 Thank you for coming. I'm Nick Gillespie, editor-in-large of Reason, and I'm happy to welcome you to the Reason Speak Easy, a monthly conversation series with outspoken defenders of free thinking and heterodoxy in an age of cancel culture and thought police. Today's guest is the brilliant Maverick Columbia University neuroscientist Carl Hart, author most recently of the controversial book Drug Use for Grown Ups, Chasing Liberty in the Land of Fear. In a world where drug legalization efforts are on the march and the pernicious effects of drug prohibition on criminal justice, education, foreign policy and racial and ethnic communities are being scrutinized like never before, Carl is breaking bold new ground on how we think about drug policy, substance use and abuse and individual freedom. The Declaration of Independence guaranteed life, liberty and the pursuit of happiness for all of us as long as we don't disrupt anybody else's ability to do the same, says Carl. That means we get to live our life as we choose as we see fit. Taking drugs is a part of that for a lot of Americans. He writes that his use of drugs, including heroin and other substances, helps him be a better person. I do not have a drug use problem he declares never have. Each day I meet my parental, personal and professional responsibilities. I pay my taxes, serve as a volunteer in my community and contribute to the global community as an informed and engaged citizen. We're going to talk about all of that tonight, his path breaking research on addiction, how he turned from an ardent supporter of the drug war to one of its leading critics, elitism within the legalization movement, and how he talks with his kids and his students, some of whom are here tonight, about responsible drug use. And we're going to have plenty of time for audience Q&A, so start thinking about that. You will be asked to speak into a microphone. You can give your name or a fake name if you prefer. That might be more fun. So get your questions ready. And now, Carl, welcome. Thank you, Nick. All right, so drug use for grownups, which came out last year, extends in deep in some of your arguments and points you made in your 2013 book, High Price. Give us the elevator pitch of drug use for grownups. What's its main argument and what are you hoping to accomplish with it? Yeah, first of all, I just want to say thank you for putting this together. The reason you wanted a few people who I actually interact with today. So I'm really happy to be here with you. Well, thank you. That's very flattering. I question your choice, but you're not hurting anyone. So, you know, today is April the fourth, and it's about seven o'clock. It's almost it's 54 years and almost to the minute that Martin Luther King, Jr. was assassinated. He was assassinated about 605 central time in Memphis, which would be 705 hour time here. So almost to the minute MLK was assassinated. And you asked about the book and his sort of thinking and people like MLK influenced my thinking with this book. I was thinking about MLK, Fannie Lou Hamer, a number of my heroes from the Civil Rights Movement. And they're sort of constant harping on the Declaration of Independence. And I wanted to know like why. And so I had to reread the Declaration of Independence. They make us read this when we're like 12 when it's not relevant to 12 year olds because 12 year olds don't have any liberty. Their parents tell them what to do. And then we don't ask Americans to read it anymore. And many Americans think they know what it's about when in fact they don't. For example, the left has conceded the sort of principles in the Declaration to the right. And then the right, the many times they want to control you and not tell you really understand what it means. It means liberty for some people. Well, the thing that really influenced me about the Declaration was this idea of all of us are born with these three birth rights, life, liberty, and pursuit of happiness, among others. And it says that they can't be taken away from us. And then in the very next sentence, it says something like, government should be created to protect or secure these rights. And when they fail to do that, government should be disbanded. And Americans don't know that. What that simply means is that we can live our life like we see fit as long as we don't prevent any other people from pursuing these rights. That's what it means. And so I thought about it from the thing that I had been studying for about 30 years, drugs. And I thought, like, why am I upset about people's use of drugs when someone like me giving these drugs to people every day in the lab, every day giving drugs like crack cocaine, methamphetamine, opioids, and other drugs? I realize now I've made a big mistake by not applying to Columbia. Yeah, thank you for clarifying that. We give these drugs to research participants who meet stringent sort of entry requirements for the study. But the point is, the point is, is that we give these drugs to people and we do so because of your tax dollars. And we do so in order to understand what these drugs do and don't do. We do so to help develop better treatments and so forth. But the point is, is that we do so without any untoward effects. And we've given thousands of doses of these drugs. And most of the people are really happy after they receive some of these drugs. And so it really got me the thinking about why are we so upset as a society? And we're upset as a society not because of the drugs or the drug effects, but what we have said this type of drug use means and who's using these drugs. And so I wrote this book in order to show the public, the American public, the global public, that most of the people who use drugs, the drugs that we're concerned about, the psychoactive substances like cocaine, psilocybin, MDMA, heroin, you name it, most of the people who use these drugs are people like me. Well, not black, but they're mainly white. But they're middle class and they are well off. They take care of their families. They're responsible people. They even sometimes become presidents because presidents have used these substances when they were in their youth. And I got to thinking about the fact that the illicit drug trade is a multi-billion-dollar industry, which could not be supported by people who don't have money, meaning that the people who are using these drugs are people who have jobs, people who are well functioning in society. And so I wanted to present a more realistic view of the psychoactive substance user. And that's one of the reasons that I wrote the book. Another reason I wrote the book is that I wanted to also kind of expose the hypocrisy as it relates to some of the claims that we've made about what drugs do. The sort of drug addiction is a brain disease model. I wanted to deconstruct that and present evidence to show how that's more myth than reality. I wanted to also help people to understand that the sort of policies, our drug policies were not based on pharmacology, but they're based on our sort of racism classes and the rest of these sort of isms more so than pharmacology. I wanted people to understand how with the so-called opioid crises, how we over count the numbers in order to inflate those numbers. And so I wanted to show people how death investigations are done when it comes to drugs. For example, most of the people who die from these things call drug-related overdoses. They have multiple drugs in their systems and the people who are doing the death investigations don't measure the drug levels so you don't know which drug actually caused that effect. And then there are all other kinds of problems like the people who are doing the death investigations are