High Price

Dr. Carl Hart’s scientific-themed memoir, High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society (2013), challenges our perceptions of drug addiction through the real-life experiences of a man growing up in a tough neighborhood before undertaking pioneering medical research. It won the PEN/E.O. Wilson Prize for Literary Science Writing in 2014. Dr. Hart is a professor of neuroscience and psychology at Columbia University. He specializes in drug abuse and drug addiction research. He served in the United States Air Force after high school before switching to a science-based career.

The main argument in High Price is that drugs are not the cause of our broken society; drug use is merely a symptom. According to Dr. Hart, drug use does not always result in poverty, crime, or addiction; thus it can’t be said that drugs are responsible for the state of our world. Instead, we should look at the reasons why people turn to drugs in the first place. We must begin by addressing the personal reasons that make individuals seek distraction from their lives. Only then can we tackle the global drug crisis.

Dr. Hart does not come from a traditional scientific or medical background. He grows up very poor and surrounded by drugs and addiction problems. He begins life in a crowded African-American community in the heart of Miami where opportunities seem limited. Schools are weak, mentors are rare, and Dr. Hart’s friends carry guns every day. However, noticing his potential, Dr. Hart’s elders steer him away from crime into the military.



Dr. Hart reflects on the effects that drugs had on his community. He questions whether current drug policies are helpful and if criminalizing drug use does more harm than good. Much of the book is spent considering the reasons why drug use should be decriminalized or, at least, punished less severely.

Dr. Hart has many reasons to justify his thinking. In particular, he looks at countries where crime levels are below the world average, such as Portugal. In Portugal, drug users are invited to attend seminars to talk about their problems and the reasons why they are attracted to drugs. They do not suffer criminal penalties. The emphasis is on fixing the pain or suffering that causes them to seek solace in drug use. Portugal’s drug addiction levels, interestingly, are far less than in the U.S.

One of Dr. Hart’s main concerns is the information spread about drug use and the consequences of drug addiction. Current drug policies are based on fear, and they alienate drug users from the rest of the population. Instead of rehabilitating drug addicts, all these policies do is stereotype addicts, making it harder for non-drug users to show compassion. Dr. Hart believes we must tackle society’s understanding of drug use and drug addiction before we can make meaningful progress.



Something Dr. Hart understands from his own experiences is that drug use often accompanies loneliness. Most drug addicts lack a support system—be it family, friends, or the community—and drugs simply distract them from their isolation. He discusses an experiment where rats kept in isolation continued to seek out cocaine, whereas rats living in large social groups ignored the cocaine.

Dr. Hart’s own research shows that most drug users are not addicts, at least not in the way society understands it. Most drug users are recreational users and have family or friends who support them. In most cases, drugs become an addiction when, sadly, the user has nothing else in his or her life. This chronic loneliness affects many people around the world, and we must tackle this to have any chance of stopping drug addiction.

Dr. Hart also considers the current rehabilitation systems available in the United States. He believes in Contingency Management, which challenges addictive behavior by offering other, positive reinforcements. He is strongly opposed to penal remedies because they do not address the underlying problems. Instead, punishments such as incarceration make it harder for drug addicts to reintegrate into society.



Incarceration leads to gaps in résumés, a loss of confidence and self-worth, and exposure to unhealthy influences. Combined, these factors make it very difficult for people already struggling with an addiction to change their lives upon release. Dr. Hart urges the government to consider alternatives, such as the counseling offered in Portugal, to tackle the personal reasons why someone is susceptible to drug addiction in the first place.

High Price challenges the current thinking that drugs such as crack cocaine are immediately addictive and that no one can walk away from these stimulants. Instead of demonizing drug users, we must work with them to resolve both their individual personal problems and the troubles facing their wider communities. Only then can we win the so-called war on drugs.