Thursday, November 14, 2013

Quotes from Carl Hart's High Price

There's so much good stuff in Carl Hart's book High Price, as I've already said, but I wanted to include just a handful of other quotes, ranging from his thoughts about growing up to how to treat drug addiction.

You may have already heard about the research that finds children of poor parents hear far fewer words by age 5 than do children of professionals (only 616 total words vs. 2,153). But Hart points out some additional findings from that work:

…families headed by professionals -- whether black or white -- spent more time encouraging their children, explaining the world to them, and listening to and responding specifically to their questions. For every discouraging word or "No!" there were about five words of praise or encouragement. Verbal interactions were mainly pleasant, enjoyable, or neutral. In the working class homes, there were also more "attaboys" than prohibitions, though the ratio was smaller. But in the families on welfare, children heard two "noes" or "don'ts" for every positive expression. Their verbal experience overall was much more punitive. (pages 30-31)
Generally, the two divergent parenting styles are called "concerted cultivation" (professional class) and "the accomplishment of natural growth" (working class and poor).
The middle-class way was not, as some might expect, superior all around. The working-class children were often happier and better behaved. They were much closer to their extended families and were full of energy. They mostly did as they were told. They knew how to entertain themselves and were rarely bored. They were more adept at relationships.

The middle-class youth, however, were much more prepared for school and far better situated to deal with adult authorities. (page 36)
On why education wasn't valued in his family or community:
Because their opportunities had been limited, because the people they knew who were educated hadn't actually been allowed to move up in management or become anything better paid than a high school teacher or licensed practical nurse, [the adults in his life] saw a focus on academic achievement as a distraction, one that would more likely lead to disappointment and bitterness than it would to real success. They'd never seen academic success genuinely rewarded. (pages 54-55)
On his experiences with teachers and the schools, starting in first grade. This was in the earliest years of Florida's desegregation by busing, and Hart was one of four or five black kids in his first grade class in a white, working class school:
Although we started our day with Miss Rose…, for much of the time, all the black boys in my class would be sent to the "portable." This was a small, supposedly temporary outbuilding at the back of the main school. Inside, it looked like a playroom with blocks, trains, and other toys. But most of our time there was spent in small groups, being drilled with flash cards on basic skills like letters and numbers. We were sent there because we had "learning difficulties."

Soon, though, I was bored out of my mind. Despite the fact that my parents never read to me as a child, I did know my ABCs and 123s. My older sisters had taught me about letters and numbers [plus he had been to preschool and watched lots of Sesame Street]. But the school assumed that because I was black, I must be behind. So, off to the trailer I went. (page 56)
In high school,
Rather than challenging me to learn, they gave up, figuring that it didn't matter because I was just one more nameless black kid who would never go to college anyway. And of course, given an easier option and no reason to challenge themselves, almost any teenager -- and most adults, too -- will take it.
His high school schedule consisted of two or three hours of basketball practice, three hours of vo-tech classes from 8:00 to 11:00 a.m., followed by a job in the afternoon, for which he got school credit. "One-third of the time I spent in supposedly educational programming consisted of classes like parking patrol." (page 107)

He points out that all three of our most recent presidents used marijuana and two used cocaine:
Their drug use was inconsequential -- in large part because they all avoided legal consequences from it. If Barack Obama had come up in a time when the drug war was being waged as intensely as it is now, we probably would never have heard of him. A single arrest could have precluded student loans, resulted in jail time, and completely ruined his life, posing a far greater threat to him than the drugs themselves did… (page 122)
Even after his first years in the Air Force,
I was so lacking in the mainstream form of what academics call "cultural capital"--the kind accumulated in the United States by growing up in the white middle or upper class -- that I made some mistakes that I now cringe to think about. Cultural capital is the knowledge of the way a culture…really operates. It's knowing the things that "everyone knows" in that class or place and the things that everyone automatically assumes that other people know. (page 178)
He points out that this lack of cultural capital is what leads poor young people to fall for shady for-profit colleges. Hart, for instance, almost enrolled in an expensive correspondence course, and later almost signed up for a women's studies course because he thought it would teach him how to get women to do what he wanted (!).
Ignorance feels shameful; attempts to hide it can prevent learning and perpetuate the problem. When you publicly illustrate that you don't know what "everyone" knows, it can be intensely embarrassing. Many of the difficulties faced by people who try to move from the hood into the mainstream involve the lack of these types of knowledge, which marks them as outsiders and can lead to repeated humiliating experiences. (page 179)
He refers to Gil Scott-Heron's song "Home Is Where the Hatred Is," which is about a man who uses drugs to relieve his pain and alienation (page 181). A line from the song that has always stuck with me is:
You keep saying kick it, quit it,
Kick it, quit it, kick it, quit it.
God, but did you ever try?
In the live version of the song from the album "It's Your World," the refrain becomes:
Why don't you stop using drugs?

