Carl Hart || Drug Use for Grown-Ups

He is known for his research on neuro's psychopharmacology and his advocacy for the decriminalization of recreational drugs. He's the author of High Price and has co authored the introductory textbook Drugs, Society and Human Behavior with Charles Kucerer. His most recent book is called Drug Use for Grown Ups, and that's the focus of my conversation today with Carl. I really like Carla, have a great respect for him as a scientist as well as really just a cool dude.

I loved nerding out with him about the latest data and facts surrounding the responsible use of drugs and how people, especially adults, can have more responsible use of drugs. But also ways in which society, policies, and the police have created a lot of racist narratives that are not grounded in the actual facts of drug use. So what I really like about this episode is being able to really dive into the realities of the matter, and a lot

of things blew my mind. You know, a lot of things might surprise you too, a lot of things you took for granted that you thought you knew about drug use.

And just how many people actually get addicted to drugs by itself is very very few in number compared to the narratives we learn, And instead we talk about the actual predictive factors that are most likely to make people addicted drugs, and also, very importantly, we discuss very concrete changes we can make in our society to lessen deaths and lessen the discrimination and stigmatization we have surrounding drug use among adults. So I really hope you enjoy this

conversation as much as I did. And without further ado, I bring you Carl Hart Ah heart so great to have you on the Psychology Podcast. I'm happy to be here, man. Yeah, yeah, you're you're I've been following your career and it's been it's been credible, and I love your spirit you bring to the field, and you're so evidence based, data based. I want to kind of trace a little bit of the development of this, thinking, what was your PhD topic?

Maybe we'll start there. I'm trying to think we do we start when you're ten or now, let's start with your PhD topic? What was your PhD? So what was the what was the title of your PhD? The title of my PhD was something like nicotine effects on L channel calcium L type channels and it has something related to dopamine. Is a long title. You you know how

we do those low complicated titles. That explains everything. But the bottom line is that I was looking at the effects of nicotine behaviors of rat and the effect in the nucleus that cumbents on dopamine cells. So why do you get interested in that topic? In particular? I was interested in drugs, so called drugs of abuse, and I wanted to know something about the new biology. And so

one of the things that hadn't been done. A lot of things had been done, but one of the things that hadn't been done that was related to the lab which I was in this's got Charlie Casir. He was doing work with nicotine, but he hadn't really delved into the new biology as well. He certainly hadn't focused on L type calcium channels, and he hadn't focused on nucleus that comments dopamine, and so it was an area that that can make a contribution that he hadn't fully investigated.

So it was a good place for me to start to learn some things. Yeah, for sure. For sure. And what was the predominant narrative at that time that you've since challenged? Because I saw a quote you said something. I was ignorant. I was believing anecdote. You said that in one of your talks, and I thought that was really interesting. Yeah, you know, there was a lot that I believe. It was a lot that even my PhD Ad buys a Charlie Kasier believe. But you know, I

would be remiss if I didn't say that. You know, he's the guy who really got me to start thinking about challenging things that were taken as fact when we had limited data. He's the guy who really started me on this path. There's just so much. I mean, this whole notion, for example, I said that I had started out studying so called drugs abuse. I mean just that term. The field still uses that term. It's a bias term, you know, as the only thing that these drugs do

are be abused. And then you say, well, even what is that rather than just thinking them about them as any other psychoactives or compounds. You can say psychoactive compounds that humans take or whatever. But drugs have abused. That's just one of the soda notions. Another notion was that most of the people who use any of these drugs cocaine, nicotine, alcohol, heroin, whatever the drug, most of the people who use these drugs do not become addicted. That is, they do not

meet criteria for substance use disorder. The vast majority use these drugs without a problem. But yet when we talk about these drugs, we talk about them as if everybody who uses these drugs will meet criteria for substance use disorder. Yeah. Wow, well, those are some dynamite findings I still see in the research literature. I see things like drug addiction is a brain disease. Even recently, you know, I came across that kind of term that must make your skin crawl, like

when you see that in the abstract. Yeah, you know it's a The drug addiction is a brain disease. Has become more of a political issue than a science issue. Now, if we can go back to nineteen eighty four, when I believe it was nineteen eighty four when the National Institute on Drug Abuse became subsumed under the National Institutes of Health, the National Institutes of Hell. Their mission is to bring to bear to science to help solve health

related problems in the country. And we can see the value in that when we think about the Institute on Heart and Blood and lung. You know you want them working on heart disease and those sort of issues. Cancer Institute, you want cancer that institute working on cancer because those

are really serious health problem. Now you take you bring the National Ascuse of drug Abuse within the Instruth's Health, the mission for the National Institute of the Drug Abuse becomes to focus on pathology, drug addiction and so forth. Most of the people who use these drugs that you want to learn information about do not meet criteria for pathology,

and so you're starting out with this bias mission. And that would be okay as long as you inform people that your focus is exclusively on pathology and not these other things. But what has happened is that the National Institute on Drug Abuse acts as if everything that they publish and might mind you, they fund like eighty percent of the world's research in this area with this bias focus, but they act as if it's the only sort of outcome related to these drugs. And that's just that's not true.

