Q.: What inspired you to write this book?
In 2008, while serving on a National Institutes of Health (NIH) grant review committee with Melissa Gerald, late one evening at dinner she suggested that I meet with her literary agent brother about writing a book. She thought that my data-driven views on drugs would have broad appeal and might even affect public policy; I was less optimistic. By this point in my career, I had published dozens of papers in important scientific journals, had been awarded prestigious fellowships and competitive grants to conduct research, and had been invited to join influential scientific committees. I had co-wrote a respected textbook that became the number-one text used to teach college students about drugs and won awards for my teaching at Columbia University. And yet, much of what we were doing, as a country, in terms of drug education, treatment, and public policy seemed to be driven by emotional hysteria rather than evidence. This approach obfuscates the real problems faced by poor people and contributes to gross misuses of limited public resources.
The thing that really convinced me that this book needed to be written, however, was thinking about the real possibility that my sons’ futures could be readily ruined because of our misapprehensions about drugs. I’d seen this happen to too many other relatives and friends. I wanted to show the public how they have been misled. This meant that I would have to discuss the implications of my work outside the insulated, cautious, and less-often read scientific journals, which were my normal vehicles of communication.
Q.: After more than 20 years in the field of neuropyschopharmacology, you’ve come to the conclusion that drugs aren’t the main problem – that drug policy is the bigger problem. Please explain why this issue is important to you?
In the 1980s, a common misperception was that drugs in general, and crack cocaine specifically, were destroying the black community. Many black thinkers, both liberal and conservative, added their voice to the chorus that blamed drugs for everything from premature death to child abandonment and neglect to grandmothers being forced to raise a second generation of children. The Rev. Jesse Jackson said, “Our culture must reject drugs. … We’ve lost more lives to dope than we did to the Ku Klux Klan rope.” Thomas Sowell, the conservative economist, added “drugs are inherently a problem for the individual who takes them.”
Notably, these sentiments were frequently expressed by individuals with no training on drug effects. Their statements were inaccurate, shortsighted and mere hyperbole. For example, although crack was often blamed for child abandonment and for the raising of children by grandparents, this happened in my family as well as others long before crack hit the streets. The primary reason for this was poverty, not drugs. And the view that drugs are a problem for all who use them is inconsistent with the scientific evidence. Eighty-five percent or more of drug users — whether they use alcohol, prescription medications or drugs deemed illegal — do not have a problem.
The ignorant remarks made about drugs were insidious: they helped create an environment in which there was an unwarranted and unrealistic goal of eliminating certain types of drug use at any cost to our citizens. In the late 1980s, Congress passed the now infamous legislation setting a 100 times harsher penalty for crack than for powder cocaine convictions. The law stated that a person convicted of possessing 5 grams of crack cocaine was required to serve a minimum sentence of five years in prison. To receive the same sentence for trafficking in powder cocaine, an individual needed to possess 500 grams of cocaine. A whopping 85 percent of those sentenced for crack cocaine offenses were black, despite the fact that the majority of users of the drug are white. Today, many find the crack/powder laws abhorrent because they disproportionately target blacks, but few critically examine how ignorance about cocaine’s real effects helped to ensure passage of these laws. Data from my studies (as well as from others) show that crack and powder cocaine produce identical effects. They are the same drug. This is only one example of how the drug policy has caused more problems than the drug itself. It is important to me to make sure that we, as a society, do not make similar mistakes in the future because such mistakes are too costly, to the indicted communities and the taxpayer. Ultimately, I hope that readers will be inspired by my approach (focus on real evidence) and their consciousness will be raised about drug use, addiction and drug policy.
Q: So, are you saying that you advocate illegal drug use?
No. I advocate for more realistic public drug education. Throughout this book, I explain to the reader that s/he had been hoodwinked and misinformed about what drugs do and don’t do. In short, the empirical evidence shows that drugs are not the source of evil or magic that many have been taught. This does not mean that I advocate illegal drug use—that would be a colossal waste of my training, skills, and talents. Any person without my training could advocate illegal drug use. My training has taught me that psychoactive drugs can have powerful mind-altering effects. Many people take illegal drugs without the proper respect for this point. And this is one reason some people experience adverse drug effects. I’d like to do my part in keeping people safe. That is why I advocate for more accurate public drug information/education, especially in light of the fact that more than 20 million Americans use illegal drugs regularly.
