“Drug Use for Grown Ups” with Dr. Carl Hart

it in the press recently. Doctor Hart provocatively argues that drugs, including drugs like heroin, are much safer physiologically than we ordinarily think, and that the major dangers, including the dangers of addiction, come from comorbidities, risks that people have associated with mental illness and poverty, and not from the physiological

substrate of these drugs themselves. He goes further than that, suggesting that we need a radical reform in light of a new understanding of drugs as having far fewer negative effects than we believe and far more positive effects associated

with the altering of consciousness than we usually consider. Doctor Hart is a professor of neuroscience and psychology at Columbia University, where he's been chair of his department, and his research focuses on the physiological and behavioral effects of psychoactive drugs. The book is heavily deeply footnoted, as I learned by

reading it closely and going into the footnotes. At the same time, it's a highly accessible and indeed personalized account of a serious and complex set of issues with major consequences for how power is distributed in our society, including an in particular on the basis of race and racialized hierarchies. Drug Use for Grownups is one of the most thought provoking books I've read this year, and I had to have doctor Hart on the show. Doctor Hart, welcome to

deep background. Let's dive in by starting with a crucial definition that you provide at the beginning of the book that really follows us all the way through, and that

is the definition of the word addiction. And you say in the book that you're going to use the definition of addiction borrowed from the DSM, the Diagnostic and Statistical manual that psychologists use, and that that definition of addiction entails not just that you are using a substance regularly, but that it is negatively affecting a major life activity and that it's causing distress to the user. And under that definition if someone drings coffee every morning but negatively

affect the person. Even though you know, if I don't get my coffee, i have headaches or I'm cranky, I'm not addicted. Right, that's right. I mean you can imagine people who drink coffee, people who drink alcohol or other substances, and their life is not impacted. They're able to meet all of the obligations. Why would we say that they have an addiction problem. Like in this culture, we have this popular saying of functional adding. There is no such thing.

That's a Nazi mourn by definition of addiction, that means you're not functional, you're not meeting your obligations. And so simply based on what people put in their body or what they're using, if you use that as a definition of addiction, everybody would be labeled an adding I think the thing that I was so fascinated about in your clarity about pointing this out about addiction is that you're a neuroscientist. So at least in principle, you're supposed to

be a physiology guy. But that definition is way bigger than the physiological definition. Right, No, that's right. So you know the goal of neuroscience is to try to explain human behavior. And if you're going to explain human behavior, you can only look at the brain. You have to understand the animal of the human in its social context. Without the context, you will make some mistakes about what's

going on without understanding the context. And so I think most of us who understand anything about human behavior know that we need to understand the social contact and under which the behavior happens, because you can imagine some behavior happening in one context maybe inappropriate, whereas it's entirely appropriate

in another. Let's say somebody physically assaults somebody and that's all you know, and it turns out the person who physically assaulted the other person was a defensive end for the Tampa Bay Buccaneers, and he physically assaulted the quarterback for Kansas City. On the field, that's entire appropriate, But off of the field that's not appropriate. So context is everything.

It sure is, And that's a great example. Let's move on to another really important topic for you, and that is you condemn the language of harm reduction that tends to surround our discussions about drugs. Say more about that, because on the surface, harm reduction sounds like the most who could argue with it, you know, idea in the world, and yet in your view that framing of harm reduction has had disastrous consequences. Yeah, I just want to be clear.