largely not qualified. They are people who are corners and the thing that's required to be a corner is a high school diploma. And then you go to a place like California, the lead sort of death investigator in most of the counties is the sheriff. And so you see how these things, how the bias happened with these things. So I wanted to point out all of these sort of things. But most importantly, coming back to MLK, I wanted to show people when we think about the effects of these drugs, the predominant effects of the drugs that we're talking about are positive. And people experience all of the sort of pro-social things that we say we value. Like people become more forgiving, more empathetic, they become magnanimous, they become more forgiving. Just all of these sort of things that we oftentimes overlook when we talk about drug use. And so I wanted to also help people to understand that this activity requires a tremendous amount of responsibility. And most people exercise as much responsibility in this activity as they do with other activities in their life, although that's not the story that we are presented in the public. So I think that's more than an elevator pitch, but that's kind of... That's a pretty high elevator, right? So we're going to like the Empire State Building. Thank you for that. Before we go further, let's define some of your key terms. Your title mentions grown-ups. What do you mean when you say this, you're talking about drug use for grown-ups, you're not talking about drug use for kids, unborn children, pets or anything. What counts as a grown-up? Yeah, I wanted to make sure when I include a grown-up in the title, I wanted to make sure people who were less than genuine in this conversation wanted to make sure that they were neutralized. So one of the things that we do with this conversation, we prevent grown-ups from having this conversation by saying, what about the kids? And so I wanted to make sure that what about the kids was not going to be the showstopper here. I mean, I have children, my youngest is 21, but there are activities in which adults engage and they have children that they don't want their children to engage. You can think about, you can have kids who are very young kids and you don't want them to engage in sexual intercourse. But you don't stop having sexual intercourse because you don't want your kids. What about the children? Yeah, no one's telling you about what about the children? Why do you have your door closed? What about the children? But we do that with drugs and so I wanted to make sure that that didn't happen in this conversation. So it's people who, you know, a legal age of majority, but it's also people who can handle drugs responsibly. Absolutely. So another sort of thing that I wanted to head off to was this notion about people who are having problems in life in general. I mean, some people who are having problems in life in general, particularly now with COVID, life is just hard in general and some people just don't have enough practice with certain responsibility skills and so they may mess up in this area or in this area. And so I wanted to make sure people understood that I was not speaking to the entire population. And so if I was going to think about people, for example, who are having problems in life because of, I don't know, because of co-occurring psychiatric illnesses, I would have to address all of those illnesses and the various nuance that come with them and this book is not that kind of book. And so I wanted to make it clear I was not talking about that group of people. And some people took it as me saying that you could only use drugs if you meet my definition of grown-up. No, that's not what I'm saying. What I'm saying is that this is who I am speaking to. That's the only point that I... Can you talk a bit about, you know, discussions of drug use as you were pointing out, immediately conflate use and abuse. And, you know, we have, and I guess it's really after about 30 years of advertising campaigns to say be a responsible drinker. That exists in our kind of collective unconscious. But then when you say be a, you know, be a responsible PCP user, be a responsible weed user, this we haven't quite got there. How do you define kind of responsible use or adult use and addiction? Because I want to talk with you about how you conceive of addiction in a different way than I think most of us have been taught to in the way certainly the rehab and recovery system does. But, you know, just in a colloquial way, so... Yeah, so when I think of the way that I define addiction in the book was the definition that we use in medicine and science. It's in the DSM, the Diagnostic Statistical Manual of the American Psychiatric Association. It's a simple definition. It's where you have these impairments in your psychosocial functioning. You fail to meet obligations at work, at school. You take more of the substance more often than you initially planned. I feel like you've been reading my personnel file. Exactly. That's one component. So you meet some number of symptoms. That's one component. But also these symptoms have to cause impairment, significant impairment, or they cause the user to be distressed. And oftentimes the people when they're making this diagnosis or they're thinking about addiction, they don't do the second component that it causes significant impairment or the person is distressed. So, for example, like me failing to meet an obligation that we typically have in the family. Say, like Thanksgiving dinner. Let's just say that there, for example. In my family, I have some people who support Trump, and I usually go to Thanksgiving dinner. But since the Trump era, I don't go. And I much rather be using a psychoactive substance. And I am not distressed by that. Now, some people might say, oh, you meet this symptom. But no, the symptom has to cause distress or significant impairment. And clearly that doesn't happen. But that's an example of why it's so important to go to the second component of making the diagnosis. Now, one of the things that I talked about in the book was I wanted to make sure people understood that I wasn't talking about drug addiction. So, like, the vast majority of people who use psychoactive substance do not meet criteria for addiction, you know. But yet, almost all of the conversation in the country surrounding these drugs focus on addiction. Whether you turn on your television set, some movies, some TV programs, TV series, in the media, you name it. It focuses on addiction, even though that's not what predominantly happens with these substances. So it would be like saying, I'm interested in a certain type of German car. I don't know a Mercedes-Benz W. And you go online to find out about these cars. And the only thing you find out about are crashes that happened in these cars. And that's what we do with drugs in our society. And so I wanted to make sure that people understood that I was not here to reinforce this inappropriate focus on drug addiction. That's not to say that people don't have problems with drugs, because some people certainly do. But that's not this book. That's every other book. Can you broadly talk about how, you know, why do people use drugs in a responsible way? You know, what do they get out of that? And obviously that's a broad question because different substances have different effects. People want different things at different times. But why are we drawn as human beings to altering our consciousness? That's a question that anybody in this audience can answer if you all have alcohol on your table. I mean, or if you talk something before you came here, you do so in order to alter your mood or to preserve a mood state. And so