01/26/14 Carl Hart

Printer-friendly versionPrinter-friendly version

Dr. Carl Hart, author of High Price: A Neuroscientist's Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society, speaking at Texas Drug Policy Conference 1/2

Share on Facebook Share on stumbleupon digg it Share on reddit Share on del.icio.us

Transcript

Cultural Baggage / January 26, 2014

-----------------------

Broadcasting on the Drug Truth Network, this is Cultural Baggage.

“It’s not only inhumane, it is really fundamentally Un-American.”

“No more! Drug War!” “No more! Drug War!”
“No more! Drug War!” “No more! Drug War!”

DEAN BECKER: My Name is Dean Becker. I don’t condone or encourage the use of any drugs, legal or illegal. I report the unvarnished truth about the pharmaceutical, banking, prison and judicial nightmare that feeds on Eternal Drug War.

-----------------------

DEAN BECKER: Hello my friends. Welcome to this edition of Cultural Baggage. Today we’re doing a two-parter and that is the first half of our program will feature Dr. Carl Hart. He’s the author of “High Price: A Neuroscientist's Journey of Self-Discovery
That Challenges Everything You Know About Drugs and Society.”

This was recorded just over one week ago up in Dallas at the Texas Drug Policy Conference.

We’ll have part 2 of his presentation on this week’s Century of Lies program available on many of the Drug Truth Network programs or you can certainly find it at http://drugtruth.net.

Once again, Dr. Carl Hart.

-----------------------

CARL HART: Sometimes people ask what can they do. Everybody kind of knows about the injustice but few of us actually know what we can do. I hope today I leave you all with something you can do. Mainly the take home message is that you can challenge some of the assumptions that people make about drugs because most of them are incorrect. Today I’m going to talk about some of the assumptions that I challenged in my research not knowing that I was challenging them.

My research deals with methamphetamine these days. Just to let you all know what I do is I actually bring people into the lab and we give them drugs and we test the effects on behavior, brain activity and a wide range of things. When I talk about what drugs do it is from an empirical perspective although I know enough about drug use and natural ecology including my own – together those sorts of things kind of help me to understand exactly what is happening with drugs of abuse.

I like to challenge three assumptions that we make about methamphetamine in the country today and I will do so primarily with data. The first assumption that I like to challenge is this notion that methamphetamine users develop superhuman strength. Many of these assumptions I relate to you based on my participation at various events – some held by the White House in which we invite scientists, law enforcement personnel, legal personnel and so forth.

Some of the law enforcement personnel back in 2005, for example, were saying how methamphetamine users were like no other drug users they had ever seen. They develop this sort of superhuman strength. You couldn’t stop them with the normal sort of Tasers.

As I thought about history it reminded me of something I read in the New York Times in an article from 1914 – almost 100 years ago – on February 8th. This article was published in the New York Times with the title “Negro Cocaine Fiends Are a New Southern Menace.”

There were a number of things that were argued in this article but one of the important things that was argued in this article is that black people when they took cocaine – this new form of cocaine, by the way, which was snorted – you couldn’t stop them with .32 caliber bullets so you needed to increase the caliber of your weapon.

Many southern police forces moved away from the .32 caliber weapon to the .38 caliber weapon in order to deal with these Negro cocaine fiends.

As I listened in this meeting in 2005 sponsored by the White House as these folks were saying how these methamphetamine users developed this superhuman strength it just reminded me of what we had said previously about cocaine. These myths about drugs are recycled from one generation to the next.

I also thought about when I first came across this article how the language in this article sounds a lot like the language that was said about crack-cocaine in the 1980s. If we check out some of the things that were said in this article and then we check out what was said about crack-cocaine...

Just briefly, “most of the Negros are poor, illiterate and shiftless.” By the way, in 1986 we couldn’t use words like Negros instead we substitute the word urban, troubled neighborhoods, inner-city because we all know who we are talking about.

So the language had changed. It had been tempered but we knew the message had remained the same. So “Once a Negro has formed the habit he is irreclaimable. The only to keep him away from taking the drug is by imprisoning him and this is merely palliative treatment for he inevitably returns to the drug habit when released.”

So the bottom line here is once these folks got addicted to powder cocaine the best thing to do with them is imprison them for life or kill them. This is some of the language that was said about crack-cocaine in the 1980s.

You see these things kind of recycle. Of course there is no scientific evidence to support this perspective but we all were kind of duped into believing it.

In the 1980s this had some real consequences and that’s when we passed those laws that we now dislike – the infamous 100 to 1 powder crack-cocaine cocaine disparity laws where crack-cocaine was punished 100 times more harshly.

