Forum Post: "Drugs Aren't the Problem": Neuroscientist Carl Hart on Brain Science and Myths About Addiction
Posted 9 months ago on Jan. 7, 2014, 3:16 p.m. EST by LeoYo
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"Drugs Aren't the Problem": Neuroscientist Carl Hart on Brain Science and Myths About Addiction
Tuesday, 07 January 2014 11:11 By Amy Goodman, Democracy Now! | Video Interview
As we continue our conversation on the nationwide shift toward liberalizing drug laws, we are joined by the groundbreaking neuropsychopharmacologist Dr. Carl Hart. He is the first tenured African-American professor in the sciences at Columbia University, where he is an associate professor in the psychology and psychiatry departments. He is also a member of the National Advisory Council on Drug Abuse and a research scientist in the Division of Substance Abuse at the New York State Psychiatric Institute. However, long before he entered the hallowed halls of the Ivy League, Hart gained firsthand knowledge about drug usage while growing up in one of Miami’s toughest neighborhoods. He recently wrote a memoir titled High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society. In the book, he recalls his journey of self-discovery, how he escaped a life of crime and drugs and avoided becoming one of the crack addicts he now studies.
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AMY GOODMAN: As we continue our conversation on the nationwide shift towards liberalizing drug laws, we’re joined now by the groundbreaking neuropsychopharmacologist Dr. Carl Hart. He’s the first tenured African-American scientist at Columbia University, where he is an associate professor in the psychology and psychiatry departments. He’s also a member of the National Advisory Council on Drug Abuse and a research scientist in the Division of Substance Abuse at the New York State Psychiatric Institute. However, long before he entered the hallowed halls of the Ivy League, Carl Hart gained firsthand knowledge about drug usage while growing up in one of Miami’s toughest neighborhoods. He recently published his memoir called High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society. In the book, he recalls his journey of self-discovery, how he escaped a life of crime and drugs and avoided becoming one of the crack addicts he now studies.
Dr. Carl Hart, we welcome you to Democracy Now! The title of your book almost was the song we were just playing, "Trouble Man"?
DR. CARL HART: That was my vote, Trouble Man, but the publishers thought that it wasn’t 1973, so we should go with something more modern.
AMY GOODMAN: Both your research findings will surprise many and also your own path in life. Let’s start by talking about, well, where you come from.
DR. CARL HART: Well, I come from—as you said, I grew up in the hood. And so, when we think about these communities that we care about, the communities that have been so-called devastated by drugs of abuse, I believed that narrative for a long time. In fact, I’ve been studying drugs for about 23 years; for about 20 of those years, I believed that drugs were the problems in the community. But when I started to look more carefully, started looking at the evidence more carefully, it became clear to me that drugs weren’t the problem. The problem was poverty, drug policy, lack of jobs—a wide range of things. And drugs were just one sort of component that didn’t contribute as much as we had said they have.
AMY GOODMAN: So, talk about the findings of these studies. I mean, you’ve been publishing in the most elite scientific journals now for many years.
DR. CARL HART: Yes. So, one of the things that shocked me when I first started to understand what was going on, when I discovered that 80 to 90 percent of the people who actually use drugs like crack cocaine, heroin, methamphetamine, marijuana—80 to 90 percent of those people were not addicted. I thought, "Wait a second. I thought that once you use these drugs, everyone becomes addicted, and that’s why we had these problems." That was one thing that I found out. Another thing that I found out is that if you provide alternatives to people—jobs, other sort of alternatives—they don’t overindulge in drugs like this. I discovered this in the human laboratory as well as the animal laboratory. The same thing plays out in the animal literature.
AMY GOODMAN: What do you mean? You’re saying that crack is not as addictive as everyone says?
DR. CARL HART: Well, when we think of crack—well, we have a beautiful example now, the past year: the mayor of Toronto, Rob Ford, for example. The guy used crack cocaine, and he did his job. Despite what you think of him and his politics, but he came to work every day. He did his job. The same is true even of Marion Barry. He came to work every day, did his job. In fact, he did his job so well, so the people of D.C. thought, that they voted for him even after he was convicted for using crack. But that’s the majority of crack cocaine users. Just like any other drug, most of the people who use these drugs do so without a problem.
