R.I.P.ped

Shelly Martin was bone tired from the countless hours she spent at the bedside of her sick friend, but she figured she had better return to the hospital, and fast. For the last 10 days, Mike Scarcella had been in the intensive care unit at Presbyterian Hospital of Plano. Now Martin had learned that his doctors were planning to transfer him to some psych ward, even though his jaw was wired shut and he was being treated for pneumonia and a staph infection. Worse, he was still going through withdrawal from gamma hydroxybutyrate (GHB). Although lucid at times, he would grow restless and agitated, suffering from nightmarish hallucinations aggravated by days without sleep. In terms of withdrawal, heroin had nothing on GHB.

When he came to the emergency room on August 15, Scarcella told the nursing staff he was a GHB addict. He knew that it would be only a matter of hours before he started to feel the anxiety and tremors of early withdrawal. It would take longer than that to fix his broken jaw, which was hanging sideways from the beating he had taken outside a Carrollton bar. He was always a stand-up guy, but that night he stood up to the wrong men. After he was cold-cocked from behind, three others joined the fray, kicking him in the head while he was down.

After she arrived at the hospital, Martin went on her own rampage: He wasn't some destitute druggie who needed to be dispatched to a detox center without so much as an explanation. He was Mike Scarcella, a competitive bodybuilder, a former Mr. America, a personal trainer, a dad. She was one of four devoted friends who took shifts and maintained a round-the-clock hospital vigil, caring for him because nurses were afraid of him. At 39, Scarcella was still a massive wall of buffed and bulging muscle.

Since so little is known about GHB withdrawal, even among emergency room physicians, Scarcella put nurses in touch with Project GHB Inc., a clearinghouse for information about the dangers of the drug. While GHB gained its notoriety as a club drug, used by date rapists preying on unsuspecting women, bodybuilders had been the first to fall victim to the "supplement," which was originally sold in nutrition stores and promised them more muscle mass, less body fat, sound sleep and great sex. Its "good for what ails you" claims were bolstered by its clinical use in Europe and medical research, some of it junk science, that found it nontoxic, nonaddictive and a treatment for certain types of narcolepsy. Government conspiracy theorists furthered its cause on the Internet, finding it scandalous that a substance that occurs naturally in the body could be scheduled as an illegal narcotic. With some science and many Web sites promoting its safety and efficacy, it became easier for the casual user to abuse. That is, until they showed up at emergency rooms, incomprehensible and sweating, their bodies trembling with anxiety, their hearts racing toward stroke.

"It's the worst withdrawal there is," says Trinka Porrata, president of Project GHB. "Most detox takes four to five days. GHB can mean 10 to 14 days of really bizarre and psychotic behavior. The withdrawal itself can be lethal."

Project GHB sent Presbyterian Hospital a withdrawal protocol, which its doctors had followed, at least at first. But when a frantic Martin went to Scarcella's hospital room on the morning of August 25, her friend seemed to be getting worse. A strap crisscrossed his formidable chest and shoulders, harnessing him to the bed. "He was pissed. He wanted to leave and kept struggling to get out of bed," Martin says. "His dementia was so severe, he thought he was driving his car, shifting gears and going home."

The day before, Martin recalls, a doctor told her that another week would pass before Scarcella was released. His staph infection had to first resolve itself. But this morning he was being moved to the psychiatric unit at North Central Medical Center in McKinney. His doctors had signed a medical certificate that authorized taking him into protective custody and committing him to a chemical-dependency facility. "They told me he was outside their scope of treatment," Martin says. "But it was clear they were pushing him out the door."

Three Plano police officers handcuffed Scarcella, placed him in a wheelchair and escorted him to a squad car. Martin says she began to "freak," turning to a nurse and shouting, "No, no, don't let them do this! How can they take him?" Jim Cardenas, another bedside-vigil friend, tried to calm her down: The doctors said it was for the best; they had to trust them. Presbyterian Hospital of Plano declined to comment, citing patient privacy concerns.