Sunday, August 24, 2014
Ending the War on Drugs: A Radical Take From Emerging Leader Dr. Carl Hart
As a public figure neuroscientist Carl Hart is changing minds about drug use itself. This after fighting the drug wars and then fighting the racism and myths behind them.
Dr. Hart Photo via
Dr. Carl Hart grew up in a tightly knit, black working class Miami neighborhood in the 1970s and 1980s. A chance decision to take the military services aptitude test in high school led him to a career in neuroscience and a professorship at Columbia University. Along the way, reports of the crack epidemic decimating black America prompted him to research drug addiction as a way to help the community he came from. These reports, however, were not supported by the data he uncovered, and Dr. Hart’s career began to move in a different direction. The result of this exploration was High Price (published in paperback this summer), a mixture of memoir and science that charts the intersection of America’s war on drugs and its hostility towards marginalized groups.
Dr. Hart sat down with me in his office at Columbia University to discuss some conclusions he has reached about the facts of drug use and effects, and the politically expedient stories we have been taught to believe.
One of the things that became apparent is that this whole notion of a crack epidemic, there simply was no evidence for it.
I understand that you came into the field of drug research because you wanted to find out what was going on, with all the media reports of this scourge on the black community, and then things took a very different turn. I would like to hear a little bit about how that journey occurred.
Well I think most of us bought into it. It was in the 80’s where you had the whole crack thing. President Reagan and Nancy, they said that we had this “crack epidemic” going on. And then there were people in the community who were blaming crack cocaine for a wide range of problems: lack of employment, crime, all of these sorts of things, crack was being blamed for. And then all my favorite artists were also buying into this sort of thing – Gil Scott Heron, Public Enemy, and movies – New Jack City, Spike Lee did some films. All of these people were my favorite artists and they were important in helping me learn how to think. The Congressional Black Caucus, they all bought into this. They signed onto the 1986 laws that punished crack 100 times more harshly than powder. And so, when you have that sort of situation, it’s like, well, all these people can’t be wrong. I admire and respect these people. So I thought that one of the ways I could contribute is to learn more about drug addiction and try and help people with their drug addiction. You solve drug addiction, you solve the drug problem, and then you solve unemployment issues, you solve issues of violence and crime. So I thought.
And in the process of learning, one of the things that became apparent is that this whole notion of a crack epidemic, there simply was no evidence for it. Use of crack cocaine was always relatively low compared to powder cocaine, compared to marijuana, compared to other drug use. So that was inconsistent. And then other things that were inconsistent were “one hit and you’re addicted.” Just not true. We found that out through research studies that we did and also that other people did. All of these things started to challenge my thinking, and so I started to really question our entire field. And after reading historical accounts, newspapers about what people said about cocaine and other drugs, previously, then you start to see that this isn’t so much about the drugs, it’s about going after groups that we don’t like. And then you start to look at the racial discrimination and the data in terms of who is being arrested for what. So when I started to see all this stuff come together, I was actually angry, because I felt like a fraud had been perpetrated against me. But I didn’t know how to do anything about it. Because at this point, I was steeped in science, steeped into trying to be a tenured faculty at an institution. And if you’re trying to do that, you have to publish, and play the game. And part of playing the game, I learned, is that you publish these findings that say, “Drugs are bad.” That’s part of playing the game, because then it’s easier to get your papers published, if drugs are bad. And you certainly can’t say drugs have these good effects. So I was kind of trapped. I didn’t know what to do. Then I figured out I could publish review papers of the literature that other people had done. And then when you publish review papers you can publish critical reviews. And you can start pointing out that the data doesn’t follow the conclusions, and so I started slowly raising questions within an appropriate science mechanism. And then once I started doing that, I was asked to do a book, and I was tenured at this time, and that then provided the perfect vehicle to really say what the data say, and to point out the hypocrisy.
But, in this country, we are allowed to have these baseless ideas and policies when they deleteriously affect groups that we don’t care about.
When you did get this opportunity to write a book, why did you decide to integrate memoir?
Well one of the things that I know is that I have written damn near a hundred science articles, and maybe three people have read them. They’re boring. And in science, we try not to interject our personal feelings into what we write. But that’s deceptive. Because we do it all the time, but we pretend that we don’t. So it’s more dishonest than anything. But that dishonesty decreases the likelihood that anybody outside your field will read what you write. So I decided to use memoir for multiple reasons. I was thinking about who I was really trying to reach. I was trying to be clear that I was writing a book about the young cats, the brothers and sisters who look like me and came from communities where I came from. That was my audience, and I was very clear about that. But I knew if I wrote it well enough, it would have universal appeal. And then when you talk about that target audience, there are few books that are written for them. And so, in order to write a book for them you have to make a connection. And if they knew where I came from and how I came up, I thought that would connect, and they could see themselves in my story, and they could learn something about critical thinking, and not even realize they’re learning about critical thinking. I know anecdotes are powerful, but they are not data, I know that too. So I had to make sure I backed up the anecdote with data. That’s the major reason, to make the connection with these people who look like me, and who books aren’t usually written for.
And what you wanted to communicate was in part that this so-called “crack epidemic” was primarily institutionalized racism and not actually based in fact? And what was really going on was…
Crack was just part of it, that’s some of it because I did some crack cocaine research. But it’s a lot larger than crack cocaine. Certainly I talk a lot about methamphetamine, and I talk a little bit about keeping people safe with drugs, and I talk a lot about neuroscience and how they’ve been manipulated to believe some of these things. But the larger sort of thing is that in the United States we have perpetrated a lot of racial discrimination and we’re not honest about it. And so I was trying to look at the bigger picture, and drugs were just used as a vehicle to get me to talk about racial discrimination, to talk about poverty, the deflection of the federal government to really deal with issues. I’m a drug expert so it gave me a way in to talk about these larger issues, but the most important thing in the book for me are those larger issues, and crack was just one of those situations where it’s a myth that you destroy right up front, and if you bust that myth, now you’ve got people willing to listen for a lot of things, and so, again, it just became a vehicle.
Could you talk a little bit about this mythology that crack versus powder cocaine is so much more powerful, and so much more addictive, and how you have contributed to busting up that myth?
When you look at the chemical structure of powder cocaine and crack cocaine, the only difference is that the powder cocaine has the hydrochloride portion attached to it. They both have the cocaine base, and the pharmacological activity is in the base, not the hydrochloride salt. The hydrochloride salt is there just to make it stable such that the drug can’t be smoked. That’s the only difference. And so what you’re really talking about is a route of administration difference, but people didn’t realize that, and so that’s where I started from. And then you look at all the data that compare the effects of intravenous cocaine to smoked cocaine. The time course, intensity of effects, all the same. Same drug, same effect. So when you just step back and look at the data, you realize that the hysteria is not based on data, it’s just some great stories that people make up.
And yet the severity of punishment for crack versus powder, you write, is now 18:1, and was 100:1 in the 1990s.
That’s right. It was 1986-1988, the laws passed were 100:1, and in 2010, like you pointed out, Barack Obama signed legislation to make it 18:1, such that crack is punished 18 times more harshly than powder, which is fucking stupid. So that just goes to show that we’re still stupid, even when we get a president that people voted for because he said that he would get rid of this difference. He didn’t. Most politicians are cowards, and they don’t have the political guts to do the right thing, and we see this now.