HIGH PRICE: A Neuroscientist's Journey of Self-Discovery That ... | Carl Hart | Talks at Google

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CARL HART: Thank you for having me here at Google. I always enjoy coming to Google. I was at Google in Irvine, and the facilities are outstanding. Actually, you guys' facilities here are better than the ones out in Irvine. Don't tell people in Irvine that. I really enjoyed my time there. So today what I'd like to do is talk today about my new book called "High Price: A Neural Scientist's Journey of Self-Discovery That Challenges Everything That You Know About Drugs and Society." Since we have a number of young people in the audience, I suspect that there will be some things that you do know about drugs, right? At least, I hope. So when I think about doing these book talks, it's a difficult thing to do to encapsulate a whole book in a short talk. I'll talk about 20 minutes or so, maybe half an hour, and then I'll open it up for questions. And so trying to encapsulate a whole book and in that period of time it is difficult. So what I like to do is to break it up in three parts. The book is a hybrid. It is part memoir, part big idea science book, and part policy book. And so, the reason why I did the memoir-- I told a deeply personal story, and it causes me a great deal of anxiety to share so many personal details about my life. But one of the reasons that I did that was so that people who came or who come from where I come from, so they could have someone to identify with, partly. And I also told this deeply personal story because I know that when we read books about drugs and policy, only 10 people read them, or so, because they're boring. And I get it. Me too, I'm bored. But if you tell a story with some personal details, some anecdotes, folks are more likely to engage and read the story. But there's a problem with anecdotes and personal information. You can sometimes learn something from it, learn by example. That's a good thing. But the problem is you sometimes inappropriately apply those anecdotes to more general situations, and you make the mistake of taking an anecdote that's not representative. And so that's why I included the science to bolster, to support the anecdote. And then when you do this, you come to some decisions that need to be made. You have learned something, I learned something in the process. And when you learn something you want to make suggestions, policy. You want to tell people what we should do. With that said, I just like to talk a little bit about the personal stuff. Now, people oftentimes ask me, how did you go from the hood-- a neighborhood entrenched with poverty, and all the problems that come with it. How do you go from point A-- that being point A-- to point B, to where you are the first African American tenured professor in the sciences at Columbia? How do you do that? How does someone do that? Well, one of the major forces that helped me to do that-- major contributing factors-- was I was deeply involved in sports when I was in high school. I played basketball throughout high school, and this allowed me to stay plugged in to the society, into school. It ensured that I would go to school, because if I wanted to be on the school's basketball team, I had to actually go to school, right? It also required that I maintain at least a 2.0 grade point average. It's not as high as what they make you maintain here at Google, but it was enough to make sure that I at least graduated, right? So that kept me plugged in, it ensured that I graduated. Another factor was that I have five sisters who are older than I am, and a grandmother who did their best to keep me on the straight and narrow path as they could. I wasn't always on the straight and narrow path, of course, because I engaged in petty crimes, sold a little drugs, did some drugs, those sorts of things. But I knew I couldn't get too far off the path, because I would disappoint my sisters, and I would disappoint my grandmother. And then I may also have gotten kicked off the basketball team. So I had to keep things in the check. I had to be in control, to a certain extent. Another thing that was important in my story was that there were programs when I was growing up. There was a program called Aid to Families with Dependent Children-- AFDC. Some of you all might know that as what we once knew it as welfare. That changed in 1996, the Clinton administration changed that. There was also another program in which people like me-- young people like me-- who were from these poor backgrounds, there were summer programs or summer jobs where we worked. Folks who were 14 years old and older could get jobs. The government supported these programs that kept us off the street, it put pocket change in our pockets. Those programs are no longer there, but those programs were critical in helping with me move along. Well, I didn't get the basketball scholarship that I thought I was going to get. So instead, I had a guidance counselor who also looked after me. She encouraged me to talk to military recruiters. She actually knew how to motivate me, so she simply said, if you talk to these recruiters on this particular day, on these particular days, I'll let you out of class. And that worked. She knew what she was doing. I talked to various recruiters and decided to go into the Air Force. The Air Force-- my time in the Air Force was all spent overseas. Most of my time was spent in England-- about three years