it's a sort of simple thing, particularly when we think about the drugs that I'm talking about, cocaine, opioids, MDMAs, psilocybin, cannabis. These are what the government calls illicit drugs. That's right. Which is fascinating and, you know, it's supposed to be kind of a medical conversation, but illicit is a moral term. They're not even just saying illegal. It's something sketchy about using it. No, absolutely. I want to be careful about even calling these things like medical terms, because we don't think of alcohol in terms of medical use. We don't want medicine controlling people's sort of desire or ability to alter their mood. I mean, because medicine functions as cops in this sort of setting. It's like, why do you want to go to your doctor and ask for prescription for alcohol? That's silly. But that's what we are kind of asking people to do. And that's really silly when you think about it. And so, when I think about the substances that we're talking about, why people take them, they take them for really to alter their mood, to feel better, to be more open, to be more kind, to have a different perspective, look at things differently. A wide range of reasons is why people take these substances. But notice, most of these reasons are, there are all pro-social reasons. We want to encourage this sort of thing in our society. You think about it, it's like, ultimately, people feel better. And so, if you feel better, you're more likely to treat other people better. And that's one of the things that I tried to emphasize in the book. You know, it's really about me having to think about the impact of my behavior on other people, particularly subordinates, wanting to make sure I didn't somehow negatively impact my behavior, didn't negatively impact the subordinate or people in my life. And that's one of the things that happens with some of these drug use, because I become more cognizant of other people in the world. And we don't emphasize that enough in our society. So it's drugs, not hugs. Drugs, not hugs. Or maybe drugs, and then, well, that could be... Well, I mean, you know, if you're with your significant other or people with whom you care, hugs are nice. I mean, drugs and hugs are nice. That's true, yeah. Why not both? Exactly. You know, I also know, like, I don't drink alcohol anymore. I'm proudly, I guess, I only know people and my family back to my grandparents. And I am the third generation in a row to have a problem with alcohol. So I don't do it anymore. I'm like other drugs, and most people tell me I'm a better person for it, as you write about, which is like, you know, I mean, it's pretty gutsy. Even, you know, he's a tenured guy, so, you know, you really have to certainly fuck up in order to get fired. But, like, I know, I write and read a lot about drug policy, and when a guy says, I use drugs, they make me a better person. I'm like, wow, I know that truth, but it's still kind of stunning to read that in print. Thank you for doing that. Thank you. Can you briefly sketch, like, at what point, obviously, intoxicants and mood-altering things are always kind of suspicious? And, you know, even in the Bible, there's cases where, you know, sometimes you're exhorted to drink, other times you're not. You know, Jesus made water into wine, so he obviously, you know, had some, you know, interest in altering his mood. What is the, you know, like, what's the origins of our fear? You know, you talk about chasing liberty in the land of fear. Our fear about the particular types of drugs that you're talking about, because alcohol, you know, pre, you know, alcohol's been around forever. We did go through a phase of prohibition, but, you know, when did it become, like, what are the roots of the drug war as we know it on the substances that you're writing about? Some people are, they genuinely fear that if you take some substance, let's just say heroin, that heroin will just get a grip on you and you can't control it and the drug controls your behavior. There are some people who actually believe that ignorant nonsense. I mean, there are people that believe that. And there are people who have used heroin who promote that sort of thing, in part because it's the only way that that person could be, could receive love from the society. Because if you say, oh, I once had a heroin problem, but I found Jesus, I'm okay now. And then now you're welcome back into the society. It's the only way. You can't say that, yeah, I did, I did do heroin every now and then, I'm good, no, I don't need your help, I'm good. You can't say that in our society because of this narrative. Was it always that way or when did that? Yeah, you get to that, absolutely. It wasn't always that way. Didn't we associated certain drugs with groups that we don't like in the society? For example, we associated the opioids with Chinese who had come over to help build the railroads and some brought with them smoking opium and they opened up opium shops and opium dens and people frequent those places and they did well financially in places like San Francisco, New York City and certain white business men were not happy about how well they were doing. They started to pass local ordinance that forbid white folks from going into those places and they eventually tried to shut them down. And so that was one reason for, related to the opium, when you think about something like cocaine, cocaine was quite pervasive in our society. In fact, Coca-Cola, they put it in the fountain drink and made a lot of money in places like Atlanta and black people were excluded from the fountain so it was really only available to white folks in that sort of setting. But then Coca-Cola bottled it, I believe in 1809 they bottled it. Now everyone has it in Coca-Cola and other places. And then you start to see these sort of negative reports associated in cocaine used with black people saying that black men started, they would put white women into slavery, prostitution. Black men, they said were impervious to 32 caliber bullets. So you can unload your 32 caliber weapon into their chest and they keep coming if they were on cocaine. And so it caused some southern police forces to shift to the 38 caliber weapons. So you see all of these sort of stories that are built up around these drugs promoting the sort of fear of certain drug use by certain groups. And I should say that this fear was not only promoted by like white Americans, it was also promoted by like black Americans and also some Chinese Americans, particularly those who wanted to be seen as respectable members of their community. And so this was just like today. You see all of these communities participating in the vilification of certain drugs. And so it didn't change. That's one of the things that I haven't done as good of a job of doing. It's to show how all Americans participated in this sort of vilification of drugs and the people who, certain people who use these drugs. And so that fear then turned into this notion, to this sort of real event where people realized they can make fear off of this money. People like Harry Anselinger, he was the first bureau chief, chief of the Bureau of narcotics. He became the bureau chief in the early 1930s and he stayed there until the 1960s. And he was the, well, Andrew Mellon, the niece, he married Andrew Mellon's niece and that's how he got that job at like 20-something years old. And he would say things like cannabis made black people think that they were good as white people. And that was a fear kind of thing. But he also got his budgets increased by promoting this kind of fear. The Bureau of narcotics was built up between the years 1932 and 1962. They really got built up. And he took over, I mean, he basically