Now when we think about the brain disease model of drug addiction, that whole sort of promulgation that was done in order to get more money from Congress. Because if you have this biological concern, then you have something that you can put your finger on. Is not a moral failing. And we're not saying it is a moral failing or it's not some nebulous sort of thing. It's a real

biological thing. Now Congress is more likely to say, oh, this is a serious problem, we have to fund this, we have to put more money into this, and so it becomes this political issue. And the problem is that many of the scientists, even who studied is don't realize it's a political issue, and they don't realize that the data does not support that position. And so in twenty twelve, I published a paper in Neuropsychopharmacology where I did a

review of the neural imaging studies that look at methaphetamine users. Now, if you're going to see some if you're going to see some neural toxicity, you would see it in the amphetamines, because the amphetamines are perhaps the best of these drugs in terms of causing neurotoxicity at large doses, doses far larger than what humans take. So if you're going to see some neurotoxicity, you would see it first with the amphetamine.

And so I did a literature review assessing the literature looking for some kind of neuropathology after people have been taking methamphetamine for some extended period of time, to see if I could find evidence of this brain disease. And I didn't find any evidence of this, and so and I published that and said this, you know, so it's maddening when I hear people continue to say this. I mean, I'm not saying that we will never find any evidence of it, but at this present time in our history,

we don't have any evidence of it in humans at least. Yeah, that was my fair. Papers that you've been is cognitive functioning and pain and metafite I can't say that word menifet users metamine users a critical review. Yeah, and you controlled for age and education. I noticed in that paper and you still found they score within the normal range

of functioning using PET imaging. This idea of cognitive function is very interesting and near and dear to my own heart, because I'm an intelligence researcher, and uh, you know, we miss all sorts of battery of tests and things to measure cognitive functioning. When we use the phrase cognitive functioning, does that include things like working memory? Does that include things like vocabulary? Uh, sort of a short term memory?

Recall your ability to like repeat back something backwards and forwards. Yeah? Yeah, yeah, it includes all of that. It includes something as simple as reaction time, and things more complex like cognitive flexibility. Can people ship sets? I mean it includes all of those things. Wow, wow, because that's not what I was told when I was a kid. I was told say no to drugs and say no to sex. Well, first of all, you shouldn't really be talking about drugs with kids.

I mean, you know, this is another one of these stupid things that we do in society. I mean, you think about sex education at what age is appropriate for sex education. I think about my own kids. I have kids, and we've dealt with these issues as they came up, and so they weren't some special issue that we set aside. But let's just say high school for example, if you're going to talk about drugs in high school and say, okay, that might be appropriate. The three drugs that you're going

to talk about are alcohol, tobacco, and cannabis. Those are the drugs that people in high school predominantly use. When you think about something like cocaine opioids, it's less than one percent of the high school students who are going to be using those drugs. And so, given that knowledge that we've had for fifty years or so, you want to just make sure that people be able to identify the signs when people are having trouble or problems, and

think about some like alcohol poisoning. If someone is starting to exhibit the signs of alcohol poisoning, you want to make sure that people are able to clear the airway if they passed out, because if they start to vomit, you don't want them to choke on their vomit. Those kind of things. If then you think it's about something like tobacco. In New York City and my kids, it seems like damnly everyone has asthma, and so you want

to make sure that people have their inhaler. You want to make sure that they are able to recognize the signs of asthma if they are smoking, whether it's tobacco, cannabis, or any of those things. Another thing related to cannabis is, like novice, inexperienced users, oftentimes they overdo it and then they get suspicious, anxious, paranoid. You want to make sure that people who are around them stay calm and the drug will float away from the receptor and they will

return back to normal. So you want to just want to you just want to make sure that your children know how to recognize these signs in order to be able to help their friends, or god forbid it, even if they get in trouble, they don't panic. That's the major problem that people panic, and that's it. That's what drug education at that level should consists of. Beyond that, you don't want anybody really talking to your kids about drugs. Yeah, there's a reason why the title of your book is

Drug Use for grown Ups. Do you see you see do you see? Thank you? Bro? That's right. I'm a fan. I'm a fan. But drug use for grown ups is about the responsible use of drugs. If you're going to be an adult about it, and you're going to be responsible, and you're going to and you're going to use it, what are the things that you should be doing to really minimize harm to yourself and others? Right? You know, I just want to say something about drug addiction, just

for a second. I'll do it in the book. I make it clear that this isn't a book about drug addiction because there's this disproportionate focus on a day and I didn't want to contribute to that. When it comes to drug addiction, if we know that the vast majority of users of any drug do not meet criteria for addiction, then it tells us we have to look beyond a drug in order to try and understand what's going on with addiction. And those things are we've known in psychology forever.