in England. While in England, something happened, something that's critical to my developing critical thinking skills. When I was in England, I started to go to college where I really intensified my college, because in the Air Force, there are college campuses or college courses that are offered on base. While in England, I noticed that the British were-- they didn't have the same reservations about critiquing American society, particularly as it relates to race. They were quite comfortable showing documentary films about our racial history. I mean, these are things that I already knew from being in the United States. At least I thought I knew. But I never had official approval, or I never had my beliefs corroborated by an official government. And so, in England, I got really interested in the American Civil rights story. And in school I learned quite a bit about it, and it just inspired me to continue my education even further. So I began my education, really, in England, and I continued it once I got out of the Air Force. And I had mentors after I got out of the Air Force, and throughout the Air Force, who encouraged me to go on to get a Ph.D. And these mentors-- without these mentors, I don't think I would have been able to continue on to get a Ph.D. So that's the sort of personal story. I tell that story in part because I want people to know that I'm not special. Those components that were in my environment that helped me move along, we certainly can do this for other people if we wanted to, as a society. But society has decided that certain groups of people or not so important, so we won't ensure that they have those type of components. So I'm not special. This is not an up from slavery story. That's not the story here. It's a logical, rational story that could happen to most people if we put these things in their environment. OK, shifting gears to the science. I went to graduate school to study what I thought was the problem in my community. I had been told that drugs was destroying the black community. This is what I learned, and so I thought, what better way to make a contribution, just like my heroes who had made contributions previously-- Fanny Lou Hamer, Malcolm X, Martin Luther King, all of those folks had made previous contributions to the community. I wanted to do the same thing in my own way. So I thought I'll study the brain, and the effects of drugs on the brain. I thought that drugs were destroying the community, I'll find out from a biological perspective what's going on, and once I figure that out, I could help save the community. So I went to graduate school, started studying drugs-- or the effects of drugs on the brains of rats. Drugs like morphine, nicotine, cocaine. Trying to understand what was happening. Now, during in my education, one of the things that I learned was that, well, the most of the people who take crack cocaine-- the drugs that I thought was really destroying the community-- I learned that most of the people that take that drug we're not addicted. In fact, most of the people that take that drug go to work and are responsible people. They are paying taxes, they're doing all the things that we want them to do. Some of them even worked at Google. So when I learned that, I wanted to know more. Was that the case for all drugs? Turns out, yeah, that was the case for all drugs. About 80, 90% the people who use these drugs-- crack cocaine, methamphetamine, heroin-- you name the drug, 80, 90% of them do so without a problem. They are responsible citizens. Hmm. So that shattered one of the sort of assumptions that I had about drugs and the evils of drugs. Another assumption that was shattered when I went to graduate school and I learned more about drugs was that, as an undergraduate, we were all told that you take a drug like cocaine, allow an animal to self administer it. Put a catheter in their vein, allow them to press a lever to receive a cocaine injection. The animal would do this until the animal dies if you allow them unlimited access to the drug. I learned that as an undergraduate. Maybe some of you all learned this as an undergraduate? Yeah. Right? And so, yep, sure enough, that was the story, and that was one that helped me to understand what was going on in my community-- so I thought. As I looked at the data more carefully, as I became a better, more critical thinker, what I noticed was that if you provided alternatives for the animal-- alternative reinforcers-- an alternative would be, for an example, if you provided a sexually receptive mate in the cage with the animal. No longer isolate animal, but provide the animal with an alternative, a sexually receptive mate. Or even some treat, like some sugar water, or some activity, like a running wheel. If you provide these alternatives, the animal no longer kills themselves with the drug. They no longer exclusively take the drug. These alternatives become more attractive, in many cases. So I thought, hmm, that is what happens in animals, but is that what happens in humans? One of the earlier studies that I did was I brought some crack cocaine addicts into our lab. Of course, we passed all of the ethical requirements, brought some research participants who were crack cocaine addicts into the lab, allowed them to self-administer-- choose to take the drug, if they want. But, in this case, we also provided alternatives. The alternatives were something like money-- cash money-- or merchandise vouchers, other things, and you