We were so concerned by crack-cocaine that black people, for example, teamed up with the Ku Klux Klan in Leland, Florida in order to rid their communities of crack-cocaine. The Ku Klux Klan’s mission is to destroy black people and those kind of folks but the NAACP teamed up with them. This is to illustrate how we’ve lost our minds in this country when it came to crack-cocaine.

The real consequences of this were really related to what happened in our prisons and our arrests. On this slide I just want you to focus on the crack-cocaine. These are the federal convictions for crack-cocaine violations. This is 1992, 2000 and 2006. These data were collected by the Sentencing Commission. The Sentencing Commission set the penalties for violations of the law.

More than 80% of the people convicted of crack-cocaine violations at the federal level were black even though most of the users were white. This was probably the most egregious thing that happened as a result of the hysteria.

As we think about hysteria...now we can come back and slow down and think about science. On this slide is a picture of powder cocaine on your left and on your right is crack-cocaine. The only difference between the two drugs is the hydrochloride portion that is circled in the red.

The hydrochloride portion is just the salt. It has no real biological activity – certainly not in the brain. So the bottom line is the toxicological effects of crack-cocaine are identical to powder cocaine. They are the same drug despite the fact that we all thought that crack-cocaine was some new animal. It’s the same drug.

OK. When I think about the superhuman strength and I think about what was said previously and I think about how all that relates to what we do today I hope it helps you to be more aware of these sorts of recycling of drug myths and the potential harms of the recycling of these drug myths.

Let’s move on to the other two assumptions. The other two assumptions I will challenge with data.

This is just a picture of my lab. We bring people into the lab and they live with us for about 2 to 4 weeks. Up top is a room. There are 4 of these rooms. They are like apartment-style rooms. The participants live with us. They can’t go outside. They stay locked in this laboratory. We call it the residential laboratory.

During the day they complete cognitive test batteries for about 8 hours. Of course they have breaks. They complete mood scales. They do a number of activities according to their schedule. We also test the effects of drugs.

After their 8-hour shift they have access to a recreational room where they can play video games, watch video-taped movies and interact with the other participants.

One of the things that we do in this lab is we alter the time at which we wake them up in the morning. We try to model shift work schedules. Some days we will wake them up at 8 in the morning. They work from 9 to 5 and they go to sleep at midnight. On other days we’ll wake them up at midnight. They work from 1 a.m. to 9 a.m. and go to sleep at 4 p.m.

We do this abrupt schedule shift change to see if we can disrupt some cognitive function. That’s one of the most reliable ways to disrupt cognitive functioning. When you do that – these are just some data – in the red that’s when participants are on the night shift and the oval circles show when they are on the day shift.

This is a measure of response time. This is a measure of learning and memory and this is a measure of inhibitory control. On the night shift they had more difficulties. They are slower. They make more errors in terms of learning and memory as well as more false alarm of errors. It’s a measure of inability to inhibit.

That’s typical when you shift people from day shift to night shift abruptly. One of the initial questions that I had about methamphetamine because people were saying that it is like no drug that we had seen previously one of the things that I know, again based on history, is that we have been using D-amphetamine (the active ingredient in Adderall) in our military since World War II. The Germans and the Japanese were using it - we couldn’t be outdone so we started using amphetamines to give to our soldiers to make sure that they were awake.

One of the things that I wanted to test in this model was would methamphetamine cause further disruptions of this shift change troubles that we saw or would it attenuate these shift change disruptions like D-amphetamine.

We reported in the literature and this is one of the early papers I did with methamphetamine back in 2003. The bottom line is that low oral doses of methamphetamine (5 and 10 mg) attenuated these shift change disruptions in response time, in learning and memory errors, in inhibitory control areas.

So the drug looked just like D-amphetamine. It looked just like Adderall. By the way, for some of you all who have been under a rock for the past 10 years – Adderall is the drug that college students are taking, Attention Deficit Disorder people are taking in order to improve their cognitive performance.

The drug performed just like Adderall. It looked just like an amphetamine.

-----------------------

DEAN BECKER: We’re listening to Dr. Carl Hart, author of “High Price.” He is speaking last week in Dallas at the Texas Drug Policy Conference.

-----------------------

CARL HART: So our findings were looking inconsistent with what people had been saying. This, by the way, is an advertisement from the Montana Meth Project. They are throughout the country now.

Our data was inconsistent with this sort of popular belief so I had to figure out why. I thought about, well, it’s always important to look at the dose of drug you are using. Maybe the dose that we were using at the lab was too low. Also you have to think about the route of administration. People when they are using methamphetamine in natural ecology they typically snort it, shoot it or smoke it but they don’t usually take it orally when they are abusing the drug.

