Dr. Carl Hart

As someone who has made a living the last five years writing about the benefits of psychedelics, I thought I was pretty woke when it came to drug policy- decriminalize everything, regulate it, legalize it where appropriate, offer honest education, and have harm reduction services for those who fall into the trap of addiction with bad drugs. I’ve written pieces critiquing the War on Drugs, and hailed the power of psychedelics to get people off of lesser substances. What I somehow missed, was that drug war propaganda was still alive and well within me.

Speaking loudly and proudly about the benefits of cannabis and entheogens was not the great dispelling of stigmas that I thought it was, I was simply moving the goalposts and continuing to assign moral judgement to a set of drugs that I didn’t understand or have experience with. Countless times I sarcastically brought up the great South Park refrain “Drugs are bad, mkay”, with no clue whatsoever that I was being a hypocrite, because I assumed that certain drugs were bad, as opposed to my precious psychedelic medicines.

I have Dr. Carl Hart to thank for jolting me out of this cognitive dissonance, as do many others. With his explosive TED talks, lectures, interviews, podcasts, and books, he has laid out the real facts about drugs, why even “hard” drugs cause more good than harm, and why we continually fall for the same trap of stigmatizing substances to suit a political agenda. Dr. Hart is a neuroscientist who has dedicated his life to studying the effects of drugs and addiction, and is currently a tenured professor at Columbia University who recently took the brave step of admitting he enjoys heroin and cocaine occasionally in a responsible way. He has published numerous articles and scientific papers in the field of neuropsychopharmacology, and his latest book Drug Use for Grown-Ups is a fascinating distillation of his life adventures, work and perspective.

Thanks so much for speaking with us Carl. I absolutely loved your book and it blew my mind, making me question all kinds of assumptions that I didn’t even know I had. This is one of the single most important and underrepresented points of view in the entire drug conversation.

Thank you for reading it! I know there are a lot of people with a lot to say about it without even reading it, so thank you for actually reading it.

The pleasure has been mine, I really enjoyed both of your books. If you don’t mind, I’d like to start with the central thesis as I understand it.

Cool man, it’s your show and I’m here.

What I’ve taken from your work is that we were lied to by the powers that be and fed misinformation about drug use. That misinformation has been so prevalent and insidious that many of us- I dare say all of us- carry it within our psyche without even realizing it. And there are layers and layers and layers of it. The origins of this misinformation were political and racial oppression– that is the reason why this misinformation was spread, it was a political weapon.

It’s crazy to me, because the more that you’ve helped me see these biases in myself, the more I see it in everyone! Even in the most progressive “drug friendly” spaces, it’s so clear that we are all carrying these biases against drugs. So my mind goes to how can we fix that? I would love to hear your answer to that. What comes up for me is unbiased and truthful information based on science.

Well I’ve been thinking a lot lately about the pressures of finishing a book, because I was late on this book, in part because I became the chair of my department at Columbia University, and kind of had to drop everything to contribute to the department. That was more than a full time job, and so I had the pressure to buckle down and just finish this. In doing so, I used the most expedient language to try to get the broadest amount of people to understand what I was saying. In doing that, you kind of take shorts in terms of really helping people to see what they can and should be doing.

So when I think about the biases that we all hold about drugs, I explained how journalists and filmmakers benefit from these biases, and how law enforcement and politicians benefit from them too. An easy way to think about this is in terms of incentives. We are all incentivized to be biased. So when we talk about how we can change, we have to change the incentives. Otherwise it’s not going to change, I don’t care how much information you have.

Think about marijuana. We have recently changed the incentives. We now emphasize the health benefits, and tax revenues that can be gained from legalizing marijuana as opposed to putting people in jail for marijuana. So if we’re talking about changing biases here, we have to focus on the contingencies, those relationships between these biases, behaviors, thoughts, and the rewards. If we don’t do that, good luck with all the education you have.

That’s so true. Just looking at myself as a journalist, many of us are incentivized to speak about “medicines”, “plant medicines”, and “medicine work”. Instead of saying “I tripped balls on psilocybin and it was a blast”, we have to say “I went to this sacred ceremony led by a shaman and it was deeply spiritual”. Both of those can be true, but there is always this pressure from the zeitgeist to differentiate psychedelics and therapeutic use away from recreational or personal use. And we have our reasons- many of us just want to be accepted by our families and friends outside of the “drug world” and so we are always framing this in this context of the sacred, the therapeutic, the scientifically proven. In a way that shuts the conversation down around cognitive liberty.

You don’t even have to say “cognitive liberty”, it’s just liberty! There’s no need to modify that term, that’s actually playing into the bullshit. It’s liberty, this is what the country is founded upon, this is what we say we are.

That’s so true. I’ve thought then, what’s a good model for how we can treat these substances, and what comes to mind is alcohol. In my point of view, alcohol is the trump card of this entire debate, and it’s so simple.

