The Rational Choices of Crack Addicts

[roseofjuly]

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.

Those addicts seemed enslaved by crack, like the

Comments

[roseofjuly]

I have to say that I do disagree with his last sentence, where he says 80-90% of people are not negatively affected by drugs. The research literature has not borne that out - I do research on substance use, too, and how it interferes with HIV prevention. And it does. People who use drugs - especially during sexual encounters - are less likely to use condoms than their non-drug-using peers.

[perthro]

There needs to be more research on that. Frankly, almost everyone I've ever known is either on drugs or has experimented in the past, and *most* of them are pretty hardcore about sexual safety. But they're also not ones to admit to non-users that they've ever done any, or are on any. You can say that's anecdotal evidence, but that anecdotal evidence is what makes up hard data when collected for surveys and studies.

[roseofjuly]

That's why I, personally, am interested in the sexual situations themselves. Our research says that drugs interfere with condom use. But when I presented in front of Carl during colloquium, he suggested that maybe the users just have a plan - that it's not that the drugs themselves cause a lack of condom use, but that people plan to go out that night, get really drunk and/or high, and not use a condom - and that's just part of the experience. We don't know, though, because so far the field hasn't really asked those questions.

It's not that you have anecdotal evidence; it's just that the people you know are much more likely to be similar to each other. I've talked to other guys who've said most of their friends look online for bareback sex, and other guys who say their friends always use condoms with their primary partner but not their secondary (or vice versa), and other guys who say all their friends think they can tell who has HIV by looking...lots of disparate groups.

[tilmon]

He didn't say that people aren't negatively affected. He said 80-90% of users aren't addicts; that is, they will quit if they have sufficient incentive from their standpoint. And he said that most users, whether addicts or not, experienced a collapse in their status prior to beginning to use. From what I get out of his research, the essential problem is poverty. Give people some hope, something to hold on for, and they will forgo drugs. The drugs come later as something to numb the pain of poverty, violence, and loss.

[perthro]

Yep. I'd like to see how the study defines 'addict' vs. how society defines 'addict' as well. Drug users who use them habitually are not necessarily addicts, although we tend to classify them as such. And yet, when given pleasurable alternatives (like earning money for something better), most people have no problem putting their recreation of choice down. I don't think people understand how many people actually use drugs of some form and just don't admit to it, and yet they have relatively functional lives. And even then, the dysfunction comes primarily from other sources, not from drug habits themselves.

[tabaqui]

I agree that this was the main point, here.

[kitanabychoice]

Yep, you pretty much nailed my thoughts on that last line too.

[roseofjuly]

On the second page, he does say that 80-90% aren't negatively affected.

“Eighty to 90 percent of people are not negatively affected by drugs, but in the scientific literature nearly 100 percent of the reports are negative,” Dr. Hart said. “There’s a skewed focus on pathology. We scientists know that we get more money if we keep telling Congress that we’re solving this terrible problem. We’ve played a less than honorable role in the war on drugs.”

[tilmon]

Thanks. That's interesting. I wonder how he defining "negatively affected".