You know, in principle, what people do with harm reduction, they try to help folks who are in need of help. I support that. The thing that I had took issue with, it's just the term harm reduction. We do harm reduction when we brush our teeth in the morning, we want to avoid cavities, we put on our seatbelt, we want to avoid any sort of harm that might come if we had a car crash. But we don't call that harm reduction, and we reserve the term harm reduction only

for drugs. And when you do that, you pair the word harm with drugs over and over in our language, shapes how we behave, how we think. So I'm asking folks maybe reconsider another term, like we're really trying to enhance the health and happiness and safety of folks, and so maybe health and happiness, But to focus exclusively on harms associated with drugs seems shortsighted. Most people are using drugs to enhance the pleasure to have a good time

to alter their consciousness. We're not thinking about harm so much, but this term harm reduction forces us in this sort of unique dimensional space, as if harms are the only things that happen when you take drugs. I think the reason that point that you're making was so powerful for me and reading the book is that, like a lot of what you do in the book, it just challenges

the reader to say, start somewhere different. You know. I get the sense again and again reading your book that what you're fighting against is preconceptions that have been kind of drilled into our heads, and not by accident. It's not just they're out there in the culture. They've been created by the television that we've watched, the PSAs that

we've been seeing. If you're in our generation since we were kids, and that the next generation is still getting it's a full you know, I guess it's what the sociologists would call a full discourse, you know, a full set of ideas and language and beliefs that have been created in a very self conscious way. Am I getting you that you're trying to start us off by saying, hey, everybody, take a deep breath and realize that you're in the

grips of these ideas and just question them. Doesn't mean you have to reject them at the end, but start by putting a question mark in front of them. That's exactly right. In our culture, we've been inundated with these messages about drugs that are largely inactress. And we've been innovated with these messages because it facilitates some sort of argument or some sort of position of the person who's

producing the messages. And it's really easy to say that anybody who uses crack cocaine will become addicted, and we all believe it. It's really easy to say one hit of heroin and then you're addicted. And I'm asking people to just reconsider this with the evidence, and I'm trying to present evidence throughout the book that I hope people will look at, consider and reconsider their starting point. Those

stories are so powerful. You know, I'm from Boston and grew up as a big Celtics fan, and i remember very very vividly as a kid when Len Bias died of a cocaine overdose, or at least so it was reported, and you know, the takeaway for kids, and I was a kid was supposed to be you could die from one use of cocaine. There was no serious analysis of the history, the context, any of it. And I don't actually know the facts of it except that, boy, did it make a central impression on me as a kid.

You know, this was a terrifying, terrifying drug and you should avoid it at all costs. Yeah, same here. I came of age about that time. Not only did Lin Baias die, a week later, Don Rogers died from the Cleveland Browns, And so the message was this drug is so unpredictable. Even one hit can take out the most fit person in our society. That's just the overly simplistic message.

Nearly every day before COVID, at least at our institution at Columnia University, we give cocaine to research subjects and never have we seen such a thing like that. But you know, it's in a controlled environment, in a medical setting. But limbaias experience as the way it was reported in the media just seemed to be an extreme aberration. But that was the standard that was presented as if it

was the standard. The real troubling thing about the media's approach to drugs is that the approach is done to the sensationalized event and almost never done to actually help people, help people who may be using a drug, or help people who want a deeper understanding about these things. And as a result, it shapes what we think, it shapes our policies, and it contributes to the restricting of civil

liberties and a number of sort of things. And that's the real concern that I have about the way that the media covers drugs. And more importantly, you can be completely wrong in your coverage of drugs and it's okay. You don't have to be complete, and you can be praised as a reporter in the media. And I wonder if that maybe has connected all sort of harm reduction, because if you said to a reporter or later on, well, gee, you overstated the risk, the reporter will say, well, that

might be true, but we were reducing harm overall. If people are more scared of drugs rather than less scared of drugs, that's a good thing, because less drugs means less harm. Yeah, you know, I think we even take that approach in science. It's it's better to air on the side of caution, and then that way, fewer people will use it's like that would be okay if there was not a price to pay. There is a big price, but airing on the side of caution when you are incorrect.

