by Carl Hart
Before any paper is published in a scientific journal, experts in the field must review it anonymously. These reviews are often brutal. They sometimes question your intellectual capacity to be employed as a scientist. So, when I received the reviews for my paper I was expecting harsh criticism because I was essentially calling into question an entire body of research. To my surprise, the reviewers’ comments were extremely laudatory: “This review is comprehensive and extremely well written. Dr. Hart and colleagues certainly challenge the status quo and should be applauded for writing a provocative paper and taking what will surely be characterized as an unpopular position. . . . The general message is somewhat of a wake-up call to the field. . . .” It’s too soon to know the exact impact the paper will have on the field, but shortly after its publication, Scientific American highlighted it in an article that questioned whether the methamphetamine hysteria is limiting the availability of effective medicines.20
This all got me thinking even more about the consequences of presenting biased, exaggerated, or misleading drug information to the public. As an educator, I worried that we would lose credibility with many young people, and that as a result they would reject other drug-related information from “official” sources, even when the information was accurate. Undoubtedly, this has contributed to numerous preventable drug-related accidents. I thought about the distorted claims made about crack cocaine and how this led to egregious racial discrimination. During the “crack era,” I didn’t know any better. I was ignorant. Ignorance could not be used as an excuse in the current case of methamphetamine. I knew better. I had published my research findings in some of the finest science journals and had coauthored one of the bestselling drug textbooks. And each semester, my Drugs and Behavior course was one of the most popular undergraduate classes at Columbia. Still, voices like mine were rarely included in national discussions on drug education or public policies about drugs. My voice was not included because I had serious trepidations about exposing myself in this way. I knew that some would say that I had an agenda, implying that I might be less than objective. This is one of the worst criticisms that can be leveled against a scientist. Others would attempt to label me as reckless by distorting my views as advocating for the complete legalization of drugs.
Presenting my research findings at a scientific meeting.
Ultimately, it became clear to me that I had to speak out beyond the walls of the academy. I started giving lectures in local community centers, at the YMCA, student-organized conferences, bars and cafés, at museums, or anywhere else I was asked to speak. I spoke with high school students and their parents about the real effects of drugs and ways to decrease associated harms. I lectured at other universities about the foolish way the country deals with drugs and the biases I was starting to see in the questions we asked about drugs in science.
A frequent question from parents was “What about the children? Isn’t it better to exaggerate drug-related harms so we keep our children away from them?” Black people rarely asked this question; it almost always came from white parents. I tried to be as patient as possible in my response. I’d point out that I too was a concerned parent with three sons—two within the critical ages of concern—and how I have educated the two that I raised about drugs without exaggerations. I explained that my twenty-plus years of drug research experience has taught me many important lessons, but perhaps none more important than this—drug effects are predictable. As you increase the drug dose, there is more potential for toxic effects. Black boys’ and men’s interactions with the police, however, are not predictable. I worried all the time about the very real possibility that my own children would be targeted by law enforcement because they “fit the description” of a drug user or because someone thought they were under the influence of drugs. Too often in these cases the black youngster ends up dead. Ramarley Graham and Trayvon Martin both were believed to have drugs or be under the influence of them.
In addition to giving more public talks, I was invited to join nonscientific advocacy organizations. I was particularly intrigued by an invitation to join the board of directors of America’s leading organization dedicated to changing the drug laws: the Drug Policy Alliance (DPA). This was a difficult decision. I knew it would put me in an awkward position with the man who’d recruited me to Columbia, Herb Kleber. Herb had served under President George H. W. Bush as deputy drug czar from 1989 to 1991; many of his views were in line with those of most politicians who claim that drugs are evil and that we should pursue a “drug-free America” at any cost. The DPA was about as far away on the political spectrum from Herb’s view of drug policy as it was possible to get. When I told Herb that I was considering joining the DPA board, he warned that it wasn’t a wise thing to do at this stage of my career—I was being considered for tenure. In order to reach a decision, I also spoke with a prominent black former DPA board member, who told me to be careful about being used because of my race. In this person’s view, DPA was a white organization concerned mainly with legalizing marijuana so that white boys could smoke without fear of harassment by the police. As a result, they were far less concerned about fighting the racial discrimination so prevalent in the drug war. I considered all of these things but ultimately joined the board. It was my way of making a very public statement about my views on our country’s misguided drug policies that disproportionately target blacks. It was also my way of making sure that the leading group challenging current drug policies was fully informed about and had access to the best scientific research.