could vary the amount of money and also the impact of the merchandise voucher. When you do that with escalating doses or escalating amounts of money, you can wipe out cocaine self-administration. The addicts no longer choose to take cocaine. Instead, they take the money. Say, how much money? Well, if you provide the addict with $1 as an alternative, they will probably take a nice dose of cocaine. Well, any rational person probably should do that-- if they have experience with cocaine, of course. For people at home, this is not to encourage people to take cocaine. That's not the goal. But if you provide the person with $5 as the alternative, now they would choose the drug on about half of the occasions, and the money on about half of the occasion. And you can completely wipe out self-administration of the drug if you provide $20 as the alternative. All of this is rational, and that's precisely how people who use drugs-- people are addicted to drugs-- behave. Rational behavior. So now that myth was shattered for me. I no longer thought that cocaine addicts or any other addicts are motivated solely by another hit of the drug. The science, the evidence, just simply doesn't support that. So another sort of more recent myth that I discover had no foundations and evidence is this notion that these drugs cause these cognitive impairments in people, in the users. So one of the drugs that I now study is methamphetamine. And if you look at the literature on methamphetamine-- whether it's the scientific literature or the popular literature-- there's this notion that this drug causes all types of cognitive impairments. Well, last year I published a critical review of the scientific literature, and I concluded that we, in science, have overstated the extent of cognitive impairments in this group. There are virtually none found with this group. When you look at the literature carefully, and you have the appropriate controls, and the studies are rigorous, you don't find these cognitive impairments. Another myth shattered. And you can do this with the brain imaging data. When you look at methamphetamine, the same is true with the brain imaging data. These negative effects have been wildly overstated. And you know it makes sense because when we think about methamphetamine as a drug-- you all know Adderall, right? Everybody knows Adderall. Adderall's the drug that we prescribe for Attention Deficit Disorder. Children take it, adults take it, writers take it, people who need to write programs take it. A wide range of folks take this drug. So when you look at Adderall, the active ingredient is amphetamine. And then you compare it to methamphetamine, they are essentially the same drug. Methamphetamine has an additional methyl group that probably doesn't contribute to its biological activity or pharmacology. I have done the studies in which I've compared the two drugs in the same people, and I measured behaviors-- from cognitive behavior, subjective effects behavior, a wide range of behaviors, heart rate, blood pressure-- and found that the drugs exert identical effects. But I'm not the only one who's done this. Other researchers have also done this. We've known this since 1971, when the first paper in this area was published in People. Yet the public seems to think that methamphetamine is some new drug. It's not new. It's the same drug as amphetamine. And we currently prescribe amphetamines to our military. Some folks who are working extended periods of time. So we have a long history with amphetamines, and we know quite a bit about amphetamines. And they can be useful in some situations, of course. So that myth that methamphetamine is so dangerous shattered. So in the book, I go down a number of myths and I shattered them. And if these are not true-- some of these assumptions that we have about drugs are not true- in led me then to say, well, what is our drug policy based on if this information isn't true? Well, our drug policy is primarily driven by hysteria and misinformation. And the people who make our drug policies are more concerned with sort of faith-based thinking as opposed to evidence-based thinking. And so, given that that's the case, I thought that in "High Price", I like to talk to the adults in the room. I'm trying to have an adult conversation about drugs. And if you do that, you have to say-- people will say, well, what do you think we should do, then? Given what you laid out. What do I think the country should do? Well, I'm glad you asked. This is what I think the country should do. Each year, we arrest 1.5 million people for drugs. Each year. 80% or more of those people are for simple possession. Just simply buying, using drugs. Simple possession, not sales. That's 80%. Also, when we look at the racial disparities in our enforcement of drug laws, we find, for example, you guys have heard the crack cocaine powder cocaine disparity, right? Well, maybe you haven't, this is Google. All right, OK, let me just explain it. In 1986, we passed legislation that punished crack cocaine 100 times more harshly than powder cocaine. Now, the only difference between these drugs is that powder cocaine has a hydrochloride salt attached to it. That hydrochloride salt prevents it from being smoked. That's the only difference. Now, the effects of cocaine is determined by the base. Hydrochloride-- powder cocaine has the base, whereas crack cocaine is just a base. It's just cocaine base. So they're the same drug, but we punish them differently. Now, what does that mean in terms of drug enforcement, racial disparities? Crack cocaine, of course, has a harsher penalty. 