Should We Legalize All Drugs? with Dr. Carl Hart

Dr. Carl Hart is a neuroscientist and professor of Psychology at Columbia University and is also the author of Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear. In this episode we:

• uncover the benefits of drug use
• debunk several myths including that (1) drugs destroy the brain, and (2) drugs cause violence and crime
• discuss the feasibility of drug legalization
• examine the importance of harm reduction efforts, including drug testing
• provide listeners data to support the argument for alternative solutions to preventing harm and violence

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Transcript

peaker 0 | 00:01

We claim to allow people to ha live their life as they choose. That's what life, liberty, and the pursuit of happiness is all about. And yet, we don't allow people to alter their consciousness. The thing that's remarkable is that Americans accept that shit like it's normal.

Speaker 1 | 00:18

Please listen carefully.

Speaker 2 | 00:23

Welcome to Critical Conversations. I'm Abbie Henson, your host and an assistant professor of Criminology and Criminal Justice at Arizona State University. This podcast is a space to learn from changemakers and experts on racial, social, and criminal legal issues, and to inspire further dialogue with friends, family, and community in order to impact culture and ultimately achieve equity and justice for all. I hope you enjoy being part of these critical conversations. Now, let's get into it. Today I'm joined by Dr. Carl Hart, a neuroscientist and professor of psychology at Columbia University, and the author of Drug Use for Grownups Chasing Liberty. In the Land of Fear, we get into drugs and the idea of legalization and harm reduction. I really encourage you to have an open mind while listening to this conversation as it deeply challenges most of our assumptions about drug use in a way that can be difficult to hear.

Speaker 2 | 01:28

This is one of the most transformative conversations I've ever participated in, and I hope that you feel equally transformed after listening, if anything comes up for you that you want further discussion about, don't forget to send your question or comment to cc office hours gmail.com so that Joan and I can address it in our YouTube episode next week. You just wrote this book, drug Use for Grownups, and as I was reading it, it challenged me in so many ways. I view myself as a pretty progressive person and a critical thinker, and yet I still found myself having feelings that I was uncomfortable with, the fact that I was having these feelings, bringing up assumptions about addiction and about drugs. And I remember the first line of the book that really got me like, oh shit, <laugh> was when you had mentioned that only 10 to 30% of those who use even the most stigmatized drugs, meaning heroin or methamphetamine, are addicts. And then you say, if most users of a particular drug do not become addicted, then we cannot blame the drug for causing drug addiction. It would be like blaming food for food addiction. And I read that. I was like, oh my God. All right. This book is gonna, yeah, really get into it.

Speaker 0 | 02:52

Can I take a step back first? Yeah, sure. And I just wanna help helps your audience understand who we're talking about when we talk about addiction. So when I'm, when I use the term addiction, um, I'm referring to the DSM five or the Diagnostic and statistical manual of the American Psychiatric Association. Their manual on that kinda lays out the symptoms and the criteria for meeting addiction, or they call it substance use disorder. And, um, so it's important for people to understand that simply because someone is using a drug, that does not mean that they meet criteria for drug addiction, even if the drug is heroin or something else. Addiction is characterized by these sort of disruptions in people's psychosocial functioning. Now. Now, that's one component. Another component that must be there is that the person themselves have to be impaired by these symptoms, or they are distressed by these symptoms. So the, that's really important, that second component, people tend to forget. So I just want, uh, people to understand, understand that that, that point throughout

Speaker 2 | 03:53

The book, you really challenged a lot of assumptions that I think I and many of my listeners have. And the first being drugs destroy our brain. So I'm hoping that you can help debunk this assumption.

Speaker 0 | 04:10

Yeah, that's a really good one. Um, so you and I are talking on a Tuesday, just so everybody knows. And last night, um, one of the things that happened in the United States a lot is that you have Monday night football. And so they have, you know, the, the, the whole Monday night American football thing, it's like the end of the football weekend, and you get like these injury reports and so forth, and the injury report reports off crazy. And then when we think about American football, there's so many injuries. People get damaged and they don't, um, uh, their lifespan is shorter than other folks' lifespan. And then we think about brain injuries that happened with playing football. We, we know that, uh, the likelihood of people having a brain injury, uh, after playing American football, particularly by the time they get to be professional, it's pretty hot.