They are psychosocial predominantly. You know whether or not the person is being subjected to chronic, unrealistic expectations. They've recently lost a job, they're no longer they no longer have good standing in their community. A wide range of did these factors, including co occurring psychiatric illnesses. Now, once you have taken care of those sort of things and you don't meet criteria or you're not at risk for those

kind of things. When I think about drug use for grown ups, I think about how people use alcohol in our society. The majority of people. You use alcohol in your moments of relaxation, in your moments of in your myopic moments, if this is your time. The same is true with any of these other drugs. The problem with these other drugs is that you don't you're not as

sure about the quality control issue. So you got if you're not sure what dose you have, whether or not you actually have what the person told you that you have. So you have to make sure those things are taken

care of too. If you've got all of those things satisfied, you take the appropriate doses in the appropriate setting of set aside the time to do these things, just like you set aside time to watch, say some sporting event, the Super Bowl, March, Madness Championship, whatever it is you set aside the time to do the same is true with drug use. And if you do all of those kind of things, you are more likely to have a more positive experience, as I try to describe in the book.

In the book, I tried to show people what it's like to be able to take drugs and enjoy the experience and do it in a responsible way, just like we do most things in our life. I mean, sometimes sometimes we are less responsible than others, but most of the time we do. We handle these things responsibly. Like if we look at our how on our highways, driving an automobile can really be a dangerous activity, but most

of us do that in a responsible way. Yeah, And we don't ban automobiles just because there's a lot of desks. I mean, people eat food irresponsibly, absolutely and get all sorts of diseases from it, and we don't ban food absolutely. Great point, great point, Yeah, thank you, thank you. But it's very clear to me that you're not advocating for drugs. It's not like you're you know, do people misinterpret your

work in that way? Do you have people who are like petitioning, They're like cow heard, it is not good for society because he's advocating drugs. But it's clear to me you're not doing that, but do you have people who've mis interpret Yeah, thank you for bringing that up. That's been one of the more painful things with the release of this book. I mean, this book has so really well and so I'm happy about that, but you

know how it is. You know, you focus on sometimes on the criticism, even if the criticism is relatively small. But that's been one of the criticissm that you just point out that I'm somehow promoting drug use, and you know, the book is really trying to promote love and treating people's humanity in the same way you treat your own.

That's the major message. And it's been disheartening when people, some people almost seems like intentionally distort the message to say, oh, you're promoting drugs and somehow trying to destroy society, when in fact, I'm saying that we want everyone to enjoy themselves while they're here, and we want to make sure we respect everyone's humanity and autonomy. And I try to like use the Declaration of Independence, at least the birth rights and the Declaration of Independence to help people see

that we're all guaranteed these birth rights. It's self evident that I have life liberty, and the pursuit of happiness. Those are my birth rights, and so I was trying to trying to ask people to extend that to everyone in our society, so long as they are not preventing other folks from enjoying their birthrights. And so when people distort the message, it breaks my heart. And that certainly

has happened at some point. Well, we just the best we can do is just keep reiterating it, re reiterating it, and hopefully this podcast will help queer that up as well. It's very clear to me you're trying to help people pursue happiness in their own way. I think that me and you are aligned in terms of of appreciating self actualization, the self of the unique self actus journey of an individual. That was what my latest book was about. We're connected

in that. Yeah, absolutely, Yeah. And I found this other paper you're really really relevant in us understanding what's going on here. It's called alternative reinforcers differentially modify cocaine self administration by humans and not as pithy as as drug use for grown ups. But academic papers don't tend to be as pithy. But what I really like about this

paper is. It shows that well, if you want people to change their behaviors in a lot of ways, you have to give them a better, more give them better alternative. And we have a lot of people who are really suffering in this world, like really really poor, really in environments, neighborhoods. They don't know if they're going to live the next day.

And you can kind of actually think of drug use as rational in some cases, again not advocating for it, but actually quite rational given the lack of alternatives to get through the day. Yeah, no, you you hit it on the head. This is just straight behaviorism, you know. It's a I think it's still a powerful way to explain behavior. We think about the options that we have in our society we as a as an individual. For example, my kids I when I raised them, I raised them

according to these principles. They have video games, they have their work at school, they have friends, significant others, all of these sort of things, and so we present these options like, Okay, if you do well at school, all right, then you might then I'll buy you a video game, or you have you can play your video game. These are the kind of options that we present to them in order to shape their behavior. I mean, this is

how the world works. And so that study that you talked about, we just wanted to do a simple study to see if people who smoke crack cocaine their behavior conformed or comported with just typical behavior. They the same principles that were underline my behavior doesn't do they underlie their behavior. So we presented them with an attractive alternative money in the case that the paper that you discussed, we presented them with an option five dollars or a

head of cocaine. They took drug and money about the same of the same number of occasions. In a follow up study, we took people and we said, okay, we're going to have five dollars be an option as well as twenty dollars be an option. When we increased the dose to twenty dollars, they took money on nearly every occasion, indicating that their behavior in both of these studies was as rational as most of our behavior. And so people said, well,

they'll take drugs on every occasion no matter what. No, their behavior comported with the regular principles of behavior, and so that was important to show. Even though people had shown this repeatedly in laboratory animals, in rats and non human primates, and then subsequently people start to show this

in humans. Wow. Wow. I do think this is related to the argument you've made that a lot of drugs are banned in America due to racism, and I do think this is related, right, Like there are specific populations that are targeted. It seems you say that, Yeah, you say there's a lot of money in misleading people about drugs.

