Let's quit abusing drug users

so there should be some things that you all should know about me beyond what was said I grew up in the hood in Miami in a poor neighborhood I came from a community in which drug use was prevalent I kept a gun in my car I engaged in petty crime I used and so drugs but as has been said I stand before you today also emphasis on also a professor at Columbia University who studies drug addiction and I know I know with some of you all are wondering especially the ones who haven't googled me yet how in the world did you get from there to here fortunately there were a few key decisions in my life that changed my course after high school I joined the Air Force and joining the Air Force started me on the path of higher education and I ultimately earned a PhD in neuroscience you see a study neuroscience specifically so I could sorrow solve the drug addiction problem see I fully believe that the crime and poverty in my community was a direct result of crack cocaine and so I reasoned that if I could solve or cure drug addiction I could fix crime and poverty in my community so I was told and I fully believed that drugs like crack cocaine were so addictive that the user only needed one hit to become addicted so in 1986 when Congress passed laws punishing crack cocaine trafficking violations a hundred times more harshly the nose for powder cocaine I thought that was quite appropriate I mean after all 16 of the Congressional Black Caucus members voted for this legislation I thought it sent the clear message to crack users and dealers in places like my old community that we wouldn't tolerate them destroying the neighborhood of the community but I was unprepared for what I would learn as I went about making my contribution to the study of the neurobiology of drug addiction and ultimately this new information that I learned changed how I view the role of drugs in the whole poverty crime cycle I first began questioning my thinking when I discovered that drugs like crack cocaine were not as addictive as we have been told there is no drug in which the user uses one time and become addicted in fact eighty to ninety percent of the people who use illegal drugs are not addicts they don't have drug brought a drug problem I think I need to say that again eighty to ninety percent of the people who use illegal drugs don't have a drug problem most are responsible members of our society they are employed they pay their taxes they take care of their families and in some cases they even become president of the United States all three of these men reported illegal drug use when they were younger now the point here my point is not to besmirch or tarnish the reputation of these men they all serve their country my point is this their drug use did not result in an inevitable downward spiral leading to debauchery and addiction and the experience of these men is the rule not the exception the overwhelming majority of drug users don't have a drug problem now the notion or the idea or the basis for this one hit and you're hooked idea comes from experiments conducted in the 1960s and 1970s laboratory animals wouldn't give an unlimited access to drugs like cocaine and methamphetamine will repeatedly self administer or repeatedly press a lever to receive intravenous injections of these drugs until it kills them these early experiments provided evidence for the drug seeking into death notion but that's not the whole story in the cages in these experiments that I'm explaining or describing contain nothing else but a lever leading to intravenous drug injections the most interesting part of the story for me however is what happened when the animals were presented with an alternative as well as the drug level the alternative being something like a sexually receptive mate or a sweet treat when given an option animals do not self administer drugs until death in fact the animals will often take the non drug alternative over the drug we followed up these experiments in my laboratory using human research participants we recruited crack cocaine addicts from New York City by the way my use of the term addict conforms to the dsm definition of substance use disorder and equally important we met all human subjects and regulatory requirements before initiating these experiments so we brought the cocaine users into the lab we gave them a choice between $5 and a hit of cocaine crack cocaine worth more than $5 we repeated this with each person many times over several days what we found was that the crack cocaine users chose to take drug on about half of the occasions and money on the other half of the occasions even a nominal amount of money was enough to deter crack cocaine addicts from taking drug on at least half of the occasions not exactly the insane anything for hit behavior that I was taught that crack cocaine users would display we next recruited methamphetamine addicts and repeated that same experiment just like the crack cocaine users the methamphetamine users chose to take methamphetamine on about half of the occasions and money on the other half of the occasions we next raise the cash reward to $20 and when $20 was the alternative the methamphetamine users almost never took to drug they predominantly tuck to money just like the laboratory animals when presented with an attractive alternative even people diagnosed with drug addiction do not choose to take the drug stated another way attractive alternatives dramatically decrease drug use these were definitely not the results that I was expecting when I set out to solve the drug addiction problem so since my time in the hood I had always viewed the plight of my family and community through the lens of those bad drugs I even perpetuated the narrative that drugs were the problem so you can imagine my shock and confusion as I started to uncover evidence that crime and poverty were mostly