Crack makes cocaine top cause of overdose deaths

From the Oregonian, March 31, 1988

Cocaine, particularly a rocklike derivative known on the street as crack, has replaced tar heroin as the drug most responsible for overdose deaths in Oregon.

Through Wednesday there have been 11 cocaine-caused deaths, three more than occurred in all of 1987, said Dr. Larry V. Lewman, Oregon state medical examiner. He said there have been six deaths attributed to tar heroin and three fatalities tied to methamphetamines.

“It’s a trend that began developing the last few months of 1987,” Lewman said. “What’s also noteworthy is that half of the cocaine deaths this year are from people using crack. The majority of cocaine deaths used to be from people using it intravenously.”

Crack, described by authorities as highly addictive, is smoked, which gives the user an immediate high. But the effect does not last long and larger amounts of cocaine are needed more frequently to get the same effect.

“In San Francisco they’re having one cocaine-related death a week,” he said. “And I know there have been a couple cases in California where heavy cocaine users have had heart transplants because the cocaine has destroyed the heart muscle.”

Lewman said cocaine users have been overdosing in two ways. The most common instance happens when the cocaine interferes with the cardiovascular or central nervous system almost immediately after it’s ingested. A more recent phenomenon is called cocaine psychosis, which is brought on by heavy cocaine use over a period of time.

“It differs from the first method in that it takes longer and is, medically, extremely complicated,” Lewman said, adding there have been three such cases in Multnomah County this year. “People are usually on the stuff for several days straight and become paranoid and start acting bizzare. Basically they die from profound stimulation, in effect a cocaine-induced seizure. The heart has a spasm.”

Lewman said a classic case occurred in February when a 28-year-old city employee collapsed and died while being arrested after running naked through two downtown buildings before attacking a newstand clerk at the Justice Center.

Leon P. Hoffard Jr., an accounting assistant assigned to the Office of Fiscal Administration, stopped breathing moments after he was subdued and handcuffed. He was taken to Oregon Health Sciences University, where he was pronounced dead on arrival.

Hoffard died of cardiac arrest brought on by a drug-induced psychosis and manic delirium, Lewman said.

Lewman said in two other Multnomah County cases, the victims died while being treated in emergency rooms or while in transit to the hospital.

On the day he died, Hoffard left work without telling anyone where he was going. When he returned he began vacuuming his office and then took off his clothes.

In years past, tar heroin has been the drug of choice for Oregon addicts. Because the drug was so pure — 60 percent as compared to 3 percent to 5 percent for the once-popular powdered forms known as China white and Mexican brown — addicts couldn’t handle it.

In 1985, there were 57 overdose deaths attributed to tar heroin in Multnomah County, more than occurred in Seattle and San Francisco combined.

In ensuing years, however, the number of tar heroin deaths has dropped dramatically. Lewman said there were 20 deaths in 1987. Law enforcement authorities said addicts are more familiar with tar heroin and know how to use it.

Lt. Bruce Prunk of the Portland Police Bureau’s Drug and Vice Division said authorities have had some success in breaking up several of the large tar heroin distribution rings.

But he said the crack and cocaine dealers are more elusive. He estimated there are as many as 35 crack houses in Portland, many of which move their operations on a weekly basis.

“The number of people who have access to cocaine has increased in the past several years,” Prunk said. “It used to be a rich man’s drug. But the price has come down and that isn’t the case any more.”