Speaker 0 | 04:59

But yet we still allow that sport as well. We should. People should have that decision. They can make that decision. They are adults, and there are a lot of those folks who experience the kind of glory that most of us will never experience. And they get some love that most of us will never get. They are celebrities superstar, in some cases, they make a lot of money, but it's far more dangerous to play American football than to take these drugs we're talking about. But we act as if these drugs are more dangerous. Now, I know the public has been told that drugs destroy brain cells destroy the brain. And we have used experiments for examples in rats where we give naive rats, large doses of a drug like amphetamine, whether it's methamphetamine, d amphetamine, just or, or M D M A in amphetamine and amphetamines are really good at causing some toxicity to certain cells.

Speaker 0 | 05:59

Cells that carry dopamine cells, that carry neurophine cells, that carry serotonin. Amphetamines can damage those cells if you give super high doses to naive animals. But if you allow these animals to become tolerant, that is es slow, slowly escalate the amount that you give the animal over time, you can attenuate block any of these sort of damaging effects, uh, to the neurons. Now, when humans take drugs, they don't take large super large doses that we give to animals in order to demonstrate some damage to the cells, right? Because if you give a drug like, I don't know, acetaminophen at those large doses, certainly nicotine, you will kill the animal. Mm-hmm. <affirmative>. Um, and so those doses in many of the animal studies are not relevant to the human conditions. Now, when you look at humans and you look at brain imaging or whatever brain method you might use, you can't differentiate the brains of people who use drugs.

Speaker 0 | 07:05

Even people who are addicted to drugs from those who have never used drugs, you just can't do that because you, there is no sort of indication or damage that would show up and, uh, on the doses based on the doses that humans are using. That's where we're currently at in our knowledge. And I, uh, try to, uh, uh, I present some evidence in the book to help people to understand this. I published a paper in 2012 looking at looking for specific differences between methamphetamine users and people who didn't use methamphetamine. I looked at all of the literature that looked at brain imaging, uh, to get at this question, because if you're going to see toxicity in humans, it will be with the amphetamines, the amphetamines of all the drugs that we're talking about, whether it's heroin, cocaine, amphetamines are the ones that might be, that would show up first because they are better at producing any kind of toxicity to, uh, uh, these cells. And, and it's hasn't shown up as I demonstrated it in my 2012, uh, review of the literature. And, uh, that doesn't mean our knowledge or understanding of this situation won't change with better data or whatever. Um, but at the moment, there is no evidence to indicate that typical recreational human use causes toxicity to our brain cells.

Speaker 2 | 08:39

So why have we been taught this then? Why do so many of us think that that's, uh, untruth?

Speaker 0 | 08:48

Well, uh, it's easier to fool a population about an activity when most of the population does not engage in that activity. And so most people don't use these drugs. Now, if you told people that, oh, you're destroying your brain when you take alcohol, then people will push back. They, because a large number of people use alcohol. I mean, now more people are pushing back with cannabis because we were told that about cannabis certainly in the 1930s. And now people are pushing back. So as the number of users increase, people start to see the lies and hypocrisy. Uh, but as long as you have lower numbers of users, you can say anything. We told incredible lies about people who engage in sex with, with individuals of the same sex. We told incredible lies about people from, uh, minority races. We, we did. All of the drugs are no different.

Speaker 0 | 09:49

So that's, that's it. And I guess there's another major point related to that. There's a lot of money involved in manipulating people about the, the effects of drugs and, and lying to the people about drugs. I mean, think about, certainly everybody knows law enforcement, their budgets are a padded increase because of the war on drugs. That's easy. But people don't think about treatment centers. All of those people, people don't think about journalists, the bullshit that they write about drugs. Mm-hmm. <affirmative>, you think about this kind of opioid crises, the number of articles that have been published. People got, uh, reporters and writers make money off of that nonsense. Uh, think about the, uh, TV shows like euphoria or whatever it is. I think about something like the Sopranos, I think about The Godfather. I think about all of those sort of gangster movies. All of those guys who are gangsters who are killing people now, that's what they do for a living. And then they are high and mighty about people not using drugs. They're like, oh, we don't, we don't, we're not in a narcotics business. Like, wait, you are murdering people and we write this shit. And people don't say, wait, hold up. This is illogical. No. Instead we repeat this nonsense.

Speaker 2 | 11:00

So I just wanna make sure that the listeners know what falls onto that. So I had never grouped together in my mind, Adderall, methamphetamine and M D M A <laugh>, I've viewed those as three very separate drugs. One for like raving with Molly, or M d m a, one for concentration with school, with Adderall and the other methamphetamine, which I kind of projected as this drug that's done in alleyways and is demonized. Right? Yes. And thinking about the chemistry and understanding that all of these drugs are actually very similar in their chemical makeup and in their outcome, which is wild when I think about then the social constructs around the perceptions of these drugs. Yeah. And I'm wondering if you can speak to why when they're so similar, they're viewed so differently.