For example, this past summer, we had a lot of protests related to Black Lives Matter, the killing of George Floyd. The killing of George Floyd is a good example because we all saw Derek Schoulbin put his knee on George Floyd's next for eight minutes and forty six seconds. We all saw it. But George Floyd had some drugs in his system, and now the story becomes, oh, the drugs did it, even though we saw with our own eyes

what happened. But people are sensitized to believe anything about drugs that's negative, and then we miss some important sort of facts like that was a horrible act by this police officer or other police officers. When they say something like oh, they had PCP in their system. The public has been sensitized to believe that PCP causes a superhuman strength,

causes people to have superhuman strength, which is nonsense. But that's the price that we pay in that the police can get away with harming people, killing people as long as they scapegoat drugs in the process. That's the price that we pay as a society for erroring on the side of caution. People are susceptible to believe nonsense about drugs, even when some abhorrent act has occurred against the person

who might have drugs in their system. I just want to pause for a second to underscore the power of the point you're making, because it goes to something really subtle about your book that's actually really different from almost all the other books that I've read on the topic. You are making a very powerful point about the real world, hierarchical and race based social impact of not only drug enforcement but drug ideology, if I could call it that.

And you make that point again and again and again, and very very successfully and powerfully, so much so that when I was describing the book to friends because I've been very excited having read it, several people said to me who hadn't read the book yet. So, is this a version of the familiar argument that we've now been hearing off and on for the last five or ten years about how the war on drugs has been effectively

a tool for racial hierarchy in the United States? And what I kept on saying people is yes, heart makes that argument, but that's not all the book is. The book is also adding a separate argument that is analytically distinct about the scientific reality underlying the assumptions that go into the war on drugs. And what I was saying was the book is trying to make both arguments in relationship to each other. Yeah, that's one of the things

that motivated me to write this book. Putting together, for example, the people who had been killed by police and they've had drugs in their system, and that kind of stops any sort of analysis about what actually happened. That's a real concern because an injustice may have occurred and we say it's okay because they had a drug in their system.

Can you imagine the millions of Americans who may have some metabolite, that is some byproduct of a drug in their system and they happen to have some interaction with someone and they're killed, and because they had a substance in their system, their death is excused or disregarded because of the fact that they had a substance in their system. That would be a horrible injustice. And that's what I'm trying to get Americans to look at so we avoid

anymore injustices. Let's talk science for a bit, and I want to start with one of the most fascinating and controversial claims in the book, which has to do with calling on us to rethink the opioid crisis or opioid epidemic. And I think you're making a bunch of different arguments here, and I want to tease them all out so that

the listeners can really get a sense of them. So the first one I think is that what we hear about the increasing number of opioid deaths or opioid related deaths, that some of that apparent increase may be a product of reporting, that there's better reporting, or more reporting, or maybe overreporting compared to what there was previously. That's just the first of several claims. And the first thing I want to ask you is what's the social scientific basis

for thinking that that might be the case. Yeah, if we think about this, we think about who does death investigations. In the United States, most death investigations are carried out by corners. Corners and medical examiners both death investigations, but corners do most. And we think about what are the skill sets of corners. In order to be a corner, all you need is a high school diploma in most cases and a few hours of a death investigation course.

So the skill levels of corners are not that high compared to a medical examiner, who is a physician who generally has training in forensic pathology. And so now we have these death investigations that are being happening all around the country, and they're not uniform, that is, they're not carried out in the same way. In some cases, we don't even have biological confirmation of what drugs the person actually had in their system number one. In other cases,

the person may have had multiple drugs. This is the case for most overdose They have multiple drugs in their system, including medications that they were prescribed. And also with a

number of deaths, people commit suicide intentionally. When you add all of this to this sort of this mix, it's really hard to tease a part what was the culprit the cause of the person's death, because when multiple drugs are involved, rarely does anyone bother to look at what drug actually caused the death or did the combination cause the death. And so when we say like these drug related overdoses. We tend to focus on the opioids because those are the drugs of the moment, but it doesn't

mean that the opioid actually caused the death. Added to that the fact that many people when they do street drugs, may get tainted drugs, and so the drugs may be tainted with other things that are more dangerous than the drug that they were seeking. For example, if someone was seeking heroin and they got analog, that analog can be a lot more potent than heroin, therefore more unlikely to

cause overdose in an unsuspecting user. And so all of this adds complexity to this overdose mix that is rarely tease the part when we document the cause of death. We'll be back in a moment. I take the point that our statistics are kind of problematic for all of those reasons. And by the way, I had no idea that most deathIn nittates are investigated by partners who don't have medical training. I guess I'm a product of the television age, and I always imagine a medical examiner involved.

