October 28, 2021 • 53 mins
Carl Hart is one of the bravest academics I know. His specialty is neuropsychopharmacology. He's the Ziff Professor of Psychology at Columbia University. He's published hundreds of scientific articles on psychoactive drugs, including many which challenge conventional thinking. And he wrote a book earlier this year in which he discussed his experience using heroin while serving as chairman of the Psychology Department. We talked about that, of course, but I also wanted his perspective on all sorts of other drugs, including MDMA, psychedelics and the growing variety of synthetic substances.
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Episode Transcript
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Speaker 1 (00:00):
Hi, I'm Ethan Natalman, and this is Psychoactive, a production
of I Heart Radio and Protozoa Pictures. Psychoactive is the
show where we talk about all things drugs. But any
views expressed here do not represent those of I Heeart Media,
Protozoa Pictures, or their executives and employees. Indeed, heed, as
(00:23):
an inveterate contrarian, I can tell you they may not
even represent my own and nothing contained in this show
should be used as medical advice or encouragement to use
any type of drug. Hello, Psychoactive listeners. Today is kind
(00:45):
of fun for me because my guest today is somebody
who have been friends with for almost twenty years now
and have huge admiration and respect for. That's Karl Hart,
the Columbia professor who's written a very important book Drug
Used for Growing Ups and follow his first other kind
of semi autographic called book High Price. So Carl, thanks
a lot for doing this. It's good to see you man.
(01:07):
Yeah you too, Carl. Let's start off with this. You're
in some hotel, maybe about to give a talk, and
you got the book, and you got somebody says, hey, man,
I saw you got that book. What's it about. Well,
the book is called Drug Used for grown Ups and
the subtitle is Chasing Liberty in the Land of Fear.
I'm just trying to get people to think about their
(01:29):
own liberty and what it means to be free. That's
that's it. And I'm using the subject that I know
best as a vehicle to help people to think about
their liberty. Uh. And I don't mean liberty in this
kind of Trumpian sense um, where your liberty Trump's everybody
else's and you can do whatever the funk you want
(01:50):
to do. That's not what I mean. I mean your
liberty in that you're not bothering anybody, so why should
people care what you do? As long as you are
responsible a dope man. I'm using drug use as as
a topic so people can think about their liberty not
only in this subject, but also with just other subjects.
I mean, from prostitution to a range of things. We
(02:12):
have over police people's personal behaviors and we don't even
think about it anymore. And in this book, I'm trying
to get people to think about why do we do this?
Stupid ship? M hmm, we you don't. I mean, look,
you were on my board of the Drug Policy Alliance
for ten years at the beginning in two thousand and seven,
maybe more than that. And so in terms of what's
wrong with the war on drugs, in terms of mass
(02:34):
incarceration and a deporation of rights and all the harms,
I mean, we're very much together on that. What's unusual, though,
is for you to put the argument of liberties so
front and center. And I say unusual because typically it's
something that libertarians do, civil libertarians do. And I will
tell you something that as me, as a white man
(02:55):
advocating on these principles of liberty, I would get a
lot of ship for this, you know, like, oh, you
can talk about your liberty, yeah, but what about poor
people suffering, black and brown people suffering the ghettos? You know,
what's liberty for them? You know that this is the
rich man's How do you how do you respond to
that or how do you deal with that? Because I
love the fact that you did this, but I want
to know the experience of coming out in that argument
(03:17):
for you. Well, you know, in our country in the US, uh,
people think of liberty as a construct owned by the libertarians. Uh.
And those people don't understand the founding principles of the country.
The founding promise of the country is that we are
all guaranteed life, liberty in the pursuit of happiness. Doesn't
matter who you are, You're guaranteed those freedoms, those rights.
(03:40):
And so I'm trying to reclaim liberty for the American
people and not only for the libertarians. This is an
American principle, not a Libertarian principle. But it's a hard
one for people to understand. And I get it. I
get the fact that some political groups have kind of
owned these kind of principles and and other people who
(04:01):
have been shut out as a result. But this is
liberty for all, and I'm asking us to live up
to our principles. Make our practice match our promise. That's
all I'm asking you. Go man, I'll tell you years ago,
I got asked to speak at some kind of progressive
economics conference and it was all people on the left,
progressive liberals, unions, whatever. And I spoke on the second day,
(04:21):
and I get a big speech and I say, you
know something, I've been here for over the whole day, right,
and I share overwhelming the values that the people are here.
But there's two words I have not heard mention in
the entire first day, day and a half of this conference.
And that's of the words freedom and liberty. Right, what
is the left wing seating these these words and these
values to the right. And so I think for you
(04:43):
coming out on this thing is incredibly important. Now, what
I also liked was, you know, not often does one
see Jerry Garcia, the Grateful Dead Maestro and Martin Luther
King put together making essentially the same argument. So just
elaborate on that one. Yeah, you know, this is a
thing that I wish people read the book because then
(05:05):
we can see how much overlap, how much connection we
all have in this country in terms of our heroes.
Jerry Garcia was influenced by Martin Luther King, and Martin
Luther King was influenced by the Row and all of
these people were influenced by what Thomas Jefferson wrote. And
we know Thomas Jefferson had his problems. Uh And and
(05:25):
of course I I talked about that a little bit.