Can you kind of elaborate on that a little bit. Yeah, So, our first national drug laws that were enacted that restrict drugs were enacted in nineteen fourteen under this thing called the Harrison Act. The Harrison Act was at a time when the Congress believe really strongly believed in states rights, so they weren't trying to enact federal laws to restrict drugs. But what happened was that they we had all of these reports first Chinese people, the Chinese people and the

opium dens. They owned opium dens and they were doing well, but then we started having these reports about white women going into these opium dens being corrupted by the Chinese, and also the Chinese businessmen were doing well, which made many of the white businessmen in these cities, San Francisco and New York be jealous, and so they enacted local laws to restrict these dens and to prevent white people from going into the Chinese owned den. And then about

the same time cocaine and black people. There were stories that were said that black men were causing white were seducing white women into prostitution with cocaine. And they were also saying that black men were they became impervious to thirty two caliber weapons, and so you had to have a larger caliber bullet in order to kill black men who were crazed on cocaine. All of these things were exaggerations and untrue, but they led to the passage of

that first drug law. And then subsequently with cannabis, Mexican Americans, Black Americans, they were saying misbehaved, they thought that they were as good as white people when they spoke cannabis. In nineteen thirty seven, they essentially banned cannabis for these reasons. And so when we say that our drug laws, they resulted from racism more so than pharmacology. This is what

we mean. But I want to be clear here to say that those laws would not only supported by white people, they were also supported by the racial minority groups that were targeted. So you would have like black, middle to upper class people in support of these laws. This thing we call politics of respectability, showing the white population that we're with you, we're well, we share your view, that we're not like those negroes. And so that happened then

and that happens even today. So I want people to understand that it's these laws are not only supported by the way to majority, but it's also supported by the same racial groups that are being subjugated by these laws. It must not be easy collecting being a scientist in such a political mindfield of a topic. You know, it's a little bit different than like Stone, who's like my life is to study the visual cortex of the You know, no one cares about the BA forty seven or what.

But but I know, I mean, I think, I mean, I I did it. Yeah, that's fascinating what you do and you can do it and you learn all of these things, and I think a lot of people are interested in it, and then you don't get called political. I think that that's cool. You know what I do at some level, I have to think about, like, all right, my heroes, I think we're not long from April fourth.

April fourth, it's the day that Martin Luther King was killed fifty four years ago, and I think about, like when he died, his popularity was in the garbage in the tank, that he was not a popular people, a person most Americans hated Martin Luther King. I mean, now we have this revisionist sort of history now that he's gone, and we can sanitize his sort of history and only focused on I have a dream and not the other

things that he really advocated for. So I have to think about people like him, like my heroes, when they were here, they weren't popular and people didn't really want to hear what they have to say. And I have to constantly check myself, check the data and make sure that I am on the right side of the data. And so if A constantly do these kind of things, I'm okay, and then history will do what it will.

But I know I have to have some integrity, and I know that if I am thinking about everybody else's humanity like I think about my own, that's a good start. And that's where I try to say, I really respect that, like, I truly respect that integrity. You've argued that we need more high profile, responsible, sensible adults who do who do drugs to come out of the closet. You know, like you're a fascinating combination of things. You're the first tenured

African American Columbia professor. Is that true? But you know there is a certainly on the main campus. So we have the medical campus, and we have so on the medical campus there there might have been somebody who was tenured before me, But I don't know what ecology department. Uh, I'm in psychology and psychiatry. I'm in the medical and and and and the arch and science campus and an arch and science campus. You know, tenure is where you

have your salary paid and that sort of thing. On the medical campus, it has something to do with you get paid if you bring in grants and and so it's I don't know exactly how that works on the medical campus, but certainly on the main campus, on the main campus. And I know you've said in a talk You're like, well, don't congratulate me for that. That's that's actually a tragedy. You know that we haven't had more

and I really appreciated how you responded. I saw some talk where people started up, you know, a video standing ovation for you, like, well up, like we need thank you for saying that. Yeah, yeah, no, I see you, brother, I see I see you. And so I've I've in my own way done that. I've I've come out as loving edibles. I even tweet about it. I actually accidentally did way too much the other day. I had a

whole Twitter thread. I'll share it with you. I thought I was doing a five mega gram snickerdoodle and I accidentally did it. Did you see that? Union had been to see that thread, did you? And I accidentally did one hundred milligrams And that was and I actually went to the er because I was having a panic attack over it, and and thedoctors. Everyone found it very funny.