Speaker 0 | 12:08

Yeah. So a again, you're getting it to this issue about us as a society. Uh, so like when it is not cool in the United States to disparage groups of people, um, although we, we, we do it still, but, um, it's still kind of taboo. So if you can't openly disparage a group of people, but you don't like them, but you can't really say it, then you disparage or you denigrate some activity in which we have associated, uh, that group. Mm-hmm. And so when we think about methamphetamine, for example, of the drugs that you just described, the group that start up more poorly are the methamphetamine users. Uh, in the United States, we, the methamphetamine use was associated with men who have sex with men and poor white rural people. Mm-hmm. <affirmative>. And so those groups we really don't like. Uh, and, but we can't say we don't like those groups.

Speaker 0 | 13:10

And so what you do is you go after an activity in which you think is associated with that group. And that's why we don't think of Adderall that way, because people have prescriptions for Adderall. And if you're gonna have a prescription for Adderall, that means you have to have some health insurance and your physician trusts you and, and these sort of things. So you're typically middle class. And so we don't disparage the middle class, particularly middle class white people because the writers in the country are largely middle class white people. And then they also, as you point out, they might like the club and live on the wild side every now and then. And they may take some M D M A, which is a great drug to take, uh, to connect with your loved one, um, and have this sort of intimacy and openness and also empathy. Middle class people have discovered that. And so we won't be disparaging the people who use M D M A. In fact, M D M A will probably become a medicine, a treat, P T S D, in part because many of the studies are focused on looking at P T S D in veterans and police officers groups that we like.

Speaker 2 | 14:21

Yeah. And I think this is the same notion thinking about the differences in perceptions between Coke and crack. It's not about the actual drug, it's about who's using the drug. And that's how the drug gets demonized. I think first, to clarify to our listeners, there's a difference between causation and correlation, right? So causation is this idea that A causes B correlation is that a happens to happen when B happens, <laugh>. So when we think about the narrative that's often publicized around drugs, it's the idea that drugs cause violence, right? So can you talk about how that assumption is false?

Speaker 0 | 15:07

And that's an idea that we attribute to a slug group of people. Cuz we certainly, I just came back from Burning Man. Burning Man, as you're talking 80,000 people in the desert, many of 'em taking drugs and just living life out loud, being who they are, no clothes on many cases, and just having a great time of their life. Now, in order to go to Burning Man, one has to purchase a ticket for about $500. And then you bring a vehicle that's another $150, and then you typically are coming from across the country or wherever, and it's a trek. So you have to have money to go to Burning Man. Now there are, there is a tremendous amount of drug use that occurs in Burning Man, but we don't ever think about violence and drug use that burning man. And so, uh, again, when we think about violence or crime with, with drugs, we are really only thinking about the groups we don't like.

Speaker 0 | 16:03

So it tells you that we're getting ready to lie to you again. The point is, when people take, uh, drugs, most people are wanting to experience the euphoric inducing effects or some other pleasurable effect of drugs. Why do I wanna engage in something that's gonna upset me? Mm-hmm. <affirmative>, this is just mm-hmm. <affirmative>. And not only that, at a place like Columbia and, and me, you know, for much in my career, I got people high on a daily basis. And we still do, we get thousands of doses of these drugs, heroin, cocaine, whether it's crack or powder, methamphetamine, cannabis, thousands of doses every year to people. No one's ever gotten violent. There's nothing that remotely resembles violence. So again, the whole violence narrative is a trick is designed to mislead the American public in order to continue to support this war on drugs. And in order to keep the sort of social slash racial hierarchy that's, this is not, it's not complicated, uh, but we act like it's,

Speaker 2 | 17:17

It's so very simple. But the way you just said, why would I take something that makes me feel bad? It's like <laugh>. Yeah. Duh. So one of the things that you reckon with personally is you say, you know, I saw, uh, drugs as the thing that tore my community apart when really drugs was the fallout of the social problems due to oppression and redlining and racism and all of these issues that lead to marginalization or that are part of the process of marginalization. When we think about drug use, it's a, the setting, but really we have to think about what's curating that setting when we think about what's problematic.

