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A review by socraticgadfly
High Price: A Neuroscientist's Journey of Self-Discovery That Challenges Everything You Know about Drugs and Society by Carl L. Hart
2.0
Sorry; upon further review, this has been moved down to two-star level. See the end for why
Carl Hart is good on the basics of what we know, and don't know, about addiction and neuroscience. He's decent on telling the story of his life, and on public policy, minorities and the "War on Drugs." However, where parts 1 and 2 intersect, he sometimes seems to soft-pedal part 1 for the sake of part 2.
Basic point 1 is that he is African-American, and grew up in lower-class neighborhoods in greater Miami, and therefore in a unique position to talk about race and addiction, race and other races' beliefs about addiction, etc.
But, that's not my first primary point. Rather, per ideas I've heard from people who think that AA is unscientific, it's about "following the science" on addiction. More specifically, it's about updating one's scientific knowledge of what may cause addiction, the little knowledge we have, being updated rather than being 20 years old. More specifically yet, that involves moving beyond simple, or simplistic, ideas that we can reduce addiction to a matter of brain neurotransmitters.
And, specifically, addiction is NOT "All about the dopamine," or anything similar. I quote from his book:
I knew a fair amount of this before I read Hart's book. But, his directly applying it to addiction, combined with his ethnicity and sociological background, gave me the perfect excuse, or reason, to blog about it more directly.
For more on neurotransmitters, which may, depending on how widely the term is defined, include a variety of peptides and even minerals like zinc, see Wikipedia. I mean, histamine and products related to several amino acids are neurotransmitters. It's much more than the few neurotransmitters that health-food stores, and Big Pharma, try to pitch us on. More on that in a minute
And, folks, that's why addiction isn't all about the dopamine. And why truly understanding addiction will proved to be more complex than current ideas. ....
On public policy issues, I do agree that much of the alarm over meth in the last decade or so mirrors the 80s alarm over cocaine and specifically crack. And just as much of the crack alarm was race driven, a lot of the meth mythos is class driven.
I don’t totally agree with Hart by any means, though. I think he tilts the scale toward “abuse” rather than “addiction” at times, and doesn’t allow for even people who are addicts, not just abusers, still having enough self-control to moderate their behavior in lab settings. I mean, the stories of alcoholics and addicts trying to pull one over on people are legion, and at some point, per the old cliche, "anecdotes" become "data." Hart talks about how some of his test subjects appeared intimidated about getting to the lab, but doesn't ask if any were still intimidated later.
Nor does he seem to ask himself if he’s over-reacting to some of his own personal, and his larger background as an African-American’s, take on things like the “crack menace” or “reefer madness” long before that.
Related to both points, he doesn't ask, as a very rare minority Ph.D. neuroscientist, if some of his test subjects are "trying to help a brother out." I hate to stereotype, and I'm not a minority, but, I've been around a boatload of drinkers and users. I'm liberal enough to know the War on Drugs is a crock, but I've been plenty a person be sober or clean for years, even a decade or more, "slip," and not be able to get back on track.
I originally went back and forth between 3 and 4 stars for this book. Again, ideally, this is a 3.5, but Ye Olde Book Review sites don't offer such nuances. So, it's a 3 here. And, I'm not even sure about that. The only real takeaway for me was that addiction by neurotransmitter problems is too simplistic. His wanting to make it look like addiction isn't that common approaches simplicity itself.
And, speaking of simplicity? Why is this now a 2-star rating?
Finally, I raise at least a partial eyebrow at his crediting Maia Szalavitz for helping get the book done. Szalavitz at least has a few of her toes in the pool of right-wing funded journalism, or "journalism," or is at minimum a "fellow traveler." Her association with places like STATS.org, which, per Wiki, has connections with Scaife money, American Enterprise Institute, etc., and is affiliated with George Mason University, is a red alert right there. That would probably explain, per some Amazon reviewers, Hart visiting Fox News, and ... more than once!
In summation ...
You can find the neuroscience work, including on neurotransmitters and related issues, from other neuroscientists, or else from psychiatrists doing research work. In many cases, it won't be explicitly tied to the decriminalization issues, and possible peddling of harm reduction over abstinence, which reportedly Hart has done on some of his TV appearances.
This is a book that has more froth than substance, after a first look.
Carl Hart is good on the basics of what we know, and don't know, about addiction and neuroscience. He's decent on telling the story of his life, and on public policy, minorities and the "War on Drugs." However, where parts 1 and 2 intersect, he sometimes seems to soft-pedal part 1 for the sake of part 2.