But that's that's an important that's an important experience because this is the thing that I tell kids that one you know, drugs interact would have recept there and they would eventually float away and you're gonna be cool. It might take some time, it might take as much as twenty four hours, but you're going to be chill. And if people just understand that, it'll be okay. Absolutely, and this is part of the story and I will absolutely

share this this Twitter third with you. There was a moment where I just surrendered to my reality, like I was definitely hallucinating, like there was the four was pulsating and everything. And I have never experienced that on on marijuana before. I didn't even know that was possible on my own. I didn't know that was possible, but it is. I found out it's possible. But there was a moment where I just leaned into it. I was like, I'm gonna be curious about it and I'm going to tweet

about tomorrow and I was fine. I was absolutely fine. It's interesting how much the mind can calm you down, even in some of these kinds of extreme states of consciousness, like self talk. It's still valuable even in these states, right, absolutely, you know that experience. I hope you write about it more to explain the help because I think so many people will benefit from that, right, I mean, particularly as

we get older. I know, like now I'm fifty five, and so one of my comprehensive questions for my PhD was this issue of drug absorption and distribution as you get older, because the liver function is not what it used to be at twenty years old, So that means that more drug will get into the bloodstream, meaning that you need to take less of it than you previously

had to. And so like something like oral THAC for me, I would I would have to say what really low doses or else I might have those kind of experiences. And so these are the kind of things that we want to teach people. As you get older, you're dosing and drug use should also change, just like other things are changing. And we don't do a good job of

teaching people these things in our society. And that's one of the things that perhaps that's the next book, teach people about these changes that occur and how to make sure you keep yourself safe. The thing is, we need better packaging. This was a complete accident. I'm used to usually buying my five milligrams Snickerdooles with like ten in one package. As I bit down into most of this thing, I then realized there's no other snicker Doodles in the bag,

and I'm like, well, that's weird. Usually there's ten, And then I realized it's one hundred milligrams per snickerdoodle. And there's only one. There was only one in the bag, So that was that wasn't clear, That wasn't Yeah, that's a that's a really good point. Yeah, that that that when they're may I hope you shared it with the manufacturer, with the store because I call I call med men

or met with medmen. I think that Yeah, yeah, no, that's that's an excellent point because yeah, at some level I think about I mean, you might need that much for I don't know patients who have extensive experience, but for typical people that's quite a bit. And so maybe that should be labeled medical so people will know that that's that's not for you, the typical person, like a red sign of like extremely high dosed, just so you know,

differentiated some way. Cool. This does relate to a lot to some points you make about the need to regulate these things better. Other countries do a better job than America. They have drug checking facilities that are much better. Right, what can we do in America to regulate these things better?

So the cannabis thing that we just talked about, that was in a legal state and you can go and buy it, and now you can talk to the manu in California, so you can also talk to the folks who regulate packaging and then they can deal with that.

But oftentimes with other drugs there's none of that. I mean with other drugs where you don't where it's not legal, like cannabis is in California and some other places, you have none of that, and so people buy drugs from I don't know their dealer or the internet or wherever,

and they don't know exactly what they're getting. In a place like Spain, Austria, the Netherlands, even Columbia, they can submit small samples ten milligrams or so of their drug to these drug checking facilities and they can do this anonymously, and it's also free, and they get a print out of all the chemicals that are contained in their little sample, and they comes with the dose, the concentrations, amount of those chemicals in this uh in the in their sample,

and so they are informed about what is actually there. In the United States, we have that technology, but we just haven't made it available to the general public, in large part because we still operate under this puritanical sort of view that if we do that, then we're condoning encouraging drug use. Which is the same silly argument we said about condoms. Uh, if we hand out condoms, then

we're condoning premarital sex. It's the same argument. And so in the book I describe talking with this woman, Lena Lina Wynn. She was the health commissioner of Baltimore at the time. Lena Wynn had She went on to become the head of Plant Parenthood. They eventually they got rid of her relatively quickly, and now she's like a public

intellectual as a physician. But I talked to her about having drug checking facilities in Baltimore at the time when Baltimore was experiencing what they thought were in large rates of drug overdoses, and so as the health commissioner, I said, you know, this is one way to deal with this. Have drug checking facility and so people can know what's

in their substance. So if they get something like fentanil or some other substance that's more potent than heroin that they're seeking, they will at least know and not overdo it and take too much. She essentially ignored me, and to this day, you know, we don't have drug checking, not officially anywhere in the United States. Meanwhile, we are lamenting the fact that we have drug overdoses and when this simple sort of procedure can take care of, will

address a lot of those drug overdoses. And so that's been one of those another one of those discouraging, disheartening things that I certainly experience as I try and get this simple message across the public health officials. This makes me mad. You don't want to see me mad. No, that was a whole whole corser. No, this this is

making me really upset. You know. It feels like in our in American society, we either stigmatize drug users or we treat them like they're Snoop Dogg, like they're cool but not smart, you know, no offense, no offense to