So that's a totally fascinating fact that I had no idea of. But let's imagine that we were able to tease a part the data. Don't you think there would be a rise in the number of deaths where opioids were at least involved, even if the cause of the death was the interaction between opioids and something else, or tainted drugs, or a fentonyl based drug that was way more powerful than the person who ended up using the

drug ever knew. I mean, you're not suggesting, are you that the idea that there's a lot more opioids out there and that there are a lot more deaths than their word is not true, but rather that their connection between those things, between the number of opoids and the number of deaths hasn't been sufficiently substantiated. Yeah, I think that we have to think about what changed, what changed

in this period where we see this increase. One of the things that changed is that we now have more phintonyl analogs or opioid synthetic opioids that are more potent than heroin and these other sort of opioids of the path that changed, and so it will be nice to tease the part to see whether or not those are the culprits of any increase that we see, and in that way, If that's the case, we can approach this problem by simply doing as some of the other countries

have done, implementing drug checking facilities where people can test their substance to see if they contain adulterants that might be potentially dangerous. And so, I don't really know what's going on, but I know one of the things that we can do is be more careful in discerning what is happening so we can better protect our public. Part of the reason that this part of your book is so counterintuitive is that we have this narrative, which is

a new narrative associated with the opioids. It's different than the narratives about cocaine or crack cocaine of the eighties, and it's a narrative that big pharma, acting quote unquote within the bounds of the law, pushed physicians to prescribe lots of opioids that were themselves. Those opioids themselves were, as it were regulated, they were legal drugs in the sense that they were legal if they were prescribed. You had physicians being under a lot of pressure and a

lot of incentive to prescribe them. And then the way this narrative runs, people got addicted after having genuine, real pain that was medically diagnosed, treated by opioids that were medically prescribed, and then couldn't get off of those opioids, and then that led them to illegal forms or other forms of the drug that may have caused the actual death. And I don't think you talk so much in the book about the big Farma part of that story, and so I really wanted to ask you, do you buy

that story? I mean, we're hearing it all the time. I suppose big Pharma at one point they wanted to deny the story. At this point they've changed strategies, right, They've given up and realize their best bet is to say we're sorry, that the companies who did the most of this will pay large settlements. That the companies who advise them were participating it will also take a hit and pay large settlements, and they'll do what big companies always do to try to move on to the next thing.

But the reason I think this is significant is that it's a different story than the story of a new drug came from the streets. This is a story of a new set of drugs came from corporate America. And I think it makes a lot of people skeptical about arguments for legalization because this looks like a story of

what happens when a big corporation gets involved. The big corporation turns into the drug pusher, according to this narrative, and is way better at it in terms of quantity than any number of street pushers could be, and the consequences turn out to be really bad. Well, don't make me defend the pharmaceutical industry. I have some contempt for the industry, just like most Americans, whether it's opioids or some other drug there. But that's part of capitalism. They're

in it to make money. The point here is that the pharmaceutical company downplayed the addictive potential of something like oxycodo. They downplayed that's a mistake and they should pay for that. Now this narrative, they pushed the drugs onto people, and these poor people got addicted as a result. That is a little troubling because as a patient, as a person, if you see yourself getting in trouble with something, you

bear some responsibility. And now this isn't to stay that people shouldn't listen to their doctor, But if you're having problems, if you're concerned that you are going to have some withdrawal symptoms or something of that nature, you can not take it. That's your responsibility too. I'm just trouble that we think that it's okay to just completely absolve adults responsibility in their own care. That will potentially lead us down a horrible path. Let's dive into that a little bit,