Speaker 0 | 18:08

Yeah. The thing is, is that, you know, I don't know, you know, I'm always thinking about these things and always updating my position. I shouldn't even really be focused on drug use when we're talking about my community, because the fact is there's far more drug use in white communities than there are in poor black men. Far more when we just think about the fact that this is, the illicit drug trade is a multi-billion dollar industry, and that can't be supported predominantly by poor communities. That's just it. It's ridiculous. And we never talk about drugs and, um, sort of middle to the upper class communities and the problems of drug use never even mentioned that thing. So why are we mentioning it here when we know that we have all these other issues that people face? Again, it's a distraction. So we don't deal with, damn, it'd be nice that people ha were gainfully employed.

Speaker 2 | 19:06

So one of the things in thinking about the opioid crisis, one of the things you mentioned is that if it were to be pure heroin, there would be much fewer deaths. But what the fact is that it's either in combination with other drugs, which heightens the risk, or it's adulterated with fentanyl or something else. And so one of the solutions that you raise is the idea of legalization so that there can be regulation of these drugs to then save many lives. Can you speak to that?

Speaker 0 | 19:42

Yeah. So when we think about these, we call 'em drug involved overdose, fatal drug involved overdoses. First of all though, it's important for the listener to know. We don't know if the drug itself actually caused the death. All we know is that the deceased person had a drug in their system, uh, multi oftentimes multiple drugs in their system when they die. And we don't typically measure the, the, the levels even to determine whether one drug reached toxic levels versus another drug. And we somet, uh, oftentimes don't even measure all of the drugs in people's system like alcohol. We oftentimes ignore alcohol. We even ignore prescription medications like, uh, nerve pain medications like neuron or, or gabapentin it's called. So we ignore a lot of these things. Even antihistamines, all of these drugs can produce a great deal of sedation. So if you're taking these drug, I don't know, an older antihistamine along with lots of alcohol, you can run the risk of harming yourself causing respiratory, depression.

Speaker 0 | 20:49

Depression. So these kind of things I try and encourage the public to understand better about, uh, drug combinations. The ones that will be, uh, they're more likely to be problematic when you're taking multiple sedatives at the same time. But if you're taking something like an opioid, like heroin and methamphetamine together, that's less of a concern. Although the public message is like, don't ever mix. And that's when you say stupid stuff like that, then you lose credibility with people who actually use drugs because they know that if I take methamphetamine with something like heroin, then that helps to deal with the constipation and it helps me to stay regular or, or it might make me feel more alert when, but yet serene, you know? So it's like these are the kind of things that people know who use drugs. So when you have idiotic messages, then you, those people who are delivering those matches, these messages don't have any credibility.

Speaker 0 | 21:49

And that's a concern as you point out that I worry about contamination, like when people sell something as heroin, when in fact it contains something like fentanyl or a fentanyl analog that's more potent. And the person who is buying does not know this. And so if someone is taking, uh, a drug that they thought was heroin, they may take more of it, right? Uh, than they would have taken if it, they knew it was fentanyl and that might cause them to have respiratory depression and die. Uh, and so I worry about that. And one way of port that we could solve this problem, of course, if that if we legally regulated heroin, uh, or the drugs that people are seeking, then we have some quality control and we decreased the likelihood of that kind of accident and that kind of problem. We had this with alcohol prohibition when we prohibited alcohol, people were making illicit alcohol that contain contaminants, adulterants, and people, tens of thousands of people were killed and maimed as a result.

Speaker 0 | 22:57

We had this issue with the synthetic cannabinoids in places where cannabis, it's illegal. People were getting more potent cannabinoids and they're having problems as a result. But you don't have that issue, uh, where cannabis is legal. Uh, we don't have the issues with alcohol and contamination now that alcohol is legal. So that addresses that. The legal regulation addresses that issue. And just some more basic American sort of principle. It's that we claim to, uh, allow people to live their life as they choose. That's what life, liberty, and the pursuit of happiness is all about. And yet we don't allow people to alter their consciousness. The thing that's remarkable is that Americans accept that shit, like it's normal. I mean, that's the thing that's remarkable. I mean, you have a drug or something, some activity that you really like and it enhances your life or whatever. And they're telling you you can't do it and you're not harming people. And but yet we have this declaration of independence that say that we're, we believe in freedom and we are the freest nation. And people don't even question this. What have we been doing in our universities that people aren't questioning these things?