Snoop Dogg. No. I feel it seems like there's a bi modal distribution of how we treat drug users, right, But there's a middle ground here, Like most people probably in America who are drug users are probably middle class, you know, like they don't brag about it, you know, they they use it somewhat responsibly in their life to

bring their life more joy and pleasure. Her. You just you just hit on so much in that little that statement, you Meyban, you hit it like you said no disrespect with Snoop Dogg, because you know, I think, yeah, I think he's brilliant. Actually I think he's it's amazing historic. But you hit on so much there because I mean, we think about the illicit drug trade. It's a multi billion dollar industry. So when we say, well, who are the users, they can't be poor people. If it's a

multi billion dollar industry. The people who are behind you drugs are middle to upper class people. They're the only ones who could support such an industry. So we know

that for a fact. That's one and two. When we think about how we caricature drug users, we typically caricature them as these poor, degenerate, lost souls that are in need of our help, or in some extreme cases, just these ultra cool people who are taking the sanctioned drugs like cannabis is kind of sanctioned cool now, and some psychedelics now, like psilocybin, Okay, that's sanctioned cool today, but

like heroin, that's always in the degenerate. So the class and so those tropes, the whole society is invested in those tropes. When we think about people who write movies without those tropes, many of the movies that contain drugs or drug use in it, they would not work because oftentimes, if you think about any movie you see related to drugs,

the drug related characters are never developed. All you say is that, oh, he's a drug dealer, therefore he's bad, and you're bringing all the cultural baggage with you to that character. So the writer does not have to develop that character. And we are supposed to believe these incredible things about the drugs, and so the writers are invested in his trope. Of course, law enforcement is invested in

this trope. When you think about all of the cop shows, they always show the drug sort of people as being the bad people. Of course the common people are the good people. The whole entire society is invested in this trope. And this trope is getting people killed. And that's the thing that I've been trying to point out. Yeah, and not just oh no no please please you got it? No please no, I definitely feel you, And I would

even go step further. It seems like the uh, the drug users in these movies are usually always Hispanic or black like. It just seems like so like so many of these movies just fall into some sort of stereotype that like it's like it never dawned in a script write or to like just break out of it. That hard to rewrite the script. Yeah, but you know, like now, of course with the opioids, they are shifting to make

sure that the drug users are white. When you think about I just came from a Tulsa, Oklahoma, one of my favorite places at some level. And and Oklahoma of course as a large white population. Even in their prison they're like one of the they're like the top prisoner prison. They have more prisons per capita than any other place

in the United States, I believe. And places like Oklahoma they ran out of a minority like Native Americans and black people to arrest, so they're arresting white folks there at in large numbers. And so there are a number of places like that, even in places like Michigan and a lot of these or of rustpelt places where jobs went away, the factories went away and the only sort of jobs are in law enforcement, and then they run out of minority people to arrest, and so they're arresting

for white people. And so we're all in the same bag. Now as a result of this sort of out of control machine, in effect, the war on drugs has become a jobs program for many people that were those factories went away, and now poor white people are paying the price, just like minorities have been paying for some period of time. And so you will see this if you go to places like the Rust Bill. Thank you for that clarification.

That is so interesting. You know, we had talked a little about the effects of drugs on cognitive functioning, but I'm also interested individual difference predictors that predict whether or not you use drugs in the first place. So kind of not post but pre I came across some data showing that IQ. Higher IQ is correlated with greater alcohol consumption, use, higher tobacco use, and among British children, more likely to

consume illegal drugs. So that doesn't fit a narrative. That doesn't fit a narrative, does it Well, it might depend on if it's just more likely to have tried a drug. So like when we think about tobacco, for example, some of the most consistent data shows that the more education you have, the less likely that you are to be a smoker. Because like as we got better education about tobacco. People with more education just don't smoke on a regular basis.

But if we're talking about simply trying a drug, people who are maybe have a higher IQ might be more likely to try it because they are might they made me more likely to be suspicious of the messages from government sources about drugs, and so they want to know for themselves somebody like me. I grew up as an athlete, and I was quite obedient, and which I never took a drug. I was dumb and obedient, you know those, and so I was not one of those people who

did any drugs. But as I got more information, more education, and learn more about our government misleading people in certain areas, I was then I was one of those candidates. When more education, who's more likely to try a drug? Yeah? Okay, great distinction between just trying drug and addiction. So let's let's double click on addiction for a second. You say people are not dying because of drugs per se, but because of ignorance. But this is solvable. You say this

is solvable. You talk about you say addiction isn't the norm, but is predictable. Yeah, really like that as well. So let's talk about some of these these things. I guess there's two separate isations here. There's well that what are the predictable predictable factors topic? And then there's the topic of how is it solvable? So let's start with a

predictable factors topic. One thing I think is replicable in the literature that I that I found is comorbidity of various psychiatric disorders does make it more well likely that you'll become addicted to drugs, particularly opioids? Is that is that correct? Does that still hold up in the literature? You hit it on the head. That's it. People who are suffering from depression, anxiety, schizophrenia, you name it. They're far more likely to meet criteria for substance USAE order

than people who are not. That's one of the major predictable predicting predictable factors. Another one is think about people who have chronic unrealistic expectations heat on them. I think about celebrities, particularly childhood stars, as they grow up throughout life, they have been taking care of their whole family, whole extended family, and if their career wanes or they might be having no problem financial problems such that they can

no longer maintain that sort of level of income. Imagine the stress that will be put on them because then people say, well, you know what about wealthy people who have who meet criteria for addiction. Yeah, we have to think about all of the unrealistic expectations heat on some of these people, and they're more likely also to be to meet criteria for dependence. And I think about the rust belt in the United States where all those jobs went away. People were making six figure incomes and they