But the point is the ideals which these people espoused,
they are ideals that are bigger than the people who
are espousing these ideas. And so I'm trying to get
the reader to think about these ideas and then if, if,
if we could maybe live up to these ideals, then
we would be a better country. We will be a
(05:46):
more compassionate country. Yeah. You reference went at one point
to a letter from a Birmingham jail by marlou Uther King,
which is something I used to sign to my students
back when I was teaching a princeton on law in society.
Why did you reference that piece? Yeah, I referenced that
piece because us where King dealt with in that letter
were his allies coming at him. The white ministers were
(06:08):
coming at him, asking him to go slow and saying
that his actions were maybe not prudent. And so he
talked the time and patients to explain why it's so
important to move in the way that he was moving.
In the way that he was moving was simply that
black people in this case deserved their humanity, deserved to
(06:29):
be respected just like everybody else's humanity. And um, there
is no such thing as moving too fast when you
want to make sure people's humanity are respected, and that
that's the same thing with drugs. We say things like
let's start with this one here, M D M A,
but not heroine here, it's like who gave you the right?
(06:50):
You know, you go back and you talk about the
history of the criminalization of drugs, about the Chinese and
the opium bands and blacks and their wine, and also
about you know, cocaine and the crazed negro drug fiend. Right,
the story going back a hundred years, and how it's
manifesting today. Right. I mean you wrote that very powerful
(07:10):
at been in New York Times a while back about
George Floyd and how the cops trying to say, hey,
because he was on drugs, right, And so do you
think that more people, and especially more black people are
beginning to wake up to the things about the anti
drug piece of this thing when they see so many
I mean one after another. I mean black people are
being killed by the cops, and the cops saying it
(07:31):
was because of the drug, because he was selling drugs
and he was using or whatever it might be. Do
you see a change happening there? I think so. I
think when you have George Floyd and you have Brianna Taylor,
particularly with someone like Brianna Taylor, um, she was not
in the game, and but the justification was that her
ex boyfriend was in the game and they were just
(07:52):
the cops were justified to come in and kill her.
And I think people are finally starting to see that,
wait a second, this is crazy. No matter how many
drugs this particular person was selling, the were alleged to him,
So you shouldn't be able to kick someone's door down
and then murder them. And so I think people are
starting to see. People are starting to put together Philando
(08:14):
can still uh he had marijuana and that cop of
shot him to death. Um, we think about Lakwan MacDonald,
the seventeen year old kid in Chicago where they said
that he had PCP in the system and he was
shot sixteen time. I think people are putting it together,
particularly now in this age where we see the police abuses,
(08:37):
and people are starting to see that drugs are always
used as this convenient scapegoat to justify this awful behavior.
And so on the one hand, I'm really happy that
people are starting to see. On the other hand, it
makes me um profoundly sad that we have to steal
deal with this particular issue when it goes all the
(08:59):
way back to the turn up the last century, the
turn up the twentieth century, and we're still dealing with it.
So that makes me profoundly sad. Yeah, yeah, I don't know.
I almost don't know where to go from there. I mean,
it's the question of, well, let me put it this way.
You know, sometimes I think we know and you and
I have both been out there talking for years and
(09:20):
you can speak to it from a much more personal
basis about the role that race and racism has played
in the war on drugs going back to the early years,
and the multiple levels at which it plays down, and
so we know that racism permeates this. It permeates why
blacks get treated different than white It's like the crack
powder laws and tougher penalties on crack. It permeates on
so many different levels. But you know, sometimes I put
(09:42):
out there that there's another ism that we're not even
willing to deal with, and for lack of a better term,
it's druggism, right that there is. Now it's not longer possible,
at least publicly to say racist things. I mean, now
on the trumpet begins to become possible again. But basically
that's been delegitimized and you can lose your job. There's
all sorts of things for making a comment that sounds
at all racist, right, But when it comes to druggism,
(10:03):
when it comes to disparaging addicts junkies, when it comes
to making assumption about them, that seems to be one
of the last remaining really legitimate prejudices, and not just
on the right, even across the political spectrum. No, you're
absolutely right when we speak about this language in terms
of the role of rais and uh drug policy or
drug policy being used to subjugate like black people, for example.
(10:27):
The thing that I have to be careful about is
I have to not be lazy, and when I'm lazy,
I might say that drug policy is used to subjugate
black people, when in fact that's just an example of
how drug policy is used. But drug policy is really
used to subjugate the powerless, the people on the margins
of our society. And then I can give an example
(10:50):
of how black people are disproportionately arrested, but I can
give another example to talk about white folks in Oklahoma
who use methamphetamy, they are also disproportionately subjugated. And I
can talk about the users in the Philippines. They're being
subjugated for the same reasons. And so um, that's why
I have to be careful so that people understand that
(11:12):
this is a universal sort of thing that's going on
with drug policy. It's not unique to black people. But
in the United States, um our drug policy. Because we
have this conspicuous difference in our race, it makes it
easier to point to it. But don't get it twisted.
This is the universal thing. And the people who are
in the middle classes, who have power, who are the
(11:35):
educated class, Um, they're not being subjugated in the same way.