took a lot of the arguments about alcohol prohibition and then mapped them onto other substances. Absolutely because alcohol prohibition ended in 1933 and so they had to find a new hated substance and he found cannabis and so... Which was identified often with Mexicans, right? To go with the idea of... With Mexicans and also blacks in the south and also black people here in New York City like Mayor LaGuardia at the time was trying to give some pushback to this notion of all people. But Mayor LaGuardia in 1944 released this report saying that this is nonsense. What Ann Slinger is saying. But Ann Slinger saw very early that if you use this fear and attach it to drugs in certain groups, it could really increase your budgets. And this is what we have seen today when we think about the war on drugs and the propping up of police budgets and prison authority budgets. Also even TV stations got a lot of money based on the drug war. So a number of people understand that this fear is tied to their pockets. Yeah I always think of the drug war. I mean you think of it in kind of a small way but it's shot through every aspect of our society. I mean your kids when they go to school they get dare, it's in our foreign policy it's in our police budget. It's on TV. I'm old enough to remember video games where at the end of you know you would kick somebody's ass in Mortal Kombat and you know somebody would come out and say real winners don't use drugs which is one of the biggest lies that has ever been foisted on people. And I remember there were urinal cake holders. Women you won't understand this but urinal cake holders in urinals I would say just say no to drugs and I always wondered if the person who came up with that was secretly a legalizer. Because it's like you're pissing on the idea of saying just say no to drugs. It could have been a legalizer but you also got to remember the people who were doing the urine testing they got a lot of money off of the war on drugs. In fact they did some of the first surveys that showed in October 1989 in the United States more than 60% of Americans said that the number one problem facing the United States was drugs. More than 60% of adult Americans people who we walk around with now in the face of homelessness poverty you got a global you got the global warming issue you have all of these issues and 60% of Americans said drugs facing the country was the number one problem and that survey was conducted by the folks who were doing urine testing and so they made sure that the American public were frightened about this. Maybe they were saying people didn't have enough drugs that was the problem I don't know. That would have been nice but what we saw with the people going to jail was different. We are having a different conversation about drugs now and over the past you know you can start I don't know when you want to say like the peak of the drug war and I might be too optimistic but we're having conversations about legalization the House of Representatives just passed a bill to legalize marijuana at the federal level it's not going to go anywhere but it's a first. So legalization or kind of drug use for grownups is this a conversation that America is finally ready to have that we're going to use a wide variety of substances to get where we want to be not just pharmaceuticals not just booze not just things like exercise and yoga or meditation you know what's driving that is it that we've opened up our pharmacopia everybody's taking Viagra and Prozac does it make sense to say well you know maybe an opioid now and then or a psychedelic why are we more open to legalization than we were? I want to push back on the sort of optimism a little bit let's think about since we're in New York City let's think about Stonewall was it 69? Stonewall was 69 and so Stonewall is where the community and the police clashed and because the police were engaged in homophobic behavior now in 1969 this happened where they were arresting people for being gay essentially now in 1969 today it's different you know we still have some place to go and I went to the University of Wyoming where Matthew Shepard was murdered so as I think about Stonewall I think about Matthew Shepard I think about those kind of things it's like when we say yeah we made progress but those people who are negatively affected by our stupidity and ignorance they were no less human then they are now so just because we don't get it doesn't mean that somehow their humanity somehow was different it wasn't the same is true with drug drug users just because the society is having some moment where they want to talk about marijuana legalization the person who is using heroin or MDMA or cocaine or something else their humanity is still equated with my humanity but just because the society doesn't get it and now they only want to talk about cannabis I can't celebrate that because I have to think about that poor person whose humanity is not acknowledged at the same level as mine and that's where I'm at but we are talking about legalizing plant based drugs so mushrooms in places we are MDMA criminalizing plant based drugs and we are talking about legalizing cannabis largely at the state level like New York we recently did this and we are doing so because we saw the tax revenue that were generated in Colorado and Washington and tax revenues that are being generated around the country so that's fueling this sort of legalization push but since we talk about decriminalization legalization we should explain the difference so when I say legalization I mean just like when we do with alcohol or tobacco and we are doing now with cannabis in some states if you are of the right age you can legally purchase it and you can legally sell it as well in shops and so forth that's legalization decriminalization means that with a personal amount amounts that have been deemed for personal use you won't get a criminal sanction or a criminal penalty but you might get some sort of administrative fine or something but typically you wouldn't go to jail and sales of that substance remains illegal meaning that you still have to go to the black market and get substances that you don't know anything about the quality so you still are putting yourself at risk in that sense and also you still give police a lot of discretion because in New York City, New York State we decriminalized cannabis in 1977 but under many mayors starting with Rudy Giuliani people in the city were being arrested for cannabis and personal use even though it is decriminalized it has been decriminalized in the state since 1977 same is true in Baltimore when they decriminalized in 2014 between 2015 and 2017 1596 people were arrested for simply possessing cannabis 96% of those people were black because of police discretion and so you see how even with decriminalization these things get abused and people still suffer and more importantly people's lives are at risk because of tainted substances and that's the most important thing and that's why it's hard for me to get excited about people talking about decriminalization without even understanding the difference between legalization and decriminalization so what is the best way then to move conversations forward about things like legalization where you're not only legalizing the use and the sale but also the production how do we get there because it does seem broadly we're moving towards we're having a better conversation about drugs than we were 50 years ago I was just born about 50 years ago so that's not really saying much it's like saying well interracial marriage was banned in many places 50 years ago and they're like oh no it's not banned that's not much progress in my mind and so