85% of the people who we arrest and prosecute for crack cocaine offenses are black, even though most of the people use crack cocaine are white. So you have these type of disparities through the enforcement of all of our drug laws, which has resulted into this situation. Right now, in the United States, black men make up about 6% of the population. They make up 35, 40% of the prison population. We have more people in our prisons today than any other country that has inhabited the earth. We have 5% of the world's population, 25% of the world's prison population. All of this is mainly driven by our current drug laws. So that leads me to say-- and given what I know about drugs-- that we've been lied to about the potential harms. Not that they're not potentially harmful, because we'll come back to that. I just want people to understand that I know that better than anyone. But since we've been lied to about drugs and our policies are based on some false assumptions, I'm arguing in "High Price" that we should decriminalize all drugs, from methamphetamine to heroin, to cocaine. Decriminalize everything. Now, some people say, well, why should we legalize all drugs? That's not legalization. Legalization is what we're doing with alcohol. Alcohol, you can purchase it, people can sell it without fear of criminal prosecution if they are 21 years and older. Decriminalization, sales of these drugs remain illegal, and you can still be criminally prosecuted. The thing that changes is possession. Remember, we're arresting 1.5 million people, 80% or so are for simple possession. Possession of these drugs under decriminalization will be treated like a traffic violation. You will no longer be subjected to a criminal offense. The drug's still not legal, but we won't ruin your life. Because if you get a felony for some drug charge, it decreases the likelihood that you will get a job, you can be legally discriminated against for some housing, some student loans, a wide range of things. Consider this, for example. Our last three presidents-- the current president, Barack Obama, George Bush, and Bill Clinton. Barack Obama used cocaine and marijuana. George Bush used marijuana, widely suspected of having used cocaine. Bill Clinton used marijuana-- although he said he didn't inhale. Now, I could say some things about that, if you were getting high with him and he was blowing your marijuana, but I won't. The point is, is that those three guys all engaged in this illegal activity. They didn't get caught. But if they did, if the war on drugs was as intense as it is today, and one of those guys would have gotten caught-- and the one most likely to have been caught is Barack Obama, because we've go after the black people with a special sort of intensity with this sort of thing, right? It one of those guys would have got caught, they would not have become president. They all have made contributions to the country, despite your politics, that's a fact. But the point is, if they would've gotten caught, those contributions we would not have benefited from. So I'm arguing in "High Price" the same should be done with everyone else. Now, I also argue that if you're going to have decriminalization-- I should just say briefly that the idea of decriminalization is not new. The country of Portugal has decriminalized all drugs, and they have done this since 2001, and they are faring better than us on all of the major indicators. And they are doing as well or better than their European counterparts on all of the major indicators. Levels of drug use, drug related deaths, all of those sorts of things. And also, in this country, we have decriminalized marijuana in a growing number of states. So decriminalization is not something new. But if you have decriminalization as I'm arguing, you have to also increase the amount of realistic education surrounding drugs. That means that you can no longer run those public service announcements about this is your brain on drugs. Are you guys old enough to remember that? With the frying pan thing, and the guy says, this is your brain on drugs? So you can no longer do those type of advertisements and that type of propaganda. You must now have realistic education. And you say, what does realistic education look like? We can go down the line, drug by drug, I do this in the book. Take methamphetamine. One of the major effects of methamphetamine is that it keeps people awake. We know that sleep disruption-- chronic sleep disruption-- is inconsistent with good health. So if you have chronic sleep loss, it's associated with health consequences like some types of cancers. It's associated with psychiatric illnesses, like psychotic disorders. So you want to make sure people are getting sleep. If you're taking amphetamine that keeps you awake, you want to encourage folks who are taking the drug not to take it near bed time. Methamphetamine is also good at increasing cardio-based vascular activity-- heart rate, blood pressure. Number one killer in the United States-- heart disease. You want to tell people if you have compromised cardiac functioning, you probably don't want to take amphetamines or other stimulants, right? Heroin. What would realistic education look like with heroin? Recently there's been a number of reports in the major press outlets about opioid and heroin overdose deaths. Now, what