In fact, they are so busy distancing themselves from the
methamphetamine users, from the heroin user, from the black user,
what have you, and so um, these laws are not
equally applied as we know. Yeah, you know, it's interesting
because it's another commonality we have in this thing. You know,
(11:56):
for many years, going back decades, I would go to
speak safety annual conferences of Normal the Marijuana Legalization Group,
which I support, and they were fighting for legalization and
they're my allies. But sometimes people we get up there
and say, you know, we gotta legalize marijuana so we
can crack down on the meth heads. And I with them,
lecture them and say no matter what you think of
mess and even if it is a more dangerous drug,
(12:18):
that's no basis for treating those folks differently. And make
the analogy to the First Amendment. The first a moment
doesn't just protect elevated speech, right, it also protects you know,
quote unquote ugly speech less elevated speech. We'll be talking
more after we hear this. Add what you do in
(12:47):
this book that I think really breaks some new ground
in different ways. Isn't talking about myth amphetamine, heroin, PCP
in a way that really, I mean, very few people have.
I know, I put my toe in the water, but
you take it many steps further. And so, you know,
(13:09):
and we see that with marijuana, right, we see that
Mariana legalization, we've radically changed that, you know, from reform
madness and brain on drug stuff and all that that's turned.
Now psychedelics is kind of opening up and changing people's
minds and things like that. But there's other drugs, the
ones who are most of what people are going to
prison for selling and possessing. You take on those one.
So let's just start off with meth amphetamine, because that's
(13:31):
something you've been studying for a long time, and you've
produced reports and studies on that thing. So can you
explain to our listeners, you know why what they may
think about methamphetamine is more or less flat out wrong. Yeah,
So when when I think about methymphetamine, Uh, it's important
for the listener to know one thing, Adderall the methymphetamine
(13:51):
are essentially the same compound adderall. Of course, it is
the medication that's used to treat attention deficit disorder. Methamphetamine
also is at the proved to treat attention deficit disorder
as well as obesity. UM. The only difference between the
active ingredients and adderall, which is d amphetamine. The only
difference between d emphetamine and methamphetamine is an additional methyl group,
(14:14):
and that method group, we have said in research makes
it easier for the methomphetamine across the blood brain barriers
such that it gets into the brain more rapidly, so
there's a more rapid onset of effects. Now, there is
no data in humans to prove that or show that
this is mainly uh kind of based on animal studies
(14:36):
and speculations about what that sort of increased lip solubilility means. Now,
we have said that that makes methamphetamin more reinforcing, that
is more addictive. Again, no evidence to show that, because
all of the evidence when you test methomphetamy against UH,
something like a d amphetamy UH in the same human
(14:58):
users they choose used to take the drugs on the
same number of occasions, and the self administration patterns look
the same. Humans can't distinguish between the two drugs on
the double blind conditions. So methamphetamine is essentially the same
drug that people are taking in adderall. Not that's not
to say that people should stop taking their adderall because
(15:20):
this is such a danger struct No, that's the same
that methemphetamine. It's f the approved for a reason because
it's effective, because it's a safe medication when used in
the doses when the medication is prescribed. So they are
essentially the same drug. Now, what people see in the
natural ecology is that methamphetamine use is primarily smoking or injection,
(15:44):
and so rout of administration certainly impacts the speed at
which the drug reaches the brain. It also impacts a
number of things the conditions under which the drug is taken.
So what people are really seeing is a function of
the legality of the drug, the route of administration, and
all of these sorts of things, but not the drug itself.
(16:05):
But they are attributing all these factors to the drug,
when in fact it's really about these sort of psycho
social characteristics are factors more so than the pharmacological factors.
So if I were to summon up by saying that
if you were to take that, I don't know ten million,
twenty million. However, many young mostly boys, are being prescribed
(16:25):
adderall today and substitute for that an equivalent dose of
oral meth amphetamine. Probably those kids would not even know
the difference, or it would be roughly comparable. And conversely,
if you were to crush up those kids adderall and
smoke or injected, it would be fairly indistinguishable from the
people using kind of underground illicit meth amphetamine smoking ejecting
(16:48):
that apart from maybe the effect of the contaminants in
the illegally produced stuff. Absolutely. And another thing about adderall
is that it has three amphetamines. There's an L, there's
a d UH and the L doesn't cross as well
as the D doesn't cross the blood brain barrier as well,
and so the adderall has more cardiovascular activity that I
(17:10):
don't really need um, and so UM, I think that
the D and methamphetamine is actually more ideal. You know,
I got my doctor to prescribed to me blow dose
five milligram dextro amphetamine. You know, I told him I
needed for jet lag, which is true, and you know
I use it occasionally. UM. And then at one time
I got a friend of mine to give me one
of his kids adderalls, and my sense was that adderall
(17:33):
was more kind of jagged e like. It almost felt
like the dextro amphetamine was a smoother one. And it
made me wonder, why aren't they using dexter amphetamine with kids.
Was there a possibility it actually might be better for
many young teenagers or is there some good reason not
to be doing that. Well, they do use a D
M fetamine dexterro emphetamine for kids. First it owned the
(17:55):
market of the tension deficit disorder UH and then Riddland.
Eventually they tuck over. But then adderall hit the scene
because Shire of Pharmaceuticals marketed and told physicians that, oh
it's a slower onset of effects and this is better,
and they had this big marketing campaign and that's why
people are prescribed adderall because of Shires effective marketing campaign,
(18:19):
not because of the effectiveness of the medication. So while
we're on the subject of big pharma, the one that's
most notorious, right is Perdue Pharma, right in the Sackler
family and their creation of of oxycontent, a drug that
appeared to be a really very effective pain controlled drug
for some people living with serious pain, but which then
(18:41):
you know, it appeared they over to marketed quite seriously.
