High Price

however, I have come to the conclusion that it would be unethical not to conduct this type of research, because it has provided a wealth of information about the real effects of drugs and the findings have important implications for public policy and the treatment of drug addiction. From this study, for example, we found out that fears about the dangers of cocaethylene were not supported by evidence. Cocaethylene turns out to be less potent than cocaine. 1 It actually has less of an effect in terms of raising heart rate and blood pressure than does cocaine itself, meaning it probably carries less risk for heart attack or stroke.
    Back in 1997, when I started working on this study, I still had many misconceptions about drugs myself. Like the idea that cocaethylene was a major new threat, my other hypotheses were being repeatedly contradicted by the data during my graduate and postdoc studies. I’d had a previous postdoctoral appointment at the University of California, San Francisco, in 1996, which I’d received right after graduating from Wyoming. I had been eager to start studying human drug users and I knew I’d have a chance to do so at UCSF.
    But in California, I wasn’t able to study people actually taking drugs in the lab: the researchers I worked with were focused on drug craving, which was supposed to drive addiction. These scientists didn’t study the effects of drugs themselves; they examined only what drug users were reporting about their desire for them. I rapidly discovered that craving wasn’t as important as I had initially thought. This was another step in the evolution of my thinking about drugs.
    The problems with craving first became clear when I interacted with real people who had sought help for addiction. To try to understand their desire for drugs, I had become a facilitator for group sessions required of the patients in a methadone program. Almost immediately, however, I began recognizing that I had much more in common with them than I’d expected. Although they did discuss drug-related issues, unless they were prompted, craving wasn’t their primary concern. The patients’ real issues were mainly related to practical things like the high cost of housing and other essentials. That was something I’d had a very acute personal experience of as I started my postdoc.
    It had been so hard for me to find an affordable place to stay in the Bay Area that I’d actually spent the first several weeks of my postdoc sleeping in my office. This was one of the many frustrations I experienced during my postdoctoral training that sometimes made me seriously question my desire for a future in science. Postdoctoral work is critical to a scientist’s career, but even now in 2013 it pays only $40,000–$50,000 a year. Back then the salary was a meager $19,000–$24,000. I understood what these men and women in treatment were going through, trying to survive on not much money and manage their work and relationships. I’d thought these drug users were going to be much more different from me than they actually were.
    Instead, I found that people with addictions weren’t driven only by drugs. Moreover, they weren’t any more antisocial or criminal than people I’d grown up with, many of whom rarely or never got high; in fact, their behavior wasn’t much different from what I’d engaged in myself with my friends back home. They didn’t seem overwhelmed by craving: they basically sought drug rewards in the same way that they sought sex or food. I began to see that their drug-related behavior wasn’t really that special and to think that perhaps their drive to take drugs obeyed the same rules that applied to these other human desires. The notion that addiction was some kind of “character defect” or extreme condition that created completely unpredictable and irrational actions began to seem misguided.
    And when I heard lectures by addiction researchers who studied animals, I began to realize how they extrapolated from extreme situations in ways that created a caricature of addiction. One researcher talked about how you could leave a hundred-dollar bill in the room and “you or I wouldn’t take it” but a drug addict always would. They talked about humans in simplistic ways that, ironically, lacked the careful qualifications they always included in their discussions of animal research.
    Later, I also came to see how our distorted images of addiction played out in the attitudes the researchers had