31 October, 2013

Book Review: High Price

I found High Price: Drugs, Neuroscience, and Discovering Myself incredibly moving, which is unexpected in a discussion of the neuroscience of addiction. There are two general classes of people who will profitably wrestle with the claims of Dr. Carl Hart, those in relationship with someone addicted and those who care about the state of black opportunity in America. When the book began I was in the first class, but by the end I found myself in both.

Dr. Hart is a reasonable and angry black man living in a nation that imprisons its black drug users at a vastly higher rate than its white drug users. At a time when 13% of America's drug users were black, 46% of those convicted for drug crimes were black. Dr. Hart ties that number to the demonization of crack cocaine. Until 2010, the possessor of an amount of crack cocaine received the same penalty as the possessor of 100 times that potency of powdered cocaine.

Dr. Hart is also a neuroscientist specializing in the effects of addictive substances on the human brain. When this neuroscientist tells me there's no meaningful difference between the effects of powdered versus crack cocaine on the brain, I'm inclined to believe him. And when he tells me inequitable sentencing laws exist because politicians are much more likely to be elected when they're tougher on black crime than on white crime, I grudgingly have to admit he might have a point.

And finally, Dr. Hart is a survivor of the destructive South Florida 'hoods that produced the hip-hop phenomenon Run DMC and countless dangerous gangsta thugs. Dr. Hart tenderly shares how his family has been impacted by too many of the stereotypical dysfunctions of those 'hoods, and his own story is one of success only by the narrowest of margins. He made it out because of his own willpower, but it was a willpower given opportunity thanks to random strokes of luck, the generosity of many mentors, and the necessary support of American liberal politics. Dr. Hart is a walking exception, but he's not forgotten his roots. And he's not forgotten the streets never needed to be so mean.

High Price: Drugs, Neuroscience, and Discovering Myself was written more to fix the root problem of drugs in America than to help individual addicts recover. I'm hesitant to summarize his formula for that fix here, because he builds his radical approach on a carefully constructed foundation, but if I try it's in hopes you'll actually read this book. Let me give just a couple hints of the data and anecdotes he supplies.
  1. You know that rat that keeps pushing the button that gives him hits of cocaine until he dies of starvation? And how that experiment was promoted as proving the powerful addictive power of cocaine? Did you know the rats in question were all kept in solitary confinement, and the only things in their cages were cocaine and food? No friends. No mates. No toys. No paths to investigate. Nothing.

    Put me in that situation, and I might O.D. on cocaine, too.

    Rats placed in a stimulating and normal environment with access to cocaine spend their time very much like rats without access to cocaine. The compulsive behavior of their more famous cousins doesn't exhibit itself in the presence of healthy stimuli. (And don't even start me on the experiments demonstrating Oreo cookies are equally as addictive as cocaine.)
  2. There are two significant differences between powdered cocaine and crack cocaine. The first is that crack cocaine can be smoked rather than snorted, which causes it to hit the blood stream in a more concentrated rush. The hit comes faster and harder, but it's no more intoxicating than powdered cocaine. To achieve the same rush using powdered cocaine it has to be injected, which is inconvenient, but both products cause the same intoxication.

    The second difference is that crack cocaine is cheaper, making it the drug of choice for poor blacks. It's sold in smaller quantities on street corners, while powdered cocaine is sold in larger quantities behind closed doors.

    Crack cocaine is not radically more addictive than powdered cocaine, but it is radically more targeted for enforcement.
  3. The social problems of the mean streets of South Florida existed before crack cocaine was ever invented, and the invention of crack cocaine has not meaningfully increased those problems. South Florida had addicts before it had cocaine, and it always will. Addiction is a personal problem, not a drug problem. An addict who cannot obtain one drug will use another, and a non-addict will not become addicted no matter what intoxicants are made available to him. Addiction is a problem of pain management.
Dr. Hart's solution to the root cause of drug addiction is to present other powerful ways to manage pain than chemical relief. Chief among those other pain management tools is the skillset required to succeed in our society, and we are actively taking that tool out of the hands of our black men.

It is painfully obvious our inner cities are not fully equipping their children to succeed in white collar America, but the problem only begins there. Thanks to the war on drugs, one misstep undoes whatever little good may have been done for these people. Being caught one time with a meager amount of crack cocaine results in a life-long felony record, with its life-long impact on every opportunity America has to offer.

Those of you who reveled in Jean Valjean's story as told in Les Miserables should consider the difficulties a black man suffers after being caught with that threshold amount of crack cocaine. No amount of change or growth will remove that scar from his life. The only injustice Valjean suffered at Javert's hand was the blind imposition of unfair justice, but that's exactly what we are imposing on one out of every three black men in America. And when those men finally complete their prison terms, they have no more stake in their own society, our society. We've left them without hope, and that makes them dangerous people indeed.

These facts barely touch the surface of what I learned from High Price. The main thing I learned is that 80% of drug users will go on to lead normal, healthy, productive lives, given the chance. Black drug users no longer get that chance. They go to prison, and when they come out their opportunity at a normal life is gone.

Dr. Hart convinced me, from many different perspectives, we are reaping in violence exactly what we've sown in false justice. We are ruining lives that could be and should be saved.

I highly recommend challenging yourself with this book.