these reports failed to do is to say that 75% or more of these deaths are not caused by heroin or the opiate alone. They're caused by combining heroin or another opiate with something like alcohol. So the major concern with a drug like heroin is that people combine it with alcohol. It increases the likelihood of overdose. If you simply don't combine this drug with alcohol or another sedative, you considerably decrease the risk for overdose. So what would realistic education look like for cocaine? Today a large percentage of cocaine is being cut with-- or adulterated with-- a drug called levamisol. It is an animal dewormer, one of its side effects is that it decreases white blood cell, decreases the person's ability to respond to infections, and in extreme cases, people can die. So you want to make sure that people were not taking bad cocaine. You want to test the cocaine on the street. You want to let people know what the real problem may be. The real problem may be this adulterant, this cut product. So we can go on and on about what realistic education would look like. Now, at this point, I see a hand up, at least one. I think it'll be better if we-- what do you think? You think we should open it up for questions? We'll do that. All right, we'll do that. OK, we'll open it up for questions. You have to come to the microphone. So now we have to wait for you. You just interrupted me, and now we have to wait for you. AUDIENCE: So I was wondering, for example, when you say if you want to test for cocaine, I think probably decriminalization would not just do it. You probably would have to legalize it. So I'm wondering why are you stopping at that? Is it just a mini step to get people to finally legalize it? CARL HART: Thank you. The question was why am I not advocating for legalizing drugs? Great question, thank you. One of the things that I am concerned that might happen. So, as you legalize drugs and then you have opponents to legalizing drugs, they will be waiting for any event to say that this is the negative effects of legalizing drugs. Now, what I'm arguing is that we inoculate the population from such hysteria and misinformation by providing more appropriate education about what drugs actually do, and what drugs don't do. So if you have a more drug literate society, you can no longer make these exaggerated claims about a drug. Think about marijuana. In the 1930s, we said that marijuana caused people to go out and murder their mothers. We did, and people believed it. Harry Anslinger, he was the commissioner of the Federal Bureau of Narcotics. He said that it was the most dangerous drug known to mankind. And we, as a society, believed it. Now, if you say that today, people will look at you like you're crazy, right? And rightfully so. And one of the reasons that they would because we have increased amount of information about marijuana today, in part because it is now marijuana is the most widely used illicit drug in the world. And so, it's harder to fool people with this information because of their own education, because of better education about marijuana. But certainly, if we take a drug like bath salts. If you make these exaggerated claims about bath salts, far more people in this society are more likely to believe it, even though it's an exaggeration and it's not true. You see this today with bath salts. People are saying these kinds of things. Other questions? AUDIENCE: Hi. Good talk. Do you think that the politicians that were initially promoting the war on drugs-- were they influenced by the bad science, or did they have other reasons for pushing this on the population? CARL HART: So, do I think that the politicians were motivated by bad science? One thing I want to make clear is that science is simply a methodology, and most of it is not bad. It's the interpretation from science-- if you look at the data, the data don't lie. The politicians, I believe, we're more motivated by this fact-- as a politician you have constituents. They have problems, and they expect you to help solve them. Drugs are excellent scapegoats. So, if you have communities that have high murder rates. I don't know, for whatever reason-- you have increased amount of males at a certain age, at a certain time, that certainly is a reason for higher murder rates. You have unemployment, people not working, a lot of idle time. All of these sort of things contribute to the murder rate. But if you can say it's because of crack cocaine, all you have to do now as a politician is to go after crack cocaine. Remove the crack cocaine, or show the people that you're putting lots of money into law enforcement efforts in removing cocaine. And they think, oh, yeah, Representative Johnson, he's our man. He's doing what we want him to do. Even though crack cocaine has little to do with the murder rate, little to do with the fact that people are unemployed. But it's an easy sort of scapegoat. Yes. AUDIENCE: Hi. So admittedly, I don't have very much first hand experience with people using hard drugs, but-- CARL HART: You say that like you're embarrassed of it. AUDIENCE: No, I say that as, I guess, a qualifier to my question, which is, a lot of the things you said were, I found, pretty surprising. Like, if you offer a crack cocaine addict $5, it's a coin flip as to whether he'll take the money or the drugs. How does that square with the sort of popular media image of junkies stealing from their mothers or their grandmothers to fund their drug habit? CARL