Wednesday, September 18, 2013

Some new research on crack and meth addiction. Or "addiction."

Pretty fascinating article about work done by a Columbia professor named Carl Hart, and a book he has recently published.

It'd be great to hear him interviewed by Mark Kleiman.


Ocean said...

Yes, good article. I wish the author had also pointed out the artificial environmental conditions of the experiment. I wouldn't get too carried away by his (relative) dismissal of the dopamine reward system. But, indeed, there's always a balance to be found between extremes positions.

Brendan Keefe said...

I agree the tests sounded somewhat artificial. But still, giving a crack or meth user an initial hit and then offering a fairly paltry option in return for not taking more hits sounds pretty realistic to me.

In other words, sure, outside the lab, the test's immediate choice between two concrete rewards -- another hit, or a small gift certificate -- is rarely ever there. But the very fact that such a small reward for not taking another hit is so persuasive is pretty intriguing.

Granted, the test subjects probably knew that they'd be getting more drugs the next day, but still: this is a highly counterintuitive result.

TC said...

Part of the allure of drugs is also that you're being adventurous and flying in the face of conventional thinking to do it. Sometimes you score some really good stuff and sometimes you get ripped off with cut, so you appreciate it when the planets line up and you make a good score. And there's the excitement of meeting someone you don't know in the parking lot at 7 eleven and all the tension that goes with that. Somehow getting really good, clean stuff at the clinic every time takes the suspense out of it. It wouldn't affect addiction presumably, but part of the allure maybe the drug culture that surrounds it. In the early days of pot, those of us who did it were making a statement about being anti-Vietnam War, anti conventional thinking, so that you were joining a kind of fraternity. When the straights starting doing it some of that sense of family wore off. I'm still surprised when I meet people with long hair who smoke pot and yet are tea party types who support the wars and want law and order and the Patriot Act. Not part of my Band of Brothers. I can't speak to Meth and Crack, but surely there must be something about the culture that you don't get in a clinic blindfolded.

My brother smoked cigarettes for 20 years and tried to quit using every method there was -- hypnotism, patches , pills and so on. Then he read a book which showed him how to think about it differently and he was able to stop. It turned out it wasn't the nicotine addiction that held him but a mental state.

Ocean said...

I don't know how they selected their subjects, but sample bias is a big one here. What kinds of addicts agree to go in for a few days and accept whatever they're given? If they're in for the money (most likely), it's a natural tendency to try to please those who are providing them rewards. They may behave according to what they think the expectations are. They're of course, away from the natural environment, where the anxiety of getting more drugs later is greater, uncertainty, and other kinds of activities.

But to TC's point, with addictions it isn't about either/or. Almost all addictions will have a physiological component, which leads to regular use to avoid withdrawal, and a psychological component which has to do with a myriad of other aspects associated with use, including what you describe as "mental states".

Brendan Keefe said...

Maybe there's a sampling bias problem, but without having read up on the study, I'd be inclined to think two things, right off the bat. First, I think the research sounds edgy enough that Hart was probably as careful as he could be to create a bulletproof (or at least bullet-resistant) methodology.

Second, regarding your question about "what kinds of addicts," I'd guess, sure, they were probably mostly poor. I'd also expect they were driven by WHAT? FREE DRUGS? AND NO COPS? AND THREE HOTS AND A COT? WHERE DO I SIGN UP? Fairly typical addicts of these kinds of drugs, in other words, at least as far as my notions go.