Basic point 1 is that he is African-American, and grew up in lower-class neighborhoods in greater Miami, and therefore in a unique position to talk about race and addiction, race and other races' beliefs about addiction, etc.
But, that's not my first primary point. Rather, per ideas I've heard from people who think that AA is unscientific, it's about "following the science" on addiction. More specifically, it's about updating one's scientific knowledge of what may cause addiction, the little knowledge we have, being updated rather than being 20 years old. More specifically yet, that involves moving beyond simple, or simplistic, ideas that we can reduce addiction to a matter of brain neurotransmitters.
And, specifically, addiction is NOT "All about the dopamine," or anything similar. I quote from his book:
When dopamine's prominent role in reward was first proposed, there were only about six known neurotransmitters: dopamine, norepinephrine, serotonin, acetylcholine, glutamate and GABA. Now there are more than a hundred. Furthermore, we now know that there are specific receptors -- or specialized structures that recognize and respond to a particular neurotransmitter -- for each neurotransmitter, and most neurotransmitters have more than one type of receptor. For example, dopamine has at least five receptor subtypes -- D1-D5. We also now know that hormones like oxytocin and testosterone can act as neurotransmitters.
But despite these ever-intensifying complexities, our theory about dopamine's role in reward has not been appreciably revised since it was first proposed [in the early 1990s]. And, as you will see later, a growing body of evidence casts doubt on this simplistic view of reward.
I knew a fair amount of this before I read Hart's book. But, his directly applying it to addiction, combined with his ethnicity and sociological background, gave me the perfect excuse, or reason, to blog about it more directly.
For more on neurotransmitters, which may, depending on how widely the term is defined, include a variety of peptides and even minerals like zinc, see Wikipedia. I mean, histamine and products related to several amino acids are neurotransmitters. It's much more than the few neurotransmitters that health-food stores, and Big Pharma, try to pitch us on. More on that in a minute
And, folks, that's why addiction isn't all about the dopamine. And why truly understanding addiction will proved to be more complex than current ideas. ....
On public policy issues, I do agree that much of the alarm over meth in the last decade or so mirrors the 80s alarm over cocaine and specifically crack. And just as much of the crack alarm was race driven, a lot of the meth mythos is class driven.
I don’t totally agree with Hart by any means, though. I think he tilts the scale toward “abuse” rather than “addiction” at times, and doesn’t allow for even people who are addicts, not just abusers, still having enough self-control to moderate their behavior in lab settings. I mean, the stories of alcoholics and addicts trying to pull one over on people are legion, and at some point, per the old cliche, "anecdotes" become "data." Hart talks about how some of his test subjects appeared intimidated about getting to the lab, but doesn't ask if any were still intimidated later.
Nor does he seem to ask himself if he’s over-reacting to some of his own personal, and his larger background as an African-American’s, take on things like the “crack menace” or “reefer madness” long before that.
Related to both points, he doesn't ask, as a very rare minority Ph.D. neuroscientist, if some of his test subjects are "trying to help a brother out." I hate to stereotype, and I'm not a minority, but, I've been around a boatload of drinkers and users. I'm liberal enough to know the War on Drugs is a crock, but I've been plenty a person be sober or clean for years, even a decade or more, "slip," and not be able to get back on track.
I originally went back and forth between 3 and 4 stars for this book. Again, ideally, this is a 3.5, but Ye Olde Book Review sites don't offer such nuances. So, it's a 3 here. And, I'm not even sure about that. The only real takeaway for me was that addiction by neurotransmitter problems is too simplistic. His wanting to make it look like addiction isn't that common approaches simplicity itself.
And, speaking of simplicity? Why is this now a 2-star rating?
Finally, I raise at least a partial eyebrow at his crediting Maia Szalavitz for helping get the book done. Szalavitz at least has a few of her toes in the pool of right-wing funded journalism, or "journalism," or is at minimum a "fellow traveler." Her association with places like STATS.org, which, per Wiki, has connections with Scaife money, American Enterprise Institute, etc., and is affiliated with George Mason University, is a red alert right there. That would probably explain, per some Amazon reviewers, Hart visiting Fox News, and ... more than once!
In summation ...
You can find the neuroscience work, including on neurotransmitters and related issues, from other neuroscientists, or else from psychiatrists doing research work. In many cases, it won't be explicitly tied to the decriminalization issues, and possible peddling of harm reduction over abstinence, which reportedly Hart has done on some of his TV appearances.
This is a book that has more froth than substance, after a first look.