when you say how do we move forward the only way I know how to move forward is to be honest in public and to call people on their bullshit that's the only way I know how to really embarrass people but people's lives and health is at stake and I have to remember that and I know that I must treat people well and I know that I must think of their humanity in the same way as I think of mine that's how we move forward when we stop thinking of other people's humanity in the way we think of our own we're in trouble that means there are some people for example who say well you know I'm a physician but whatever I'm thinking about your humanity and I know what's best for you I don't mean that I mean you equate people's humanity like you equate your own that means that they are autonomous individuals and they can make their own decisions even if those decisions seem to you not to be the most sound decisions but that's not my role unless you know of course there are other people being negatively impacted especially if that person doesn't think about other people then I may have their inner being but if not it's not my business so you know part of your research looks at and you were talking a bit about this with addicts or people who would generally be you know relegated to a category of not being in control of themselves not being autonomous and you've done experiments with people who use methamphetamine and you find I mean I think this is one of the ways you allow people to recognize another person's humanity while they're making choices you might not understand but that you found that giving small amounts of money to people or giving them the option of drugs or money you found that people are making a wide variety of decisions that doesn't comport with that addict model where you're kind of a zombie could you talk a little bit about that? Yeah so at the core I am a psychologist a behaviorist at my core and when you think about the principles of behaviorism it's very simple it's that there are consequences to behavior that's it and so if you can figure out the things we call contingencies that is the consequences and the antecedents the things that set up the consequences then you can figure out how to alter people's behavior you can control people's behavior or you can understand why people are behaving the way they behave and so all we wanted to do was to show that drug taking behavior followed the same principles as any behavior so if you present the choice between something like taking a hit of a drug whether it's methamphetamine crack cocaine and an attractive alternative attractive being that it too can control behavior or it's powerful enough to influence behavior then you would see that choice to self administer a drug like crack or methamphetamine could be malleable or it could be altered it could be decreased if you simply have an attractive alternative that's potent enough and so if you increase if you offer something as little as $5 versus a hit of methamphetamine or a hit of crack cocaine you'll see that they'll take the drug and the money about on the same a number of opportunities but if you increase the money to something like $20 they'll almost always take the money I mean because it just makes sense and it shows that people who use drugs can and do behave rationally as rationally as the rest of us there was a time when people said oh one hit of crack you're addicted forever then they said the same thing about methamphetamine then they said the same thing about heroin and then the cycle repeats and then we go back to these drugs crack cocaine is the heroin of drugs and then heroin becomes the methamphetamine and then it's a weird vicious cycle you spend a lot of time in Switzerland which you know partly because of the way that they deal with drugs and you know I don't think anybody here I've not been to Switzerland but you know it's not the first place I think of as you know this is the civilization that gave us the cuckoo clock and you know really you know exact changing of the guards in front of the Vatican or something what are they doing right about drug policy and what should we be learning from these uptight Swiss people so you gotta make sure you're out of the country anymore when I go back oh yeah sorry about that no no no that's a good point I mean Switzerland you know in all seriousness they managed to be neutral during World War 2 you know that's quite a feat when you yeah that so I'm not in Switzerland because they are what they're so laissez-faire I'm not there because of that and there are some things about Switzerland that I don't like I mean they really follow the rules like we can't flush out toilets at the 10 o'clock at night or something like that you know or somebody might not get your door with a 200 year old fine or Swiss bank Frank's fine and so I am in Switzerland because people leave me alone I live next to a park in Geneva which is really lovely in the summertime you see teenagers out there anywhere from I don't know 14 to early 20s smoking cannabis having a good time it's dark doing alcohol whatever they have not a care in the world and the police don't mess with them and those kids growing up in that society actually know what freedom is and liberty and having a good time is and so my wife and I we just go to the park and watch the kids just have a good time and we think we like can you imagine this happening in Central Park without the police coming over messing with these kids it's just a beautiful thing we walk down the streets and they prostitution is decriminalized you see people it's not it doesn't look anyway like it's untoward people are kind to each other the police are for the most part don't mess with people yeah it's just they kind of leave people alone and it's a lovely thing to just see people living and not hearing like safety and that sort of thing and the safety concerns I have in America are largely related to our police let's talk about psychedelic exceptionalism because you're a critic of that and you're actually more a critic I think I heard you talking with the former head of the drug policy alliance on a podcast that he has talking about drugism where people still feel comfortable with saying we're all drug users here but you do certain kinds of drugs so I don't take you seriously but there is within the broader drug legalization movement certain people who are really into psychedelics will talk about how these drugs are special these are unique these are more potent they're more powerful and they can't really go into general circulation you seem to be a critic of that model am I being accurate in your view and where does that stem from yeah so one of the things I did in the new book was I came out as a heroin user right also as a number of other drug use that I said I used you were really going for the niche markets right like morning glory seeds banana strings everything heroin yeah of course throw that exactly but I put heroin in the prologue upfront in order to align myself with the most vilify in our society yeah I think only juggalos followers of the insane clown posse are lower than heroin users exactly I did it intentionally not that I'm some connoisseur or an expert at some level I feel like a fraud because there are people who know a lot more about that substance than I do but I align myself with that group because they are the most vilified so I did it intentionally and it's been an interesting thing in terms of the press that I've received because the press have tried to dismiss me because of it I said that I'm a regular heroin user and so regular for me is it could be once a month it could be once every six months but just regular that's all it is but