Faces of Drug Abuse Research: Carl L. Hart, Ph.D.
February 2, 2009
Associate Professor Carl L. Hart, Ph.D. (PubMed; Department Website; ResearchCrossroads Profile) of the Psychology and Psychiatry Departments of Columbia University conducts research on several drugs of abuse with concentrations on cannabis and methamphetamine. In his studies he uses human subjects to determine many critical aspects of the effects of recreational and abused drugs including acute and lasting toxicities as well as dependence. Dr. Hart is also a contributing member of the New York State Psychiatric Institute Division on Substance Abuse.
In his academic research role, Professor Hart works within the highly respected and very well known Substance Use Research Center of Columbia University where he directs both the Methamphetamine Research Laboratory (Meth R01 Abstract) and the Residential Laboratory. The blurb for this latter will give you a good flavor for the workaday of Dr. Hart’s work:
The residential laboratory, designed for continuous observation of human behavior over extended periods of time, provides a controlled environment with the flexibility to establish a range of behaviors, and the ability to monitor simultaneously many individual and social behavior patterns. This laboratory is equipped with a closed circuit television and audio system encompassing each individual chamber for surveillance and measurement purposes, and to provide continuous monitoring for the participant’s protection. We believe that this relatively naturalistic environment can best meet the challenge of modeling the workplace to predict the interaction between drug use and workplace variables. Because our participants live in our laboratory with minimal outside contact, we are able to evaluate multiple aspects of the effects of drugs on workplace productivity in the same individuals.
If you review his publications on PubMed you will note that Dr. Hart has contributed to quite a number of studies evaluating possible therapeutic medications for helping with cessation of substance use, has evaluated the effects of many of the more-common drugs of abuse on “shift work” related parameters and investigated potential lasting cognitive effects of sustained use of cannabis, stimulants and alcohol. In short, he has worked on what I think of as all the main areas of health interest when it comes to recreational drugs- What are the long term risks to cognitive function? What are the acute effects? How do we help the drug dependent to stop using? If you are readers of my occasional musing on drug abuse topics you will quite rightly conclude that I find Professor Hart’s papers to be must-reads because his work focuses on the real-world issues that are ultimately of greatest importance. Animal research on basic principles is fine and all but research on the various human drug-using subpopulations is both the launching pad and backstop for nonhuman studies.
Professor Hart is also author of an excellent introductory text on drug abuse, suitable for undergraduate instruction (I have used a prior edition myself). Drugs, Society and Human Behavior is currently in the 13th edition (Publisher; Amazon) which lists Dr. Hart as the first author. This text was originally developed by Charles Ksir (Prof. Hart’s graduate advisor) and Oakley Ray (RIP) and the authorship over recent editions would suggest that Professor Hart has now taken over primary responsibility for subsequent editions of this book. As the publisher website notes:
In addition to his substantial research responsibilities, Dr. Hart teaches an undergraduate Drugs and Behavior course and was recently awarded Columbia University’s highest teaching award.
Having seen Dr. Hart give a few research presentations over the years I can certainly believe this latter, he is quite a dynamic speaker. Well, perhaps not dynamic exactly…more like a commanding speaker. I doubt anyone is falling asleep in the back of the lecture hall.
As a final note, it looks very much from the research Google-fu as if Professor Hart is a person who embodies many of the realities of modern research careers as I detail them on this blog. He appears to have joined the Columbia group as a postdoc, gained a faculty appointment and worked his way through to tenure at a fairly elite University. Along the way he took over responsibility for some of the larger research group’s core operations (including becoming PI of the R01 award and successfully renewing it), launched his own domain of concentration (with R01 funding) within a highly collaborative group, published some great papers, won teaching awards and took over responsibility for subsequent editions of a highly popular and excellent undergraduate text book. And that is just the public record. It is unimaginable that he would have arrived at his current career position without a lot of hidden service reviewing papers and grants, doing committee work for his University, etc.