I mean, how much do you hold Perdue Pharma sort
of responsible for the kind of starting phase of this
significant expansion of opioid related fatalities in the beginning of
this century. They certainly deserve some responsibility here because they
got the FDA to schedule oxycotton at a lower level.
(19:04):
It wasn't a scheduled too, I think it was scheduled three,
whereas other opioids were scheduled too. They said it was
less addictive than the other opioids, which was not true. Uh,
And so they deserve some responsibility there, of course. But
when we think about, uh, the fact that people are
dying from drug related overdoses. Uh, An important reason that
(19:27):
people are dying from drug related overdoses is because people
are getting contaminated drugs on the street, and that's an
easy fix. You can just make sure that people have
a clean supply or safe supply, or make sure that
they have access to drug checking so you can check
and see what's contained in your your substance. That's an
easy fix. And we as an American public, we haven't
(19:49):
done that. But yet we're blaming the pharmaceutical company for
that which they have nothing to do with that. And
we also blamed the pharmaceutical company for like addiction rates,
when the fiction um has nothing to do with the
drug itself. Addiction is mainly related to all these other
psycho social factors, like beginning in the nineteen seventies and
(20:09):
continuing in the eighties, when all of these factories left
the Midwest, they left the rust belt places, and people
who once had jobs that paid the middle class salaries
they no longer had it. They once had standing in
that community, they no longer had it. That increases the
likelihood that people will become addicted to have all kinds
(20:29):
of problems. And we see that sort of thing, but
we don't talk about all of these other sort of
issues that are involved. Instead we just say perdue, Yeah, Carl,
I mean, well you're talking about, obviously is what people
have referred to as these deaths is to spare right,
the high rates of alcoholism, opioid misused suicide happening in
parts of the country, you know, whether black, brown, or white,
(20:50):
where people have been struggling, and especially sometimes where people
are downwardly mobile. But the other thing I think when
you're talking about is the thing about the pharmaceutical companies.
I mean, obviously they're all really aggressive. Promoting of this
stuff created a problem, as did ignorant doctors and ignorant
nurses and patients wanting to pop a pill, and insurance
companies not wanting to pay for this stuff, all those things.
(21:11):
But interestingly, when they were getting it there, those drugs
were relatively pure, and once they started once and started
to crack down for some good reason on the pharmaceudical companies,
people started turn to even more black market drugs, first
heroin and then fenton al And so there was a
paradoxical thing where the crackdown the pharmaceutical companies may have
(21:31):
actually made the overdose epidemic even worse than or otherwise
would have been. Yeah, we know that when you have
the crackdown in the legitimate source, then you have the
illegal sources pop up. Absolutely. Um just I have to
be careful when we talk about this thing we're calling
the opioid crisis, and we're talking about overdoses. In the book,
(21:53):
I try to help the reader understand that these things
that we're calling overdoses and we're blaming opiates for, we
don't really know that opioids are the actual causal agent
for the overdose. UH and I try to walk the
reader through how medical examiners and corners do their death
(22:14):
investigations and the level of education that's needed to be
a corner in most locations are high school diplomas. That's
all you need and a few hours of a death
investigation course. And there's no uniformity in terms of how
these death investigations are done. Most of the people who
(22:36):
die from drug related overdoses have multiple drugs in their system,
and then there is no levels that are measured to
determine what drug might have been the causal agent, and
in some cases they don't even get biological confirmation that
that was actually opioids in the system. And so UH,
(22:57):
I asked the reader to really think about what's going on,
Because dying from a single opioid like heroin, it's not
the easiest thing to do, particularly something like fantonol. Of course,
a single drug one can die from more readily. I mean, basically,
what you're saying is that the large majority of what
are called over those fatalities are really fatal drug combination fatalities, right,
(23:22):
I mean, it's that mix, and that the media and
sometimes the corners, you know, rather what I didn't saying, oh,
this was a fatal drug combination, or saying this was
a benzo death or an alcohol death or a set
amath and death. They just call it an opioid death
because that's easy. That's what the media wants to report.
Or even if the small print doesn't say that, that's
what the headline writers put up there. That's exactly it. Now,
(23:43):
it also seems to me that what you're saying about federal, though,
is that federal is in a bit of a special category.
They've given that it's what fifty times more potent per
milligram or whatever than heroin. People can die just from
a straight federal way in a way that was unusual
with heroin or oxyes or things like at Now that
seems to me to maybe present one of the strongest
(24:04):
arguments for some form of legalization or safe supply of opialities. Absolutely,
people will use opioids. People will use drugs. The question
before us as a society is how do we best
keep people safe? And it seems as though we have
been comfortable and pretending that people won't use drugs and
(24:26):
allowing people who do use these drugs to uh engage
in this precarious activity of taking drugs that are purchased
on the list of market. To me, that's not what
responsible society should do, particularly one that claims to be
proponents of life liberty in the pursuit of happiness. Now,
(24:47):
you talk a fair bit in the book at many
places about drugs safety testing, right, testing the quality of
what the pills are, and just explain why that's so important. Yeah,
we call that drug checking or drug purity checking, drug
purity checking um. It occurs in a number of countries
including Portugal, the Netherlands, Austria's, Spain, Colombia, uh and none
(25:11):
of these countries have so called opioid overdose crises or
any overdose crises. Drug checking what it does is that
it allows UH drug users to submit anonymously UH small
samples of their drug UH and then get a print
out of what's contained in that sample. These subances are
free and they're done with the primary goal of keeping
(25:34):
people safe, so people are not exposed to UH poisons, adulterants,
or other toxins that might be in UH the illicit
drug supply. And so I have been advocating that we
do the same thing in this country. We have the technology, UH,
we certainly have the resources, but we haven't and we
(25:55):
have one of the biggest sort of overdose concerns, but
yet we have not made these services available to our people.