Still, I understand when parents raise questions such as, “What about the children? Isn’t it better to exaggerate drug-related harms so we keep our children away from them?” Black parents ask this question less often; it almost always comes from white parents. I try to be as patient as possible in my response. I should point out that I too am a concerned parent with three sons—two within the critical ages of concern—and how I have educated the two that I raised about drugs without exaggerations. My twenty-plus years of drug research experience has taught me many important lessons, but perhaps none more important than this—drug effects are predictable. As you increase the drug dose, so does the potential for toxic effects. Black boys’ and men’s interactions with the police, however, are not predictable. I worried all the time about the very real possibility that my own children would be targeted by law enforcement because they “fit the description” of a drug user or because someone thought they were under the influence of drugs. Too often in these cases the black youngster ends up dead. Ramarley Graham and Trayvon Martin both were believed to have drugs or be under the influence of them.
So, while I do not advocate illegal drug use, I do advocate for more realistic public drug education. I think we should not misinform kids that if they use some drug even once, they would become addicted. Currently, we are doing this with methamphetamine “education,” despite the fact that the overwhelming majority of users will never become addicted. I worry that we (educators) will lose credibility with many young people when they discover that they have been lied to. As a result, they might reject other drug-related information from “official” sources, even when the information was accurate. Mind you, this approach does not encourage kids or anyone to use illegal drugs. This approach also emphasizes that illegal drugs can have powerful mind-altering effects that may lead to disturbing behaviors, especially in cases where people are uneducated about drug effects.
Realistic drug education aimed at law enforcement officials might start with dispelling many drug-related myths such as some drugs cause the user to develop superhuman strength. I suspect this drug myth is the source of many incidents of excessive force perpetrated the police on citizens suspected of drug use.
Q. A great deal of the book covers your background, growing up in one of South Florida’s toughest neighborhoods. At one point, when you were in high school, you sold drugs. Were you worried about exposing your personal life and family history to the public, and readers who might be work colleagues or students?
Of course, the vast amount of personal information revealed within the pages of this book causes me a great deal of anxiety. And I know that some will judge me unfavorably because of my past transgressions. But, I hope that most readers understand that I don’t present my past bad behavior in order to glorify it. Rather, I discuss it with the hope that this approach will help the reader to learn by real-life examples and then generalize more broadly.
And, I’d like to also make it clear that I am not the same person that I once was – the one who engaged in the inappropriate behavior described in the book. I have grown and have made considerable contributions to our society – some scientific and others non-scientific such as community service. Even still, I am not perfect. I, like other humans, still make mistakes.
Q.: You had a some mentors along the way who made a difference in your life. Can you talk about them and what they did for you? In your opinion, do you feel that everyone needs a mentor or do some socioeconomic/ethnic/gender groups need them more than others?
I have had multiple mentors ranging from drug dealers to directors of scientific laboratories. I discuss many of these individuals in the book. Undoubtedly, I would not have been as successful were not for my mentors.
During my last year as an undergraduate – I had left the military and was studying at UNC-W – I was invited to conduct research with my neuroscience professor (Rob Hakan). He got me to believe that I was Ph.D. material. Of course, this meant that I had to be admitted into a Ph.D. program, which would not be easy because my test scores on the entrance exam were abysmal. In fact, the first year that I applied, I wasn’t accepted into one single program. On my second try, the University of Wyoming was the only school that accepted me. Despite the fact that Wyoming was (and remains) the whitest state in the union, I gladly accepted and dedicated myself to researching the brain mechanisms responsible for nicotine addiction.
In Wyoming, I studied with Charlie Ksir and Jim Rose, and these individuals really helped me to develop and hone my critical-thinking skills. For a black guy from Miami, there was little to do in WY besides study and conduct research. And, that’s what I did. I was in the lab 7 days/wk, on some days for as much 24 hrs. It was exciting. I was learning what others didn’t know. I thought I was getting even closer to uncovering the neural mechanisms responsible for drug addiction.
In terms of my science mentors, nearly all were white males. Sometimes minority students and/or junior faculty mistakenly believe that they must have a mentor of color. Indeed, research shows that having a white male mentor is advantageous to women and minorities in science. When a field contains few members of historically excluded groups, having a mentor from the privileged majority can open doors. In one study of sociologists, for example, blacks with white male mentors were found to be more likely to be on track for tenure and to get a position at a major research university, which led to publications in higher-quality journals and greater academic productivity. For me, both in college and graduate school, having a variety of mentors with different experiences and strengths made a massive difference. I was happy to receive all the knowledge and insight I could from wherever it was offered.