In short, one of those very smart and dedicated individuals who is working for you, the US taxpayer, to do some GoodThings for public health. Thank you Professor Hart.
DrugMonkey 
February 2, 2009 at 7:54 pm
this is very cool of you, DM. i hope you do more of these!
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February 3, 2009 at 9:47 am
I plan to. Not having done anything with quite such a personal focus before (my post on the women of MDMA was close, I admit) I’m sort of inching through the process. At the moment I’m most comfortable getting the OK of the subject in question in advance. I have a few more irons in the fire…
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February 3, 2009 at 4:53 pm
This is a Way-Rocking!!! Diversity in Science (Black History Month Edition) submission. And the first one I know about. This is Great!! I’m so excited….and it looks like this profile was well-received by one of your readers. I can’t wait to put the carnival together.
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February 3, 2009 at 7:25 pm
“Because our participants live in our laboratory with minimal outside contact, we are able to evaluate multiple aspects of the effects of drugs on workplace productivity in the same individuals.”
That sounds really cool and profoundly disturbing. Aren’t there some serious ethical issues here?
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February 3, 2009 at 7:31 pm
That sounds really cool and profoundly disturbing. Aren’t there some serious ethical issues here?
Yes there are always serious ethical issues when it comes to human and animal subjects research. This why it is closely regulated and must be approved by a review board on an experiment by experiment basis for the most part.
Without knowing your specific concerns it is hard to address but the vast majority of experimental studies which give recreational drugs to humans (in the US) are required to stick to people who claim to have used recreational drugs (typically the specific one under investigation) in the past.
If I am not mistaken the majority of studies using an extended duration do not last more than a couple of days. They also have more than one person interacting. We are not talking about some extended interval of social isolation if that is what concerns you.
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February 4, 2009 at 12:25 pm
Given the description I can’t tell what exactly the experimental design is, but it sounds like they’ve got a bunch of addicts locked away in a lab and they give them drugs and see if they can type or organize manila folders… but I’ve probably got the details a bit wrong.
I’m sure there’s an ethical way to do this, it just sounds kinda crazy. “Participants live in our laboratory with minimal outside contact” sounds like… well, they live there, and not a weekend binge at the university. But, I’m sure there’s a technical definition of “live” is much shorter than my own. Still, it sounds interesting.
I’ve had a hard enough time just allowing people to donate blood. I can’t imagine what hoops they had to go through to get this approved.
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February 4, 2009 at 1:52 pm
ahh, well some of this is easily solved by reference to the methods, e.g for a recent paper from the group on Meth and “shift-work”.
19 days is a little longer than I might have remembered. but still, hanging out with a limited group of other people, doing some computer tasks and otherwise watching TV or movies or playing videogames or whatever is not tremendously different than some people’s lives out in the real world. all they are missing is the commute and shopping….
regarding the subjects themselves:
Axis I would be where substance use disorders are placed so these were not “addicts”.
The active dosing conditions permitted the subject to decide to take a 10 mg dose of methamphetamine (orally) twice per day. Not whopping by any means.
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February 4, 2009 at 2:03 pm
Well, the study is suddenly way less disturbing and a little less cool in my mind.
Still, it’s pretty interesting stuff, and I’m still amazed any review board would approve it (not that they shouldn’t, I’m just surprised that they did).
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February 27, 2009 at 4:04 pm
Children on Drugs
by
Richard Wilmot Ph.D.
Clinical Director
Path to Recovery
510 879-7394
This article is published in Counselor,The Magazine for Addiction Professionals, October 2006, v.7, n.5, pp.38-40.
Whenever a politician wants to rouse the public to champion a policy all he or she has to do is invoke the name of children: “it’s all about the children”; “it’s for our children,” “it’s to protect the children.” There is a lot of hypocrisy and disingenuousness attached to such an invocation, as poverty and the lack of health care – two of the most manifest endangerments to children – seem to be perennially ignored.