So when politicians say that they care about the opioid
crisis or the health of the public, and they are
not advocating for these services, then you know that they
really don't give a ship. Well, let me I say,
(26:15):
can these testing services checking services also detect the potency
of a sample? Yes, UH, they can detect the potency,
They can detect the amounts UH and all of the substance.
Because our seeing now, I think especially the harm reduction
programs either on the US right doing these sentinel testing strips.
Since you're trying to detect the presidents of fentanyl. Na, No, no, no,
(26:37):
that's a joke. Man. That ship is a joke. I mean, obviously,
if that's all you got, Okay, I get it. But
for a country like ours with so many resources, for
the people who have to revert to using fentanyl strips,
that's a shame. I mean that this is a shame
because it only detect fentanyl and some pentonel and not
(26:59):
any other of compounds that might be uh contained in
the substance. And and we have the technology, so to
pretend that that's a fix, or to pretend that that
that's what we should be doing, it's insulting, particularly when
they're doing this in Colombia, in Austria. It's a joke.
I mean, it's it follows in a long line, right
(27:19):
of opposing needle exchange programs because it might encourage people
to say shooting drugs is safe. Of opposing the lock
zone because it might make people feel safe for using opioids. Right,
it's that whole thing or where the politicos and the
public health folks are scared if even when they know better,
I mean, if even goes back to a hundred years
ago when they used to talk about giving how condoms
to soldiers, and people say, how can you do that?
(27:40):
It's gonna make it safer to have extramarital sex or
illicit sex or whatever. That's the thing that is remarkable
to me, and that why should I care what someone
else is doing? As long as they're not bothering other
folks and long is that they are not preventing other
people from enjoying their rights. Who am I to say
(28:00):
what they should be doing? They are adults. You know,
you're talking the book about the novel psychoactive substances, things
that became known as bass salts or these synthetic cathinones
are synthetic cannabinoids and things like that where it seems
like the drug checking would be incredibly valuable because often
has people have no idea what their getting. Yeah, we
vilified the cathinones, uh, these bath salts. Again, we lied
(28:23):
about the effects of these cathinones. Many of these captain
oons produce effects similar to M D M A and
similar to cocaine um. But we said that these catherinons
make people bite other people's faces off, And of course
that's not true. And I detail that story of the
Miami cannibal and how that person never had any cathinones
(28:47):
in the system. But that's not what the press said. So, UM,
don't believe the hype about the catanones. Uh. Many of
these cathinones produced in D M A like effects, and
they produce cocaine like effects. You wrote in the book
about assuming at one point that you could do a
double blind test and that people taking extra amphetamine and
m d m A would have the same response to it,
(29:10):
and then being somewhat surprised that that actually wasn't the case.
The reason why I thought that they were produced nearly
identical effects is because when you look at them chemically,
they looked nearly identical. M d M A has a
methyline dioxy ring added to the methomphetamine structure. I thought
(29:30):
that they were produced effects that would be nearly identical,
and sure enough, when we looked at some cognitive tests,
they produced a lot of overlapping effects. Uh, some different
effects whereas m d m A disrupted some performance, methomphetamine
improved performance, but they produced a lot of overlapping effects.
(29:51):
But that's not what people say. In the natural ecology
and the natural ecology people say that nah, M B
M A, there's nothing like it. You know, this empathy,
the openness, this connection with others. And at that point
in my career I had tried me them fettermy, but
I hadn't tried M D M A. But then I
tried M D M A and then I saw like, oh, well,
(30:12):
maybe our lab measures are the problem in that we
just are not capturing the unique bits of M D
M A. Let's take a break here and go to
an ad M. Carl And I know you gave a
(30:35):
lot of thought to this one part of the book,
and it's the one that's gotten a lot of attention,
which is the way you talk about heroin. Just gonna
read a few of the good quotes you had in there.
At one point you say, there aren't many things in
life that I enjoy more than a few lines by
the fireplace at the end of the day. I think
you said, listen to Billie Holiday, And then you said
Heroin enhances my ability to feel and think. You said,
(30:57):
I also want to ensure that others are afforded safe
out tunity needs to benefit from the serene bliss opioids
can offer. Should they so choose now I will admit
that heroine's always scared me. I mean, I've tried it
a numerous times to see what it's like. I mean,
the last time I did it was with you and
another friend in Europe a few years ago, you know,
so you know, and my friends always made sure that
(31:18):
I took just a low dose, and they were watching
al for me and say, you know, look, if you're
gonna have a drink afterwards, be moderate. But I got
to admit there was something about heroin that scared me
almost not unlike the way that tobacco and nicotine scare me.