because it's very provocative in the following way. We live in a society where we're really unsure about personal agency and responsibility in some zones, and addiction is one of those zones, right. I mean, for a long time, the society did have the view that someone who's a drug addict it's his fault or her fault, and the society assigned a lot of blame for that and was happy

to punish people. In recent years, it seems like there's been a bit of a shift, and there's a lot of talk about whether the shift is driven by the largely white nature of the opioid crisis, and that may well be the case, but regardless of the whether the underlying cause is race driven, there has been a shift to talking about people who have drug addictions as less responsible and as less culpable, and that's usually associated that

shift is usually associated with reformist approaches. And so it's interesting to hear you in the context of an argument that's radically reformist, still making an argument for personal responsibility. And I just wonder if you'd say more about that. No, see, please understand you can hold two things in your hand at month, right, and so that's this is a nuanced argument. First of all, addiction has almost nothing to do with

the drug itself. That's a that's a myth. The vast majority of people who are prescribed opioid pain pills, We're talking ninety to ninety nine percent of those people never become addicted. So the vast majority, so let's just be clear about that. Now, that tells you this has little to do with the drug. But we also know that addiction has a lot to do with people who have,

for example, co occurring psychiatric illnesses depression, schizophrenia, anxiety. All of those sorts of things increase the likelihood of someone becoming addicted. So if that's the case, make sure people

co occurring psychiatric illnesses are treated. We also know that addiction is much more likely in people who, for example, who are under employed, unemployed, particularly those individuals who once had middle class paying jobs, and now those jobs are gone, and those people now do not have the status in their community, in their home that they once had. Those people are much more likely to become addicted to someone who have not have to face that sort of thing.

And so how about we make sure people are gainfully employed. All of these sorts of things can be done to make sure that we take care of our people and ensure that they have a less likelihood of becoming addicted or any other problems. Now that puts it on us too as a society, But me, as a person, I have responsibility in making sure that I notice when something is going wrong. To be an adult means that you do bear some responsible but it does not absolve the

state of its responsibility. I think that was very powerfully put. It does make me think that you could imagine someone who's a sympathetic reader saying something like this. Listen, you know, doctor Hart, I've read your book, and I accept every argument you make in there on the facts. But I look at a statistic that says somewhere between ninety and nine percent if people prescribe opioids don't get addicted, and I say, okay, let's imagine that it's ten percent who do.

Then let's look break down the data and look at who those ten percent are. And some of them are people who, as you say, have mental illness or depression, or alternatively, they're people whose risk factor is there fact that they're poor because they've lost their jobs. So that's

not distributed fairly or justly across the society. So then I might conclude if all that's true, and that say ten percent are people who are particularly vulnerable, and whose vulnerabilities are a product not of randomness but of structural racism and other features, that's enough to end up with

a policy of strong prohibition. Even if it were the case that there are stable, mentally healthy middle and upper middle class people who could take opioids or other drugs and be totally fine, and then to you know, to conclude that even a little more strongly. You know, one of the things that you talk about in your book is that it's totally reasonable for people who have good jobs and are you well adjusted to take drugs and well, they're pretty much certainly couldn't be fine. But maybe that's

not where we should be focused. You know, maybe the upside for those folks doesn't outweigh the downside for people who are more vulnerable. How would you respond to that. I would call it a sympathetic reading coupled with a disagreement with your conclusion. Yeah, well, we would have the ban alcohol of that, But we tried, right, I mean, I think a lot of people thought we should ban alcohol. We did ban alcohol, and then it went south and

we ended up unbanning it. But I mean, you know, as a moral principle, I don't think you could be wrong about that. I mean, I don't think prohibition was irrational. Prohibition was highly rational. There was huge harm that was being caused by alcohol, and it's just that the society was unwilling to tolerate the social cost. Ultimately. Well, I don't know, I think that's naive. We think about automobiles. Every year we lose forty thousand Americans on the highway