One of DPA’s mottos is that it promotes “alternatives to current drug policy that are grounded in science, compassion, health and human rights.” This really appealed to me because it suggested that this organization understood the importance of using science to inform drug policies and ultimately enhance health and human rights. After I had spent five years of service on the DPA board, however, it became inescapably obvious that their understanding of science was slightly different from my own. I naively thought that the scientific evidence would guide DPA’s focus and positions taken much as it does in my own research. In my view, if DPA had simply followed the scientific evidence, their priorities would look quite different. Rather than a predominant focus on marijuana legalization and increasing the number of states with medical marijuana programs, unbiased scientifically informed public education about drugs would be the major priority. The evidence that I have presented throughout this book suggests that the average person is woefully ignorant about illegal drugs and their use. As a result, an organization like DPA could fill an important knowledge gap if they spearheaded public education campaigns aimed at enhancing the intellectual tone around drug-related issues that substantially impact public health. For example, because the majority of heroin overdoses occurs in combination with another sedative—mostly alcohol—a massive media campaign warning users to avoid combining heroin with other sedatives would not only be educational—it could also be lifesaving. I also recognize that government agencies, such as ONDCP and NIDA, should take the lead on these efforts, but they have consistently demonstrated their unwillingness and/or inability to do so.
I discovered, though, that DPA faced the same pressures and limitations that many other nonprofits face—the donors influence priorities. That is why, for the past several years, marijuana law reform has been the major focus of DPA, even while it has played a major role in bringing attention to racist stop-and-frisk laws in New York City. As it turns out, like ONDCP, the use of the term science in DPA’s slogan seems to be a matter of convenience rather than a commitment to truth that guides the organization’s positions and focus. Of course, this cunning use of language is more egregious when employed by ONDCP, because it’s a government agency and not an advocacy organization. These sad realizations contributed to me being more vocal on the board and writing this book in an effort to educate the public about drugs.
CHAPTER 16
In Search of Salvation
If the society today a
llows wrongs to go unchallenged, the impression is created that those wrongs have the approval of the majority.
—BARBARA JORDAN
God is offering Salvation, apply through Jesus Christ,” read a huge billboard on Sunrise Boulevard. Sitting in rush hour traffic, I reflected on where I’d just been. It left me demoralized and definitely in need of some salvation, even though I’m not particularly religious. As part of my research for this book, I was interviewing relatives and old friends in South Florida and had just spent the last hour with my cousin Louie. Growing up, he and I had shared a bed at Big Mama’s; he was the math whiz that I admired. Now he lived in a halfway house just off the Florida Turnpike in Fort Lauderdale, and it had been nearly thirty years since I saw him last.
“What’s up man, you know who I am?” I asked the skinny man standing in front of me. He was wearing a wife-beater T-shirt and oversize blue jeans. The home care attendant had pointed out Louie, who was standing outside speaking with another resident. “Big Jun,” he responded. When we were boys Louie had always called me Lil’ Carl or Junior; now I was Big Jun. I was surprised that he’d even recognized me, because my appearance had changed so much over the past three decades. His had, too. He stood about six feet but weighed, at most, 110 pounds. His face was so emaciated that you could see nearly every bone. The few remaining teeth he had looked like they were on the way out. I was shocked, disturbed, and profoundly sad but showed only that I was happy to see him because I didn’t want to hurt his feelings. Over the years, I had become a master at masking my emotions, although this skill had been seriously tested in the course of writing this book.
We slapped hands, did the bro-hug thing, and without interruption, Louie talked for the next hour. He talked about the various crimes he had committed over the years and the amounts of money he had stolen and stashed. I learned that the police had beaten him up on many occasions and that he believed his insides had been replaced with those from other people. He contemplated whether he had done the right thing by not becoming a police informant, “I didn’t tell nothing. Maybe I should’ve start telling. I did plea guilty and didn’t snitch on nobody. They wouldn’t let me go home since I didn’t give ’em no information. I should’ve turned state on ’em.”
Louie’s thoughts were disjointed and difficult to follow. He jumped from one subject to another without a break or transition and paced around the small yard the entire time I was there. His involuntary, repetitive movements were a textbook case of tardive dyskinesia brought on by taking antipsychotic medications for more than two decades. Although the details aren’t clear, family lore has it that he was initially put on these medications in the ER after having a “bad reaction” to an unknown street drug. And when he was sent to prison, they kept him on them in order to keep him obedient and calm—a chemical straitjacket.
In graduate school, I’d learned quite a bit about antipsychotics and what they were used for. These were the drugs used to treat schizophrenia and related illnesses. The simplistic idea is that psychotic behaviors such as those seen in schizophrenia are caused by overactivation of dopamine cells in the brain. Antipsychotic drugs block dopamine receptors and thereby prevent excessive dopamine activity. Behaviorally, these drugs quiet the voices in the heads of schizophrenics and reduce their paranoia and agitation. The problem is that the older generation of these medications, the type that Louie was prescribed, block dopamine receptors so extensively that the brain compensates by increasing the density of dopamine receptors. The brain is now hypersensitive to dopamine, and after years of treatment, the person develops tardive dyskinesia and becomes even more susceptible to psychotic symptoms. In other words, the treatment for psychotic symptoms can actually cause these symptoms. It’s a trap.
