In mind and body

Max DalyThis year’s HIT Hot Topics conference delved into neuroscience to challenge our perceptions of drugs and drug taking. Max Daly reports 

The fervour around crack cocaine reached such a level of hype in the US in the 1980s, neuroscientist Dr Carl Hart told the 2014 HIT Hot Topics conference, that at one point black civil rights activists teamed up with the Ku Klux Klan to combat America’s new Public Enemy No.1.

In 1989 the KKK launched the ‘Krush Krack Kocaine’ initiative, to rid the streets of Lakeland, Florida of crack dealers. People selling crack were legitimate hate targets at the time – they’d been described by Jessie Jackson, the Democrat civil rights activist and Baptist minister, as ‘death messengers’ and ‘terrorists’. Incredibly, the KKK initiative was ‘welcomed’ by the local National Association for the Advancement of Colored People.

Crack hit the black community hard. Around 80 per cent of those convicted for crack offences were black. Harsh new anti-crack laws introduced by President Ronald Reagan meant that those caught with crack received prison sentences up to 100 times more severe than for the powder form of cocaine, more commonly used by white Americans.

Dr Hart became curious about a drug that had so damaged his community in Miami. He wanted to know more about the drug being mentioned in such fearful tones by his heroes Gil Scott-Heron and Public Enemy. Dr Hart decided to leave his job in the US airforce, where he had spent time based over here in Swindon, and returned to the US to study neuroscience in order to understand crack’s effect on people’s minds and bodies.

The subsequent research he conducted into the psychology of crack cocaine use has since become famous. What he found blew holes in the accepted narrative – that crack cocaine was an entirely new drug that transformed addicts into mindless zombies intent on violence and getting their next fix. Hart’s experiments, where crack users were given a choice between $5 and a rock of crack, found that half the time, these ‘crack addicts’ went for the money. In other words, they made rational decisions.

‘A small amount of money was enough to shift their drug-taking behaviour. This made me rethink the crack narrative,’ said Hart. A similar experiment he conducted among crystal meth users yielded the same kind of results – the drug users did not blindly lunge for the drugs. ‘I realised that the vast majority of people who use this drug don’t have a problem. Look at Rob Ford. He could use crack and be mayor of Toronto. He was a jerk, but he could use crack and be mayor.’

Dr Hart said exaggerations around crack and crystal meth – that they cause brain damage, obliterate rational thought and are uniquely novel compounds – are perpetuated more by design than by accident.

Screen shot 2014-12-01 at 14.14.12The public has been misled about drugs. Why is this? It serves a function. It allows us to target people who we don’t like. We can’t say we don’t like black people, but we can say we don’t like an activity they are involved in, such as taking crack. This narrative helps to avoid dealing with the real problems of the poor, that if we get rid of crack, we don’t have to talk about bad education, bad housing and so on.’

Our understanding of drugs is further skewed, Hart told the annual conference in Liverpool, because scientific research only looks at drugs from one angle. He said that America’s drug science body, the National Institute on Drug Abuse, funds 90 per cent of global research on drug abuse. And the focus of NIDA’s research is the pathology of drugs.

As a result, Hart said, there is a disproportionate amount of information in the media about the bad effects of drugs, ‘creating an environment where drugs are seen as evil and there is a focus on eliminating drugs at any cost’. Hart says researchers fail to understand other aspects of drugs because their salaries depend on failing to understand them.

‘The future is bleak if we rely on science to lead the way, because the story that goes with the data is often distorted.’ He said the war on drugs had been a success for the criminal justice and health industries, which have raked in huge profits as a result.

But it’s not all bad, said Hart whose book High Price was published last year. While admitting that providing attractive alternatives to drugs is ‘a big job’, there is a way people can change the narrative and reduce the harm. He sees decriminalisation and harm reduction as vital. Meanwhile drug users need to ‘get out of the closet and admit their use’, as President Obama has done, in order to normalise the use of drugs and get the debate into the mainstream.

Screen shot 2014-12-01 at 14.15.23A more open discussion about drugs will reduce the levels of what one speaker at the conference referred to as ‘intoxophobia’ – discrimination against people who use drugs. Russell Newcombe from 3D Research told delegates that while minority groups such as women, the BME community and gay people had gained legal rights in the UK, drug users had not. Despite a lack of laws to protect them, drug users are subject to discrimination across the board – including by employers, doctors, the welfare system and insurers. Newcombe suggested the government agrees to a drug users’ charter.

But as the long-time drug commentator Sara McGrail pointed out in her speech, any changes to drug policy – despite the best intentions of the Lib Dems in the last few months – are unlikely anytime soon. The drug issue, she said, is not a vote winner, instead ‘it has been kicked so far into the long grass that we can’t see the pitch anymore’. That drugs will be off the agenda for the next election is a shame, said McGrail, because harm reduction has been ‘decimated’ and services have been cut at a time when austerity is preparing the ground for potentially more problematic drug use.

Katy MacLeod of the Scottish Drug Forum said that research she has carried out has revealed that it is among society’s most socially excluded people that new psychoactive substances are gaining a foothold, not just young people. Research at a Glasgow night shelter found nearly a quarter of its clients had tried synthetic cannabinoids, although most admitted they didn’t like it.

Despite being class C substances, GHB/GBL are the ‘most dangerous drugs on the planet’, according to David Stuart, substance misuse lead at 56 Dean Street, a drug charity based in London’s Soho. He said the drugs represented a big danger to the gay community, as did the use of other ‘chemsex’ drugs such as crystal meth and mephedrone. Stuart said the emerging chemsex scene had necessitated a need to create closer bonds between the fields of drug harm reduction and sexual health.

According to Professor Gerry Stimson, one the biggest developments in drug harm reduction in recent years has been the rise and rise of vaping. E-cigarettes could, as some economists have predicted, overtake their deadly tobacco equivalents in less than ten years. However, the success of vaping in reducing the smoking population has been accompanied by familiar fears.

Professor Stimson showed delegates a recent Twitter post by the World Health Organization (WHO) declaring that e-cigarettes ‘pose a risk to public health’. But he said fears that e-cigarettes could be a gateway to smoking and undermine government anti-smoking policy are reminiscent of opposition to clean needles and foil for heroin users.

He said it would be ‘unethical’ for governments to deny or discourage the use of life-saving products and said one of the ‘perverse’ consequences of over-regulating e-cigarettes was that there are now higher controls and constraints on them than on regular cigarettes.

Screen shot 2014-12-01 at 14.14.49At the start of the conference, organiser Pat O’Hare told delegates that now, almost all the taxi drivers he gets chatting to in Liverpool favour drugs legalisation. He said this represented a swing in the public mood. ‘I never thought in my lifetime we would see drug legalisation, but now I think we will.’ And few of those who listened to the final speaker of the day, Anne Marie Cockburn, whose 15-year-old daughter Martha died last year after taking MDMA, could deny that change is required.

She challenged the politicians who think current policy is a success to stand by her daughter’s graveside. ‘Martha became another face on a newspaper. I feel helpless when I see another death of a child. The law is past its sell-by date. I want drugs to be legalised because I want safety first. Please help me.’

As Dr Hart pointed out in his talk, before he died in 1987 the gay, black writer James Baldwin was marginalised for his views about drugs. He said no one should be sent to jail for drugs, that anti-drug laws were laws against the poor and that banning drugs did not stop people taking them. In fact, he said, lots of money was being made on the back of the dope laws. After hearing the latest evidence at this conference in 2014 it seems Baldwin, all those years ago, was something of a visionary.

Max Daly is a freelance journalist and joint author of Narcomania: How Britain Got Hooked On Drugs