In Dr. Carl L. Hart's enlightening book Drug Use for Grown-Ups, the professor of psychology shares the findings of his research into the effects of recreational drugs and argues that their illegality is much more harmful than the drugs themselves. We chatted with Dr. Hart about the war on drugs, the stigma of being a drug user and the pursuit of happiness in the United States.
Drug Use for Grown-Ups sets out to challenge many myths and cultural norms around drug use and drug users. What’s the most important thing you hope readers will take away from your book?
The complete title of my book is Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear. The most vital arguments of the book focus on the concept of liberty as guaranteed by our Declaration of Independence. The declaration states that each of us is endowed with certain unalienable rights, including life, liberty and the pursuit of happiness, and that governments are created for the purpose of protecting these rights. I use the topic of drug use—because it’s my area of expertise—to show how we, as a society, are failing to live up to the country’s noble promise to all citizens. For instance, the adult use of drugs in the pursuit of happiness—as long as it does not infringe on the rights of others—is an act that the government is obliged to safeguard. Yet hundreds of thousands of politically inconvenient Americans are arrested each year for using drugs, for pursuing pleasure, for seeking happiness, while the general public remains virtually silent. My conscience will no longer allow me to remain silent about this injustice or my own drug use.
Why do you think these myths and norms deserve to be reexamined? Why now?
Many of the myths that we believe about drugs are more damaging than the drugs themselves. They have led to countless preventable drug-related deaths and disproportionately high incarceration rates among Black Americans, and they have prevented us from exploring new treatments and healthier, more humane policies.
Why now? The summer of 2020 has shown with brutal clarity that Black life in the U.S. is valued less than white life. This book not only predicted events such as the police killings of Breonna Taylor and George Floyd, but it also shows a path forward to reckon with these chilling events and prevent them in the future.
You are an advocate for legalizing and regulating all drugs, including drugs that are considered by many to be dangerous, like opioids. What is one way that legalization and regulation would help to control overdoses and addiction?
Our labeling of certain drugs as “dangerous” is biased against drugs that are currently illegal. Alcohol is potentially more dangerous than heroin in many ways, as shown in the book. During alcohol prohibition, for example, hundreds of thousands of people were maimed or killed due to drinking alcohol produced in illicit stills. There were no quality controls on the drug, and drinkers were forced into the shadows, which are both factors that can can increase toxicity. The problem went away when Prohibition was repealed. Likewise, 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.
You open your book with this quote from the writer and critic James Baldwin: “If you want to get to the heart of the dope problem, legalize it. . . . [Prohibition is] a law, in operation, that can only be used against the poor.” How has this quotation informed your views on the war on drugs? Why was this quote important to include?
Baldwin recognized that adulterants contained in “street” drugs are frequently far more dangerous than the drugs themselves and that a legally regulated market would help keep people safe. Equally important, Baldwin predicted what actually happened with drug law enforcement: Drug laws are selectively enforced such that poor and Black people are the primary targets.
Baldwin’s quote is so important because he said it in December of 1986, 34 years ago. Today, all of the evidence backs up his assertion. I find it remarkable and disappointing that we still haven’t heeded his advice.
According to your book, the chemical composition of methamphetamine and Adderall are almost the same, yet they are considered vastly different drugs with different effects. Why do drugs that are virtually the same in composition have different legal statuses and social perceptions?
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 that connect use of the drug with heinous crimes, addiction and other adverse effects will dominate the airwaves. This is designed to influence public perception and public policy. It also justifies the subjugation of those deemed inconvenient.
"Rates of drug addiction are much lower than I once believed."
Do you consider the illegality of certain drugs to be an infringement on civil liberties? If so, how?
Absolutely! For example, each American citizen is guaranteed at least three birthrights: life, liberty and the pursuit of happiness. Undoubtedly, many people use drugs in their pursuit of happiness. And as long as these individuals do not infringe on the rights of others, then they should be left alone to pursue happiness as they see fit.