That there's a stickiness to those drugs that if you
start to like them too much, they just make the
hard to detach yourself from. And you describe going through
(31:41):
a withdrawal experience. What I love about it is you're
out there saying, you know, for all you marijuana and
psycholic exceptionalists, it's not just the political principle that shouldn't
be exceptional, it's actually a way we think about these
drugs and understanding that they actually can play a beneficial
role in your life. So just say more about you're
coming from on that and how you feel about that,
(32:02):
and if you feel like talking about how people have
responded to that. Yeah, what heroin is the boogeyman drug
of course in the United States. And so h your
point about liking it too much and then getting attached
to it, think about that for a minute. You know,
there still is nothing better than the sexual orgasm. But
(32:23):
do we hear people saying ship like m, I better
stay away from this orgasm because I might get too attached.
I mean, it's it's just a matter of when we
have these drugs be illegal, then we have to go
through all of these various obstacles to get the substance,
and that plays a role in terms of the addictive
(32:44):
potential of the something. And so I don't think heroin
is particularly addictive. Of course, it can produce physical dependence,
so two can alcohol, So too can your antidepressant. A
number of these drugs can produce physical depends. But the
majority of people who use heroin are not addicted to
the substance. But they just don't say that they use
(33:07):
heroin because of this negative sort of view that we
have of heroin. You alluded to how people have responded
to me admitting to having used heroin. In fact, people
would like to dismiss me simply because I've used heroin.
And so imagine that somebody like me who published more
than a hundred scientific papers, three books, and people are
(33:30):
trying to dismiss me. Imagine what they will do to
other people who don't have such a record. So I
I get it. I understand why people don't say they
use heroin, and so it gives this impression that certainly, uh,
this drug is so addictive that you shouldn't do it.
And then the filmmakers, the documentary filmmakers, the TV filmmakers,
(33:51):
the comedians, they need heroin as a foil because then
they can describe drug addiction in this awful way and
they use herible. And imagine if comedians didn't have these
drugs to make fun of. Imagine if the documentary film
had somebody like me who've used these drugs and go
on with their life, take care of their family, have
(34:12):
a happy life. That would be boring. And so we
need heroin in this culture to vilify for all of
these pop culture sort of reasons. You mentioned that I
went through heroin withdrawal. It was intentional, so I could say, okay, um,
it's something, it happens. But it's not life threatening like
alcohol withdrawal, it's life threatening. I will never put myself
(34:34):
intentionally through alcohol withdrawal because I would be afraid of
the life threatening effects. But heroin withdrawal from most healthy people,
it's not life threatening, and so that's why I did it.
I haven't gone through heroin withdraw sense or before, certainly
not in a way where the symptoms had me feeling
like I described in the book. Then I can take
(34:55):
heroin or leave it. And being that we've had this pandemic,
for example, I've been stuck in the United States, so
that meant that I wouldn't have access to good, pure heroin,
So that meant that I couldn't use heroin. And it's
no big deal. That's just like um, caffeine or some
other substance that I choose to use or choose not
to use. You know. Reading that parts of your book
(35:16):
about heroin, it reminded me of one of the classic
studies in the field, which was the Harvard professor Norman
Zenberg Right, who many decades ago did a book called
drug Set and Set It Right. And drug set and
setting was the phrase that was coined by Timothy Leary
and developed by Andrew Wild and then Norman Zenberg, professor
Hart Medical School, tested it. And I think what he
did was he put advertisements in the local Boston newspapers
(35:39):
looking for people who said they used heroin but did
not feel they were addicted. And hundreds of people came
out of the woodwork, postal delivery workers and school teachers
and people who are living rough on the streets, and
people who had significant professions, and even coined the term
I think chippers to describe people who used heroin occasionally
without becoming addicted to it. Now, interestingly, between his writing
(36:02):
that forty years ago or whatever and you're coming out,
so little is actually said and written about this. And
I wonder if one reason is that the key research
funding agencies, so the government, naturally student on drug abuse,
is just not interested in finding this sort of an
information out. No, they're not, But you know, we know
(36:23):
the role that NINER has played Nighter. It's the National
Institute on Drug Abuse. Their primary mission certainly has been
for most of its life to focus on the negative
effects produced by drugs, so we know they're so to bias.
I was on Night as advisory council. I'd served my term.
I was a grant reviewer, I was a chair of
(36:45):
a grant review session. I had grants myself, So I'm
not speaking as someone who doesn't know. I mean, I
was a part of the system. But I think it's
it's a lot bigger than Nina. It's uh the people
who do drug treat and they are so invested in
this as well. They have come out really strongly against
(37:06):
someone saying that you can use heroin occasionally, even though
we know that heroin and noxycontin are essentially the same drug.
We know that heroin and morphine are essentially the same drug.
But heroin has this sort of additional uh vilification attached
to it for some reason, because it has this important
role in our society. It helps us to define us,
(37:29):
and then we can uh persecute these people who use
heroin because they are somehow morally less than we are. Something.
It's playing some important role in our society that is
far beyond the pharmacology of the drug. Yeah, although what
you're saying about heroin was probably also true of meth
(37:52):
and messi anthetamine back in the early two thousand's right
that nobody could use it without being addicted. I remember
when I go out and speak to people, and I
let me give you this example. You know, an editor
of a newspaper tells his reporter to go write a
report about alcohol in the city, right, And the reporter
goes out and he comes back with all these articles
about twelve step meetings, you know, detox wards, jails, treatment programs,
(38:16):
and the editor pulls open his drawer, pulls out his
bottle of whiskey. From the drawing goes, what are you
talking about? I understand that's one part of the story,
but what about the people having a beer? What about
the vineyards and the wine? What about you know, story
not told? Same editor tells, same reporter, go, do me
a story and meth amphetamine. The reporter goes out, goes
to the jails, goes to the treatment programs, goes to
(38:38):
that sort of thing, comes back and the editor goes,
great job, and never stops to say, wait a second,
aren't there people using meth there who are not this way?