HART: Thank you for that question. Certainly, you have people who use drugs and they engage in those bad behaviors that you just said. There are certain people who will rob somebody to support their drug habit. We certainly can show that. Now, what people don't do, or what they fail to do is go deeper. So it's like, well, was this person robbing people before they used cocaine or whatever drugs they're using? Probably so, yeah. And then, when you look at the majority of people use cocaine, are they engaged in that behavior? Not no, but hell no. So when you have a more comprehensive look at the data, those stories don't hold up. But those stories make great films. They are great for documentary filmmakers, who we think of as being more thoughtful. They are great for reporters, they're just great stories. Even though they're more fictitious or they're less representative of the broader picture. So it's a hard sort of image to get out of the American conscious. But they simply are aberrations. AUDIENCE: Thank you. AUDIENCE: Hi. CARL HART: Hi. AUDIENCE: Some of the other advocates of more sensible drug policy-- like your colleague Professor David Nutt in the UK-- they very often compare the harms of illegal drugs with legal drugs like alcohol, and tobacco, and caffeine, and even horse riding. And that is very controversial in the UK. But I think it highlights the fact that these things are comparable, but only in a very niche scientific community, and the public doesn't really like to compare their horse riding with their ecstasy. Well, because they call the drug equasy. CARL HART: I hear you. AUDIENCE: So yeah, he wrote a paper about comparing equasy with ecstasy. So, what do you think about it? Do you think that comparison can lead to more sensible drug policies, or does it hinder? CARL HART: Well, I'll stick with the comparison between the prescription drugs or the legal drugs and the illegal drugs. Because, like my man here, I don't have much experience with horse riding. So one of the things that concerns me sometimes when we make these comparisons with alcohol or legal, prescription drugs in our zeal to show people how comparable, say methamphetamine is to Adderall, we vilify Adderall. And that's not my goal, because Adderall actually helps a large number of people. And my goal is not to vilify alcohol either, because the vast majority of people who drink it do so safely, it contributes to the tax base. It also-- well, it makes them more interesting at parties sometimes, right? So I don't want to vilify those drugs, but it's clear that the body does not make the same distinctions that we make in society. So the body doesn't make a distinction between methamphetamine and Adderall. It doesn't make that distinction. That's our own distinction. And that leads to us making drug policies based on social factors, cultural factors, rather than pharmacological factors. When you go through the history of our drug policies, drug policy is based largely on cultural and social factors, and less on pharmacology. Because if that was the case, our legal and illegal drugs would look differently. AUDIENCE: So I really enjoyed your talk, thanks for coming. CARL HART: Thank you. AUDIENCE: I want to go back to the issue of the legality of sales. Because most of what we, as a society, perceive as the negative effects of illegal drugs are due to their prohibition. You have gang issues with sales, you have all that illegal money flowing around, being used to buy guns and things like that. And it seems to me like, while obviously, the arresting and throwing in jail of a huge percentage of the population for simple possession is a worse evil than all this gang violence, it seems like it's a very close second, and that getting rid of a lot of the perceived negative effects of drugs in communities-- like New York, which has a history of having an issue with crack-- could be a huge step in trying to change the perception about drugs. Because when there's less violence or less theft around drugs, you would seem to have an increased understanding of how it's not necessarily as big a problem. CARL HART: Is there a question? I'm sorry. AUDIENCE: I guess is there a way that you think that we could focus on the legalization of sales, or providing some legal outlet to get clean drugs and legal drugs without and getting some of the money out of these back channels? CARL HART: I see. I haven't really thought about legalization that far yet, because of our ignorance with drugs. My goal as a neuropsychopharmacologist is to help people understand drug affects, more so than the legality in the markets and that sort of thing. I'm less versed on that. And I recently wrote a piece in the New York Times, saying that public intellectuals should stick to their expertise. I'm going to take my own advice with that one. Yes. AUDIENCE: Hi. Thanks so much for coming. CARL HART: Thank you. AUDIENCE: You mentioned Portugal, and I've read a little bit about it, and it seems they decriminalize and then also shifted some public resources toward treatment and things that we would call soft punishment, so when somebody who commits a criminal act gets arrested for that act and they also happen to be on drugs while they committed the act, they'll have rehabilitation programs that they're sentenced to and treatment programs. And I'm just wondering, is there much science-- because, certainly, drug addiction is bad, and it can get people to do-- is there much science on