Speaker 2 | 24:06

Right? Yeah. And I think that the value system that we've been socialized into that's so black and white of what is good and what is bad causes these very dogmatic views that take so long to unpack and deconstruct. Cuz I agree with you. And yet there's this small voice that's like, oh, I'm struggling. And so, you know, when

Speaker 0 | 24:33

I agree, I I completely understand. But you know, the fact that you say, you know, I have this voice continues to struggle. You struggle with these ideas and that's okay. But that's what, that's what, uh, education and all these things are about to help us to decrease the amount of those things that happen. You know, like we come across people who don't look like us, they don't dress like us, they look weird, they do all of these things. And you have that voice in your head like, wait a second. And then you realize that, wait, uh, what I'm doing is I'm treating these people, uh, uh, humanity in a way that's less than my own. And then you catch yourself and you behave appropriately. But so that's okay. We, we all have that, and it's okay to go through these sort of internal calculation, but ultimately we have to understand that we have these principles for a reason.

Speaker 2 | 25:27

This morning I read an article, and you talk about it in the book, but it came out this morning about the use of ketamine for depression as a way of managing depression. Then we're seeing, as you said, with M D M A and P T S D, and then if you, you know, watch how to change your mind on Netflix or read the book Michael Poll, you see that there's this huge wave of, you know, legitimizing psychedelics in a way that's mind expansive and all of these things. And so as we gain more data, we understand the benefits to these drugs. And I don't doubt that there will be at some point an article that I read in my daily skim saying Heroin is found to create these benefits. And we see it in these clinical trials because again, it's just these perceptions. And when we take them out of the box that they've been put in, in these certain communities, and we open them to the idea publicly, because I'm sure we know it's being used in these other communities, more affluent communities, white communities, if we publicly take them out of the space that we perceive them to be in, which is the low income marginalized minoritized communities, then it becomes more generally accepted, which is an obvious display of that racism that we're talking about.

Speaker 0 | 26:55

Yeah. But just to be clear, we don't need any more data to tell us that heroin has beneficial effects. Um, uh, uh, you know, in the book I talked about heroin being used in the clinics in Switzerland mm-hmm. <affirmative>, they have more than 25 years of data experience that the American scientific community and public ignores. And so, um, we, we don't need any more data. Uh, and then so we think about Michael Poll. America listens to a, a bald middle-aged white dude, sad his stuff. Mm-hmm. <affirmative> <laugh>, uh, who has no expertise in this area, I've been studying for 30 years, and they listen to him. Mm-hmm. <affirmative>, that's about what did we come on? This is, uh, we, we know what time it is. Um, and so we don't need any more data for that. We know this is clear. Uh, I've, I've published a hundred papers in the scientific literature.

Speaker 0 | 27:51

Other people have to, we have the data. Uh, we, you know, and this is not to say, uh, that people should go out and just recklessly use any of these drugs, uh, because they are drugs. And drugs have the potential for producing some positive effects, some negative effects. And so you have to know what you're doing, just like you have to know what you're doing when you're driving an automobile. The, the question is, is that they're just like cannabis. We know cannabis have beneficial effects, and we've known it for years, but now we have this movement to legalize cannabis at the state level, not because we want do the right thing. It's because we discovered that the tax revenue from cannabis is in the billions. And so as a result, um, states are rushing to legalize cannabis, right? It leads states outside of the south, because in the south they're still betting on the sort of the banning of cannabis.

Speaker 0 | 28:45

They're still banning on that being more profitable than legalizing cannabis. And also in the South, we have this issue of, uh, the racial hierarchy. And that helps to keep that because of probable cause. You can mess with people because you say you smell cannabis if mm-hmm. <affirmative> if you are a police officer. And so they have all of those issues going on in the south. So the south is in a very interesting place to watch with cannabis legalization because facing in the South are not rushing to legalize cannabis like other places. And it has a lot to do with our racial history.

Speaker 2 | 29:20

And I think an important point too is that most people don't think about is they just think that the outcome of an arrest is incarceration. But this is a money-making scheme when you look at the fines and fees that go into an arrest. So even if you don't spend that much time in prison there, you get feed for the ride in the cop car to the jail, you get feed for the judgment. So you pay the judge essentially to judge your case. You pay for your time in jail even before you were convicted. So there are all of these money making schemes that no one really talks about.

Speaker 0 | 29:55

I didn't know about the paying for the ride, uh, yeah. To jail. Wow. Yeah. That, that those are critically important and and it's profitable.

Speaker 2 | 30:05

Yeah. It's profitable. We've talked about the benefits and how these drugs are falsely demonized, but there are, you know, that 10 to 30% who are addicted, right? Yes. And so how do we kind of deal with that fact and what leads certain people to addiction as opposed to others?