Who's actually attracting new meth users? Because it's not gonna
be the guy who's down and out in teeth falling
out all this sort of stuff. There has to be
something else going on. But it doesn't even occur to
people to think that way at all. That's exactly right,
(39:00):
and that's one of the things I was trying to
do with the book. I traveled around the world. Each
chapter is kind of set in another country, and I
tried to show people that the vast majority of folks
who are using drugs are middle to upper class people
who are captains of industries, who are famous, people who
are important people in our societies, people who we love
(39:20):
and respect. They are the vast majority of our drug users.
And I tried to get people to understand that the
illicit drug trade is a multibillion dollar industry, and a
multibillion dollar industry could not be supported by people who
are poor and down and out. That ship just doesn't
make any sense. But we still believe that nonsense. I
(39:44):
remember one time asking somebody who's middle class business owner
or family, etcetera, who had taken method on daily because
he had once had a heroin addiction, And I said,
why don't you speak out publicly? I mean, you would
help transform the image of who is a Method on consumer?
He says, he's a Let me tell you something. I
run a business. If one day I come in and
I'm exhausted because my kid was up sick, or I
(40:06):
was finding my wife and I put my head down.
People go, oh, poor Joe. I guess he had a
rough evening when it was going on. If they knew
I was on method on, they would go, oh, Joe,
he must be nodding out. They'd make that negative assumption.
He goes, I can't come out, And so in your case,
I'm wondering. I mean, I remember back in two thousand seven,
I actually joined my board. I said, Carl, you're not
even tenured as yet, and you got, you know, a
(40:28):
drug war guy chairing your department, and you wrote me saying, Ethan,
as a matter of principle, I got to do the
right thing, even if it costs me a bit. Here
you're coming out, but you do have tenure now and
your kids are now going to college or graduated. Right
do you think you would have not done this when
you're an assistant professor, when your kids were younger. I mean,
there's something about this being a point both a point
(40:49):
of the broader culture, at a point in your life
where it felt safe to do so, relatively speaking, not safe,
but relatively speaking. But yeah, uh know, it's Uh, we
have to also understand that, you know, I was still
developing and I'm I am still developing and I'm still learning.
(41:09):
And so it's at a point in my life where
I am comfortable enough to deal with the bullshit that
I get because anybody talking about drugs and the subject
I can deal with because I noticed subject so well,
Whereas five years ago, ten years ago, I didn't know
the subject as well, and I couldn't deal with the
(41:29):
questions to pushbacks and and I just wasn't knowledgeable enough.
And so as I gained more knowledge, I gained more confident.
And so it really has to do with my confidence
and my ability to explain what I do and why
I do it now, not so much a political calculus.
That's not what's going on here, because as you know,
(41:53):
people are trying to dismiss me as crazy whatever. They're
still trying to do that. And people in my departments,
uh they I'm into departments. There are people who talk
shit about me about this, and they are they are plotting,
they're doing their things, and so there are consequences, uh
to this, and there have been consequences in terms of universities.
(42:16):
Are people who invited me to give talks, have disinvited
me as a result of me coming out of the closet.
I have been censored in all kind of ways. So
there are so many consequences that the public does not
see and does not know. But I don't really care
about that, because I would be a coward if I
didn't stand up and say this, given what I know now,
(42:40):
And so that's why I am speaking out my I
mean over the moon for the way you're handling this stuff,
because it is courageous. One of the things you stress
in the book is that this is a book for
growing ups, and you point out that a lot of
the advice and the margins of safety for using drugs
like matthian fetemine or heroin and are safe, responsible way
(43:00):
probably don't exist for tens of millions of American adults
who you know are struggling in one way or another.
So what do you say about the obligation? You know,
are there risks in which you're advocating for the tens
of millions of Americans who don't have it together to
do it responsibly. You're right, I did say that this
is a book for grown ups, and I just wanted
(43:21):
people to understand I had a definition of grown ups,
people who are responsible, take care of themselves and take
care of their families and so forth. But it's important
for people to understand too that being a grown up
it's a dynamics sort of process. It's one in which
it's not static. I mean, I'm struggling with that every day,
and many of us do. Then, So, UM, I don't
(43:43):
want to exclude people when I have my definition of
grown ups, because that's not the goal here. The goal
is inclusion. But then do you have this question that
you raise about, like what about the people who don't
have their life together to people who don't have the resources. Yeah,
there are those people. Um, that's like saying, though driving
a normal bill is a tremendous amount of responsibility. You
(44:04):
think about being on a two lane highway traffic going
in opposite direction. Uh, You've got cars coming towards you,
and all they have to do is just turn into
your lane and maybe injure you or injured themselves. Um,
but we have to um, trust them, and we do
that and they do okay. And so it would be
(44:24):
kind of arrogant of me to think that I can
say who should have access to these substances as long
as they don't violate our norms, that is, in terms
of preventing other people from enjoying their rights. I don't
have the right to say that they should be restricted, uh,
in their access. I think that's part of the problem
(44:47):
with society. We have these people who think that they
have the right to tell other people how they can
live their life, and that's wrong. You know, sometimes we
define it as um the majority of people of adults
who can responsibly use these drugs need to be prohibited
from doing so in order to protect the minority who
(45:07):
cannot use them responsibly. But in point of fact, and
one of the major divides in the legalization debate is
between those people who think that if many more of
these drugs were legally available, the number of serious addicts
quote unquote would increase dramatically, whereas other people who say,
you know what, even if a lot of the drugs
that are now illegal were legal, the fact of the
matter is the number of people getting addicted wouldn't go
(45:29):
up that much because there's already so many other drugs
available legally and illegally that they could already screwing up on.
