In essence, Hart's research shows that drug use and addiction are intimately connected to, even dependent on, societal conditions of poverty, safety, abuse, and trauma. The worse the context, the more rational drug use seems. This draws into question long-standing assumptions that crack methamphetamine use is 1) addictive, and 2) all but impenetrable to societal interventions. The war on drugs, in yet another study, is shown to be in some ways avoiding the core issues of poverty and discrimination that, in this case, makes drugs and drug use more prevalent.
As Pynchon once said, "If they can get you asking the wrong questions, they don't have to worry about the answers."
Read the NYTimes article on Hart's work from 9/17/2013.
Interesting. I certainly don't doubt that crack/meth use and abuse is associated with structural issues of poverty and discrimination, but I do question the method of the experiment and whether it really is set up to debunk the idea that crack/meth is addictive. Participants still smoked the drug every day, so it's not as if they went without it at all. Maybe this proves that rabid uncontrollable addiction is a myth, but I don't think it disproves that the drugs have an addictive property. The NATURE of this addiction may not be understood well, but that doesn't mean it's not addictive at all.
ReplyDeleteThe overall point about questioning some of these longstanding assumptions (inline with our video today) is well taken, and may still be at play here, but I think some of the claims may be overstated.
I'm glad you posted this. I saw the NYT article yesterday and have been thinking a lot about it. I think the "crack is not addictive" point certainly ruffles feathers but that ruffling of feathers is a big part of the larger point he's trying to make. Drugs are indeed not good for the human body for a number of reasons. We receive message after message with this takeaway; the drugs themselves are a very easy "bad" thing to grasp onto, to blame, to fight. It's the pain behind addiction, often the most dominant contributing factor, that is less easy to acknowledge, and of course less easy to fight.
ReplyDeletePhysical dependence is very real with some drugs, like opiates (can result in physical withdrawal) but it can be separate from addiction. With a drug like cocaine/crack, I don't think physical dependence occurs. It mimics the effects of dopamine in an extremely magnified way which leads to that euphoric feeling; that's what's "addictive" although Hart is focusing on the psychological piece of it rather than the physical piece. For some people, when life is particularly sh*tty, they want that euphoric feeling as often as they can get it. Many factors contribute to substance abuse, and I think contextual/environmental factors are more likely to be ignored or even thrown into the "poverty as a character flaw" line of thinking (i.e. something is inherently wrong with people who are poor so it is no wonder they do drugs, sell sex, etc).
Anyway, I think he's starting a very important conversation.
Hmmm....I don't read Hart's work as denying full stop that drugs are addictive (coffee, cigarette, etc), but that our single frames of addiction can and should be better understood through a more socially situated study of drug use (and other habits) in context. Rather than debunking addiction wholesale, I think the point here is not trying explain too much with a narrowly conceived data point. And let's not sleep on the damages perspective that Hart calls into question.
ReplyDeleteLike Annie, I have also been thinking about this article for the last couple of days. I found a link to one of his more recent articles on this topic (http://www.nature.com/npp/journal/v37/n3/full/npp2011276a.html), which is basically a lit review of methamphetamine and cocaine cognitive effects. It is really fascinating, to me. Many of the narratives about drug research findings are not based on empirical research, is one striking nugget from the paper, for example.
ReplyDeleteHart's work, across publications, seems to be focused on the neuropsych component of addiction, and less the social one(s)- based on a PubMed search. Given he has three separate departments he is affiliated with, I wonder how that academic home context shapes how he approaches the work he does. What I appreciated about the study presented in the NYT article was the investigation of actual drug use (and distal trade offs) in this sample. So many substance use studies are based off of self-report, which might be challenging to make sense of while thinking about stigma. At least in studies like this, it would be easier to think about substance use as being a little less stigmatized since you have metaphorically people in lab coats/with certain authority handing out the drugs. It's a curious experience.