Speaker 0 | 30:28

Yeah. So if we have, like the majority of people not being addicted, as you pointed out earlier, then we can't blame the drugs then, then it requires us to look beyond the drug. And now we have to look at the lives of those people, you know? So we know that people who have co co co-occurring psychiatric illnesses or co-occurring pain that's undertreated or not treated, all of those sort of things increase the likelihood of people meeting criteria for addiction. So when that tells us that we have to do a better job of taking care of people in our society, particularly people in our society who are isolated, people who have, uh, lost jobs, people who are unemployed, underemployed, people who have once, who were once someone in their community, and they're now not, uh, all of those people are more likely to meet criteria. People who have unrealistic expectations heaped on them.

Speaker 0 | 31:25

Chronically, we can think about the poor young person who is a celebrity, I don't know, even athlete, uh, and they take care of all of this extended family, and now they're not making as much money, or they have all of this pressure. Those people are more likely to meet criteria for substance use disorder. So all of these things are really important when we think about substance use disorders. That's one of the reason the Swiss, for example, in these heroin treatment programs or opioid treatment programs where heroin is sometimes used as a treatment, um, the person has a social worker, a psychologist, a psychiatrist, a general practitioner, internist, uh, nurses, they, they have a whole treatment team and they have housing that's number one. Um, they have housing. So that's taken care of. So all of these things are critically important to helping people, uh, not meet criteria for substance use disorder. But those things require us to work. And we can't just simply say, we're gonna put more cops on the street. If we just say, we put we're gonna put more cops on the streets, then we don't have to put in much more effort.

Speaker 2 | 32:35

Right? I think that's a really important point, thinking about the co-occurring or underlying issues that lead to a dependence to feel good, right? Like as we've established, the purpose for most of engaging in drug use is to feel good. And so what is the underlying issue that is causing this individual to not feel good? And I think about AA or NA or any of these kind of support groups for those who are dealing with addiction and thinking about that it's not just them on their own, not doing the drug to then be okay. It's that they have this support system, they have this community that they've become a part of, and that can be an underlying reason that they're not engaging in the drug. And I think, again, like to go beyond the personal responsibility narrative, that these individuals who find themselves in a position where they have a substance use disorder, it's not that they're less than anyone who doesn't find themselves addicted to these drugs and is able to do recreational use. It's to also implicate the structures that aren't providing the adequate healthcare or the social support or the education. All of these elements that lead people to finding themselves in that position. And so I think that's a really important point to bring up as well.

Speaker 0 | 34:03

Uh, I think so too. You know, uh, in the book, in the prologue, I I I say upfront like this is not a book about addiction because addiction has received a disproportionate amount of the tension. When we talk about drugs, even you and I are sitting here talking about addiction. That's not what I want to really get into because drug use could be fun and productive. All of these things, we never really get to that issue. And it's like we are apologizing almost for, uh, saying that people enjoy drugs. And that's what the book is about, right? Responsible people engaging in activities that enhance their life.

Speaker 2 | 34:44

Right? One of the things that I struggle with sometimes is I feel like I'm pretty plugged into this pretty mainstream wellness world. And one of the things within that is this idea of, well, is alcohol use or drug use of any sort, a cop out for not actually addressing the reason that you're suffering? Why do you want to expand your consciousness? Why do you want to numb yourself or whatever these ideas, right? And so when we think about these, it again, it's like these social constructs. It's the demonization as perceived by certain individuals that don't actually have a basis of evidence. And so I'm wondering if you can speak to that too, cuz cuz I know that through this book you divulge that you engage in drug use, recreational drug use from time to time of a range of drugs, from those perceived as quote unquote harder drugs, and those perceived as quote unquote lightar drugs. So if you can speak to your personal experience, and I can speak to mine as well, of why you engage in drug use and how you feel like that helps you and not, and doesn't just negate the issues that you're experiencing.

Speaker 0 | 36:07

Right on. Have you ever engaged in sexual activity? Have you ever had an orgasm? Sorry. I mean, why are you doing that to escape? What are you doing? Right, right, right. Why do you need to do that? To escape? And the the question is silly, just like the question related to drugs. It's silly. I mean, so you get asked a bad question and now you go down this bad avenue. And so it's a silly question. You, you know, it's like people say you, why do you need a drug? You know, it's like, um, I just came back from Denver to New York. It's like, I took an airplane. Why do you need to take an airplane? Why didn't you walk? You know? Well, it's, it's a lot more pleasurable and it's a lot more convenient, you know, it's a silly question, but it's a trap. And so all of these things are built into our sort of cultural ignorance. Mm,