Of course, making good use of multiple mentors means recognizing their specific expertise: a white male mentor may give useful advice on science but be less knowledgeable or effective in advising on the race-related challenges a black student faces.
Q. At some point, you decided that you needed to use human subjects to study the effects of drugs on the brain instead of mice or rats. What made you come to this conclusion?
While in graduate school, I won a fellowship to finish my Ph.D. research at the NIH in Bethesda MD. Because I was one of the few black scientists at NIH, periodically the Institution would bring local black high school students to my lab as part of tours. It was part of the NIH’s community service. During these visits, I’d explain my research with rats and how nicotine and cocaine affected their “dopamine reward systems.” I was quite pleased with my ability to talk about the brain structures and neurotransmitters involved. Then, on one of these visits, a student asked how the knowledge that I was learning would help with his parent’s addiction to crack cocaine. I realized that I could tell himloads about why a rat would take cocaine, but I knew little about the behavior of human cocaine addicts. It was then that I decided to apply for postdoctoral fellowships studying human drug addicts. As it turns out, I did three postdoctoral fellowships and have been conducting research with human drug users ever since. I’ve chosen this route because many results obtained in laboratory animals are not readily translated to human drug users.
Q.: One of things you study is the question of whether participants can make a choice between another hit of crack cocaine, for example, and an alternative enforcer such as money. What did you find out?
A persistent stereotype is that most drug users (especially crack users) are impulsive, focused only on getting another hit of the drug. Evidence from my own research (as well as from other researchers) shows that this is incorrect. During my studies, I impose demanding schedules on crack and methamphetamine users; they are required to do considerable planning, inhibit behaviors (for example, drug use) that may interfere with meeting study schedule requirements, and delay immediate gratification. Most meet these demands with no problems.
Q.: Can you explain the difference between taking drugs and being addicted to drugs?
Knowing that someone uses a drug, even regularly, does not tell us that he or she is “addicted.” It doesn’t even mean that the person has a drug problem. To meet the most widely accepted definition of addiction—the one in psychiatry’s Diagnostic and Statistical Manual of Mental Disorders, or DSM—a person’s drug use must interfere with important life functions like parenting, work, and intimate relationships. The use must continue despite ongoing negative consequences, take up a great deal of time and mental energy, and persist in the face of repeated attempts to stop or cut back. It may also include the experience of needing more of the drug to get the same effect (tolerance) and suffering withdrawal symptoms if use suddenly ceases.
Q.: Your experience with the military was very positive – do you think you’d be the scientist you are today if you had not enrolled in the Air Force?
Prior to joining the Air Force, it seemed that I was on the same path that landed many of relatives and friends under the control of the criminal justice system. Outside of sports, the military was the most the meritocratic organization that I had been involved in thus far. I was treated with respect based on how I behaved/performed, rather than on race. The military rules were clear and felt less capricious. I began to change my attitude and became more open and hopeful about the future. It was in the military where I enrolled in my first college course.
During my time in the military, I gradually became aware of the gaps in my knowledge, and the analysis that I undertook would allow me to transcend them by understanding their roots and the forces that shaped my family and neighborhood. I didn’t go instantly from being an indifferent student to one who spent hours in the lab. And I certainly didn’t change from someone whose focus was primarily on my social life into a serious academic simply by joining the air force. But the air force was the environment that allowed me to start to make these changes, to start to understand what I’d missed in my earlier education and my own capacity for change.
As I grew up, I maintained a complicated relationship with the street. First and foremost, I saw myself as an athlete. Sports kept me busy at many times when cousins and friends were getting into trouble. Sports also gave me the typical “jock” perspective of skepticism about things like smoking that might interfere with performance. First football and then, for most of high school, basketball was the primary reasons I went to school: while I practiced intensively and with great commitment in sports, I only did the bare minimum schoolwork needed to keep up the 2.0 average required to stay on the team.