You argue that the criminalization of drug use is more harmful than the drugs themselves. Can you explain this idea?
A frequent outcome of drug prohibition is the proliferation of novel, potentially more harmful substances. For example, today we have seen an explosion of fentanyl analogues onto the illicit drug market. These chemicals produce opioidlike effects and are frequently passed off as heroin to unknowing consumers. The problem is that fentanyl analogues are far more potent than heroin, meaning a small amount can produce an overdose. Thus, if an unsuspecting person consumes a large amount of a fentanyl analogue thinking it is heroin, the consequences can be fatal. This is a frequent, predictable and preventable outcome caused by heroin prohibition.
As a clinical researcher of drugs and addiction, what has been the most surprising finding in your research so far?
Perhaps the most surprising finding from our research is that the predominate effects produced by so-called drug abuse are actually positive. Also, rates of drug addiction are much lower than I once believed.
"I hope readers will be less likely to vilify individuals merely because they use drugs."
In your book, you speak to experts who have dealt with their own countries' drug problems in more humane ways that the United States' war on drugs. Which countries are getting things right? What are they doing differently that has led to better outcomes?
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 respect users' autonomy and keep them safe, not to infantilize them. Each of these countries has accepted the basic fact that humans will always seek to alter their consciousness through drug use. As a result, they have put policies in place that do not criminalize this pursuit but instead enhance its safety.
The state of Oregon recently decriminalized the personal possession of all drugs, while many more states are legalizing marijuana and citizens across the country are rejecting carceral solutions to drug problems. Do you think we are witnessing the beginning of the end of the war on drugs?
In the U.S., the drug war is quite lucrative, especially for a select few. These include law enforcement personnel, prison authorities and business owners dependent on the prison economy. At the federal level, American taxpayers contribute approximately $35 billion each year to fighting this war. Any serious discussion about ending the war on drugs will have to grapple with finding alternative job prospects for low-skilled, white workers who are the primary beneficiaries of drug war funds.
What do you hope is the outcome of your writing this book?
Broadly speaking, I hope readers will come away with a greater appreciation for the noble ideas expressed in the Declaration of Independence. I also hope they will understand that it is our responsibility to fight for and protect the liberties of others. More specifically, I hope readers will be less likely to vilify individuals merely because they use drugs. That thinking has led to an incalculable number of deaths and an enormous amount of suffering. Finally, I hope readers will recognize the prodigious potential good derived from drug use and develop a deeper understanding of why so many responsible grown-ups engage in this behavior.
"I may not be considered for certain positions, honors or awards. But my conscience allows me to sleep well at night, which is worth more than any accolade."
How has what you’ve learned about responsible drug use shaped your current work or research?
Prior to learning the information expressed in this book, my research questions were shape by the implicit but biased assumption that drugs were bad. This limited my ability to make new discoveries outside the “drugs are bad” framework. Now that I am no longer imprisoned by this type of thinking, I can expand my research focus. For example, one new line of research is investigating the conditions under which positive drug effects are more likely and vice versa. The public health implications of this research are obvious.
Many of the ideas in your book may be considered controversial. Have you gotten any pushback from the drug research community or from the National Institute on Drug Abuse (NIDA), which you have worked with in the past?
Yes, of course. Some within the research community may consider me controversial. In science, the term "controversial" is used to dismiss the person saddled with the label. As a result, I may not be considered for certain positions, honors or awards. But my conscience allows me to sleep well at night, which is worth more than any accolade.
What, if any, are the personal and professional challenges you have faced since coming out as a recreational drug user?
As I have gotten older, the thing that matters most to me is my family. Everything else in secondary. Once I was honest with my family about my drug use, other challenges could come as they may. My family understands that I chose to come out of the closet as an act of civil disobedience on behalf of those unjustly persecuted simply because of what they put in their own bodies. I faced far more unacceptable challenges by remaining in the closet.
Author photo courtesy of Carl L. Hart