So I thought, hmm, I need to readjust what I am doing in the lab to better model what is happening in the natural ecology. In order to investigate this issue of whether methamphetamine produced unique pharmacological effects what I did in the next study was to increase the dose of methamphetamine that we were studying.

We went from studying 5 and 10mg orally to studying as large as 50mg given intranasal. A 50mg dose of methamphetamine is a really nice dose. It’s a dose that is related to abuse.

So this study we compared the effects of methamphetamine with the effects of D-amphetamine. If you look on the slide this is a picture of D-amphetamine. This is a picture of methamphetamine. The only difference is this methyl group that is added to methamphetamine. There have been some wild claims made about this addition of this methyl group. People have said this methyl group makes the drug more lipid soluble meaning that it gets across the blood-brain barrier a lot more rapidly so that makes the drugs a lot more potent. That is what people have been saying.

OK. Again, as a student of history I read a paper from 1971 that tested D-amphetamine against methamphetamine but it was oral doses and they only tested 30mg of oral methamphetamine versus oral D-amphetamine. They found that the drugs were the same.

So I thought OK they didn’t do a larger dose and they didn’t test it via a route that the drug was being abuse so that’s what we did in this study.

We brought people into the lab and on one day they received a placebo, another day they received a low dose of D-amphetamine, another day a higher dose of D-amphetamine, next day they received a low dose of methamphetamine, another day they received a high dose of methamphetamine - all of this done in double-blind, carefully, rigorous conditions.

So we test the effects and we wanted to know the physiological effects. Here I show the physiological effects of systolic blood pressure but the effects of heart rate, diastolic blood pressure they were the same.

The bottom line here...focus your attention here. In the light green is D-amphetamine and the dark green is 12mg methamphetamine, light red is large dose (50mg) of D-amphetamine and the dark red is large dose of methamphetamine (50mg). The bottom line is that the drugs produced the same effect on all of these physiological measures – systolic blood pressure, diastolic blood pressure and heart rate.

When you look at subjective effects this is a measure of high – the same thing – euphoria, all these things produce the same effect. One of the things that we like to do in our lab is give people an opportunity to self-administer or to choose to take the drug. We gave them an opportunity to take the drug versus $5 and we wanted to know whether or not (we call these the reinforcing effects of the drug) the reinforcing effects of D-amphetamine and methamphetamine would be equivalent because the reinforcing effects tells you something about abuse potential and abuse liability of the drug.

It turns out they took the drug about half of the occasions when the $5 wasn’t available the larger dose but they produced the same effect. So when you hear people saying that methamphetamine produces unique pharmacological effects there’s just no research evidence to support this notion.

This study was the third replication of those findings so other groups have also found this. Yet you still hear people saying how uniquely dangerous methamphetamine is even though there’s no evidence to support that belief.

Let’s think about something that is important for us – cognitive impairments. This is another thing that people like to point to when we think of methamphetamine. When I started to investigate this issue of cognitive impairments there was virtually nothing in humans that looked at cognitive impairments in methamphetamine users. What I did was to go to the animal literature because the animal literature could sometimes provide some clues to what’s happening in humans.

When I looked at the animal literature one of the things that became very clear was that methamphetamine produces neurotoxic effects – monoamine neuron. Monoamine neurons are dopamine, serotonin, norepinephrine – those transmitters we think are important for a variety of functions including mood, cognitive functioning – a wide range of things.

Sure enough methamphetamine had been shown to have these disruptive effects on cognitive functioning in these laboratory animals but one of the things that one must do is look at the literature carefully because when you look at the literature carefully and you look at the studies, for example, that allow the animals to develop tolerance to some of these effects - that is the studies that administered escalating doses of the drug and then gave a whopping dose of the drug - these disruptive or deleterious effects were blocked.

When we saw the pathology, the damage done to monoamine neurons I’ll tell you how those studies are done. You take a naive rat, for example, and you give them a dose of methamphetamine that is usually 10, 20, 30 times that what you would give a human and you do that 4 times a day for several days consecutively and then you kill the animal and you look at the brain and you see all the mispathology.

Humans don’t take drugs like that. If you do I assure you you won’t be around to tell us about it. In order to become a regular drug user you can’t be that stupid.

So another thing that blocks these disruptive effects that I reported is when you allow an animal to self-administer the drug rather than having the experiment administer the drug. Remarkably animal self-administration plots these disruptions.

All of these findings as you look at the literature carefully tells you that we our models have to be ethologically relevant or else we are essentially participating in an exchange of ignorance. We have to be careful.

