Summer House

WASHINGTON (AP) — They were indelible images of the cocaine world of the 1970s and ’80s: Rich yuppies and white suburbanites partying down with a couple of lines of "blow." Stockbroker Charlie Sheen snorting up in the limo in "Wall Street." Woody Allen’s sneeze in "Annie Hall."

More than 30 years later, the image remains but the reality of coke in the United States has shifted significantly. Long portrayed as a white crime, Hispanics now make up the overwhelming majority — 60 percent — of federal offenders facing powder cocaine charges.

In fact, data show, more Hispanics than whites or blacks have been sentenced on federal powder charges as far back as 1992. Law enforcement officials say that’s because federal agents almost exclusively pursue cocaine traffickers from South America and Mexico instead of end-of-the-line U.S. consumers.

Until the last decade, when the price of cocaine dropped sharply, consumers were largely affluent and educated. That fed into the misperception — often reported by The Associated Press and other news organizations — that most powder cocaine offenders were white, experts say.

"There was a lot of publicity about the white population using it; it was more of a higher economic status thing," said Dorothy K. Hatsukami, a behavioral scientist at the University of Minnesota’s Masonic Cancer Center. She co-authored a 1996 study medically challenging federal sentencing guidelines that penalized black cocaine offenders more harshly than white ones.

The study cited 1993 data indicating that 69 percent of powder and crack cocaine users were white, compared with 15 percent black and 13 percent Hispanic. However, it suggested that far more blacks and Hispanics used the cheaper crack cocaine than whites.

"Articles in the papers were all related to the jet-setters into powder cocaine, so that’s probably why we were focusing on the white population," Hatsukami said in an interview this week. "There was a lot of media focus on whites and powder in the 1980s — then, it was almost legitimate to be using powder.

"That’s what people did at parties, and people didn’t think it was all that harmful."

The issue of race in cocaine use surfaced again recently with last winter’s U.S. Sentencing Commission vote to ease penalties for crack cocaine offenders — more than 80 percent of whom have been black, according to data between 1992 and 2006. Fewer than 10 percent of crack offenders are white or Hispanic, the Sentencing Commission data show.

By contrast, the number of Hispanic offenders has risen steadily over the years, from 40 percent in 1992 to 58 percent in 2006, the data show. At the same time, the number of white offenders has steadily dropped: from 32 percent in 1992 to 14 percent two years ago.

Federal drug agents and prosecutors are quick to defend their focus on leaders of major drug rings and international traffickers — mostly blacks and Hispanics — instead of small-time or individual cocaine users who are generally charged with state and local crimes.

Last year, for example, federal prosecutors won convictions against 445 people suspected of simply possessing drugs, according to Justice Department data provided in a study by the Transactional Records Access Clearinghouse at Syracuse University. The federal government convicted more than 12,209 — nearly 30 times as many — drug traffickers, manufacturers and distributors during that time, the TRAC study shows.

In the late 1970s and early-to-mid 1980s, cocaine traffic mostly moved up the Interstate 95 corridor. Colombian traffickers airlifted or shipped bricks of the drug to Miami, then moved it up the East Coast to New York, where it was distributed. A kilogram (about 2.2 pounds) then was usually worth at least $50,000, Drug Enforcement Administration agent Michael Sanders said.

"That’s a chunk of money — it was a big affluency thing," Sanders said. "It was pretty much white Americans — that was the market that was purchasing it."

Once the feds started cracking down on Miami, much of the traffic moved to Southwestern states, where Colombians paid Mexicans to smuggle the cocaine across the border, Sanders said. The price of a kilogram has since dropped substantially — to as little as $15,000 in Houston and New Orleans recently, he said.

By 2000, half of all cocaine traffickers facing federal charges were Hispanic, U.S. Sentencing Commission data show. Additionally, Hispanics made up 61 percent of traffickers smuggling in more than 5 kilograms (about 11 pounds).

"I’m not going to tell you it’s not worthwhile to put the user in jail," Sanders said. "But we are mandated to dismantle and disrupt major cartels. That’s our ultimate goal."

For the most part, Sanders said, state and local police and prosecutors are responsible for cracking down on cocaine consumers.

The FBI reports that more than 875,000 whites and Hispanics were charged with local and state drug abuse crimes in 2006. By comparison, 483,800 blacks were similarly charged.

