Everything You Know About Drug Use and Addiction is Wrong
Dr. Ira Chasnoff was a doctor in the early 1980s who wrote a preliminary report based on his study of infants born to women who used crack cocaine while pregnant. These “crack babies” were smaller than average and jittery as if in withdrawal. He predicted these children would never be able to attend school with regular children or fully integrate into society. Our country, the experts said, was going to be burdened with supporting these children for the rest of their lives.
It wasn’t long before others began to question Dr. Chasnoff’s findings, which was based on a study of just 23 infants. All of the symptoms attributed to crack cocaine were common of premature babies, which all of the infants in the study were. A 30 year study of these children showed that none of the dire predictions came true and their lives were not dependent on the circumstances of their mothers’ drug use.
The sky did not fall.
Carl Hart saw the detrimental effects of crack cocaine firsthand. One of eight children, he grew up in poverty in Miami and saw relatives succumb to the effects of drug use. Friends ended up in jail or worse. By his own account, he was not immune to the negative influences, including having both used and sold marijuana and other petty crimes.
His life trajectory put him in the military and later in college. Memories of his childhood propelled him into his chosen field of neuropsychopharmacology, which uses neuroscience to study how drugs affect the mind. Now an Associate Professor of Psychology at Columbia University, Dr. Hart began his research career with the goal of curing the addiction he saw destroy lives of those close to him.
One such study involved paying addicts to smoke crack. The participants, found through ads in The Village Voice paper in New York City, had to stay in the hospital for the duration of the several week study. Each day, participants smoked a varying amount of crack, blindfolded so they didn’t know the amount. Throughout the day, they would be given a choice to either smoke more, or receive a reward, either cash or a voucher for merchandise. The smaller the amount of drugs, the more likely they were to choose the reward. Conversely, the larger the amount, the more likely they would choose drugs.
One of the beliefs about crack cocaine is that it is instantly addictive and that people are unable to stop using, even if they wanted to. The belief is that the highly potent form of cocaine provided such huge stimulation to the brain users become addicted to the high. This added to the mythology of the danger of the drug, and was used to justify the harsh penalties associated with its distribution.
Dr. Hart’s study showed this just wasn’t true.
The fact that these so-called addicts would choose a cash reward that they wouldn’t get for several weeks over getting high showed that if they had an alternative to the drug use, they would take it. The amount of the reward mattered. With small amounts of drugs, they would still accept a reward as low as five dollars. However, when the cash reward was increased t0 20 dollars, participants would overwhelmingly choose the cash, even when they smoked large amounts of crack (he had similar results when the drug of choice was methamphetamine).
They weren’t addicted to crack, they just had nothing better to do.
In his book, “High Price,” Dr. Hart details the results of his studies, as well as discusses how incorrect assumptions about drug use and addictions has led to detrimental social policies. He is quick to point out that it’s not the science that was incorrect. It was the interpretation of the results.
For example, he reviewed several studies on methamphetamine users and cognitive impairment. Meth has become the latest drug blamed for the destruction of a new generation of addicts. Like crack, it is believed to be instantly addictive, cause severe cognitive damage, such as memory loss and psychosis, and physical damage, such as tooth decay. Upon careful review of several studies, he showed that psychosis was extremely rare, tooth decay was probably due to bad dental hygiene, and that cognitive function impairment was not proven. In fact, the performance on cognitive tests by meth users did not differ greatly from the control groups. Where they did perform worse, the results were in line with their education and age range.
This was their brain on drugs…and it was working just fine.
Dr. Hart is not claiming that drug abuse is not harmful, and there is evidence that long term use of drugs can be detrimental. He suggests that any negative actions while on drugs, i.e. stealing or violence, are irresponsible behavior that was probably there long before the drug use began. Still, he points out that 80-90 percent of drug users do not become addicted nor are they violent or criminals. The average drug user isn’t the black kid in the inner city but a white male often gainfully employed and living his life — on drugs (see Rob Ford, mayor of Toronto and admitted crack cocaine user).
Dr. Hart’s book goes on to discuss how change in social policy is needed in order to truly combat drug use. He supports decriminalizing drug use, pointing out that the vast majority of drug arrests and sentencing are for possession. He also believes that educating the public on what recreational drugs actually do instead of creating false narratives of instant addiction would help people make better informed decisions about use.
Most importantly, we have to combat the core issue related to the majority of drug use – presenting a better alternative. Dr. Hart talks of how he had support of guidance counselors, family and government programs that gave teenagers jobs which paid. As his studies showed, most users aren’t getting high because of some pathological motivation of addiction. They use drugs as a means of coping, lacking other options in their social environment to find fulfillment.
Each generation has had a drug scourge. Marijuana in the 1930s, heroin in the 1970s, crack cocaine in the 1980s. Today it’s methamphetamine ringing alarm bells for tougher laws and scholarly articles are being on the effects of meth use on infant development.
The sky is falling.
The question is, are we going to wait another generation before we accept what we already know? Drug use is the symptom, not the cause, of our problems.