independent of drug use I mean crime was in poor communities long before crack cocaine ever hit the streets and annual FBI statistics clearly show that the overwhelming majority of prisoners were not addicted or intoxicated during the time of their crime and as I think back over my family situation growing up we certainly were poor well before drugs ever entered the picture and I certainly engaged in petty crime but it had nothing to do with drug addiction it was about money and status in other words if you take drugs out of the equation poverty and crime still exists it's not drug addiction causing people to commit crime it's other factors so to make matters worse drug laws are not uniformly enforced across all segments of our society and this perpetuates the cycle of poverty and crime the popular notion is that poor black people use crack cocaine while wealthy real white people tend to use powder cocaine and in 1988 Congress extended the crack cocaine law such that we now punished possessions of crack cocaine a hundred times more harshly than those for powder cocaine scientifically it makes no sense crack and powder cocaine are the same drug they both have pharmacological predictable effects as the dose of either are increased so too are the effects on blood pressure heart rate euphoria addictive potential you name it it's true that smoking crack cocaine produces a more intense effect than swallowing or snorting powder cocaine but that increase intensity is it's due to routed administration not the drug itself because injecting power cocaine dissolved in water produces the identical intense effects as smoking crack cocaine and those same laws require that anyone caught would even small amounts of crack cocaine were required to serve a minimum of five years in prison but that's not that's not even the real injustice here's the real injustice the real injustice is this more than 80% of the people convicted under these laws were black despite the fact that most users of all forms of cocaine are white this selective targeting and racial discrimination has contributed to the horrifying statistic that one in three black males can expect to spend time in prison I'm a father of three black sons one has spent time in jail because of drug laws the same number by contrast for white boys is about 1 in 20 so the question becomes what do we do about this shameful situation we can do at least three things that would have an immediate positive impact first my research shows that attractive alternatives can decrease drug use because meaningful employment is one of the most important attractive alternative reinforces providing viable economic opportunities will go a long way in decreasing drug abuse second I believe we should decriminalize all drugs decriminalization would be like treating drugs like a traffic violation someone might be required to pay a fine if they're caught would with possessing illegal drugs but they will not be subjected to criminal prosecution when you consider this fact each year we arrest 1.5 million people in this country for drug law violations and 80 percent of those folks are for simple drug possession decriminalization of possession would have a huge impact countries such as Portugal and the Czech Republic have already decriminalized drugs their drug using rates and overdose rates are lower than ours in the United States and are equal to or lower than their European neighbors but under decriminalization significant portions of their society are not stigmatized marginalized and unfairly incarcerated if our goal in the United States is to have a legal system that treats everyone fairly one that's just then we must change the way we criminalize and selectively enforce drug laws third I believe science should be driving our drug policy and drug education even if it makes you and me uncomfortable the first step is to be honest about drug use if we are honest we can decrease the number of people who die from drugs dramatically here's just one example of being about being honest 75% of the people who died from a heroin related overdose death do so because they can bind heroin with another sedative like alcohol or benzodiazepine the public health education message it's simple rather than vilifying heroin the message should be if you're going to use heroin don't combine it with another sedative people will always use drugs they always have used drugs we must learn to live with this fact we already take this approach with other potentially dangerous activities such as sex alcohol even driving I've come a long way since the mean streets of Miami and even a longer way since the starry-eyed young man who wanted to eradicate drugs that's the best way to deal with the drug problem today I no longer want to eradicate or eliminate drugs from our society it would be naive to think so don't get me wrong I still want to help people who have a drug problem but equally important I want to help keep safe recreational users who don't have a problem because they make up the vast majority of drug users what I now know is that the drugs themselves are not the problem the real problems are poverty unemployment selective drug law enforcement ignorant and the dismissal of science surrounding these drugs as a scientist I'm doing my best to lessen the science to lessen the ignorance by disseminating the science I hope you will take some of the information that I have shared with you today to help join me in my efforts thank you

Channel: TEDMED

Views: 429,623

Rating: 4.8651977 out of 5

Keywords: Carl Hart, TEDMED, TEDMED 2014, Drug Use, Drug Policy

Id: C9HMifCoSko

Length: 19min 1sec (1141 seconds)

Published: Tue May 19 2015

Reddit Comments

[u/_GuyMontag_]

Man I love that guy. He is doing some real good work. It's great to have these drug myths debunked scientifically. Its especially courageous considering the stigma attached.