The data do not detail how many Hispanics alone were charged because the statistics only look at differences in race, not by ethnicity, said FBI researcher Nancy Carnes.

In recent years, the big-time distributors have started sending cocaine traffic to Europe.

"It’s a market that’s been largely untapped — up until now," Sanders said.

BALTIMORE, Maryland (CNN) — "Heroin, cocaine, alcohol…whatever was on the table, I wanted it," recalls Baltimore native Tyrone Lewis, who struggled with drug addiction for most of his life.

His addictions made it impossible for him to hold a job very long. For a time, he was homeless.

"After a while you just feel … alone," says Lewis. "That made me want to give up. "

But that all changed when he met Galen Sampson, a five-star chef who offered Lewis the chance to join Chefs in the Making, a culinary training program that offers jobs and education to people who’ve been homeless, incarcerated or have struggled with addiction. For Lewis, it was the chance of a lifetime.

"He was offering me a free education," Lewis says. "What he was doing gave me hope."

For many years, hope has been in short supply in parts of Baltimore. While some areas have been revitalized, much of the city is plagued by crime, poverty and drugs. According to the Census Bureau, nearly 23 percent of residents live below the poverty line and the city has an estimated 60,000 addicts.

As a chef at one of Baltimore’s elite hotels, Sampson often saw his employees struggling with these problems in their own families. When he met his wife, Bridget, a writer who ran literacy programs in the city, he got involved with her work and wanted to do more.

"I was a chef; that’s what I was good at," Sampson recalls. "How could I apply what I did to help?"

Sampson had always dreamed of having his own restaurant. So in 2005, he and Bridget decided to create a socially responsible business that could address some of Baltimore’s problems. They decided that part of their restaurant would be a training program, and Chefs in the Making was born. 

In many respects, Chefs in the Making is run like any other culinary school. Apprentices take classes four hours a week and the rest of the time, they work at The Dogwood, Sampson’s restaurant, which also includes a deli and catering business. Students not only earn a living and learn a trade, but they also build a job history.

The program has partnered with other programs to give apprentices additional support; there’s even a counselor on staff who meets with them every couple of weeks. For Tyrone Lewis, the restaurant itself is a refuge.

"Here there are no secrets," Lewis says. "Most of us just know we are people who are trying to get our lives back together. " 

Sampson admits this unorthodox approach had its skeptics.

"A lot of people think we’re crazy. We’ve pretty much put everything that we have into this project," he says.

But for Sampson, it’s well worth the risk.

"To see what our apprentices have been able to do here has been very rewarding. I think we’re setting the foundation for something good," he says.

In 2008, Chefs in the Making intends to provide training/jobs to more than 30 people. Apprentices make up about 25 percent of the restaurant staff and Lewis’ own situation suggests what potential the program has to change lives.

"Ten years from now, I see myself owning a home, maybe owning my own business," he says.

It’s a future that he wouldn’t have dreamed was possible before meeting Sampson.

"A lot of people say they want to help," says Lewis. "Galen actually makes a difference."

CHICAGO, Illinois (AP) — Two years ago, scientists had high hopes for new pills that would help people quit smoking, lose weight and maybe kick other tough addictions such as alcohol and cocaine.

The so-called "super pills" worked in a novel way, by blocking pleasure centers in the brain that provide the feel-good response from smoking or eating. Now it seems the drugs may block pleasure too well, possibly raising the risk of depression and suicide.

Margaret Bastian of suburban Rochester, New York, was among patients who reported problems with Chantix, a highly touted quit-smoking pill from Pfizer Inc. that has been linked to dozens of reports of suicides and hundreds of suicidal behaviors.

"I started to get severely depressed and just going down into that hole … the one you can’t crawl out of," said Bastian, whose doctor took her off Chantix after she swallowed too many sleeping pills and other medicines one night.

Side effects also plague two other drugs:

• Rimonabant, an obesity pill sold as Acomplia in Europe, was tied to higher rates of depression and a suicide in a study last month. The maker, Sanofi-Aventis SA, still hopes to win its approval in the United States.

• Taranabant, a similar pill in late-stage testing, led to higher rates of depression and other side effects in a study last month. Its maker, Merck & Co., stopped testing it at middle and high doses.

The makers of the new drugs insist they are safe, although perhaps not for everyone, such as people with a history of depression. Having to restrict the drugs’ use would be a big setback because it would deprive the very people who need help the most, since addictions and depression often go hand-in-hand, doctors say.