Likewise, if one wishes to provoke intense public scrutiny all one has to do is mention children and drugs in the same sentence. If they are so juxtaposed, then the link between them had better emphasize their contrast and conflict. There is nothing good to say about the use of drugs by children … except by children themselves and only when adults are not present. Perhaps we should put down the Ritalin and simply listen to them.
Of course children know better than to say anything to an adult that could in anyway be construed as favorable towards drugs. Although among themselves, they will reveal their true feelings. It is too dangerous to talk frankly with an adult about drugs. There are sanctions. There is pain and punishment … hurt feelings. Why bother? And it is just such a conspiracy of silence and self-censorship that places us in the position we are today: awash with drugs and drug problems with only clichés to say out loud about them.
We are now engaged in yet another war – a civil war (for the children) against drugs, except it appears that the “enemy” is becoming a little more devious, a little more stealthy, and is hiding in common, ordinary household products and personal grooming aids such as finger nail polish and nail polish remover, spray paint, marking pens, spray on solvents, and whip cream dispensers. These are the products used in inhalant abuse, and although one does not necessarily need to be a child to use them, it is understood that a troublesome percentage of both adolescents and preadolescents do so.
Who is this enemy in these products that threaten our children? NIDA director Nora Volkow, MD, identified the enemy in her article “Youth and Inhalant Abuse” – the enemy is the “quick high” (Volkow, 2006).
Tell us more about this “quick high” threat to our children. But alas, throughout the remainder of the article, “quick high” is never mentioned again. Perhaps that is because of the profane reputation of the word “high” itself. It is really a “quick (& dirty) high”.
Be that as it may, now that the “enemy” has been identified, let us bring on the war! What should be our weapons to keep children off inhalants? Aerosol sprays, propellants, and solvents are not good things to inhale; on that we can all agree. However to ban such products because of their possible abuse would be absurd. It is incredulous to consider the makers of glue, shoe polish, paint thinner or gasoline as drug pushers. So the weapon of prohibition seems out of the question. What about propaganda? Perhaps if children knew just how bad it was for both their mental and physical health, they would cease and desist. Yet, as Volkow points out, studies indicate that users report that they “abuse inhalants in spite of known negative consequences.” And after a lengthy description of just how negative those negative effects can be, Dr Volkow concludes with this prevention tip: “A solution to this problem … aims to educate children and others about the dangers and risks involved.” In other words: more propaganda about the negative effects of “huffing,” “snorting” and “bagging” that children, as Volkow reports, do not listen to anyway (Volkow, 2006).
How can we get the children to listen? Perhaps we should listen to them, and if not through words, at least from a different angle – through their actions (i.e., behaviorally).
Dr. Volkow made the comment: “It is difficult to understand why anyone would stuff a solvent-soaked rag in their mouth, and begin huffing the concentrated vapors.” Perhaps the reason has to do with that “quick high” mentioned at the beginning of her article.
When Sigmund Freud first proposed “infantile sexuality” his conjecture was considered absurd. Nowadays, childhood erotica is viewed as a normal part of psychological development and genital manipulation is observable behavior in infants. Our knowledge about psychoactive drugs and particularly drug use by children seems to be at a similar parochial stage of understanding as was sex at the turn of the last century.
However, just as Freud postulated sex as a universal drive, many experts in the field of drug studies are beginning to recognize that “getting high” is also a universal drive. Ronald Siegel, Andrew Weil, Stuart Walton and others have observed that “getting high” or altering one’s consciousness is an evolutionary inevitability having to do with our human biology. To paraphrase Siegel: “getting high” is as natural as falling in love (Siegel, 1989).
Weil also calls our attention to the natural orientation of children to alter their consciousness:
The desire to alter consciousness is an innate psychological drive arising out of the neurological structure of the human brain. Strong evidence for this idea comes from observations of very young children, who regularly use techniques of consciousness alteration on themselves and each other when they think no adults are watching them.
These methods include whirling until vertigo and collapse ensue, hyperventilating and fainting. Such practices appear to be universal, irrespective of culture, and present at ages when social conditioning is unlikely to be an important influence (two and three years old). Psychiatrists have paid little attention to these activities of all children.
