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.