For me, I mostly spent time thinking through the recruitment aspect of the study. In many ways it seems like questions about ethics was what I spent time thinking through the last few days. We offer incentives for studies to help with recruitment, but I think we have to also balance incentives with exploitation. After all, those living in poverty may feel more compelled to participate not out of desire but out of a real necessity for the funds. This would not only affect the data (e.g., getting a higher poverty sample with unique characteristics related to SES and yoked constructs; getting a more financially dependent sample, etc.), but also would affect the nature of the research. It kind of reminded me about (transnational) commercial organ donation- where the donor/participant may be making an informed decision based on the info available- however the options presented are not as varied as someone living somewhere else.
I think that it is an important debate here about addictions and drug abuse, but I focus my attention to the assumptions of the research study. The dominant-Western conception of health and sickness is based on the idea that what happens in the body is disconnected from feelings. There is also the assumption that illness are a personal issue and not a social issue. From this perspective, it is logic to study the physical reaction of drugs and the addicts responses to drug in order to find a remedy. From this perspective, it is also logic to think that the responses to drug are disconnected to the social environment, the personal relationships, and the options that people have. When researchers such as Hart question these assumptions, there is also a questioning about our ways to understand health and sickness. Beyond the issue of drug addiction, this study made me think in how deep my conceptions and worldview are imbedded in Western culture.
ReplyDeleteThinking about re-thinking immigration policies and advocacy, from our readings this past week and discussions in class. Thought y'all might want to know about this event on Saturday.
ReplyDeleteFrom MIRA (Massachusetts Immigrant & Refugee Advocacy Coalition)--
Hundreds March in Boston Saturday for Immigrant Respect
WHO: Hundreds of Immigrants and Allies
WHAT: March for Immigrant Respect and Immigration Reform
WHERE: Copley square to Boston Common
WHEN: Saturday, October 5, Starting at 12 Noon
SCHEDULE FOR SATURDAY
Buses will come from Fitchburg, New Bedford, Brockton, Lynn, Springfield, Williamstown and Worcester and gather in Boston
Hundreds of marchers will gather at the corner of Boylston St and Dartmouth St (public sidewalk in front of the Public Library in Copley at 12 noon
Public figures will be the "Leaders of the March," guiding participants towards two Bank of America branches on Boylston St. to deliver a letter demanding a public statement against anti-immigrant politics and in support of Immigration Reform.
The march will continue down on Boylston St. to turn on Charles St.
Attendees will arrive at Boston Common’s corner of Beacon St and Charles St. to begin the 1 hour program on the stage with music and the testimonies of 3 families and request the commitments of our MA congresional delegation to meet with Speaker Boehner and demand to enact immigration reform NOW.
THE MESSAGE OF THE MARCH
The Boston rally will demand an end to the deportation practices that have driven 11 million immigrants into the shadows, and the passage in the House of Representatives of a comprehensive immigration reform bill with a path to citizenship, which would accord these immigrants the full respect of the society to which they belong and strengthen the economy to which they contribute. Marchers will also call for the passage of important state bills such as the Safe Driving Bill and the Trust Act, measures that would increase the safety of our roads and return real security to our communities
The march will be held at a crucial moment — the final days in which the U.S. House of Representatives can move forward with an immigration reform bill this year. After the U.S. Senate passed bipartisan immigration legislation (S. 744) that includes a pathway to citizenship in June, progress was blocked by House Speaker John Boehner, who refused early this summer to bring any comprehensive bill to the floor of the House. Now, after a summer of actions in which 26 members of Boehner’s Republican party have declared their support for reform, the combined force of labor, community, ethnic and faith organizations will call for Speaker Boehner to stop blocking the passage of comprehensive immigration reform with a path to citizenship —a concept now supported by a bipartisan majority of representatives.
To that end, the rally will call on all members of the Massachusetts delegation to the House — all of them Democrats — to raise their voices publicly for consideration of a comprehensive bill, one with a path to citizenship and without militarization of the border. The rally will begin with a noon and march from Copley square past several branches of Bank of America, which supporters will publicly call to stop supporting Speaker Boehner with campaign contributions.