Examining “Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear”

MAPS Bulletin Winter 2021: Vol. 31, No. 1

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In a powerful moment of social change, America is at a turning point as it searches its soul around social justice, liberty and the history that created this country. In this interview with Dr. Carl L. Hart, Ziff Professor at Columbia University and former chair of the Department of Psychology, Dr. Hart challenges all reasonable people to examine how we’ve allowed ourselves to be criminalized for the drugs we enjoy.

As one of the world’s preeminent experts on the effects of so-called recreational drugs on the human mind and body, Dr. Hart’s forthcoming book entitled,Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear eviscerates the irrational myths that surround compounds like PCP, bath salts, methamphetamine and heroin. His powerful voice challenges us to remember our unity with all people — especially the poor and certain racial groups — who are being targeted with mass incarceration and murder. And to be open about our own drug use as an act of civil disobedience to disrupt a system that uses drug law terror to limit our freedoms.

Kerthy Fix: Tell me about your new book?

Carl Hart: First of all, this is a book for and about grown-ups. I have to define what I mean when I use the term “grown-ups.” These are autonomous, responsible, well-functioning, healthy adults. They meet their parental, occupational, and social responsibilities. Their drug use is well planned in order to minimize any disruptions of important life activities. These individuals get ample sleep, eat healthy diets, and exercise on a regular basis. They don’t put themselves or others in dangerous situations as a result of their drug use. These are all grown-up pursuits, examples of how grown-ups take care of themselves. As you may know growing up is difficult and it’s not guaranteed. This book is for those who have managed to grow up.

At its core, the book is an invitation for grown-ups to contemplate their own Liberty. In other words, do you have the freedom to do as you please—as long as you don’t infringe on others’ rights, of course? Do you have the freedom to alter your consciousness as you see fit? Clearly, you do not. So the question is: why not? In the book, I show how Americans have made a bargain to sell out certain people’s liberty when it comes to personal drug use. This is not only wrong but will inevitably lead to us forfeiting even more fundamental rights. 

Another goal of the book is to get the country to reconcile its practice with its promise. The Declaration of Independence, our founding document, is a radical reification guaranteeing each person “Life, Liberty and the pursuit of Happiness.”

KF: What does this mean in practical terms? 

CH: Life? It means that I can do, with my life, what I choose. Liberty? This provides me with freedom from tyranny, freedom from political oppression, or simply the freedom of choice. The pursuit of happiness? Well, this means that I am free to pursue happiness as I see fit, even if it includes taking psychoactive substances. Of course, these rights are dependent upon me not interfering with the rights of others. The point is that the government doesn’t have the right to tell me what to think, what to put in my body, or how to live. Importantly, drug laws, banning person drug use, are out of step with the principles that we claim make us American. 

KF: What recommendations do you offer?

CH: I urge readers, especially privileged-class readers, to get out of the closet about their own drug use. I urge them to blatantly disregard laws that prohibit adult drug use. Such laws are ruthlessly unjust and they are inconsistent with the nation’s promise of Liberty. Massive civil disobedience, like the one I am proposing, is how people like Rosa Parks, Martin Luther King Jr., helped to make our society more just. Clearly, we still have a lot of work remaining. I hope this book helps.

KF: It seems as though your position on drugs and drug policy has evolved since you started studying the brain and drugs some 30 years ago. Can you explain this? 

CH: When I began studying drugs, I believed that drug use damaged the brain and ruined people’s lives. I now know that there is virtually no evidence indicating that drug use causes brain abnormalities in otherwise healthy individuals. I also now know that many other complex factors are responsible for the turmoil that is inappropriately blamed on drug use.

KF: Are you advocating for the legalization and regulation of all recreational drugs? Why?

CH: Yes, I am advocating for the legal regulation of drugs like cocaine and heroin and methamphetamine and so forth. My research has clearly shown that most of the harm attributed to drugs flow from their being illegal. During alcohol prohibition, for example, hundreds of thousands of people were maimed or killed due to drinking alcohol produced in illicit stills. There was no quality controls on the drug and drinkers were forced into the shadows, both of which can increase toxicity. This problem went away when Prohibition was repealed. Similarly, today most people who overdose on opioids do so because of tainted opioids obtained in the shadows of the illicit market. Legally regulating the market would dramatically reduce opioid overdoses, because it would introduce a level of quality control and decrease opioid users’ social isolation. Furthermore, responsible adults should be permitted to alter their consciousness with drugs, should they so choose, just as they are allowed to engage in consensual sexual activities, operate automobiles, and own firearms.

KF: You write for the first time about your own drug use. What made you write so personally and openly about this part of your life?

CH: My conscience would no longer allow me to remain silent about my drug use, nor could I remain silent about the absurdity of punishing people for what they put into their own bodies. How could I remain silent when countless people are subjected to harsh punishments for merely using drugs? What kind of man would I be if I didn’t publicly voice solidarity with these individuals? I’d be a hypocrite and a coward. I should know because I had been living as such for many years. I refuse to do so any longer.

KF: It’s clear after reading DRUG USE FOR GROWNUPS that so much of what we think we know about drugs isn’t rooted in science or fact. For example, you explain PCP and ketamine are chemical siblings, but messaging is starkly different around these drugs. What is at the root of this bias and why is it important?