that phrase turned into I shoot heroin every day that's what that phrase turned into and it's been quite incredible because I thought that you know my accomplishments if you really read them who could argue with the accomplishments and it's like who wouldn't want their child to do this trajectory and so I thought that would be some Were you trying to get like a Wheaties box endorsement of I use heroin and I think you should too I didn't get to Columbia by snorting cocaine I used you would think that's what the way that it was reported so it's been good that I had to experience this because then again it makes me be even more sympathetic even empathetic towards those folks who are being castigated because of this sort of thing and so when I hear people who are promoting their substance while disparaging another it infuriates me because clearly the person they don't understand what is how drugs are classified for one many of the drug classifications are arbitrary and it depends on who's doing the classifying the persons don't understand about dose they don't understand about administration they don't understand about setting all of these things influence the sort of effects more than even the substances in many cases and so it's maddening to see well it's important for us to know that folks who are opinion makers in our society some writers comedians a number of people who have the microphone they shape the opinions and many of them now it's cool to use psychedelics and now they that's sanctioned cool which is bullshit sanctioned cool they don't understand that people don't get it and so that group of people are touting the benefits of psychedelics meanwhile they are disparaging things like crack cocaine methamphetamine and heroin without even understanding so this is one of the reasons why you get a push a lot of pushback from within the drug legalization movement I mean this is a super radical position where you're not saying I'm going to leave the power structure in place and I just want to put my stuff is now legal you're saying I want to get rid of this power structure and stop having a hierarchy like malt liquor is not good wine is okay LSD is okay that's the heart of your project absolutely as you know drug users in general have faced this sort of prejudice and then so like you know what it feels like to face such prejudice and now you want to promulgate this or you want to do this to another group but it's one of the more infuriating things that I face in my life because I would think that people understand that it's not right to make anyone feel but on the upside now you have a better reason to take heroin right because you're mad I don't really need a reason you know I'm this is the lovely thing about being a man I do what I want as long as you know I'm not negatively impacting other people's sort of experience or their life but that's a lovely thing with being free so many people in our society don't understand what freedom is and that's one of the reasons I wrote the book could you demystify you know on some level I apologize for harping on the heroin it's a bold rhetorical move that you made demystify what it's like to use heroin because I think most of us when we think about it we don't have direct experience or if we do and I had a friend from college he became a junkie and died of an overdose in the kind of stereotypical way found in a bathroom with a needle between his toes it's everything from the man with the golden arm to him for a dream and all of this but when you write and talk about heroin it's almost like you know it's a feel good kind of pleasant thing it's not this horrific tableau I think people like William Burles and those guys they really fucked it up I mean because you know they were looking for a reason to be hit and they were looking for things to write about that were on the edge and the dumb ass society allowed them to say these things about heroin and be believed and so it's really the society got hoodwinked with those guys and we still celebrate those idiots you know and so I if anybody has had I don't know, Vicodin Percocet, you had some pain that's an opioid experience that's all it is it it can be euphoric anxiety relieving a wide range of those things it's just that you with something like heroin straight heroin, real heroin you don't have to deal with things like acetaminophen in your Percocet that's far more dangerous but can be far more dangerous than heroin if you take too much of it and so if you've had an opioid for tooth pain some other type of pain think you've essentially had heroin it's not a big deal the reason why it's so mystified in our society is because of these people who wrote who were looking for a life who wanted to look like they were cool and interesting when in fact they weren't as a matter of fact in Burrow's first published novel under the name William Lee Junkie he talks about junk as a way of life I mean it's an entire set of associations that are far beyond anything pharmacologically he's talking about they were frauds it's annoying to people who are really cool let's open this up to questions Malik can you raise your hand if you have a question for Carl Hart and wait for Malik to I used to live in San Francisco and it's turned into a dystopian nightmare driven by and large by the open opioid use and fentanyl use on the streets wondering how do you address these sorts of social concerns well I used to live in San Francisco too and I was there recently and I know the narrative I mean there are people who use drugs and they're also homeless and they are in those spaces but this is not because of drugs I think about a place like LA which I know the homeless population or those numbers better there are more empty houses in LA than there are homeless people the problem is housing lack of housing lack of ability to pay for housing our sort of simplistic way of looking at drugs and pointing to drugs as a problem that for why people are experiencing those problems in San Francisco that's not it the problem is related to the expense of San Francisco I've been homeless once in my life and it was in San Francisco I had just got my PhD moved from Laramie Wyoming to San Francisco I had to sleep under my desk and I showered at the hospital people didn't know because it was so damn expensive and so this is the first time I'm telling that story publicly but that's a fact and but yet we want to blame drugs for what the people in San Francisco experienced what do you do about people who clearly are not flourishing they might be homeless or not but they have a drug problem and they resist treatment and I say this as a libertarian I don't want to coerce people into doing things but how do you as a psychologist or as a caring person with that kind of situation well people who are not flourishing so what we should do is maybe let the experts deal with this first I'm not an expert in that area and I won't the reasons for why people are not flourishing they vary widely and in our culture one of the things that's happened with these damn podcasts and the rest of these things is that everybody becomes an expert on everything I know a lot about structural steel and the level that jet fuel will or will not melt it you know and I became kind of an epidemiologist during COVID exactly and so this is the problem we need to make sure that if you don't know what you're saying shut the hell up well I don't know that we have a lot left to talk about then but let's go to the next question please Malik so in this discussion about difference between psychedelics and other drugs we have to give credit to people like Roland Griffiths who's done the research to help show utility of those agents for