were respected members of their communities. Those factories went away, and then so too that their sort of positive regard or that positive standing in that community. All of those things make you more likely to meet criteria not only for drug addiction, but other sort of problems that you might have in your life as a result. And so what it tells us is that we have to take

care of the psychosocial environment. If we're concerned about drug addiction, if we're concerned that people in our society are not doing well, we have to take care of the environment. And that's not as sexy as identifying a gene or a specific type of neuron. That's not as sexy. It requires actual work. And so That's why we haven't so much focused on that many of us who study drugs, because it's not as sexy couple of things that we can get this fixable drug consumption rooms sounds like a

very viable option. And drug purity testing services. Can you talk about some of those? Are we hopefully lacking those in America? Yeah? Let's think about drug overdoses for example. The things that we know about drug overdoses, which you never see in the headlines, but I point this out in the book, is most of the people who die from a drug related overdose have multiple drugs in their system at the time of their death. And so what it tells you is that it's rare or is a

lot more or less likely. It's a lot less likely that people will die with only one drug in their system. So what it tells you is that you want to figure out the drug combinations that become toxic. So if you take something like an opioid heroin or some other opioid e. Fentanel, and you mix it with another set of alcohol of benzodazepine like xanax, or even with pain nerve pain medications like gabapin nor neronto or even older

ana histamines. They they they also induce sleep. So you mix these kind of medications, these drugs together, it increased the likelihood that you might have respiratory depression. So you try and that you're part of your education. You tell people don't mix certain sedatives, but you don't have don't have the messaging don't minx drugs, because people use drugs

will automatically ignore that messaging. Because we know that some drug combinations, like, for example, oh, cocaine and heroin together, that's a nice speedball and people like that effect, and that effect certainly is not as deadly, or that combination is certainly not as deadly as say, heroe and promethazine, which is an older and a histamine that induces quite a bit of sleep. So you have to be specific

in your messaging about these drug combinations. That's what Another one is just simply those drug checking facilities that will go a long way if people actually knew what they were getting. Now, when we think about the safe or the supervised consumption rooms, the thing that I worry about there is obviously it's a good thing to have if you have nothing else. My concern there is that when people have those or they fight for those things. They

think that they have done all of the work. First of all, the only people who will go to a supervised consumption facility are people who have no homes. And like me, I would never go to and use drugs in a public setting like that. I would like to have it in the privacy of my own home and a setting which I'm comfortable. But if I had no home, I would have to go there. So what it tells us that we really should be working on housing, and

that's what we That's where the real problem is. My concern is that people are treating these supervised consumption facilities as if they are solutions to unhoused people. We really need to make sure they have housing. Look, you're raising a lot of really good points. I really want to think this through with you for a second, because you know you can have people start to make the argument, well, like, Carl, are you ignoring personal responsibility? Are you ignoring the role

that personal responsibility takes in drug overdoses and addiction? And what is interesting by that argument because it's like, on the one hand, your whole book is speaking to the individual. On the one hand, your whole book is saying you can take personal responsibility to a degree and have a responsible drug use. But then the other hand, you're talking about all these environmental things we can change that can

really help a person. The problem is when people have either or thinking right, when they're like, you know, you have the big one of the other. And also, I just want to put a wrench in this and say, well, if comorbidity of mental illnesses do play a role, that is an internal factor that does have a pretty substantial heritability, and even if so, that suggests that, like it's still beyond the person's control to a certain degree whether or

not they're going to have and developed mental illnesses. And then you throw in the mix mental illness and poverty. You throw these things into a system. I love systems thinking. That's why I like to think of it. And you have you have almost like no free will of this individual too, if drug is the only option in their life to a certain degree. So I just wanted to riff with you about all this. Yeah, no, yeah, when

you so. One of the reasons that we have this sort of a brain disease model of addiction is because there's a there is a concern that people have and that if we if it's not a brain disease, then that that means you're blaming the victim, you know. Then, so what you're pointing out is that no, you can still look at these other sort of factors and you can see that it's not blaming the victim. There are all kinds of other ways that we can intervene and

we're not blaming the victim. But ultimately, we as individuals, we ultimately we have some responsibility for our life. I mean that we can never get away from that because we're going to feel the consequences more than the other folks, because these are the consequences to us. And so there's an interplay with all of these things. And you, I think you summarize it better than me well when you

pointed out all of these things. But I absolutely agree. Yeah, I just see a lot of parallels between the same arguments being made about iq as and stratification of society and how personal responsibility. All the same arguments keep you can just generalize them to every specific field you see the same fights being absolutely absolutely you say our moralism

is killing us. That's something you've said. I love that, and that suggests maybe we need to tone down the moral superiority of non drug users, right like the like you know, the stigmatization of drug users who are using it, responsibility, even irresponsibly stigmatizing them and having more compassion for the factors that led to that decision. Yeah, you think about it. You know, we have done such a good job of manipulating the public thinking around drugs that we don't even