because of car accidents. Well, we should probably think about banning cars, and we can think about other activities that people die in. People humans should understand that life is not without risk. But you know, when we think about restricting these things, first of all, the people who had the means are still going to get their substances, and we have these laws that ban these substances, and that means that these laws will primarily affect those people who

don't have means. So those individuals will probably pay an even higher price if we ban these substances, while the people of means they're always going to be okay. They're always going to get their substances because they can circummit the laws in ways that the folks without means cannot.

There's a fascinating chapter in your book, Carl, about psychedelics, where you begin by saying that, unlike lots of other drugs, which you have experimented with in various ways are used, you haven't done so much in the way of psychedelics.

But you observe that the mostly white, mostly upper middle class people who are into psychedelics and it's a big cultural movement these days, are at pains to differentiate themselves from users from other drugs which are coded as less white, and you have a sort of call for people to

be a little more open mind about this. Do you want to say more about whether the movement towards legalizing psychedelics, which does seem to be making progress is a useful thing from your perspective insofar as it could be leverage to achieve the social goals that you're looking for, or whether you see it as actually part of the problem, because it does rest to some extent, as you argue, I think very convincingly on a kind of hierarchy of

good drugs versus bad drugs. Yeah, it troubles me if someone says, oh, I use some ayahuasca or psilocybin to achieve some spiritual enlightenment or to be one with the universe, or to heal some problem I had, it's totally acceptable at it in this day and age. Now if someone says that I took her one and I felt great, that person it's vilified. And when in fact the two

individuals are doing exactly the same thing. They are choosing to alter their consciousness, They're doing exactly the same thing oftentimes. And my point is that we're all doing the same thing. So why not come and stand on behalf of those people who have been vilified for doing exactly what you're doing?

I know why not? Because the sort of folks who are enthusiasts of psychledelics don't really want to be associated with those other drugs because of the baggage that those other drugs carry, including the perception of the users being predominantly non white. I get it. I understand that that's

why it happens. What I'm pointing out is that it's wrong because those people who have been persecuted for using heroin or cocaine there the penalties that they have faced are very real, while these other folks face no penal lease and not that they should face, but they should stand up on behalf of those other people. And I'm

asking them to do this very thing. Speaking of baggage, I intentionally waited till the end of the interview to ask you about this, but it's been upfront in reviews of your book, and you talk about it very frankly in the book, and that is your own willingness to say. You know for the record that for a few years you've used heroin in a controlled setting, with controlled dosage.

You even describe in the book deciding to get off of it and going through the withdrawal symptoms and how you manage that, and then deciding to use it again. And that grabs the attention to the media, and it gets people to sit up and take notice when they're reading the book review and say, oh, I'm going to go out and buy this book because this is remarkable. This is unusual someone would say this. When you think deeply about how your decision came about to put it

in the book, did you weigh this issue. Did you think to yourself, man, on the one hand, people are really going to folk on this and the whole conversation could end up being about that. But on the other hand, it'll get more people to hear my message. Or did you just think no, I just want to be honest and damn the consequences. Oh, yeah, of course I thought

about this. I thought that people would read the book, and I really cared about the people who are being persecuted for having being identified as a heroin user or some other vilified drug. So I thought about that group first, and I thought that, you know, I know more about drugs than most people, and so if anybody takes the arrows and shots, let it be meet on behalf of

those people. That's what I thought. But frankly, I didn't think that folks would lose their mind as some have, for example, saying that you use heroin occasionally but regularly, or something that that means that you're an addict. That means that you have no control, you need help. Nobody's stops to look at things like, oh, you just published this book, which is really hard to do. You published I published another book this year, It's really hard to do.