what treatment methods actually work to get someone off a drug that is causing them to do-- CARL HART: Yeah. So in the book, I talk about some of the treatment programs that we have. There's a lot of good treatment research going on in the country. One of things I describe is this program or this strategy called contingency management, where you, essentially, pay people to stay off drugs, and you give them skills, so you increase the likelihood of them getting jobs, and those sorts of things. So, yeah, I think we're doing-- although there is this belief in the country that treatment doesn't work, that's just not true. There are a number of good programs that are available to people. But the problem is, is that there are also a lot of bad programs, and a number of people go to those programs. I don't talk so much about treatment in the book. I do talk a little bit about it. In this book, I'm not as concerned-- or the focus is not on the 10 to 20% of those users. The focus is on the 80, 90%. It's been alluded to here, why do we continue to do this awful strategy that I laid out, when many of us think it doesn't work? Well, we continue to do it, in part, because of the frame that we're talking about. The frame is either jail or treatment. But the majority of the people don't need either. But that's our current frame. And you have treatment providers who have a huge stake in his drug hysteria game, because they want to keep the laws and the way we view drugs the same way. Because if the people are not going to jail, they're coming to them. And, of course, law enforcement has a huge stake in continuing the same strategy that we're doing, because we spend $26 billion a year on our controlling of drugs. 70% of that or so is going to law enforcement. That's a lot of money, and there's a lot of jobs at stake. And so, that frame is a narrow one, and it's one that I'm trying to break out of in "High Price". AUDIENCE: Thanks. Fascinating. AUDIENCE: Hi. Thank you for coming. CARL HART: Thank you. AUDIENCE: So I was curious about your thoughts with regards to teenagers and preteens. So decriminalization is based on somewhat of an assumption that an individual can make a choice. And when I was 16, I thought I was able to make a choice, but in hindsight, I was pretty stupid. CARL HART: But yet you work at Google, and you are doing well in life. AUDIENCE: I manage. So what are your thoughts, with regards to approaches, what's the right framework for a population that, perhaps, does need some protection? CARL HART: You have children? AUDIENCE: Nope. CARL HART: OK. Well, I do. I have a 12-year-old, 18-year-old, 30-year-old. So I get asked that question a lot about children. You would deal with them in terms of this subject in the same way you deal with them in another potentially dangerous activities. Driving a car, you make sure they have skills to do that. You make sure that they understand under what conditions that should happen, and how it should happen. Sexual behaviors. I'm sure you had sex at-- I don't know when. That's a joke. But the point is is that that's certainly a potentially dangerous activity, and we manage to make sure that our kids stay safe. The same is true with drugs. Give them the appropriate amount of education. They understand that if you use some drugs before school, that's inconsistent with the goals of this household, the family. And so, you just treat it just like any other activity that might impact negatively on their ability to do well in life. Thank you. AUDIENCE: So, I have a non-drug question here. You mentioned in the first section of your talk, while you were in England, that you were able to sort of ground your knowledge of American history there. For people who do not have the opportunity to leave the country, especially when they're younger, is it possible to get that kind of grounding in history now, is it easier or harder now, and what sort of outlets are you aware of, if any, for people to pursue? CARL HART: That was a great question. Thank you. One of the things I try to do in "High Price", I try and aim it towards those folks, like me, who grew up ignorant about our history here. So I hope that those people, they'll have more potential education or information in books, like "High Price", that's one. And then people like me speaking out, even though it's popular to do this, pointing out what the issues are. But you asked the question, is it more difficult today or easier today than when I was coming up. Think it's more difficult for young, ignorant people in the situation where I was in when I was younger, in part, because they're told that we have a black president, and things are improved. But yet, rarely do we hear anything coming from the official administration about problems related to race in the country. And so, there was a time-- when Ronald Reagan was president, when I was coming up, for example-- we were happy to criticize him, particularly about all the things that he was not doing for the community. Folks who are community protectors now are a lot more reluctant to do those sorts of things. So I think young, ignorant people in those situations, I think they have it more difficult now. AUDIENCE: I have a lot of questions. So, my first question starts with, because you touched on children, right? And one of the things I want to know is, is there any science or evidence behind what makes someone become an addict? Because I actually feel that it permeates all walks of life, all