Eight months after his fiancee died in Baltimore after injecting bogus drugs, former University of Maryland pharmacologist Clinton B. McCracken has ended his silence, calling his substance abuse "a cautionary tale regarding the extreme dangers of intellectualizing drug use."
McCracken, writing in the Journal of the American Medical Association, says he thought he was smart enough to keep a handle on his drug use — for example, by limiting his use of opioids like OxyContin to no more than two consecutive days every few months.
But "the perception of control is really nothing more than illusion," he writes, and such misplaced confidence "produces blindness to the devastating consequences of drug abuse and addiction."
His personal essay appears as the 33-year-old scientist remains in Baltimore following his March guilty plea to growing marijuana, a felony. Under a plea deal, he was given a suspended five-year sentence that spared him jail time but meant he would likely be deported to his native Canada.
McCracken wants to go home, said his lawyer, David B. Irwin. He is a possible kidney donor for his father, who has end-stage kidney disease. But several factors — including the expiration of his Canadian passport and required probation in Maryland — have left him in limbo, his lawyer said.
"It's a complicated scenario," Irwin said, adding that McCracken was not available for interviews.
Irwin said the 1,700-word essay, written in a clinical tone despite the intensely personal subject matter, grew out of a suggestion from a mental health counselor who met with McCracken after the death of his fiancee, Carrie E. John.
John, 29, was a fellow pharmacologist at Maryland. Like McCracken, she had earned a Ph.D. at Wake Forest University and was working in a Maryland lab as a postdoctoral fellow. The two shared a Ridgely's Delight rowhouse and planned to get married. She died Sept. 27, 2009, after injecting what she and McCracken thought was the narcotic buprenorphine.
An autopsy found that her death was caused by an allergic reaction and that John had no drugs in her system at the time. Those findings suggest that McCracken had been duped by the online "pharmacy" in the Philippines that sold him the supposed buprenorphine.
The counselor thought that writing about the ordeal would help McCracken "work through his pain," Irwin said, while serving as a warning to well-educated health care workers of the dangers of drugs. McCracken was not paid for the piece, which ran under the journal's regular "A Piece of My Mind" feature, which gives doctors, nurses and sometimes patients a platform for sharing their stories.
McCracken, who has conducted drug abuse research in his career, titled his essay, "Intellectualization of Drug Abuse." In it he writes, "I was able to rationalize my drug use in a number of different ways, all with the similar end result of deluding myself into thinking I did not have a problem."
McCracken's essay was criticized by Dr. Michael Fingerhood, an addictions specialist at the Johns Hopkins University School of Medicine.
"His thinking he's different than someone on the streets who uses heroin is simply not true," Fingerhood said. "He did it to get high; they do it to get high. Everybody thinks they can control it. It doesn't matter if you're a college graduate or a high school dropout. The receptors in his brain are the same as receptors in everybody else's brain."
McCracken reveals that his first exposure to opioid drugs came when he was prescribed a pain reliever after an injury — and not, as has been speculated, because his close work with such drugs in a lab setting made him curious. "I enjoyed the effects," he writes, "and began to seek other sources to attain these drugs."
Of his drug use, McCracken writes: "I was a daily user of cannabis for most of the past decade, and an intermittent user of opioids, primarily via the intravenous route, for approximately three years." For the first time he says that John used IV drugs long before her death: He refers to "my fiancee … with whom virtually all of my intravenous drug use occurred over the previous three years."
Because he did well professionally and maintained successful personal relationships, he did not feel that he had a drug problem. He writes that he believed that by limiting his use of opioids like morphine and OxyContin to two-day stretches every two or three months, he would avoid growing tolerant and dependent.
And he thought that IV drug use — which he liked because it gave him a stronger "rush" than pills — was not especially risky in his case, because of his "technical experience" and "access to sterile needles."
McCracken lists other ways he was able to "intellectualize" his drug use: He thought "small-scale cultivation of marijuana" inside the Ridgely's Delight house was less risky than buying it and lowered the odds of being caught. He also saw a certain logic in buying morphine and OxyContin from the Philippines rather than off the streets of Baltimore.
"The impact of these events on my life has been enormous," he says. "First and foremost is the loss of the woman I loved, my best friend and partner, with whom I had planned to spend the rest of my life."
As for himself, "my career as an academic research scientist has been undeniably derailed, if not destroyed." After John's death, he was charged with several felony drug counts, evicted from the house they shared and fired by the University of Maryland.
At the conclusion of his essay, McCracken returns to his central point: "Neither advanced education nor knowledge of pharmacology nor familiarity with the addictive process was able to prevent tragic consequences for me."