September 18, 2013

Getting High, Rationally

Many years ago I saw a documentary on HBO about a community of meth users somewhere in the Midwest (I want to say Missouri, but don’t hold me to that). This was before meth exploded into the national consciousness, but the behavior of those folks matched preconceptions of how addicts (of cocaine or heroin, in prior ages) behaved. All they cared about was the hit, the rush, and they’d do whatever it took to make the next score.

But what if that’s not right? What if the decision by most drug users to get high is as rational as your decision about what to have for dinner? That doesn’t fit the stereotype of the out of control junkie, but research is starting to show that might be the case.

The New York Times has an interesting profile of a researcher who has studied how addicts behave in terms of how they decide to get high. He’s got a good reason to be interested in the issue:
Long before he brought people into his laboratory at Columbia University to smoke crack cocaine, Carl Hart saw its effects firsthand. Growing up in poverty, he watched relatives become crack addicts, living in squalor and stealing from their mothers. Childhood friends ended up in prisons and morgues.
Hart’s research has suggested that the popular conception of the drug user isn’t accurate:
when he began studying addicts, he saw that drugs weren’t so irresistible after all.

‘Eighty to 90 percent of people who use crack and methamphetamine don’t get addicted,’ said Dr. Hart, an associate professor of psychology. ‘And the small number who do become addicted are nothing like the popular caricatures.’
Hart conducted studies – first with crack cocaine users, then meth users – in which they received a hit in the morning (of “pharmaceutical-grade cocaine,” which must be some good shit) and then offered them a choice later in the day: more drugs or some economic reward (money or store vouchers) in its place. Starting a $5, Hart found that users who had a smaller hit in the morning would take the money later in the day. Users who got a big dose in the morning still chose more drugs.

Later, however, he upped the reward:
He also found that when he raised the alternative reward to $20, every single addict, of meth and crack alike, chose the cash. They knew they wouldn’t receive it until the experiment ended weeks later, but they were still willing to pass up an immediate high.
Which means what, exactly, for how society should view drug use and addiction? It’s actually pretty obvious, if you think about it:
Crack and meth may be especially troublesome in some poor neighborhoods and rural areas, but not because the drugs themselves are so potent.

‘If you’re living in a poor neighborhood deprived of options, there’s a certain rationality to keep taking a drug that will give you some temporary pleasure,’ Dr. Hart said in an interview, arguing that the caricature of enslaved crack addicts comes from a misinterpretation of the famous rat experiments.

‘The key factor is the environment, whether you’re talking about humans or rats,’ Dr. Hart said. ‘The rats that keep pressing the lever for cocaine are the ones who are stressed out because they’ve been raised in solitary conditions and have no other options. But when you enrich their environment, and give them access to sweets and let them play with other rats, they stop pressing the lever.’
Which brings me back to the Missouri meth crowd from the HBO doc years ago. For about the first half hour you think, “holy shit, these people are pathetic junkies,” but the more you notice the world around them, the more you start to think it’s not hard to see why they’d seek any kind of respite they could.

That’s why the War on (Some) Drugs is bound to always be a losing proposition – you’re not fighting an enemy on a battlefield, you’re battling a basic human desire to feel better and to escape the world around you, if only for a moment.