It nev­er starts as a full-blown night­mare. It starts with cu­rios­i­ty. Con­fi­dence. The lie: “I can han­dle it.”

The first use of co­caine feels like pow­er — eu­pho­ria in pow­dered form. Your heart races. Thoughts sharp­en. You feel in­vin­ci­ble, like you could tear the world apart and re­build it. But it doesn’t last. The high fades in min­utes. And in its place comes a crash­ing void — so you chase it. Again. And again. And again.

Soon, you’re not us­ing co­caine — it’s us­ing you.

You’re no longer chas­ing eu­pho­ria. You’re run­ning from the lows: para­noia, crav­ings, self-hate. You lie. Steal. You stop eat­ing, sleep­ing, car­ing. Life be­comes a loop, and the on­ly ex­it seems to be an­oth­er hit.

The worst part? You know it’s killing you. You see it in the mir­ror: sunken eyes, pale skin, soul miss­ing. But you can’t stop — be­cause the drug stops be­ing the re­ward and be­comes the re­quire­ment. Not to feel good — just to feel less bro­ken.

You lose every­thing — trust, dig­ni­ty, health — and still crave the very thing that’s de­stroy­ing you. Ad­dic­tion be­comes a prison with no vis­i­ble walls. A hell in­side your own skin.

This isn’t just one sto­ry. It’s many. In­clud­ing a 25-year-old man—once a promis­ing school­boy at a pres­tige school—now a shell of who he was. His fam­i­ly tried every­thing. Got him clean, then watched him re­lapse. Over and over, like a stuck record.

They even con­front­ed the deal­er. Begged him to stop sell­ing. He found an­oth­er.

His moth­er, ex­haust­ed, called me af­ter his lat­est re­lapse. She said, “My coun­try failed me.”

She wasn’t wrong.

De­spite Ras Shorty I’s warn­ing 25 years ago in Watch Out My Chil­dren, we al­lowed the co­caine trade to flour­ish. The drug is cheap. Easy to find. The deal­ers are known—and still op­er­ate freely. Law en­force­ment is in­ef­fec­tive, bor­ders porous, cor­rup­tion ram­pant. She begged for long-term re­hab op­tions, for judges to man­date treat­ment over prison. She wel­comed in­ter­na­tion­al co­op­er­a­tion to dis­rupt sup­ply chains. And in des­per­a­tion, she said: “If blow­ing up the drug ships saves oth­er fam­i­lies, do it.”

Her fury is jus­ti­fied. I’ve seen it too many times. Friends, neigh­bours, cousins—bright, promis­ing peo­ple turned in­to ghosts, chas­ing a high they couldn’t af­ford to sur­vive. I’ve seen par­ents bury their chil­dren. Moth­ers who can’t stop ask­ing them­selves what sign they missed.

I’ve got three boys of my own. And the world is loud­er, mean­er, more dan­ger­ous than when I was grow­ing up. Co­caine. Fen­tanyl. Ec­sta­sy dis­guised as can­dy. One mis­take. One bad night. That’s all it takes to lose every­thing we built for them.

So I talk to my boys. Not just about drugs, but about pain. About pres­sure. About not need­ing to prove any­thing to any­one. But I know I can’t shield them from every­thing.

I’ve worked at St Ann’s Hos­pi­tal long enough to know many pa­tients by name — not from deep ther­a­peu­tic bonds, but be­cause they come back like clock­work. An­oth­er co­caine-in­duced psy­chosis. An­oth­er ER ad­mis­sion. It’s a bru­tal cy­cle: hos­pi­tal, street, jail, re­peat.

Let me be clear: ad­dic­tion is a med­ical ill­ness, not a moral fail­ure. But when some­one shows up for the fif­teenth time—ag­i­tat­ed, delu­sion­al, near­ly co­matose—I don’t just see a pa­tient. I see a sys­tem that’s bro­ken.

Many com­mit crimes to feed the ad­dic­tion—theft, as­sault, deal­ing. And the im­pact isn’t lim­it­ed to health­care. It’s in our com­mu­ni­ties: stolen cars, ris­ing vi­o­lence, pub­lic spaces that no longer feel safe. Hos­pi­tals were nev­er built to be detox cen­tres. Psy­chi­atric wards aren’t re­hab fa­cil­i­ties. But we ad­mit, sta­bilise, dis­charge—and watch them walk straight back in­to the same tox­ic en­vi­ron­ment. Re­habs are full. Wait­lists are long.

It’s dis­heart­en­ing. De­mor­al­is­ing. Un­sus­tain­able.

We need se­ri­ous in­vest­ment in ad­dic­tion ser­vices—re­al long-term re­hab, with wrap­around sup­port and hous­ing. We need co­or­di­nat­ed sys­tems that ad­dress ad­dic­tion and the trau­ma, men­tal ill­ness, and home­less­ness that so of­ten fu­el it. But most of all, we need to stop pre­tend­ing this is just a per­son­al fail­ing.

It’s not.

It’s a pub­lic health cri­sis.

And our cur­rent re­sponse— a bro­ken cy­cle of short stays, missed op­por­tu­ni­ties, and un­treat­ed pain—is no match for the scale of de­struc­tion co­caine is caus­ing in our fam­i­lies, com­mu­ni­ties, and coun­try.