "Even the conservative numbers sound overly optimistic," he says. "About seventeen percent of people who go through these programs are sober after a year." An admitting nurse at a northern California hospital may be the most accurate when she tells me the number for meth addicts. "The true number is in the single digits," she says. "Anyone who promises more is lying."

The more I learn about the rehab industry, the more it seems in disarray. Some highly touted, and expensive, rehab programs are ineffective. Many rehabs employ one-size-fits-all-addicts programs. Whether private or public, some are only slightly better than useless when it comes to the treatment of meth addicts, according to Richard Rawson, the associate director of the Integrated Substance Abuse Programs at UCLA, who calls them "the Earl Scheibs of rehab. The paint job doesn't last."

Dr. Rawson doesn't suggest that many programs don't have useful components. They tend to be rooted in the principles of Alcoholics Anonymous, which seem to be essential to staying sober for most, if not all, alcoholics and addicts, no matter the drug. But other than that, they offer a slipshod patchwork of behavioral, psychological, and cognitive therapies. Many programs include lectures, individual counseling sessions, chores with harsh consequences for shirking, and confessional and confrontational group therapy, including badgering patients who resist the gospel of treatment. (According to the drug and alcohol counselors in these programs, resistance means denial, and denial leads to relapse.) Some programs offer life-skills training, such as résumé writing, exercise, group and individual sessions with family, and consultations with a physician and psychiatrists, who may prescribe medication. Some facilities offer massage and nutrition consultations. Some outpatient programs add a relatively new technique called contingency management, a system of rewards for abstinence. However, without standards based on proven protocols, patients are often subjected to the philosophies of a program's director, some of whom have no qualifications other than their former addiction. "Having six children doesn't make you a good ob-gyn," says Walter Ling, a neurologist and the director of the UCLA program. Even rehabs run by
trained doctors and clinicians employ a wide range of treatments, many unproven. Most important: many programs fail to take into account the specific conditions of methamphetamine, which is, according to some experts, the toughest addiction to treat. But what else can I try?