Part II: Sober hope

Mary's resolve tempers with reality as the days go by and the ache in her back becomes increasingly debilitating.

"It's the worst pain I've ever been in, in my whole life," she says.

It started just after a fender-bender on the way to a follow-up appointment after her gall bladder surgery a month ago. But instead of healing, the pain keeps getting more intense.

In a matter of weeks, it hurts too badly to walk upright.

She's living in a fifth-wheel trailer parked next to the home her mother and grandmother share with her two sons.

The trailer is small and crowded. Little of winter's scarce sunshine makes its way inside.

Still, she rarely leaves the cramped darkness. She stays in bed most of the time. Today, she barely crawled to the bathroom.

In pain, she gives in. She calls a friend. In a matter of moments, the same drug she called "the devil" becomes her salvation in a pipe shaped from a scrap of tinfoil.

For a moment.

Then she's thrust back into hell's excruciating embrace as the high wears off and the pain in her back returns with a vengeance.

Nine days later, she's still reeling.

"I would rather be in pain for the rest of my life than feel as bad as I did coming off of it."

• • •

Coming down off methamphetamine, while not physically painful like other drugs such as heroin or life-threatening like alcohol, can be dangerous, according to Pamela Hill, an alcohol and drug counselor who runs an outpatient counseling service on Fairview Drive.

"Meth users don't know how to deal with their emotions," Hill said. "In the first three to five days, the chance of suicide increases because of depression. They'll sleep eight to 10 hours, wake up, gorge, then sleep again.

"After the fifth day, the depression is so deep, they go out looking for the drug."

Methamphetamine stimulates the release of dopamine, the natural "feel good" chemical created in the brain. Those who have low levels of the neurotransmitter become quickly addicted to the drug.

"The euphoria is very powerful," Hill said. "But it's toxic."

It has a roller-coaster effect of extreme highs when using the drug, accompanied by extreme lows when the drug wears off.

Long-term meth abuse can cause dopamine nerve axons to eventually die. When the nerve endings die, they are gone for good. All emotions - from pain to pleasure are dulled.

Hill said the first high is always the highest.

"They see the benefits right away," she explained. "They lose weight. They have energy and can accomplish a lot, clean the house - whatever."

But over time, she said, they begin using the drug just to have enough energy to get out of bed. Cleaning house is no longer a priority.

"It can get pretty disgusting, what we would call uninhabitable," Hill said.

And the original weight loss deteriorates into what Hill describes as "claymation," when the skin turns a grayish color and the pores get big. The eyes lose their luster and sores break out.

For the user, though, the drug masks its own devastation.

"They feel extremely attractive," Hill said. "Mothers are convinced they're good mothers. The whole world is that drug environment."

Love and lust are confused.

"Meth increases the desire for sex, and the sex is so powerful because of the drug that they become convinced it's mad, passionate love," Hill said. "But chances of a relationship lasting once they're clean is slim."

And sex becomes a bartering tool.

"There's a lot of prostitution, but they don't see it that way," Hill said. "Their cognitive brain doesn't recognize it."

Methamphetamine stops the absorption of calcium and protein leading to muscle and skin damage, tooth decay and hair loss.

Abusers often stay awake when they're "on a runner." Hill said she had one patient who didn't sleep for 33 days.

The drug, combined with the effects of no sleep, leads to paranoia, anxiety, hallucinations and schizophrenic-type behavior.

Getting clean involves more than quitting the drug.

"You're usually dealing with about a 10-year-old child," Hill said. "Either they've never learned appropriate socialization or life-coping skills, or they lost them while using."

The best thing friends and family can do to help, she said, is to get away from the addict and get help for themselves through programs, like Al-Anon.

And the best thing for the addict is to enroll in a formal program.

"The chances of getting clean on your own are pretty low," she said.

If they don't, she said, the likely outcome is either prison or death.

"There's not too many midway alternatives if they don't get help."

• • •

It's not just pain Mary has to cope with. Giving up meth means giving up all of her friends.

"I feel empty. I cry a lot," she says. "It's like learning to live again. It's just boring to me."

It's the first time she's been single. She's been through "a string of men," and says she's a sucker for the "outlaw, convict type."

And when she's sober, she's no longer numb to the guilt.

"It's hard to be a mama," she says. "I'm not ready to be a mama, but I love them unconditionally."

Her own shortcomings as a mother bring back memories of her own childhood spent in foster care, receiving only sporadic supervised visits from her mom.

She remembers only bits and pieces of her girlhood. She knows a couple of the six families she lived with tried to adopt her. She sabotaged every attempt.

"I didn't want anyone to take me from my mom," she explains. "I never gave up on her. I knew she'd come back for me some day. ... She never did."

Mary swore she would be a better mother. So far, she hasn't been. But she vows she will make it up to her boys.

"I owe them still," she says.

This morning, 8-year-old Ryan walked to the convenience store where he bought temporary hair dye. His normally brown hair is blue as he works on his bike in the garage.

Jason, 11, comes into the camp trailer with Mary. He crawls up on the bed and snuggles under her arm.

She runs her fingers through his already disheveled sandy-blond hair.

He tells her he's glad she's not using.

"When you're on drugs, you just stay away from us," he says, not looking at her.

Mary recalls the first time she realized her little boys were growing up. She was in jail and placed a collect phone call home.

Jason answered.

"He accepted the call, and he listened to the directions. It was like he was a little adult."

He smiles at this adoration.

"But it made Grandma real mad," Mary admits.

They laugh, and it's a respite from the pain. Mary starts to recognize the positive changes.

She's gained four pounds on her 5-foot, 7-inch frame. In the month and a half since she's been out of the hospital, her sons are slowly starting to trust her again.

"It's cool at the end of the day when my kid comes up to me and says, 'I love you.' It shocks me."

She looks forward to feeling better and finding a place of her own.

"I've never had my own place without a man," she says.

She looks forward to decorating it however she wants.

"I want a place we can live together as a family," she says. "I think it will give me hope. I like the way I feel when I'm sober."

But that feeling can be fleeting.

"Once you're an addict, you're always going to get that craving. Some days you really want it, some days it doesn't even bother you."

Mostly, she's scared. Scared she'll use again, scared she won't.

"I hate dope. I really hate it," she says. "But as much as I say I don't want to do it, it's hard. I like it."

All she has left is hope, but she's wary of the emotion. She knows how quickly it can dissolve into disappointment.

She believes she has a chance.

The next day, she collapses.

Her mom and grandmother roll her onto a sheet, carry her to the car and drive her to Washoe Medical Center in Reno.

• Contact reporter Teri Vance at tvance@nevadaappeal.com or at 881-1272.