disease processes it's been and it's sad that we don't have that being showcased for opium because I mean it was the first drug that we really learned to use well for treating pain and discomfort but no one's looking at that anymore instead of that science is stronger than what Griffiths put out for psilocybin and yet we don't say you know these are miracle drugs the opiates were miracle drugs for saving disease that was more of a comment my real statement I wanted to ask the question about was as a kid we all first experience illicit agents when we're in our adolescence and that makes sense because we're in our stage of exploration how did you deal with it with your children and wanting to do that exploration as far as making them responsible during it because who wants to be responsible when you're an adolescent yeah and you are you provide the ultimate instantiation of the old anti-drug I learned it from you dad when the father finds his kid using drugs and so how did you deal with that and the students here you know kids stay in school if you're in Carl's class stay in school but how did you deal with all this you sound like a rapper now one of the things that used to be in the old hip-hop sort of PSA public service announcement by the way I used to be in that game for a little bit I did some shows with Run DMC when I was a kid and we all smoked some weed and together and then I would see Run DMC public service announcement saying stay in school and stay out of drugs and I'd be like what the fuck so that's who you sound like now back to this this issue when you said we should give credit to roller grifters and people like that I know Roland and I also did some research on the science too and you know it's an interesting thing it's really I've been hoping Roland comes out of the closet about his own you know I haven't seen him use or anything but this is just suspicion and it would do a lot more good and you know he's could you explain who he is and why he's a doctor at Johns Hopkins and he like me does lab work with humans where he gives psychoactive substances and tests them Roland has given drugs ranging from cocaine nicotine to psilocybin and he has a long impressive career and he's over 70 now I suspect and it'd be nice if he just came out of the closet and said look I've been I'm responsible I've been doing this but he won't I suspect he won't and so when we are praising people how about we see let's see first because I think that would go a long way to dispel these myths about what a typical drug user looks like you talk a lot in the book about the chemical closet and so you like the Spartacus moment people like I'm Spartacus and I use heroin I'm Spartacus and I use nicotine I want people to be out of the closet in their way you know it's like I recognize that some people they put themselves at risk of course there's a lot of risk with what I'm doing but when we started off the talk thinking about MLK people like him we admire all of them put themselves at risk that's why we admire them that's what fighting for freedom looks like putting yourself at risk and so how people decide to do that that's fine I don't want to tell them how to do it but they have to understand that of course there's risk that's part of it now back to the children when I think about my own children who by the way were honest students did well we never talks about drugs special about drug drugs where just like we never really talked about their girlfriends or video games anything that they could potentially I don't know have problems with it the thing that we emphasize was long term goal we wanted to make sure that they contributed to the society in which they were growing up and so you take the sort of focus off of them and you put it outwards what are you contributing what are you doing and then their performance in school was like a marker if you're doing well in school and you're doing these other things like they're playing sports they're doing all these things that we asked they got into the university that they wanted to get into they did all of these things that we asked that's what we focus on and I should also say my children they came with me to the lab when they were young they were I don't know since they were able to walk they would come to the lab and see me bringing a drug to someone and we might have a conversation about that sort of thing they had their birthday parties at the lab because we were poor and this was what we did and so they were always at the lab but there were no special conversations about drugs if one is having special conversations about drugs then you probably have lost the battle this is really about just raising good decent people if you raise good decent people and they're meeting all of these sort of things that you're requiring of them that's what you want drugs are not special and so we didn't want to treat drugs like they were special another question hey there so thinking about like taking away the arbitrary classes off of drugs from your experience is there a drug or a substance that actually is more harmful for people or a society that we might not be aware of because of our prejudices well so my focus has been on drugs that we are aware of like cocaine, heroin, MDMA psilocybin, those kind of things so outside of those drugs there have been drugs developed up in the society that were really dangerous and concerning often times these drugs pop up from people trying to skirt around the current legal regulations there's sort of a prohibition on one drug so I'll give you an example in the 1970s and 1980s people were trying to make synthetic opioids and they were calling it things like white and then there was a compound that was promising it looked kind of like dimerol which is an opioid but what happened was that the compound some people call it MPTP, MPP plus but it ultimately gets converted to MPP plus by the body and it selectively destroys dopamine cells dopamine neurons are important particularly in the midbrain they're important for movement and you selectively damage or destroy these cells you can have something that looks like Parkinson's disease and so clearly a drug like that is dangerous and should be banned but when we're thinking about something like the actual drug that people were seeking something like heroin we don't have that concern and so as long as we have this sort of prohibition the way that we're currently running our prohibition we can expect to perhaps see some of these substances pop up periodically. Is that what's going on with fentanyl which is a very useful anesthetic but it's being used to for opioid or heroin right? Yeah so something like fentanyl which is an opioid too fentanyl is slightly different fentanyl does not selectively cause damage to brain cells fentanyl the concern fentanyl is that it's so potent meaning that so small amount is required to produce an effect if someone thinks that they have something like heroin and in fact they have fentanyl they may take too much and then overdose that's the real concern with something like fentanyl so yeah there is a concern but it's important for us to realize that fentanyl is an FDA approved medication and it's been approved for about 50 years now and so fentanyl itself is a safe medication as long as the person understands that they actually have fentanyl and not something else. So it's like Boys Town there are no bad drugs right there are no bad boys right it's just it's the context context is important Malik can we get a microphone up here for Charlie at the front table. Thank you maybe you can clear up some misunderstanding or just make me more clear about what you what your critique of psychedelic exceptionalism