I have hundreds of scientific articles. Nobody stops to look at things like my kids graduated from Ivy League institution, all of these sorts of things. And so I wasn't really I didn't think that would happen. I didn't think the message would get to start it so badly. But even still, even if I knew that, I wouldn't change my mind, because it's the right thing to do. I'm trying to get people to focus on not the drug itself, but the individual's behavior. Is that person meeting their obligation?

Are they good people? All of these sorts of things I'm trying to get people to focus on. But the sort of current media frenzy about this is really just proving my point. The vast majority of people have read the book and understood this like you have. And that's what I'm really happy about. Your comparison to religion I

think is exactly on point. And I always say to people, you know, when you're in a supposedly secular context and you see that a religious metaphor explains everyone's behavior as it does here, you know you're in the presence of orthodoxy.

You know you're in the presence of a deep community commitment to a set of beliefs that it's very costly for anybody to dissent from because of the fear that if one person speaks out and says, hey, this is not true, the whole edifice, the whole structure of beliefs, customs, practices, interests,

power is in danger of being corroded. And I just want to give you all the respect that I know how to give for being someone who's willing to break out of that and to provide detailed, analytic, scientific arguments which I think are just tremendously important, and whether people agree with them or whether they disagree with them, people should engage them. And I think you made a huge contribution to intellectual discourse around this very difficult set of

issues by doing that. So I just want, I really want to say thank you for that. And I you know what, I could talk to you all day about this, and maybe in the future, when you're out from book publicity, we come back and we'll have a more relaxed and lengthy conversation about associated issues too. It's just great to have you here. Thank you, Thank you so much for reading the book and taking the arguments seriously. That's all

I ask. I really appreciate it. I can't tell you how much I appreciate it, particularly in this moment, So thank you so much. When I read a book that really gets me thinking, I am always incredibly excited if I get the chance to talk to the author, And in fact, for me, one of the great pleasures of deep background is that I have an excuse to call up the authors of new books and say, pardon me, would you be willing to have a conversation with me

about this thing you've written. My interview with doctor Carl Hart fit that bill for me. His book Drug Use for Grown Ups is a book that basically demands that you think anew about something that you thought you understood before. Not every argument in the book necessarily will convince every reader, and I don't think that every argument in the book necessarily convinced me. But what the book did is the

thing that I feel. Nonfiction books often do it. They're most powerful upset my fixed expectations, change my ideas, and the book does so by drawing attention to two different dimensions of our One is an argument about power in the world and about the effects of our drug policies on ordinary people, especially people of color and people who

have less money. The other is to make us reconsider what we take to be scientific evidence of propositions that seem to have common sense weight and value, and it requires us to ask ourselves whether the science supports what the public discourse entails. Through that, we can then ask ourselves whether the discourse that we've been hearing all of our lives around drugs is accurate or not. The point of intellectual work that makes us question all of our assumptions.

Isn't that every time we read something like that, we throw away everything we thought we knew. That's not how the brain works, and it's not how the brain should work. We always need to build on what we've learned, We always need to update what we know in light of new data and new information. What's most exciting for me, however, is that by challenging what we think, we know we have a chance, just a chance to start afresh, and without fresh starts, we never change the world around us.

There's nothing more thrilling for me than seeing things differently and in the real world. There's nothing that gives us greater reason for possibility of change and optimism than taking on board ideas that, if followed, would change the way power is configured in our society and change the way the world really operates. I look very much forward to hearing how all of you think about Doctor Hart's interview and his book, And until the next time I speak

to you, be careful, be safe, and be well. Deep background is brought to you by Pushkin Industries. Our producer is mo La Board, our engineer is Martin Gonzales, and our shore runner is Sophie Crane mckibbon. Editorial support from noahm Osband. Theme music by Luis Gera at Pushkin. Thanks to Mia Lobell, Julia Barton, Lydia Jean Cott, Heather Faine, Carle Binggliori, Maggie Taylor, Eric Sandler, and Jacob Weisberg. You

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