This is the story that I got from the animal literature but I still needed to find out what was happening in the human in terms of cognition. One of the studies that we did is think about how rational people can behave when they have their opportunity to take their drug of choice compared with these alternatives.

In one study we gave methamphetamine users an option to take a nice dose of methamphetamine (50mg) versus nothing. They had a choice. You can take this 50mg dose of methamphetamine or nothing. What do you all think that they would choose?

[various audience responses]

Come on. Don’t be bashful. This is Texas.

Take methamphetamine, right?!

Sure enough that’s what they did. So here’s the choice to take methamphetamine on the red. They had 10 opportunities and they took it on 10 occasions. This is placebo over here.

But when you give them the opportunity to take methamphetamine at the same dose and $5 they take methamphetamine on about half the occasions. What happens when you give them the opportunity to take methamphetamine and $20? They almost never take methamphetamine – they take the $20.

It just shows that people can behave rationally even though they are drug addicts. Some smart people in the audience, for example, will say, “Well, Dr. Hart, they were in your lab and they were just saving the money to go out and buy some more drugs. The money that you gave them they can use it now to buy some street drugs.”

OK, let’s think about it. First of all we had said about these folks that they couldn’t inhibit. They had limited inhibitory control. The drug that we give in the laboratory is 100% pharmaceutical grade methamphetamine. Some of the drugs on the street might be stepped on or adulterated. So they still buy an adulterated drug even though they have a choice to take 100% grade because for whatever reason. They might want to take the drugs with their friends – who knows?

That’s certainly a possibility but even if they behaved like that they demonstrated an ability to have long-term planning. One of the things that I know is that for some of these people we wrote checks for bills that they hadn’t paid with their steady earnings – not all but some. So even if they chose to go out and use methamphetamine with the money that we gave them they earned it and they exhibited an extreme amount of executive planning.

Let’s think about this issue about what about cognitive performance. In the lab we certainly test these sorts of things. Participants in these studies complete a wide-range of cognitive tasks under the placebo conditions, baseline conditions. Then they receive methamphetamine and we test these cognitive functions again repeatedly throughout the day to see how the drug altered performance if it altered performance.

We were expecting some destructions particularly when we gave the drug at large doses. When I think about all the studies that we did and I reviewed the literature studies that have used doses larger than 20mg and have given the drug smoked, intravenuously or snorted none of those studies have reported disruptions in cognitive performance after taking the drug. In fact, the studies have reported improvements in cognitive performance when you give these larger doses.

This is not a surprise. Amphetamines are used for that purpose. Amphetamines are used to help people who have cognitive issues like Attention Deficit Disorder. So that’s not surprising.

What is surprising are the sort of mythologies surrounding methamphetamine cognitive impairments.

-----------------------

DEAN BECKER: That was Dr. Carl Hart, author of “High Price: A Neuroscientist's Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society.” He was speaking last week in Dallas to the Texas Drug Policy Conference.

You can hear part 2 of his discussion on this week’s Century of Lies program available on many of the Drug Truth stations and on our website, http://drugtruth.net.

-----------------------

(Game show music)

It’s time to play: Name That Drug By Its Side Effects

Works directly on the brain by interfering neurotransmitters and dopamine levels, because of drug prohibition, this product is made with over the counter cold medicines, matchbook covers, hydrochloric acid, drain cleaner, battery acid, lye, lantern fuel and antifreeze.

(Gong)

Time’s up!

The answer: Tina, chalk, go fast, zip, Christie, crank, speed, methamphetamine hydrochloride.

-----------------------

Young man: Ok, let’s say drug prohibition does support terrorism.

Older man: And murder?

Young man: And murder.

Older man: Torture?

Young man: And torture.

Older man: Corruption? Bribery?

Young man: And whatever.

Older man: What’s your point?

Young man: Change the law.

Older man: I gotcha. Make it cheap, more available, everywhere. Like soda or cheesy puffs.

Young man: Exactly.

Older man: Cocaine at the playground. Crack stands at the Laundromat. Heroin at the mini mart. Like that?

Young man: Face it, old man. That’s what we’ve got now.

Please visit the website of Law Enforcement Against Prohibition at leap.cc.

-----------------------

DEAN BECKER: Please listen to the second part with Dr. Carl Hart on this week’s Century of Lies program.

As always I remind you that because of prohibition you don’t know what’s in that bag. Please, be careful.

-----------------------

DEAN BECKER: To the Drug Truth Network listeners around the world, this is Dean Becker for Cultural Baggage and the Unvarnished Truth.

This show produced at the Pacifica Studios of KPFT Houston.

Tap dancing… on the edge… of an abyss.

Transcript provided by: Jo-D Harrison of www.DrugSense.org