Speaker 2 | 36:54

That's very good point. <laugh> thinking about any kind of escape, any kind of thing that brings us joy. We could ask that question, but because of the social perceptions of drugs specifically, you know, someone could ask me, why do you like going on a hike <laugh>? You know, it's like, yeah, exactly the same thing, because it makes me feel better because it makes me see the world in a certain way. It makes me appreciate beauty, it makes me do all these things that I'm sure you could say the same about your experiences with

Speaker 0 | 37:24

Drugs. Absolutely. Absolutely. It, it makes me more patient, open, happy, <laugh>, all of these kinds of things. Uh, it helps me to connect with my wife, whatever. It's just like when we go to a show and we watch a comedian, you know, we feel better and we connect.

Speaker 2 | 37:41

Right? I'm sure there might be some listeners. And even me reading your book, I was like, dang, I kind of wanna, like, I'm more open to the idea of trying these things. But the unfortunate reality is that we live in a society that does not regulate these drugs because it's illegal. And so if I were to go out and try to cop some heroin right now to try it, there's a large chance that I could get something laced with fentanyl and have a really horrible, potentially fatal experience my first time. Yeah. And so one of the things that you talk about is not just legalization, but also the safety, the drug safety testing. Yes. So the ability to go somewhere, test the drugs, see how much, uh, potency there is to see what exactly is within the drugs that you are planning to take to make sure that you know exactly, which is essentially what we get. If you go to any dis weed dispensary right now, you have the level of T H c, you have the whole breakdown of what you're about to take so that you know, and you're prepared and you can cultivate a setting that you know is safe.

Speaker 0 | 38:50

Yeah. So when we think about that within the context of our so-called opioid crises, so like if people, uh, understand that some people are dying because they are getting tainted drug, we understand that, then why not make sure that we have these centers where people can submit small samples of their drugs so they can determine whether it contains an, uh, an adulterant or something that's potentially dangerous when they have these things in Switzerland, the Netherland, Spain, even Columbia. And we have the technology because police forces in many major cities have this sort of thing. Uh, but we are not making it available to the public. And so when people say they are concerned about overdose deaths or they care about the public, and they're not advocating this sort of approach, then you know, you have someone who's lying to you when they're saying that this technology is not new, we have the money for it.

Speaker 0 | 39:54

It's not that expensive. It blows my mind that this never comes up in conversation when people are talking about the opioid crisis. And then we're talking about someone who's starting to use an illegal substance for the first time. They really should be thinking about making sure that they're with someone who knows what they're doing. Because I really worry about, uh, contam contaminants and adulterate in the sort of, uh, out in, in the us. Um, and so I live between here and Switzerland, six months in New York, six months in Switzerland, in part, so I can be an adult. So in Switzerland, I don't have to worry about getting tainted drug or I don't have to worry about the authorities. Uh, and I can be an adult, I can do my thing. It's a remarkable thing to have freedom. Like in the United States, people don't know what freedom is about. Unless you're really wealthy, then you, you have your freedom. But most of us are not really wealthy. Mm-hmm.

Speaker 2 | 40:51

<affirmative> mm-hmm. <affirmative> this conversation, <laugh> is likely to challenge a lot of people. It certainly challenged me to read this. One of the things that people are likely concerned about in the idea of legalization is that if we legalize heroin, for instance, then we're gonna have to deal with a bunch more heroin users and heroin addicts. And what we saw in Portugal is that the legalization of these drugs actually decreased by millions, the amount of heroin users.

Speaker 0 | 41:28

Um, yeah. So they didn't, they didn't legalize. They just decriminalized.

Speaker 2 | 41:32

Right, right, right. So what do you think, like how would you rebut that, that fear?

Speaker 0 | 41:38

So we have the forbidden fruit phenomenon going on when you ban these sort of substances. Like people for years, uh, in the, the, the Netherlands, they, cannabis was not a big deal. So their young people use less than our young people because of this sort of forbidden fruit phenomenon. And when we think about a drug like heroin, even if we get a spike in users or what have you, and we know what people are getting, it's an opioid. The people we can control the unit dose that we sell to make sure we decrease the likelihood of people getting so much that they harm themselves initially. Uh, and also there'll be a number of people who just simply won't want to take heroin on a regular basis. So they get dependent because, um, of a variety of a variety of effects. Like, uh, heroin is really good at causing constipation.