Anything we use to vilify any drug, we can see that exact quality in alcohol. It kills people, it’s physically addictive, the withdrawals can kill you, it can make certain people crazy and violent in certain situations, it endangers innocent lives when people drive drunk- it literally contains every harm that any of the hardest drugs have. And yet, it is de facto accepted- since the prohibition era ended- it’s the wallpaper, it’s just part of our surroundings.

It seems to me that we need to first of all make those connections, which are scientifically proven, with your work, Professor David Nutt’s work about comparative drug harms, this is the model we should be using for all drugs. Everybody knows, from your upbringing, your parents, your culture, that alcohol is generally safe when used responsibly- have it in moderation, don’t drink and drive, it’s your right to use freely as an adult- and we have laws to contain behavior of course, so that you do not harm others, but no laws restricting access or general use. Is alcohol the model for how we should approach all drugs?

Yea, I don’t have anything to add, just amen brother. You hit it on the head. People say no it’s different because of this or that, but it’s really not. You are absolutely right. That’s why in chapter two and the final chapter I tried to use alcohol as a foil, and to show what happens when you prohibit it.

It occurs to me that how we treat illegal drugs is as if anytime someone admitted to enjoying a beer after work or a glass of wine with dinner, we instantly thought “Oh no, this poor hardcore alcoholic, they are in deep trouble”, as if every time we thought about alcohol, we instantly and reflexively conjured up the worst manifestation of it. That’s how it is with PCP, heroin, cocaine, meth, and so forth. And yet, as your studies and others have shown, even these “hard” drugs are predominantly used without harm and in a responsible way. It sounds radical, but it is factually true, and it’s not a promotion of these drugs to say that, it’s speaking the truth, just like saying “a glass of wine after dinner is generally harmless” too.

Yes, and again if you look at those contingencies, our behavior and how we’re incentivized for it, that’s what’s going on. Alcohol has a lobby. Alcohol has this huge and important cultural significance. We built it into Superbowl Sunday for example. We built it into celebrating life’s good events. We changed the contingencies with alcohol, but immediately before World War 1, it was different. The contingencies were “Those evil Germans are the ones that have all of the alcohol distilleries in this country, and we go after them, it’s an evil substance. But we’ve changed that now. The Germans are now “white”, and alcohol is fine.

The question is, if we want to change the way we see other drugs, first we have to think about what sort of cultural significance those other drugs serve, because they do. Heroin, PCP, crack, they have this huge cultural significance. Whenever writers get lazy and need a subject to write about, just write about the degenerate crack use or heroin user, that’s a great story, even though whatever they are talking about has no real basis in reality. But we’ve agreed in the collective consciousness of our society, this is what it’s like.

You can throw any kind of bad behavior in with those drugs. Filmmakers, when you need a story, you need to kill off somebody, oh they were a crack user or a drug dealer, you don’t even have to develop their character or think of that person as a person, and so that’s a huge cultural importance for us. Even our truth tellers, the comedians of our society, they normally tell the hard lessons that we need to learn, but even they don’t tell the truth about drugs, even they have agreed to play into this game. When the comedians follow the dominant culture like that, that’s when you know you’re really fucked.

Yea that’s so true. They serve that archetypal function of the jester, speaking truth to the king, and to me that illustrates just how deeply ingrained this is. We’ve been completely brainwashed to think that anyone who touches illegal drugs- heroin, crack, meth- and there’s different stereotypes that come with each of those- that they are a degenerate. It’s very hard to unlearn that.

As you and I are speaking, if you turn on late night television we have on CBS Stephen Colbert, NBC Jimmy Fallon, ABC Jimmy Kimmel and with Comedy Central Trevor Noah, you check out those comedians. A really good example is Stephen Colbert. When he went into this location during the pandemic where he did his show that looked like his house, he used to have a glass of alcohol almost every night, and making fun of how his drinking isn’t a big deal, it’s a normalized behavior. But almost every opportunity he gets, he besmirches any other drug, even marijuana, he just denigrates it. As you watch this you think “This is a smart comedian, he’s one of our best, and he doesn’t realize how much ignorance is emanating from him.”

I think your courage in coming forward, your character, your accomplishments, your voice is irreplaceable in this. As someone who has made it their life’s work to study the effects of drugs scientifically, to come out with this message, it cannot be ignored. There have been people who have said “I use cannabis but I’m a functional and productive person”, or “psychedelic use has benefited me”, and of course you have Terence McKenna and his great perspectives on the benefits of altered states- but he was an outsider figure. You are coming from inside of the system, from the front lines of scientific data and even personal experience, and speaking truth to power. I just want to commend you for your courage in coming out in this way, and being so blunt and honest.

Thank you, I’m glad that people like you appreciate it. Because you know, there are people that hate me for it [laughs]. So thank you.

We are very grateful to Dr. Hart for taking the time to speak with us. Check out his latest Book Drug Use for Grown-Ups, and stay tuned for more conversations with Dr. Hart in the coming days and weeks.