My priority was athletics. I’d practice constantly. Sometimes I was the only guy shooting hoops at 2 a.m. in the projects where we lived. No matter what was going on, I always practiced at least two to three hours a day. And then, if I was angry, bored, couldn’t sleep, or was just sick of dealing with people and their drama, I’d go out and do even more drills and shots, rarely tiring of ensuring my skills were on point. (I now realize it must have driven the neighbors crazy, given that the court was in the center of the projects in an open plaza surrounded by ten buildings.) The summer between eleventh and twelfth grades, I was on three different teams and must have played in practice and games for at least six hours on most days then, often more.
All those kiddy biographies I’d read about athletes stressed hard work and infinite practice. They said that drugs were bad, that smoking anything could hurt performance. They heavily emphasized believing in one’s own inner strength and willpower, reinforcing the American ideal of the self-made man, the guy who triumphs through sheer persistence and unending grit. They showed me that the way to win was to outwork your competitors and use everything you had to maximize your skills.
In this context, avoiding cigarettes and drugs seemed an easy choice. And so, when I wanted to abstain, I always had the out that I was worried about my wind on the court. To be cool, of course, I wasn’t always completely abstinent and I certainly wouldn’t preach about not using. But as a result, my early drug use was mainly symbolic and I carefully monitored any high that I experienced in order to avoid feeling like I was out of control.
Q. How did your sense of the importance of education and developing critical thinking evolve?
When I was a youngster, my grandmother’s favorite saying was “A black man without an education don’t stand a chance.” Growing up I heard this and similar statements frequently but didn’t fully appreciate the message until I had left home to join the Air Force.
In the Air Force, I began to understand the importance of having a college degree but still didn’t know how to think critically. It wasn’t until graduate school that I began to learn the importance of critical thinking. In a society where there are many people with varying agendas trying to wrap themselves in the cloak of science, it’s important to know how to think critically about information that is presented as scientific, because sometimes even the most thoughtful people can be duped.
In graduate school, I learned the importance of empirical evidence—that is, evidence that comes directly from experiments or measurable observations—in understanding issues like drugs and addiction. Importantly, such evidence is reliable and experiments are designed to avoid the bias that can come from looking at one or two cases that may not be typical. The opposite of empirical evidence is anecdotal information, which cannot tell us whether the stories told are outliers or are ordinary cases. Many people rely on personal anecdotes about drug experiences to try to understand what drugs do or don’t do, as if they are representative cases or scientific data. They are not. I learned how easy it is to get bamboozled if you do not have specific tools for critical thinking, such as understanding different types of evidence and argument.
Q: In your book, you show examples of “street smarts (cred)” vs. books smarts/ mainstream credibility – can you explain the difference between the two?
Street smarts/cred is knowledge learned mainly from observing others. It’s the practical knowledge about one’s environment. The environment in which I happened to grow up was primarily on the streets and there were several things that I needed to know in order to survive/thrive. Most importantly, I had to know what was valued and what wasn’t, who had juice (influence) and how they got it. I was careful not to cross those with influence, unless I was prepared to deal with the consequences. Just like the “mainstream,” the street has its rules. A major one centered on respect and how we interpreted it. Embarrassing someone or their loved ones (for whatever reason) was a serious violation of respect and was cause for violence that in some cases turned deadly.
Book smarts, on the other hand, is usually the theoretical knowledge learned from books or from formal instruction. Of course, book smarts could be useful on the streets if instructors made relevant connections between Street smarts and books smarts in settings where book smarts are taught. This rarely happens because many instructors do not value street smarts or are simply too ignorant about it.
Street cred and mainstream credibility is essentially the same thing. Individuals who are proficient and respected earn creditability from those who are a part of the community that evaluate their skills. Participants on the streets evaluate the talents and skills of street lifers, just as participants in mainstream evaluate talents of mainstreamers. I have found that street life and mainstream endeavors such as science aren’t that different. They both have clear rules and winners and losers.
Q.: Talk about how drug use is treated differently and punished differently depending on who is taking them?
The short answer is that black people make up about 12 percent of the U.S. and drug abusing populations, but they comprise about 60 percent of those sent to prison for a drug-related charge.
The crack/powder cocaine laws have been criticized extensively because they disproportionately target blacks. In the late 1980s, Congress passed the now infamous legislation setting a 100 times harsher penalty for crack than for powder cocaine convictions. The law stated that a person convicted of possessing 5 grams of crack cocaine was required to serve a minimum sentence of five years in prison. To receive the same sentence for trafficking in powder cocaine, an individual needed to possess 500 grams of cocaine. More than 80 percent of those sentenced for crack cocaine violations are black, even though most crack users are white.