Speaker 0 | 42:31

And if you're health conscious, you know, you can't do heroin on a daily basis, uh, the heroin has, uh, some other sort of effects that, uh, that are not good to do on a daily basis. So most, uh, people would never do that kind of thing. And then you don't wanna really have a dependence on anything, whether it's caffeine or whether it's heroin. And so this sort of notion, again, it's paternalistic, kind of protecting people from themselves. And the thing that we say that we are not in this country when in fact we are paternalistic, that is

Speaker 2 | 43:08

Mm-hmm. <affirmative>. So one of the things you bring up is that as you've become more free in talking about your own use, there are questions about your kids and how you can be, uh, you know, active and functioning father, if you're engaging in, you know, heroin use or methamphetamine use or whatever it is on, uh, you know, not necessarily a regular basis, but on, you know, uh, whatever recreational use basis. And so how has your, how has that impacted, if at all, your relationships with your family and

Speaker 0 | 43:50

Friends? Well, you know, like in the book I described, like my drug use primarily with my wife, and that's, it's a, it's an activity that we do together. So it's like it brings us closer, you know? So that's a, and then, you know, my kids, like my older kid graduate of an Ivy League institution, <laugh>, the youngest kid is in a senior year in a Ivy League institution. So just check the record. My kids can think my kids are good people. They're considerate people. They care about their community and other people far more important to me. Like, and, and when they were growing up, we didn't talk about drugs. I mean, like, if you're a parent and you're talking about with your young kids about drugs, you've already lost the battle. Mm-hmm. <affirmative>, uh, you should be making sure your kids have long-term goals that you're reinforcing, making sure that your kids are concerned about other citizens in their world. You know, all of these things are far more important than drugs, uh, making sure your kids can think critically, but, uh, they hoodwink parents into believe to focusing on these things that are irrelevant in terms of your kids being good, decent, kind people

Speaker 2 | 45:08

In thinking about, and maybe this is putting both of us too high on a horse, but in thinking about the intention of these kinds of conversations, it's far less about power than it is about liberation. And I think that that's the important takeaway from your book is that this isn't about dictating who does what, but creating a sense of freedom for us all and a a state of independence on a personal level. And so, yeah,

Speaker 0 | 45:42

That's absolutely right. I'm just asking the, you know, it's really geared to an American audience. I'm asking that audience, like, if you're Declar Declaration of Independence, mean anything to you, it's the founding document of the country, particularly those people who talk about their for freedom and liberty. Why aren't you here in this fight allowing people to live their life as they see fit? And because eventually they're gonna come at the you too for some activity in which you're engaged in, and you're not bothering anyone. You're not preventing anyone from enjoying their rights. And so, uh, I'm just asking people to live up to the ideals that we claim to be fundamental to being an American. It's all I'm asking people to do, in this case,

Speaker 2 | 46:27

For many, the knee jerk response, at least in their mind, will be, well, it's because drugs are bad. It's because it causes violence and because it's because it causes poverty, it's because of all these things. And I encourage people, if that is what they're finding to be their knee jerk response, which is normal, especially given our society today, especially in America, I encourage them to then read drug use for grownups, because I think that that really challenges those assumptions within that knee-jerk response.

Speaker 0 | 46:58

Yeah. But also I want, I want people to understand that, like, let's just say, I don't know, the drug destroyed this personal and they chose to do that sort of thing. It is their life, you know? And, and, and, and so people have to understand that too. Adults have the right to make decisions for themselves, even if I think that decision is not in their best interest. Mm-hmm. <affirmative>, I don't have to live their life. They have to live their life. I mean, like, people who go skiing, you know, I think that's a dangerous activity, man. Uh, I, you know, I can't do it. People who play American football, I think that's a dangerous activity. People who engage in, what is it? U f C, the, the, uh, mixed martial arts fighting dangerous activity. I, I wouldn't, I don't want my kids doing that, but if you wanna do that, that's your decision. So why not think of drugs in the same way?

Speaker 2 | 47:51

Right. A hundred percent. Well, I think we've given them enough to chew on, but thank you again so much.

Speaker 0 | 47:59

Thank you for having me. And I, uh, really enjoyed talking to you. And I hope Tempe is, uh, nice and cool this time of year.

Speaker 2 | 48:07

It's not <laugh>. Thank you so much for listening to my critical conversation with Dr. Carl Hart. I think I'm just gonna let this one marinate and encourage you all to watch the office hours with Abbie and Juwan episode on YouTube next week where we unpack everything that was discussed in this conversation. I really hope you enjoyed it and feel expanded. Please be sure to subscribe, like, and leave a review, and I'll talk to you all next time.