is is it simply that people who promote the use of psychedelics but then put down these other drugs are hypocritical or are you saying that drugs such as heroin or cocaine are as efficacious and healing and potentially transformational as psychedelic drugs can be. I'm saying both I am saying that people who are disparaging who are propping up psychedelic not all but some who are pumping up psychedelics propping them up and at the same time they are disparaging things like heroin and then if you really think about heroin the effects and you do it objectively as I tried to point out in the book heroin in a place like the heroin clinic in Switzerland where people who are being treated for an opioid use disorder take heroin they have those sort of transcendent experiences some of those people with something like heroin certainly heroin can be that depends on the setting depends on the dose depends on the experience of the user yeah that's that's what I'm saying absolutely so would you say drugs don't really have any inherent qualities or characteristics is it always the way that it gets used or no I wouldn't say that because you know drugs have unique properties you think about your cannabis experience versus your cocaine experience versus your MDMA experience they have unique qualities so I want to acknowledge that but what I'm saying is that if persons are seeking let's say a transcendent experience they some if they know what they're doing they can certainly obtain that with something like heroin but it might be more readily accessible to someone who has a tremendous amount of experience with psilocybin so they do have their unique qualities but they overlap just as they were about out of time and I just wanted to close on the topic you were and you've written about this you were a drug warrior and then you became a critic of the drug war can you talk briefly about what flipped that switch for you and what can society learn from your experience so that we become a better we become more critical readers of the information that we get about drugs and hopefully lead to a better set of policies and experiences with these substances well between 1984 and 1988 I served in the US Air Force and so in that period in 1986 the country thought that crack cocaine what a country was manipulated into believing that crack cocaine was the major problem facing the country even though crack cocaine used was always relatively low and never really approached anywhere near powder cocaine use levels certainly nowhere near marijuana use levels or any of these other drugs I got food like everyone else in the Air Force I was trying to think about how could I best serve my community so I went to university while in the Air Force and I was going with the notion in mind that I wanted to solve the drug addiction problem in my community and so one way to do that was to study neuroscience and try to understand how neurons in the brain worked try to manipulate this with drugs in order to treat people who were suffering from drug addiction and I figured that if I cured drug addiction I could solve some of the problems in my family also in my community and then that's what I did for the next 30 years wholeheartedly working in the lab giving drugs to laboratory animals and humans and along the way the story just started to fall apart I thought that most people who use these substances were addicted turns out the vast majority are not you can't go to work every day and give drugs to people who you thought were irresponsible people who you thought would not be able to show up on time would not be able to follow direction and you see this over again seeing that this isn't true and then reading the literature starting to see how people were would get a set of data but didn't have a different interpretation you can't be a critical scientist and not say start to see these pieces these cracks and then over time I started to realize how much money was being pumped into the war on drugs I started to realize that I was a beneficiary my PhD was paid for because of the war on drugs I got million dollars of grants because of the war on drugs and then I had to go home to Miami and see many of the males, my friends, my family members gone dead or in jail because of the war on drugs so I had to look at myself and think about my participation all of those things helped me to change my mind and then at the writing high price traveling around the world places like Brazil and seeing that we have exported our war on drugs and then at the same time I'm being offered some America's finest cocaine and from some captains of industry all around the globe and all of these things cause cognitive dissonance and then you have to solve cognitive dissonance and this is facing the truth is part of the way I solve cognitive dissonance as a final point and this was shortly after George Floyd's death at the hands of Minneapolis police you wrote a piece in the New York Times and this is like an instance of critical reading of something when George Floyd's toxicology report came out. He had a bunch of different drugs in his system and you cautioned and saying that this data is almost completely useless the way it comes out and I was thinking about that when the Foo Fighters drummer Taylor Hawkins recently at the age of 50 he had a bunch of different drugs in it just very quickly when we see this thing come out what should we be looking for as critical readers? So tonight I have with me my seminar students it's about 12 of them there here and this semester's seminar is focused on basically toxicology and overdoses and we're looking into the overdose literature and we look at some toxicologies and so one of the things that it's important for us to do whenever there are reports out saying that someone died from an overdose if you can get the toxicology and then you will see drug levels in the person's system often time the drug levels don't indicate that the person even used drugs in the past few days because you know some of these drugs stay in your system for several days but when we see what's reported in the media they say oh he used methamphetamine even though the levels are so low that it would suggest that the person hasn't used for at least 24 hours and so that's what I try to do when we have these high profile cases in the media I try to get the toxicology and then we can look and see exactly what is likely contributed to the person's death like in the case of George Floyd the initial reports were that he overdosed on fentanyl and then if you look at the video you see George Floyd was interacting with the police and interacting just like you would expect until they cut off his air supply but they tried to say that it was the drugs and so I looked at the toxicology the levels of fentanyl and George Floyd system were so low it was highly unlikely that that was the cause of his death they also said something about cannabis and methamphetamine those levels were even lower and so I just simply went through what was in this toxicology and tried to walk the reader through in a recent way but even publishing that piece was really difficult because again medicine has been reluctant to comment on these kind of things I think it's a dereliction of duty quite frankly and the police narrative is the only one that stands and so in my class this semester I'm trying to train people to know how to look at toxicologies and so I won't be the only one in the public saying wait a second this doesn't make any sense well it's an extremely helpful article look it up I want to thank Carl Hart the book is drug use for grownups chasing liberty in the land of fear thank you for your work thank you for your service