AMY GOODMAN: Compare it to alcohol.
DR. CARL HART: Well, when we think about alcohol, about 10 percent of the people—10 to 15 percent of the people who use alcohol are addicted or meet criteria for alcoholism; for crack cocaine, about 15 to 20 percent—the same sort of thing when we look at the numbers. And we’ve known this in science for at least 60 years. We’ve known—I’m sorry, at least 40 years, we’ve known this sort of thing, but we haven’t told the public.
AMY GOODMAN: So, you’re saying someone who has wine every night for dinner would not be considered an alcoholic in the same way if you take crack every day?
DR. CARL HART: Exactly. So, the criteria, to me—the way we judge whether someone is an addict is whether or not they have disruptions in their psychosocial functioning. Are they going to work? Are they handling their responsibilities? Or are they overindulging in the activity? And when we think about drugs like alcohol, wine every day, people can drink alcohol every day and still meet their responsibility. The same is true with crack cocaine. The same is true with powder cocaine. The same is true with marijuana. Think about it this way. The three most recent presidents all used illicit drugs, and they all have met their responsibilities. They’ve reached the highest levels of power. And we would be proud if they were our children, if they—despite the fact that they’ve all used illegal drugs.
AMY GOODMAN: But they are saying they didn’t use them in a regular kind of way. I mean, who knows?
DR. CARL HART: Well, when we say "a regular kind of way," for example, I use alcohol. I may use it once a month, twice a month, four times a month. It may vary, but that’s certainly regular. And so, when we think—I think the public, when they think of regular, they think of overindulging. And when people overindulge, like every day multiple times a day, it’s going to disrupt some of your psychosocial functioning. Now, that is a small number of people. Only a few people engage in behavior like that. And I assure you that if they engage in behavior like that, that’s not their only problem. They have multiple other problems.
AMY GOODMAN: So why do some people get addicted to crack, and some people don’t?
DR. CARL HART: That’s a great question. People get addicted for a wide range of reasons. Some people have co-occurring or other psychiatric illnesses that contribute to their drug addiction. Other people get addicted because that’s the best option available to them; other people because they had limited skills in terms of responsibility skills. People become addicted for a wide range of reasons. If we were really concerned about drug addiction, we would be trying to figure out precisely why each individual became addicted. But that’s not what we’re really interested in. We are interested, in this society, of vilifying a drug. In that way, we don’t have to deal with the complex issues for why people really become addicted.
AMY GOODMAN: Talk about brain science.
DR. CARL HART: Yeah, so we talk about—"talk about brain science," that’s a real good question. Brain science, at some level, in terms of drug abuse, has become voodoo, in a sense, because people think—I mean, that’s not to be disrespectful, because that’s my favorite sort of science, by the way. But the way we have been thinking about brain science is that people show you pretty pictures, pretty images, and you think that that tells you something about how they behave. It doesn’t. And so, from that perspective, it concerns me deeply. But on the other side, I am—I marvel at what we are learning about how the brain works, in general. And so, we are not anywhere near being able to explain drug addiction with our brain science yet. But that doesn’t mean that we shouldn’t continue to try and figure out what’s going on in the brain.
AMY GOODMAN: You’ve been testing humans. How does human experiments compare with rat and animal experiments?
DR. CARL HART: Depends on the question that you’re asking. For example, if you’re asking a question about simple neurochemistry. When we think about dopamine, and you’ve heard a lot about that neurotransmitter, it’s in the brains of rats, it’s in the brains of humans. If you want to know what dopamine—what cocaine does to dopamine, you can use a rat brain to figure that out as well as a human brain, and that’s pretty close. But when you start to talk about drug addiction and the complexities, drug addiction is a human sort of ailment, not an ailment in rats. What you can do in rats is maybe model one component, maybe two components of drug addiction, but understand that that model might be quite limited.