My brother died from an accidental overdose when he was 26 years old. Ever since, I have had an interest in drug addiction—never in a scientific way, but always with an eye on the debate. On this blog, I have reviewed and mentioned some of the authors mentioned below, just as I have published a few chronicles in Danish newspapers (Narkomaner er (også) mennesker, Udbud og efterspørgsel slog min bror ihjel og Legalisér narko).

Recently, I read Carl Hart’s book, High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society. The title says it all!

Hart is a professor of neuroscience and psychology at Columbia University. In High Price, the author mixes memoirs with summaries of his and others’ scientific research into drug abuse and addiction. This blended approach gives him street credibility. 

His reason for telling his own story is to illustrate how growing up in certain areas with lower income, poor education, unemployment, and racism affects people negatively. Basically, the underlying—and very important—moral of the book is that drug addiction is caused bymany of society’s problems, not the reasonfor them. This contradicts many of the stories most people are being told about drugs and crime. 

Similarly, Italian writer Roberto Saviano and journalist Johann Hari both claim that anti-drug policies (e.g., the war on drugs) are causing more harm than the drugs themselves. Why? Because the criminalizing drug policy marginalizes poor, undereducated, and (at least in the US) often black people. However, to actually solve the problem of drug abuse, a government ought to focus more on education, employment, racism, and alleviating general life anxieties and loneliness. 

Loneliness plays a crucial role in addiction. At one point, Hart refers to Bruce Alexander’s “Rat Park” (which made me think of the Rat Pack!) experiments of the late 1970s and early 1980s. Hart describes how rats in a social, enriched, and engaging environment self-administered morphine on offer in their cages at a significantly lower rate than rats kept in solitary cages with no alternatives offered to them. 

Most of Hart’s own research follows Alexander’s results. For example, Hart tested whether drug users would choose financial rewards over a certain kind of drug and determined that it depends on the alternative and the context. Sometimes the drug abuser would choose money or sex instead of drugs. Also, addiction is not a consequence of drug use. Sometimes people just use drugs because there is nothing else. In Alexander’s work, the rats lived in isolation. For this reason, the studies suggest, they preferred drugs over water, even if it meant killing themselves. Hart mentions that, if you were in isolation with only one film to watch or one book to read, you would probably watch or read it many times simply because you had nothing else to do. Yet, that doesn’t make you an addict! 

Again, this is related to the social environment. If you grow up in a place with little future, no money, no care, a lot of violence, discrimination, etc., then perhaps alternatives to drugs are few (or less obvious).

Thus, the conclusion High Price offers is: change the people and environment around you; then, you will change yourself. Or, change the world, and you will change accordingly.

Carl Hart’s book is an important contribution to a discourse that still seems to be governed by ignorance and prejudices.