Approach in jeopardy

A bigger fear is that the whole approach may be in trouble. Researchers say blocking pleasure, especially the way the obesity drugs do, might take the fun out of many things, not just the harmful substances and behaviors these drugs target.

It may be possible to improve the drugs so they act more precisely. Chantix targets a different pathway — nicotine pleasure switches — and in a different way from the obesity drugs, which aim at the same pathway that gives pot smokers the munchies. That is one reason many doctors are optimistic that any risks about Chantix will prove manageable.

But doctors are no longer talking about "super pills" for a host of addictions.

"It certainly diminishes my enthusiasm" to see these side effects, said Mark Egli, co-leader of medicine development at the National Institute on Alcohol Abuse and Alcoholism.

The buzz started four years ago, when studies showed rimonabant helped people shed weight and keep it off longer than previous pills had. It also was being tested for smoking cessation. The Associated Press and other media reported extensively on prospects for a pill that might tackle two big problems at once.

Rimonabant won approval in Europe. But advisers to the U.S. Food and Drug Administration opposed it because of depression risks that became clearer with further study. Sanofi withdrew its U.S. application and said it hoped to resubmit after more research.

But in a new study last month, 43 percent of people taking rimonabant developed psychiatric issues versus 28 percent of those on dummy pills. One rimonabant patient committed suicide and one in the placebo group tried to. Unlike previous studies, this one did not exclude people who had depression in the past.

"I felt it was important to do an ‘all-comers’ study" to see how real-world patients might fare, said Cleveland Clinic’s Dr. Steven Nissen, who led the work.

Not for those with history of depression

Sanofi now tells doctors to avoid giving the drug to people with a history of depression, said a company vice president, Dr. Douglas Greene.

"We are at the cutting edge of being able to manage this risk," he said.

Meanwhile, Merck had bad news from a study of its obesity drug, taranabant, which showed an increased risk of depression and other side effects among people taking medium and high doses.

"We’re doing a lot to define this risk-benefit," including adding another year to all studies under way and going forward only with the lowest dose, said a Merck vice president, Dr. John Amatruda.

Others were less optimistic.

"The door is closing" on this approach, said Dr. James Stein, a University of Wisconsin-Madison cardiologist. If another study he is helping lead does not show benefit for rimonabant, "this drug’s already slim chances of approval will be even more jeopardized," he said.

The situation is murkier with Chantix, which went on sale in the United States in 2006 and is sold as Champix in other countries.

The drug binds to the same spots in the brain that nicotine does when people smoke, causing the release of a "feel-good" chemical, dopamine. Taking it is supposed to keep any inhaled nicotine from giving the same buzz.

In February, the FDA said a link between Chantix and psychiatric problems appears "increasingly likely." Pfizer added warnings to the drug’s label and said that although a link had not been proved, it could not be ruled out.

But a Pfizer vice president, Dr. Ponni Subbiah, said nicotine withdrawal and even quitting smoking can cause mood swings and depression.

It is hard to know "what is causing what," she said. "We know that smokers are at higher risk of suicide than non-smokers, and heavy smokers are at higher risk than lighter smokers."

Some doctors agreed.

"Psychologically, just giving up this ‘friend’ that they’ve had many years in their life can be depressing," said Dr. Geoffrey Williams, co-director of the Greater Rochester Area Tobacco Cessation Center and a paid speaker for Pfizer.

Jeanne Morrison, 63, of suburban of Louisville, Kentucky, looked forward to giving up cigarettes when she and a friend went on Chantix. The friend did well, but Morrison lasted only 10 days on it.

"I got so depressed, I didn’t want to go anywhere. I didn’t want to do anything, and I’m a very high-energy person. It was a depression like I’ve never experienced in my life," she said. She also had "major, major nightmares. These would wake me up, and I would be absolutely shaking and sweating."

Several doctors said such reactions are rare, and that most patients do well on Chantix.

Morrison’s doctor, psychiatrist Dr. Jesse Wright at the University of Louisville, said Chantix helped one of his schizophrenic patients, "who smoked like a smokestack," without worsening his psychological symptoms.

"The risk-benefit ratio is still very much on the side of use of the medication," Williams said. "The alternative, smoking, is extremely highly risky."