The Rational Choices of Crack Addicts

The New York Times has an article about the research and new book from Dr. Carl Hart from Columbia University that makes for a potentially paradigm shifting encounter.  What is most encouraging is that it helps us, and other communities like ours, to think even further and deeper about the implications and power of belonging and hope that we so ardently espouse. 

Traditional views of addiction focus more on the weakness of the individual, or pathology, and less so on the context of the person. This view is mainly fostered from research on rats that have suggested that for someone who uses cocaine, the desire for it overcomes all other desires and leaves them helpless.  But, according to Hart, “Eighty to 90 percent of people who use crack and methamphetamine don’t get addicted. And the small number who do become addicted are nothing like the popular caricatures.” So where is the disconnect?  Hart’s research pushes back against the traditional view.

The rats that keep pressing the lever for cocaine are the ones who are stressed out because they’ve been raised in solitary conditions and have no other options. But when you enrich their environment, and give them access to sweets and let them play with other rats, they stop pressing the lever.

This sensibility is being supported by other researchers, most notably by Dr. Nutt, a British expert in addiction.

Addiction always has a social element, and this is magnified in societies with little in the way of work or other ways to find fulfillment.

So, if we know that addiction has much to do with social belonging and sense of worth through contribution, why is so much focus and money being spent on treatments in the form of twelve-step style rehabilitation or chemical treatments?  According to Dr. Hart, it has something to do with the wrong kind of incentives – not for addicts but for academics and politicos.

It’s much simpler for politicians and journalists to focus on the evils of a drug than to grapple with the underlying social problems. But Dr. Hart also puts some of the blame on scientists.  “Eighty to 90 percent of people are not negatively affected by drugs, but in the scientific literature nearly 100 percent of the reports are negative,” Dr. Hart said. “There’s a skewed focus on pathology. We scientists know that we get more money if we keep telling Congress that we’re solving this terrible problem. We’ve played a less than honorable role in the war on drugs.”

The whole article, and I assume book, is worth the read.

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