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By Jeffery DelViscio, Pedro Rafael Rosado, David Corcoran, Kriston Lewis, Robin Lindsay, Amy Rio and Abe Sater
Béatrice de Géa for The New York Times
The Science of Drug Addiction: Carl Hart, an associate professor at Columbia University, is the author of the book “High Price,” a mix of memoir and scientific research about drug addiction.
By JOHN TIERNEY
Published: September 16, 2013
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Béatrice de Géa for The New York Times
Carl Hart, an associate professor of psychology at Columbia, arranged experiments in which drug addicts were offered a choice between a dose of the drug or cash or vouchers. When the dose was smaller, addicts often chose cash or vouchers instead.
Those addicts seemed enslaved by crack, like the laboratory rats that couldn’t stop pressing the lever for cocaine even as they were starving to death. The cocaine was providing such powerful dopamine stimulation to the brain’s reward center that the addicts couldn’t resist taking another hit.
At least, that was how it looked to Dr. Hart when he started his research career in the 1990s. Like other scientists, he hoped to find a neurological cure to addiction, some mechanism for blocking that dopamine activity in the brain so that people wouldn’t succumb to the otherwise irresistible craving for cocaine, heroin and other powerfully addictive drugs.
But then, when he began studying addicts, he saw that drugs weren’t so irresistible after all.
“Eighty to 90 percent of people who use crack and methamphetamine don’t get addicted,” said Dr. Hart, an associate professor of psychology. “And the small number who do become addicted are nothing like the popular caricatures.”
Dr. Hart recruited addicts by advertising in The Village Voice, offering them a chance to make $950 while smoking crack made from pharmaceutical-grade cocaine. Most of the respondents, like the addicts he knew growing up in Miami, were black men from low-income neighborhoods. To participate, they had to live in a hospital ward for several weeks during the experiment.
At the start of each day, as researchers watched behind a one-way mirror, a nurse would place a certain amount of crack in a pipe — the dose varied daily — and light it. While smoking, the participant was blindfolded so he couldn’t see the size of that day’s dose.
Then, after that sample of crack to start the day, each participant would be offered more opportunities during the day to smoke the same dose of crack. But each time the offer was made, the participants could also opt for a different reward that they could collect when they eventually left the hospital. Sometimes the reward was $5 in cash, and sometimes it was a $5 voucher for merchandise at a store.
When the dose of crack was fairly high, the subject would typically choose to keep smoking crack during the day. But when the dose was smaller, he was more likely to pass it up for the $5 in cash or voucher.
“They didn’t fit the caricature of the drug addict who can’t stop once he gets a taste,” Dr. Hart said. “When they were given an alternative to crack, they made rational economic decisions.”
When methamphetamine replaced crack as the great drug scourge in the United States, Dr. Hart brought meth addicts into his laboratory for similar experiments — and the results showed similarly rational decisions. He also found that when he raised the alternative reward to $20, every single addict, of meth and crack alike, chose the cash. They knew they wouldn’t receive it until the experiment ended weeks later, but they were still willing to pass up an immediate high.
These findings made Dr. Hart rethink what he’d seen growing up, as he relates in his new book, “High Price.” It’s a fascinating combination of memoir and social science: wrenching scenes of deprivation and violence accompanied by calm analysis of historical data and laboratory results. He tells horrifying stories — his mother attacked with a hammer, his father doused with a potful of boiling syrup — but then he looks for the statistically significant trend.
Yes, he notes, some children were abandoned by crack-addicted parents, but many families in his neighborhood were torn apart before crack — including his own. (He was raised largely by his grandmother.) Yes, his cousins became destitute crack addicts living in a shed, but they’d dropped out of school and had been unemployed long before crack came along.
“There seemed to be at least as many — if not more — cases in which illicit drugs played little or no role than were there situations in which their pharmacological effects seemed to matter,” writes Dr. Hart, now 46. Crack and meth may be especially troublesome in some poor neighborhoods and rural areas, but not because the drugs themselves are so potent
and it's plenty more basehead politicians where he came from.
You probably never encountered a crack head in your life