Q. You had your very own racial profiling incident at the NIH’s campus after you came out of the student union bank depositing a paycheck – what happened?
As I left the NIH credit union after depositing my paycheck or getting some cash, two men approached me. They were looking at me so intently as I came out of the door that my first thought was that they were gay men trying to pick me up. I was dressed in a dark purple sweat suit that was fashionable among young black men at the time and had my big laminated NIH ID hanging prominently from a lanyard around my neck. I had a bank statement in my hand. I noticed the men’s intense stares, but at this point, I was still thinking about my lab work.
When they approached me, however, they identified themselves as police; the NIH campus was so large that it actually had its own force. One said to me, “A crime just happened and we want to know if you can help us.” I said, “Sure, absolutely, whatever I can do.” I had no idea that I was the suspect. I identified myself as a doctoral student conducting research and offered them my bank statement.
Nonetheless, the two officers told me that there’d been a strong-arm robbery near the bank and that the perpetrator was wearing dark clothing. That is all I was told. I assumed that the suspect was black but didn’t learn this from the police. Nor was I told the suspect’s height, weight, or any other identifying characteristics. What was apparent was that the two officers, who seemed to be in charge, were brown-skinned: a black guy and a Filipino.
Of course, it would have been rather stupid for a bank robber to return to the scene of the crime for another transaction—let alone provide a bank statement full of identifying information—but that didn’t matter. Being a young black man wearing dark clothing was enough for me to “fit the description.” Nor did it matter that the officers themselves were minorities. In many instances like this, because institutional racism is so pervasive in some police organizations, the behavior of minority officers is more egregious than that of their white colleagues, in part because everyone in the organization knows what gets reinforced (rewarded) and what gets punished. The risks of mistreating me are far less than those of mistreating a white counterpart, who may be the son or relative of some “important person.”
The police asked: would I consent to walking in front of one of the campus buildings so the victim could try to identify me? They wanted me to participate in an impromptu one-man lineup, which are notoriously unreliable. I didn’t see any choice other than to agree. I walked toward the police cars that I now saw across the parking lot and was told that the crime victim was watching from one of the windows. They had me turn one way, then another so that the person could get a better view. After about twenty minutes, they let me go, saying that the victim hadn’t recognized me. The whole thing was excruciatingly embarrassing, being conducted in the center of campus where any of my friends or colleagues could potentially have seen it.
Q.: A wonderful part of the book is the section where you talk about reconnecting with your cousin Louie in Fort Lauderdale nearly 30 years later. How was his life effected by the country’s current drug policies?
My Cousin Louie’s story is one of the most difficult ones for me because his story could have been my own. What’s worse is that his story wasn’t unique. I had seen similar scenarios with other male loved ones. Virtually all had been initially caught up in the system via a drug charge while in their teens and early twenties, which began a vicious cycle from which they couldn’t escape. At fifteen, Louie was sent to juvenile detention for some trivial, nonviolent offense. That started a downward spiral that ended with him living in a halfway house so sedated on psychiatric medications that he barely knows who he is.
On a recent visit back home, it was heartbreaking to see how much Louie had decompensated over the years. I just cried because I felt as though I had failed to look after him as he had done for me when we were kids. Prior to writing this book, I hadn’t cried since I was a child. Now, the tears flow readily when I think about why I made it and he didn’t, when I think about all of the other Louies we’ve failed to look after. I also think about all the years that I spent away from my Florida family in order to obtain an education that seems inadequate to help solve the problems they face.
Q.: Why should someone go out and buy and read your book? What are the main “take aways” for readers?
HIGH PRICE is a hybrid of a book – part inspirational memoir, part science/”big idea book”, part commentary on the state of race and politics around the drug wars. This book is my own story of self-discovery, and also a book that I hope will challenge all reader’s views about what addiction is.
One of the major take-home messages from my story is that you don’t have to be perfect in order to make contributions to our society. If perfection were required, then previous illegal drug users such as William Jefferson Clinton, George W. Bush, and Barack Obama would have never been elected president, and we would have been deprived of their contributions. I hope that my personal life story empowers other fallible people, especially those who have been shut out historically, to make meaningful contributions to our great society.