Freud noted them and called them ‘sexual equivalents’ which they may be, although that formulation is not very useful (Weil, 1972).
In his book Out of It (2002), Walton describes the death of a 15-year-old boy at Eton College resulting from a game of recreational asphyxiation, which had been all the rage in Britain’s famous public school. In this asphyxiation game, intelligent adolescents from functional homes choked each other into unconsciousness by tying cloth cords around each other’s necks and tightening them until one’s playmate collapsed. When asked to explain the reason for such behavior one of the participants said: “The attraction was that it was something different. It makes you feel abnormal.”
Spinning until dizzy or asphyxiating until close to passing out and experiencing the disorientation and hilarity that such an altered state can produce are the same motivational triggers for doing drugs, whether it be inhaling nitrous oxide from an empty whip cream dispenser or smoking marijuana. The need to alter one’s consciousness is a perfectly natural drive. When children attempt to “get high” they are doing something natural. They are playing. Adults who use spinning to promote spiritual mysticism (Sufi Dervishes) or enhance their sexual foreplay through erotic asphyxiation are using a child’s game to do the same thing: alter their consciousness.
If we can view a child’s motivation for getting “high” as part of a universal desire to alter consciousness, we will have a better understanding of how to deal with abuse. What the child is doing is natural, but the tools he or she may be employing may be dangerously inappropriate. Approached in this way, we will have a better rapport with the child, and on that basis, be better informed as to what our children are doing. No longer do we have to threaten the child by saying: “What in the hell are you doing that for or why in the hell are you taking that stuff.” Such a prohibitive reaction simply ‘shouts’ down further communication. We can bypass the inquisition because we will already know. We can then say: ” I know how you feel when you do this or take that … this is natural … I’m just concerned you might hurt yourself. Here is why.”
In conclusion, it should be noted that one of main propellants used in aerosols is nitrous oxide, considered the most abused of all other gases. William James, the father of modern American recovery psychology, used nitrous oxide himself in his experiments on human consciousness. He titrated his dose and created for himself a uniquely religious experience that he wrote about in his now classic work The Varieties of the Religious Experience.
Do children have such experiences themselves when they ingest such drugs as nitrous oxide? Perhaps it is time that we ask them. Maybe the answer to childhood drug abuse is to begin a dialogue with children on drugs that recognizes the fact that what they are doing is natural (not necessarily pathological or immoral) but also can be dangerous, and that our concern is over the danger and not about the alteration of consciousness itself.
References
James, William (1929). Varieties of the Religious Experience. London, Longman Green.
Siegel, Ronald K. (1989). Intoxication: Life in Pursuit of Artificial Paradise. New York, E.P. Dutton.
Volkow, Nora (2006). Youth and Inhalant Abuse. Counselor, The Magazine for Addiction Professionals, Vol. 7, Issue 2.
Walton, Stuart (2002).Out of It. New York, Three Rivers Press.
Weil, Andrew (1972). The Natural Mind. Boston, Houghton Mifflin.
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February 27, 2009 at 4:13 pm
I used Drugs Society & Human Behavior in my classes when Oakley Ray did the editing. I understand that Hart is the new editor and I’d like to see that edition. I remember a part that was edited from the original 1972 edition. There was a mention of CENSORSHIP in which the Children’s nursery rhyme. Old King Cole was CENSORED as the king called for his pipe (for smoking drugs) as well as his bowl.
Of course it’s hard to speak or write about drugs when they are called so many names… like “seductive”…like “addictive”.
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February 27, 2009 at 4:21 pm
NAME THAT DRUG! The new game show that links the drug with the metaphor!
“quickly seduces those who snort, smoke or inject it with a euphoric rush of confidence, hyper alertness and sexiness that lasts for hours on end. And then starts destroying lives.”