With each passing minute, Louie’s voice became background noise and I felt more and more grief and despair. I wondered how this could have happened but already knew the answer, because his story wasn’t unique. I had seen similar scenarios with other male loved ones. Virtually all had been initially caught up in the system via a drug charge while in their teens and early twenties, which began a vicious cycle from which they couldn’t escape. What’s worse is that the cycle wasn’t even new. One hundred years ago, on September 29, 1913, the New York Times printed an article that described how a white mob in Mississippi lynched and shot two black young men, one eighteen and the other twenty, because they were suspected of starting “a reign of terror” under the influence of cocaine. The following day the paper reported that the town’s two thousand black residents had been forced to walk past the bullet-riddled bodies of the two boys to view them; this, the article continued, “had a remarkably quieting effect on the negro population.” I would imagine it did.
Of course, we no longer lynch people for violating drug laws. Today the damage is far less visible and starts more subtly. The educational and vocational skills that sustain people throughout life are usually obtained during young adulthood, from the late teens throughout the twenties. This is a critical period. I, for example, spent most of my young adult years in classrooms and labs learning how to think and write. These skills have allowed me to support my family financially, which gives me a sense of worth and manhood. As a result, I have a stake in this society and do my best to make a contribution to it. It doesn’t matter whether the contribution is in paying taxes or doing public service or takes some other form. The point is that society and I both benefit from me having a stake in it.
In contrast, so many of the black boys with whom I grew up don’t have any stake in our society. They didn’t acquire the necessary skills and didn’t get the needed support during that critical period. Instead they were under the supervision of a system that doesn’t seem to understand or care about the importance of black men being invested in this society. Supporters of this system have an irrational focus on eliminating certain drugs and are preoccupied with those who violate drug laws, especially if they are black. Selective enforcement of drug laws seems to serve as a tool to marginalize black men and keep them in the vicious cycle of incarceration and isolation from mainstream society. I am not arguing that people shouldn’t be sanctioned for legal infractions. There are many cases in which sanctions are appropriate. However, the penalty should not be so severe that the penalized young person is unable to recover and stake a claim in society. In such cases, we all lose. The young person’s loss is obvious. The general public is deprived of the contribution that would have been made if the person were a stakeholder. With no real stake in the larger society, many of my friends and relatives feel they have nothing to lose. And as James Baldwin observed, “The most dangerous creation of any society is the man who has nothing to lose.”1
After speaking with my sisters, I could see that we were beginning to lose some of my nephews. They had already started to repeat the incarceration-isolation cycle. What could I tell them? Hell, I don’t even know what to tell my own son Tobias. He has spent time behind bars for a drug violation and doesn’t have a high school diploma; nor does he have an employment track record or any prospects for a legitimate job. I’d recently spoken with him on a previous visit and he caught me up on the current events in his life. I learned more about baby-mama drama than I cared to know. “Man, they always want some shit,” he complained about the difficulties of dealing with the three different mothers of his children. At the same time, he was extremely proud to be a father five times. It was his badge of honor, something that “real” men do, even though he was unemployed. And unless there is some radical change in this society, his chances of getting a legitimate job are extremely bleak because these irrefutable facts remain: he is a black male who has a drug conviction and limited marketable skills. Like Louie, he too is trapped.
Don Habibi, my old mentor from the University of North Carolina Wilmington, was fond of saying, “Once you know, you cannot not know.” There was a period in my life when I was unaware of the forces preventing Tobias and people like him from legitimately competing in mainstream
society. That time has passed; I have come to understand that the game is fixed against them. That’s why I am frequently disheartened and stressed when asked what to tell someone in Tobias’s position. I recognize that I can’t give up on him or our society. So when we met last, I again encouraged him to get his GED and a legitimate job. I told him about my brother Gary, who had also dropped out of high school and dabbled in cocaine sales, but would eventually graduate college and own a multimillion-dollar company. I didn’t tell him that Gary had never been convicted of a crime, nor did I tell him that Gary had only one child when he started to turn his life around. That contextualization might have been too daunting. After all, I was trying to convince Tobias, as well as myself, that he too could do it.
Along Gary’s journey, I had given him a copy of Nathan McCall’s Makes Me Wanna Holler. It was the first book that he had ever read cover to cover. He found it inspirational. So I bought Tobias a copy, too, and asked him to read it so we could discuss it. I also got him Bob Marley’s Survival CD, printed out the lyrics, and asked him to listen to it with a particular focus on the track “Ambush in the Night.” I explained that the song poignantly describes how the system is stacked against people like him and how sometimes it’s nice to know that someone else gets it. Still, this felt insufficient for what he faced. It felt like giving a Band-Aid to a gunshot wound victim who is profusely bleeding when everyone knows that a surgeon is needed to remove the bullet so the healing can begin.