think about the main reason that people use drugs. Most people use drugs in order to alter their consciousness and in order to feel better, in order to feel better about other people. I think about like in the book to describe my use of media, of these drugs and feeling more magnanimous, more forgiving, more hopeful. All of these things are pro social things that we want to encourage, And when we think of that, it's like, why would

you not want people to experience these things. We've been so good at manipulating people to move away from those main sort of reasons that people take drugs into automatically going to this frame that the drugs are going to imprison them, and that rarely is a thing that happens, whereas these other pro social things are far more likely. I know, I feel much more hopeful about our society, about the people in our society at the having take something like MDMA or even heroin than I am most times,

and then I can think about things differently. I think about how my behavior might have negatively impacted someone else, and make sure that I apologize. Is a tone for that, make sure I don't do that sort of thing anymore. All of these things are what I do when I am maybe psychoactively altered. I want to make sure that I'm taking care of our environment, our people, all of these things. Yes, yes, I love that. What's what drugs

do you use? In the book? I describe the stimulants, from cocaine to uh, the amphetamines, also the opioids, from heroin to some like oxycon cotton or oxy codone, cannabis of course, So I describe all of these drugs, some of the psychedelics. I've done things like two c b U. Yeah.

So I heroin, Oh yeah, that's an opioid. Yeah. So the heroin thing, you know, I put that in the prologue up front, so I knew it would be an attention grabber, and I said that, you know, I'm a regular heroin user, not defining regular and regular just meant at regular intervals, so it could be once a week, once a month, once every six months, once a year, depending on, you know, whether I can get it, which

in the United I mean get good pure heroin. But what that turned into in the press was I shoot heroin every day. Of course, you know, I no one. I can't do that and then accomplish all the things that I do. And so the reason why I pointed out that I used all these drugs because I wanted to be an example. One. I wanted to be an example of getting out of the closet so we can change this awful narrative about what a drug user look like.

I figured, with someone with my accomplishments, it would be hard for the press or people to disparage me or to smirch myation. But sure enough they tried. Another reason I stayed at my drug Youth up front is because I wanted to align myself with the people who were being demigrated in our society. I wanted to be with them. I wanted people to know that you're not alone, and I wanted people to get out of the closet so they also could align themselves with those people who are

being denigrated in our society. I love it. I love it. I'll join you. I'll join you on that, on that cause I've been I've just started started to experiment with some high end the macrodosing of psilocybin, microdosing macro dos, you know, like for five hundred programs, and I'm just working my way up. But to me, it's just all about exploration. And you know, I am. I have very high openness to experience personality scores. I imagine you do

as well. You know, you could be a highly intelligent person. High openest experience, try lots of things responsibily doesn't make you a horrible human being. Yeah, So who are some of your greatest influences outside of psychology? Because I see Bob Marley behind you, Is that right? Yeah? Bob Momley is actually Bob Marley, I should say, but I see a yeah, one of the albums. I'm making a drug joke. You see, Bob is always over my show. But by the way, you know, I see I see Bob Marley

right now, I'm seeing Bob. No, was that is that a disc? Is that like a record? A record? Yeah? That's a record? You know, that's the old vinyl. Yeah, yeah, yeah, No. So Bob is one of my biggest influence because you know, I did four years in the Air Force eighty four to eighty eight, and during that time, you know, I grew up in Miami, and so my grandmother it's from the Caribbean. Her father's Jamaican, her mother Behemian. She's Bahamian,

and so we had a lot of Caribbean influence. But when I went to the Air Force, I really got into like more of my Caribbean sort of upbringing. And Bob his music and lyrics helped me to start questioning our society and that's where I really began to start thinking. And then you know, other people Gil Scott Herron, another artist, musician, even I mean like writers, people like Upton Sinclair. The Jungle of that book was really important. James Baldwin one

of my favorite writers. Yeah, you know, many people James Bowen has seen a resurgence in popularity here recently. But one of the things that current or contemporary contemporary writers don't write about Baldwin is that Baldwin was arguing for drug legalization as early as nineteen eighty six, and nobody really mentions that I pointed it out in a new book, But I hope people understand like Baldwin predicted this sort of awful war on drugs and the imprisonment of all

of these poor people. He predicted this before it happening, and he was saying that the only thing that you're going to get is poor people behind bars, because wealthy people are going to continue to use drugs and be fine, but our poor people will be behind bars, and a lot of people, law enforcement and others will make a lot of money on this war on drugs. And that's exactly what happened. He was so prescient in so many ways,

such a genius. So we have now two Columbia professors who've come out of the closet, Carl Hart and Scott Barry Kaufman. So we need to rally the troops in the psychology there. We know, we see you Mary soon not objeking out. There's no one called Mary Sue in her department. But I'm not mentioning any picar but no, we see you, you know, But anyway, I love it. Look, I will thank you so much for your time today,

and let's let's grab a coffee on campus sometime. Absolutely, Man, will you please hit me up and let's do it. I would love to. I really appreciate it, and thank you man for even taking the time to check out the work. I really appreciate it. Likewise, keep it up, keep it up, all right, Take care, bro. Thanks for

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