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March 1, 2009 at 11:25 pm
The August 8th, 2005 edition of Newsweek magazine’s front cover depicts a person smoking “ice” (the smokable form of methamphetamine): “The Meth Epidemic: Inside America’s New Drug Crisis”. The article inside is a description of a professional working wife and mother who gave up her $100,000 per year job, her family, and her suburban life style for “something that mattered more: methamphetamine.” It goes on to describe “meth” as a drug that:
“quickly seduces those who snort, smoke or inject it with a euphoric rush of confidence, hyper alertness and sexiness that lasts for hours on end. And then starts destroying lives.”
The rest of the article is about law enforcement efforts to eradicate illegal meth labs (two per day in California). There are pictures of people with faces and bodies burned from meth lab explosions, and the evacuation of entire neighborhoods due to the possibility of Meth lab contamination; there are a plethora of descriptions of destroyed lives. There is never a return to the most interesting introductory comments: “a euphoric rush of confidence, hyper alertness, and sexiness that lasts for hours.” In other words there is no extrapolation about what matters most. Why do people use methamphetamine even when it is so stigmatized and even when it destroys their lives? What is it about the Meth experience that keeps them coming back for more?
Understandably the authors of this Newsweek article want to make the point that the use of Meth in America is creating a problem of epidemic proportions. They want to dramatize their point by using a metaphor of seduction: “quickly seduces” those who use it. However, seduction is something that is limited to human beings. It’s a human characteristic. In no way is it the chemical property of an inanimate drug. There is no part of the methamphetamine molecule that can be identified as “seductive” . Thus talking about a chemical substance as if it were human is the first step in promoting fear & loathing. It gives to the drug magical powers: the power, for example, of seduction. It makes the drug more potent by the words we use when describing it both to ourselves and to others.
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March 2, 2009 at 8:41 am
rwilmot: They want to dramatize their point by using a metaphor of seduction: “quickly seduces” those who use it….
-snip-
It gives to the drug magical powers
Well you won’t get any arguments from me, I’m not a big fan of the way the MSM treats drug abuse issues. (With respect to Meth hype I think I’ve only touched on it the once on the old blog. )
There’s a certain sense to this type of hyperbole though which is that this is how many addicts describe their first try of their most-problematic drug of abuse. So for some subset of addicts this may be a valid way of talking about it. It conveys their subjective reality.
The problem is that, as you say, it conveys the general message that a drug is magical and will hook just anyone. The data do not support that contention for any drug of abuse…
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March 2, 2009 at 2:08 pm
What else is Meth purported to do? It creates “confidence”, “hyper alertness” (vigilance), and “sexiness”. Each of these qualities demands a social definition; one person’s confidence is another’s “confidence game”, someone’s hyper alertness is another’s paranoia and given the cultural parameters of “sexiness”, an entire book could be written about the meaning of “sexy”. No, Meth does not make you sexy… but it could… depending on the set and setting.
Each of these descriptions about what it is that Meth does needs further social discussion. One thing that can be said about Meth without the use of metaphors is that movement on Meth is effortless and more energy can be put into artistic expression so that a pole dance at the local gentleman’s club or at the soccer mom’s gym becomes, for the performer, a ballet. Does this translate into sexiness? It could, but that is a matter of social definition.
What I’m saying here is that the ways in which we talk about a drug conditions its use… particularly, its dose.
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March 3, 2009 at 5:27 pm
What else is Meth purported to do? It creates “confidence”, “hyper alertness” (vigilance), and “sexiness”. Each of these qualities demands a social definition; one person’s confidence is another’s “confidence game”, someone’s hyper alertness is another’s paranoia and given the cultural parameters of “sexiness”, an entire book could be written about the meaning of “sexy”. No, Meth does not make you sexy… but it could… depending on the set and setting.
Each of these descriptions about what it is that Meth does needs further social discussion. One thing that can be said about Meth without the use of metaphors is that it allows one to feel as if one has completed a marathon without raising a finger or lifting a foot. Movement on Meth is effortless and more energy can be put into artistic expression so that a pole dance at the local gentleman’s club or at the soccer mom’s gym becomes, for the performer, a ballet. Does this translate into sexiness? It could, but that is a matter of social definition.