That's easy for you to say.
That's easy for you to say.
That's easy for you to say.
That's easy, easy, easy.
Hart looks back on his upbringing within
the southern culture of honor that doesn't allow even the slightest dis, like a stepped-on shoe or dirty look, to go unchallenged… The motives of young men who engage in these types of potentially fatal interactions over slights to honor are frequently portrayed as irrational overreactions. But these types of altercations that seem to have such petty origins are by far the leading motivation for deadly violence -- contributing to significantly more crimes than the pharmacological effects of drugs. In their influential study of homicides in Detroit, Martin Daly and Margo Wilson concluded that the young men involved, far from being irrational, "may be acting as shrewd calculators of the probable costs and benefits of alternative courses of action." (page 183)

…such crimes take place overwhelmingly among young men who have little to lose, with few resources and limited future prospects. This type of behavior had characterized male youth in my neighborhood long before crack cocaine was even invented. (page 184)

Once crack came in, the change meant upheaval in established drug sales territories and power groupings. It wasn't the nature of the drug itself, but rather the addition of a new drug that caused the violence. And for people with no opportunities, selling drugs seems like a good option.

While the risks of selling crack may not, on the surface, seem worth the low salary ultimately earned, to many young men it seemed the best of a bad lot. At fast-food chains or in similar low-level jobs, these youth would have to wear dorky uniforms and submit themselves to often demeaning treatment from (typically) white bosses and customers, with rigid hours and little apparent chance for advancement. Selling crack, however, offered a choice of hours, the opportunity to work with friends, and visible routes to success… The potential glory made the risk of prison and death seem worth taking. (pages 187-188)
On the differential treatment of crack vs. powdered cocaine (disparate sentence lengths were 100:1 for a long time and are still 18:1) and stepped-up enforcement in black communities:
…in Los Angeles, for example -- a city of nearly 4 million people -- at the peak of the crack epidemic, not a single white person was arrested on federal crack cocaine charges, even though whites in the cities used and sold crack. (page 191)
After reading historical documents that demonstrated the racism that underlies the demonization of drugs like cocaine, Hart began to realize there was more going on.
…I'd always assumed that the legal status of a particular drug was determined primarily by its pharmacology. However, I found that there was actually no sound, pharmacologically rational reason behind why alcohol and tobacco were legal, and cocaine and marijuana were not. It was mainly about history and social reasons, about choosing the drug dangers that would be highlighted to spur public concern and those that would be ignored…. Bans on drugs were inevitably preceded by hysterical coverage filled with scare stories about drug use by despised minorities, often immigrants and the poor. (page 242)
And I learned that withdrawal from opioids is not as bad as I have been taught:
The symptoms usually begin about twelve to sixteen hours after the last heroin dose and look something like a case of the 24-hour, or intestinal, flu. Most of us have experienced these symptoms at some point in our lives: nausea, vomiting, diarrhea, aches, pains, and a general sense of misery. While this condition is most unpleasant, rarely is it life-threatening or accurately depicted in films that suggest the sufferer is on the verge of death. (page 264)
Why didn't crack (or meth, for that matter) ravage the suburbs or afflict large percentages of middle or upper class youth?
Money has a way of insulating people from consequences. In addition, it carries with it more reasons for abstaining -- there are things a high-socioeconomic-status person has to do that are incompatible with being intoxicated. Becoming an addict is tantamount to disavowing one's social niche. (page 271)

There is now a whole body of literature showing that providing alternative reinforcers [to crack users] improves addiction treatment outcomes. It is far more effective than using punitive measures like incarceration… (page 272)
And what about treatment with those alternative reinforcers, which is the focus of Hart's research?
Fifty-eight percent of participants in the contingency management group [with alternative reinforcement] completed the 24-week outpatient treatment -- compared to just 11 percent in the 12-step group. In terms of abstinence, 68 percent achieved at least eight weeks cocaine-free, versus just 11 percent in the 12-step condition. (page 274)
In Portugal, where drugs have been decriminalized for the past decade, a panel reviews the cases of users thought to have a health problem. If treatment is recommended but doesn't stick, repeat offenders can get noncriminal punishments like having their driver's license revoked or being prohibited from areas where drug sales are known to happen.

As a result, "The number of drug-induced deaths has dropped, as have overall rates of drug use, especially among young people (15-24 years old)" (page 325). And Portugal has greatly decreased spending on prosecution and imprisonment, of course.

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