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Many common ideas about addiction are misconceptions, says neuroscientist
A Columbia University addiction research neuroscientist says many of the commonly accepted ideas about substance use, abuse and addiction are just plain wrong.
For example, says Carl Hart, Ph.D., crack cocaine does not create addiction in someone the very first time they use it. Pure crack cocaine and powdered cocaine are chemically identical, and create identical effects on users if the amounts and delivery methods are the same.
In fact, he says, the same is true for any substance – no drug causes addiction the first time it’s used. Even if someone wants to use it immediately a second time, it doesn’t mean they are addicted, he said.
Speaking at a recent TED Talk, Hart said that 80 to 90 percent of drug users never become addicted at all – including those who try cocaine. He reminded the audience that our last three presidents – Obama, Bush and Clinton – all used drugs when they were younger. “Their drug use did not result in an inevitable downward spiral leading to debauchery and addiction,” Hart said. “And the experience of these men is the rule, not the exception.”
From a societal perspective, Hart said he has had to learn that drugs and drug addiction are not the cause of crime, violence and gang activity in our inner cities. Raised in a minority, crime-ridden neighborhood of Miami, he was personally involved in drugs and petty crime as a youth. He was constantly told, and thoroughly believed, that drugs were at the source of all the ills in “the ‘hood”.
“I came from a community where drug use was prevalent,” Hart told the TED Talk audience. “I kept a gun in my car, I engaged in petty crime, I used and sold drugs. But I also stand before you today, emphasis on ‘also’, a professor at Columbia University, who studies drug addiction. And I know what some of you are wondering – ‘How in the world did you get from there to here?’”
Hart made it through high school, and credits his joining the Air Force with sparking his interest in higher education. He received a Bachelor of Science degree and a Master of Science degree from the University of Maryland, and earned his Ph.D. in Neuroscience from the University of Wyoming. Finding a solution to addiction became his mission. He says he chose neuroscience specifically so he could solve the addiction problems in his old neighborhood.
And after more than a decade of research, he has convinced himself and his co-workers that crime, violence and gangs are based on poverty and the lack of opportunities and positive choices. Crime and violence exist independently of drug abuse and addiction, he says.
Many common ideas about addiction are based on old animal research from the 1960s and 1970s, he said, which has not stood up to the test of time. For example, in old research, rodents in cages could access a lever that would give them a shot of cocaine. They immediately began self-administering the drug, and wouldn’t stop until they died. This was the “scientific” basis for everything known about cocaine abuse.
Those rodents were never offered an alternative, he said. So Hart’s team ran experiments in which the rodents were also offered sweets and sexually active mates as well as the drugs. The results were fascinating. They no longer drugged themselves to death and chose the non-drug alternatives. They favored the sweets and the sexual partnerships more than the drugs.
Encouraged, Hart’s team began similar tests on human subjects. Hardened addicts who agreed to take part in controlled lab experiments were offered a free hit of their drug of choice or a small sum of money – $5 in the first round of experiments and $20 in a subsequent round.
The results were surprising, to say the least. More than half of the participants chose the money over the drugs. The experiments showed over and over again that even a majority of hardened coke and meth addicts, not beginners by a long shot, were more interested in an alternative that meant more to them than just getting stoned again.
Modern science and better, more creative research has taught Hart that the drug addiction problems in America will never be improved unless new ideas are brought to the table. Hart proposed three basic steps to begin reducing drug addiction and crime in a meaningful way.
The first is ensuring that employment and better education are available to all. It will require a huge shift in drug policy, but “important, attractive and meaningful ‘reinforcers’ as alternatives to drug use and abuse” are essential, Hart said.
“My research shows that attractive alternatives can decrease drug use,” he said. “Providing viable economic opportunity will go a long way in decreasing drug abuse.”
The second is decriminalization of drug possession – treating it like a traffic violation, Hart said. Hart pointed to other countries, such as Portugal and the Czech Republic, where drug addiction and crime have been significantly reduced through these methods.
“Significant portions of their society are not stigmatized, marginalized and unfairly incarcerated. If our goal in the U.S. is to have a legal system that treats everyone fairly, one that’s just…we must decriminalize drug possession” and change “selectively enforced” drug laws. For example, racial profiling is rampant in drug enforcement here in the U.S., where 80 percent of cocaine users are white, but 80 percent of people in prison for cocaine possession are black.
“Third, I believe science should be driving our drug policy and drug education – even if it makes you and me uncomfortable. First we should be truthful about it.” He pointed to the massive media coverage of the recent rise in heroin abuse and overdose deaths in the country. The actual truth is that 75 percent of so-called heroin overdose deaths involved other sedative drugs, either alcohol or benzodiazapines.
“Rather than just vilifying heroin, the message should be, ‘If you’re going to use heroin, don’t combine it with another sedative!’”
People will always use drugs, Hart says. They always have used drugs. We must learn to live with this fact. Drugs will never be entirely eradicated no matter what approach is taken, and to think otherwise is naïve. Hart said that we already take this approach with other dangerous activities, such as sex, alcohol and even driving.
“I’ve come a long way since the mean streets of Miami, and even a longer way since the starry-eyed young man who wanted to eradicate drugs as the best way to deal with the drug problem. Today I no longer want to eradicate or eliminate drugs from our society. It would be naïve to think so.”
He added that he wants to “keep safe” the countless recreational drug users, the vast majority of drug users, who don’t have an addiction problem and who need the truth about drugs and who need real justice.
Hart closed his talk by saying he is dedicated to disseminating the real science about drugs and addiction to the public and he asked the audience to join him in these efforts. “What I know now is that drugs are not the problem. The real problems are poverty, unemployment, selective drug law enforcement, ignorance and the dismissal of science surrounding these drugs.”
Hart’s book, High Price: A Neuroscientist’s Journey of Self Discovery That Challenges Everything You Know About Drugs and Society, was published by Harper in June 2013. Called a “harrowing and inspiring memoir”, it won a PEN/E. O. Wilson Literary Science Writing Award.
At Novus, we also believe that ‘the drug problem’ can best be helped by applying proven advances in science and by sensible adjustments of social policies when needed. Here at Novus, we are dedicated to helping reverse the effects of addiction by using the most modern medical detox protocols available. We know what our role is, and we encourage anyone with a drug problem of any kind to call us any time. We are always here to help.
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