One cannot do Meth on a daily basis without suffering ill effects. Just as one cannot run a marathon on a daily basis. Illegal Meth is a potent but contaminated stimulant that produces a wide range of physiological consequences (partly due to its contamination).
These consequences may be translated into words like confidence, hyper alertness, and sexiness but they are social translations. What chemically clean Meth does is what any psychoactive drug does; it produces chemical changes in our Central Nervous System that provides us with sensations. Whatever else Meth does, we do to ourselves. We provide the interpretation of the sensations and that interpretation is a social process. This is why what people feel from Meth needs to be openly discussed. One very simple illustration of how increased discussion can foster less harmful use is a discussion on dosage. How much speed should be used and for what purpose? Most Americans who take speed are overdosing, developing tolerance and becoming “addicted”.
How many milligrams of Meth are in a “line” of contaminated speed? What are the sensations? How long will the sensations last? Are there stages to the sensations that the user can anticipate and plan for in advance? How does one titrate Meth? How does one avoid “meth mouth” (tooth loss) and the other negative consequences of doing too much speed? Given the value placed on industriousness in America, why does the government allow caffeine and caffeine products as its one and only legal stimulant? However, such discussions will not come easy when the mantra of Just Say No makes it difficult for anyone to admit to any use. The epidemic of Meth use is perpetuated by the silence engendered by not being able to talk about something that is illegal to do. The epidemic of Meth is a product of censorship about Meth.
If Meth kills, then why are so many people using it and using it at great risk? Why is there an epidemic of Meth abuse? The orthodox answer is that it is the addictive nature of the drug. The occurrence of “craving” supports methamphetamine as an “addictive” drug. And how are people… excuse me… “addicts” expected to deal with this subjective “craving? The same way people over 30 years ago were encouraged to stop smoking cigarettes:
“put a rubber band around their wrist, and when they recognize they are thinking about methamphetamine, they snap the rubber band to jog their thinking process and prevent the momentum toward craving and eventual use.” (Methamphetamine Treatment: A Practitioners Reference, California Alcohol and Drug Programs, 2007:48)
If this (rubber band therapy) seems humorous, it is not intended to be so. The use of the rubber band is considered “state of the art” for Methamphetamine treatment. (One cannot make this stuff up!) What it offers is a simple replay of aversive conditioning where pain becomes the replacement for euphoria… in this case, self-inflicted pain… or as it has more recently been called: self-injurious behavior. This is what “puritan drug treatment is about: spreading guilt and pain, fear & loathing.
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June 9, 2013 at 9:00 pm
Just saw this guy on Fox News (Stossel show – very libertarian). His basic message was anti-anti-drug (i.e., very anti-drug war; also, suggesting that most dangerous aspects of street drugs are toxins that might be used to cut the drugs, etc.)
http://www.college.columbia.edu/cct/winter12/features6#.UbVonfkp_Kg
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June 10, 2013 at 6:09 am
Yep. Can’t wait to get my hands on his new book. Sounds very provocative.
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August 4, 2013 at 2:59 am
Hey, chief! I came across this old post after watching the superb documentary, “The House I Live In,” about the failed U.S. war on drugs. Dr. Hart was one of the major commentators and characters in the doc, showing both his research and his personal/familial issues in substance abuse. I concur completely that he’s a commanding speaker.
Dr. Hart also serves the public well with clear and concise speaking on the complex psychology of drug misuse and the collusion of factors that disproportionately punish African-Americans. He posted several excerpts at his book website.
Speaking of Hart’s book, it’s entitled, “High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society.” I really have to buy it now but it sounds like he argues for the decriminalization of drugs, a stance that I believe you oppose.
I’d love to learn your views on his argument. Perhaps we could have a Scientopia book club on this one. At the very least, watch the doc if you haven’t already. What an impressive researcher with a terrific gift for public communication of science and its impact on society.
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