Hart has also written a book for a general readership: High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society. He provides this description of his motivation.
Hart is also a black man who came to adulthood about the time of the surge in usage of crack cocaine. He grew up in a segregated area of Miami, the type of location that became ground zero in the "War on Drugs." Hart had left to join the Air Force before this surge actually hit, but he was able to observe the effects of cheap cocaine on his family, friends, and neighborhood. He could have written a book that focused solely on drug and drug effects on humans, but feared that such an approach could not deal adequately with the importance of a person’s individual circumstances in determining the difference between no drug use, recreational drug use, and drug addiction.
Hart tells his story about drugs and society from the perspective of his own life and experiences.
Hart’s autobiography provides valuable insights into what it is like to be a young black man in our society. He makes clear the historical tendency to link drug use and race, and to use that link to argue for strict drug laws and tough mandatory sentences even for mere possession. The result has been a situation where illegal drug use and sales are roughly equally common between the races, but arrests and incarceration fall far more heavily on blacks and Hispanics. This is too important a topic to treat casually. Consequently, the focus here will be on drugs and physical response with racial issues mostly left for a later date.
Hart focuses on cocaine. At some point drug producers concluded that marijuana was too bulky and not sufficiently profitable and switched to cocaine as their drug of choice. The characteristics of cocaine are summarized in Wikipedia.
"Occasional cocaine use does not typically lead to severe or even minor physical or social problems."
Much the same could be said for alcohol use and cigarette smoking. Why has cocaine then been long viewed as a dangerous drug that must be declared illegal? Hart references a study by David Musto: The American Disease: Origins of Narcotic Control to arrive at this observation.
It was understandable at the time that stories like this would emanate from the South where it was important to maintain the myth that blacks were inferior in as many ways as possible to whites. It is disturbing to realize that so many historians and others of influence in the North bought into this myth and propagated it.
Does the use of the drug actually produce "cocaine-crazed" brains? First some facts about the drug and its usage are required. For those who are not already conversant with the details:
What is important to a drug user is that the effect be delivered reliably and quickly. Ingesting the drug is a slow and unreliable process. Snorting powder delivers an effect in a few minutes. The fastest approach to a high is by getting the drug into the blood stream via injection or by inhaling vapor into the lungs. Smoking also allowed for an efficient high while requiring only a small amount of the drug. The discovery of a simple and safe way to mass produce crack cocaine meant that the drug could be sold in small amounts and at low prices.
Powder continued to be the drug of wealthier whites, while crack provided a high cheap enough to become popular in the black community. This upsurge in usage led to an upsurge in scare stories about crimes and family dissolution similar to the "cocaine-crazed negro brain" tales from an earlier era. The War on Drugs was in place and pounced on this phenomenon and declared "black cocaine" to be more dangerous than "white cocaine." Much more severe penalties were associated with crack than with powder cocaine. This allowed, and even suggested, that law enforcement should focus on arresting and incarcerating blacks even though usage was just as common among whites. And that is exactly what happened.
Strict laws against the possession, usage, and sale of a drug seem reasonable if the drug is actually highly destructive in leading to addiction, criminal behavior, and social disruption. The point Hart makes is that this condition does not exist for cocaine—nor for many other drugs we criminalize.
A definition of addiction is needed. Hart uses the one described by psychiatrists in their catalogue of mental disorders.
Given this definition and actual data on drug dependence, such behavior is relatively rare.
Even the person who becomes a regular user of the drug continues to maintain the ability to choose to take the drug or not depending on the given circumstances. The image of the addict being driven mad with desire for his drug just doesn’t happen. Hart suggests that the desire for the drug is more closely analogous to the desire humans feel for sex and food—both being cravings difficult but possible to control.
Destructive use of a drug does not spring from an uncontrollable physical craving, although the craving is a factor.
Further enlightenment comes from animal studies. Hart describes an experiment where a collection of rats were divided so that one group lived in a shared space (referred to as Rat Park) where they could interact and socialize in whatever manner rats do. The others were placed in isolation in individual cages. All the rats had access to water doped with morphine at a level that should have produced a physical response.
Similar results have been obtained with rats using cocaine and amphetamines rather than morphine. The conclusion seems to be that when natural rewards are available, they are generally preferred to the artificial, drug-induced reward.
Humans and rats have needs. If those needs are not being met in their existing environment, both are more likely to turn to drugs as a source of satisfaction.
The importance of social context for drug use cannot be overemphasized. People who live in an environment with social support and other alternative reinforcers are less likely to use drugs in a destructive fashion than those whose environment is more devoid of alternative reinforcers. One would then expect addiction to be higher in lower-income neighborhoods than in middle class or wealthier environments.
Given the data Hart has assembled, the path we are following seems to make little sense. Recreational use of drugs seems to be as old as recorded human history. If recreational use is a viable lifestyle choice, why criminalize it? Why not leave controlled users alone and provide support for those in need of help. It is a lot cheaper to provide counseling to a few than to imprison many.
Hart recommends the approach taken by Portugal. In 2001 Portugal decriminalized all illegal drugs. Possession of drugs for recreational use is no longer a crime. Those found in possession of drugs are cited and required to appear before a board consisting of a social worker, a medical professional, and a mental health professional. If the person is deemed to not have a health problem due to drug use, he/she is fined and sent on their way. If a health issue exists, the person is referred to appropriate care givers. But even in this case treatment is not mandatory. Repeat offenders can be issued greater penalties, but are still not considered criminals.
Compare that to our system with its severe penalties and immense prisoner population.