colors. It's more of a personality thing. Are there any thoughts on that? And then the second question I have is, because I do have children. You mentioned having a home, right? And having rules which clearly you grew up in, right? But what about these communities where there really aren't those rules, because there isn't a nuclear family to keep younger kids today from growing up and being just like those that are around them? So how do you stop that? Because I couldn't agree with you more on the drug conversation. But how do you educate them all together? CARL HART: Now, I should tell you, it's difficult for me-- my working memory has been taxed. So I need you to repeat that first question. AUDIENCE: So, the first question is, is there any evidence-- CARL HART: Oh, personality. AUDIENCE: Just about the personality. Because it does seem to me, and I-- CARL HART: Right on. I got you. AUDIENCE: I am totally a proponent of drugs it is not a color thing. CARL HART: It's OK, we don't have to do our personal divulging here, it's all right. AUDIENCE: Oh no, no, I mean, I'm just saying if someone says it effects one race or one gender or whatever disproportionally to the other, I completely disagree. I think it's a personality thing. CARL HART: So a personality thing. There is no evidence to support the idea that somebody has an addictive personality. Although it works well in terms of pop culture. But there's no evidence to support that's. That's one. And you're right-- drug addiction certainly does not discriminate. That's the fact. But you're asking is there any evidence for us to know what causes someone to become addicted to drugs? A lot of science is looking for the biological sort of explanation, as well as it should. But I think that it's more simple than that. If we look at the criteria for addiction-- inability to cut down your use of the drug, using the drug in situations that are places you in, potentially, harm's way, using the drug despite the fact that you have knowledge that it causes you physical or psychological problems. So, you go down the list of these criteria, and these criteria mainly are sort of behaviorally irresponsible people. And so, when you look at that throughout, it tells you that even before the drug use, folks may have been over-indulging or irresponsible in some ways. Of course this isn't the case for everyone, but I think that's a large component. And so I think that if we simply look at the behaviors, help people to get better skills, a wide range of things-- how to be more responsible, a wide range of things. So I think that we have overlooked those sort of factors. Now, back to your second question, about what about in the communities where people don't have rules, as you put it. Believe me, there are rules in every social circle. There are rules. You may not understand those rules, but there are rules. And I wouldn't worry about that so much. I'd worry more about making sure that those communities, those people, have a stake in the society, the larger society. And one way you do that is make sure they have jobs. Make sure that they have potential opportunities to contribute to the larger society. Make sure they're not socially isolated. All of those are far more important than us worrying about whether they have rules. And one of the things that concerns me most of all is when I give this presentation to certain groups, they say that they are concerned about those communities, but that concern is disingenuous. Because their only concern when someone like me comes along and say, hey, we need to do something radically different. But when you look at-- have you gone? Have you said anything? Have you contributed? Have you tried to change the situation in those communities? No. And so, I think that the things that I outlined-- skills, jobs, all those-- are far more important. AUDIENCE: One other thought. CARL HART: Sure. AUDIENCE: So you had said originally you benefited from playing sports, I did, too. It kept me engaged in school, I did well, it was one of those things. For you, you probably just kept going, right? So in these communities where there are no longer the programs that you had available to you in tandem with your call for saying, OK, let's at least decriminalize drugs, are you also championing resources so that-- because you do worry that it only self-perpetuates. It becomes a self-fulfilling prophecy if no one actually breaks that cycle of what they believe is happening, even within the isolation of these communities. CARL HART: Certainly. Your point is, is that if we're calling for decriminalization, that alone is not going to solve the problem. I agree wholeheartedly. The goal is to also make sure that our politicians, our population understand that we have to provide skills, jobs, education about drugs, as well as other, broader education. So I agree wholeheartedly, and I certainly try to say that. Timeout? Heather? OK, Heather's said it's time to go. All right. Thank you all very much.
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Channel: Talks at Google
Views: 79,713
Rating: 4.8588233 out of 5
Keywords: talks at google, ted talks, inspirational talks, educational talks, Carl Hart, science talks, neuroscentist, self discovery, self help, mental health, self help talks
Id: PdsN_vYZ3w8
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Length: 56min 20sec (3380 seconds)
Published: Mon Jul 22 2013
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