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Dr. Carl Hart on Addiction Treatment. An Interview by the Saint Jude Retreats

March, 2015

Michelle Dunbar, host of The Saint Jude Retreats Blog Talk Radio Show, was delighted to have the opportunity to interview Dr. Carl Hart, a prominent researcher specializing in neuropsychopharmocology, the science of how drugs affect individuals.

Dr. Carl Hart is seen in some circles as a controversial figure for his research on drug taking behaviors. He has been able to show, in rigorously designed studies, that individuals make choices regarding drug taking that much of society would intuitively disbelieve. In studies using cocaine and methamphetamine, Dr. Hart and his colleagues reported that heavy substance users were not only able to choose between taking a dose of a drug or receiving money but that they were as likely, if not more so, to choose the money rather than the drug. His research reflects what Saint Jude Retreats demonstrates daily on a practical program level that individuals make choices about their substance use and, given what Dr. Hart terms "attractive alternatives" to substance use, individuals are likely to decrease or even abstain from drug use.

Dr. Hart wrote a well received book, High Price: A Neuroscientist's Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society, which serves as part autobiography, part research review, and part sociological overview of the impact of drugs on society. Through the filter of Dr. Hart's experiences, his life becomes a literal bridge between the world of academia and research and the economically deprived background he came from. Incorporating his upbringing in the Miami projects, surrounded by the chaos caused not of drugs and their effects, but from the effects of poverty, cultural and societal issues, Dr. Hart takes the reader along his journey from youth to researcher. He believed the drug myths, particularly the hysteria of the 80s he grew up with, until his critical thinking and scientific fervor led him to test and ultimately dispel these myths. Dr. Hart has made a career not just of researching the validity of these myths but of ultimately refusing to stay silent and shining a light on the evidence and how it relates to societal agendas and reinforcement. In the academic and world of addiction science, he is the equivalent of a lone man standing up to a well financed, highly connected drug cartel. It is the convergence of this research interest and Dr. Hart's personal experiences that is so compelling.

As the first black tenured associate professor of social sciences for Columbia University, he had already made his mark and could've kept his head low. He instead decided that youth, like his young sons, needed the information that he had discovered through chance, experience, and his professional background and out of this came High Price. Later this fall he will follow up with Addictions written in a similar vein. But, as Dr. Hart teased during the Saint Jude Retreat Blogtalk Radio Show, Addictions will delve in greater depth with the correlations between drug and addiction mythology and its effects on society in general and how these effects filter down to individuals.

Dr. Hart and Ms. Dunbar discussed the misinformation of addictions still being systematically disseminated by those who propogate the myths, those who profess the myths, and those who profit from them. The perpetuation of these myths, despite the vast stores of research and evidence to the contrary, sustains many industries and agendas. Dr. Hart points out how racially discriminatory drug policies with deliberate, as well as unintentional effects, have disproportionately impacted those with low socioeconomic status in the black community and enriched concerns such as the addiction treatment industry, Big Pharma, and law enforcement.

Ms. Dunbar and Dr. Hart reflect on the continued issues with correlation equaling causation in substance use discussions. Dr. Hart recounts how simplistic fixes, which seem to show effort and attention by political leaders but are not effective, have been employed to finance the War on Drugs while obfuscating the real issues. High Price provides some possible answers to what "attractive alternatives" would really move forward the issues including greater availability of mental health resources and meaningful, well paying jobs in socioeconomically deprived communities.

Dr. Hart shared with Ms. Dunbar why the US may not be mature enough as a society to handle the legalization of drugs. He analyzed decriminalization supported by evidence in Portugal and Czech Republic and why decriminalization may be a more viable plan for making inroads on excessive substance use. Dr. Hart suggests that while many are seeking to know why people use the drugs that the better, more helpful question may well be why people choose not to use drugs when they are so efficient in enhancing human functioning. It is this kind of provocative, take nothing for granted curiosity sharpened by the critical thinking skills of science which has shaped Dr. Hart's life path and career.

Ms. Dunbar and Dr. Hart agree the scientific evidence of drugs is very different from the misinformation on addiction provided to today's youth. Both share an interest in developing the critical thinking faculties of youth and how this asset can be a strong deterrent to harmful, heavy substance use. They contend the current state of drug education for youth leans toward a total abstinence policy built on inaccuracies and a reliance on hyperbole with an absence of harms reduction discussion.

As one of his final points, Dr. Hart expresses hope and optimism that the youth of today, from whom will rise the future researchers of tomorrow, will actively question the addiction community and challenge the conversation to greater levels. He hopes that better quality and more reliable data coupled with a tenacity of youth to change the world and reveal the truth will finally dispel these lingering myths of addiction and help all of society to get on with the work of making the world a better, more equitable place. He hopes his work has a part in that change. We believe it already has.

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