CH: The legal status and social perceptions of psychoactive drugs are rarely determined by pharmacology, or science, alone. Oftentimes, if a specific drug is perceived to be used primarily by a despised group, exaggerated media stories connecting use of the drug with heinous crimes, addiction, and other adverse effects dominate the airwaves. For another example, consider powder and crack cocaine. Powder is either snorted intranasally or dissolved in saline or water before injecting it intravenously. Crack is smoked. The resulting effects are essentially the same
, regardless of the form of cocaine ingested. Simply put, powder and crack are the same drug. It’sour perceptions about the users of the different forms of cocaine that differ. We tend to associate powder with wealthy white users, whereas crack evokes images of poor, Black, menacing users. In 1986, these perceptions influenced passage of legislation that established penalties that were one hundred times harsher for crack infractions than for powder infractions. A whopping 80 percent of those sentenced for crack offenses are Black, even though most users and dealers of the drug are white. Similarly, heroin and morphine are basically the same drug. Heroin is made by slightly modifying morphine’s chemical structure, and both produce nearly identical effects. Yet heroin is banned and morphine is used medically to control pain. At the root of this bias is our need to vilify individuals deemed politically inconvenient—e.g., the poor, specific racial minorities—and to justify their subjugation.

KF: You also debunk misconceptions and point out lies spun about drug “epidemics.”

CH: Media reports frequently claim that we are experiencing an opioid overdose “epidemic.” People are dying because of ignorance, not because of opioids. For those who may not know, opioids are pain medications like oxycodone and heroin. Some people also use these drugs to get high. Perhaps that’s one reason opioids have been blamed for the recent “overdose crisis.” Consider the year 2018, for example. More than 45,000 Americans died with at least one opioid drug in their bodies. Now, does this mean an opioid drug caused all these deaths? I think not. 

Please don’t get me wrong. I am not suggesting that opioid overdose isn’t a real risk. It is. But the odds of this occurring have been exaggerated. For example, it’s certainly possible to die after taking too much of a single opioid drug, but such deaths account for only about a quarter of the thousands of opioid-related deaths. Opioids taken in combination with other sedative drugs (such as alcohol or a benzodiazepine) or tainted opioid drugs cause the vast majority of these deaths. In other words, many deceased drug users likely didn’t know that the drug they took contained contaminates. Others didn’t know that combining an opioid with another sedative increases the risk of overdose. The bottom line is this: People are not dying because of opioids; they are dying because of ignorance. Drug Use for Grown-Ups contains important information to remedy society’s ignorance about drugs, information that will help keep drug users safe.

KF: One particularly eye-opening and heartrending section of your book discusses how drug use is often wielded as a justification for stopping, searching, and detaining Black people as well as excusing excessive force and murder.

CH: There have been countless cases during which police cited the fictitious dangers posed by drugs to justify their deadly actions. This gimmick was used when police (or a proxy) killed Trayvon Martin, Michael Brown, Laquan McDonald, Philando Castile, Terence Crutcher, George Floyd, among a host of others. In each of these cases, the deceased’s toxicology findings, combined with their behavior, revealed drug levels that I believe were too low to have contributed to their death. In other words, drugs didn’t make them act so violently that lethal force was reasonable or necessary; nor did they cause some fatal medical condition.

Even the mere accusation that an acquaintance might be a drug seller is enough to justify police breaking down your door in the middle of the night. That’s what happened to 26-year-old Breonna Taylor. Just after midnight on March 13, 2020, police entered her apartment under the auspices of a legal search warrant in search of her ex-boyfriend, a suspected drug dealer. He wasn’t there. But her new boyfriend was there and he fired a shot at the entering plainclothes officers, fearing they were intruders. Police also fired. They fired multiple shots, hitting Ms. Taylor eight times and killing her. Back in 2006, police killed 92-year-old Kathryn Johnson under similar circumstances. 

KF: You write about your travels speaking to drug experts and activists around the world. Which countries are getting things right and how has that led to better outcomes?

CH: Several countries are on the right path, including the Netherlands, Portugal, Spain, and Switzerland, although no country is perfect. Still, in these countries, the first intent of drug policy is to keep users safe, not infantilize them, and to respect their autonomy. Each of these countries have accepted the basic fact that humans will always seek to alter their consciousness through drug use. As a result, they have put in place policies that do not criminalize this pursuit but instead, enhances its safety. Each of these countries has lower rates of drug-related deaths, as well as other negative effects, than in the United States. 

KF: In the November election, four states legalized recreational marijuana while two legalized medical marijuana. DC decriminalized psychedelic plants; Oregon went much further – decriminalizing all illegal drugs, a historic first. What was your response to these ballot initiatives passing? 

CH: All these developments are steps in the right direction. The Oregon decriminalization law is, by far, the most significant. Essentially, Oregonians will no longer be arrested for merely using a drug, no matter whether the drug is marijuana, cocaine, heroin, or some other substance. This is an excellent initial step. Drug Use for Grown-Ups lays out additional drug policy measures that should be taken in our continuing quest to “secure the Blessings of Liberty to ourselves and our Posterity,” as the Constitution states. 

carl hart

Dr. Carl L. Hart, Ziff Professor at Columbia University and former chair of the Department of Psychology, is one of the world’s preeminent experts on the effects of so-called recreational drugs on the human mind and body. He is also a Research Scientist at the New York State Psychiatric Institute. Dr. Hart has published numerous scientific and popular articles in the area of neuropsychopharmacology. His book High Price: A neuroscientist’s journey of self-discovery that challenges everything you know about drugs and society was the 2014 winner of the PEN/E.O. Wilson Literary Science Writing Award. His new book is entitled, Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear.

kerthy fix

Kerthy Fix is a documentarian, who together with Paul Kloss, is following Dr. Hart’s work as well as some of the other trailblazers changing the drug landscape in America in a film called “Ecstatic.”