In fact, some of the ones that they're not able
to get right now might actually be less problematic than
the ones that they're being prescribed by doctors are usually
legally over the counter. Absolutely, the notion that the availability
of these substances will cause society to fall apart. We're
(45:52):
living that experiment right now with cannabis. Remember what they
said about cannabis and how Washington, Colorado, those states will
fall apart. Not only have they not fallen apart, other
states are trying to damnus to emulate those states. Uh,
And so that just doesn't hold any water that sort
of notion. We think about alcohol, which is one of
(46:15):
the most potentially dangerous substances to HUGH known to humans.
But we we do that okay, because we control the
unit dose, We controlled the purity, the quality, the education.
That's the part of being in a society. Let me
ask you how you respond when people ask me what's
the strongest argument I can think of against legalization, by
(46:38):
which I mean a legal, responsible legal regulation, And I say,
my biggest fear is when I look at what the
food companies have been able to do right The combinations
of sugar, fat, salt, a play on the brain that
are marketed effectively. And when you look at the dramatic
rise right in obesity and obesity related diseases in the
(46:59):
US and really through much of the world, right where
that where the humult of health consequences exceed those of
illicit drugs are illicit drugs, right. And I worry about
the power and the ability of major league, multinational companies
to devise interesting concoctions of all these drugs that are
adept at getting people to be dependent, even if they
(47:20):
can control it up to a point, and that ultimately
land up doing even more harm. That's my biggest fear
than in the capitalist world we live in. That may
be hard to prevent. You no, I agree, but what
you're describing is a problem with capitalism, not a pharmacological problem.
And so that's partly what happens when we have these
discussions about legalization, all of these issues get conflated, and um,
(47:43):
we we have some problems with our capitalism. I mean,
we can think about the billionaires that we have in
this country that pay no taxes, but that's not a
drug problem. That's a capitalism problem. That's like saying that, well,
ship we have the bad food because these people you
have these sophisticated ways of marketing these foods. It's like,
(48:04):
we're not gonna ban food. We need to check our capitalism.
We need to check the regulations that we have on
these companies. Uh. And we're trying to do that a
little bit with we do and on some of these
other drug companies. But that's capitalism, that's not the drug.
You know, in the earlier years of my studying drugs,
to the formative experiences, one was going to Amsterdam in
(48:28):
eighty nine and not just seeing the clannabis coffee shops
but also seeing their harm aduction stuff in action. And
the other one was going to Switzerland and ninety two
I happen to be there the day that this federal
government green lighted doing the heroin maintenance programs for people
who had not succeeded in method on programs, and then
going back a number of times to actually see these
programs in action. So you write about that in your book.
(48:50):
You write about the successful heroin maintenance programs there for
people which don't exist in the US. And now you
tell me tomorrow you're heading off to Switzerland again, so
you know, are we gonna see her coming back to
the U. S here you're giving up on this place here,
gonna gonna hanging Europe for a long time. I gotta
tell you, man, Like I remember in the board meetings
or I don't know, at some point, um in the
(49:13):
early two thousand's, I don't know when you you were
pretty enthusiastic about the results that they were achieving in
Switzerland with the heroin maintenance for people who were struggling
with heroin addiction. That you you helped me to understand
that early on. And um, and I think I remember
telling you many years later, like damn, you were right.
(49:35):
And I was actually embarrassed because here I am a scientists,
a pH d in this area, and I hadn't read
the studies that showed what you were so enthusiastically telling us,
and we were dismissing you, um and um. So it
was an embarrassing moment for me. And I don't ever
(49:56):
want to be embarrassed like that again. So you're right.
Who are right then? And you're right now about this
and so much so that I have decided to spend
half of my time in the US and half of
my time in Switzerland, not because I think the Swiss
are are somehow better than most people on the planet.
(50:17):
Not that's not It's just that they simply treat their
citizens better than we treat our citizens here. And I
have a scientific community that I can interact with, and
they are also close to Paris, and they and I
can get to Spain and other places in the European
Union that have better drug policies, and they are more
(50:40):
civilized about this issue, and so um staying in the
US for extended periods of time, it just makes me
a more angry person. And I don't want to be
that way. I like feeling like, uh, I have taken
M D M A. I like feeling like I have
taken six A p B because I'm more generous, I'm
(51:02):
more forgiving, I'm more magnanimous, and those are qualities that
we should encourage other people to be. Well. Carl Le,
let me just say, I so much value what you've
been doing with your life, with your books, with your teaching.
I value our friendship. I'm gonna miss you a bit
when we're out in Switzerland, but I do you know.
I love your man and wish you all the best
(51:23):
in these next steps. I love you too, man, and
you know. I learned from you a lot. But one
of the most important things is that you always say,
oh my bad, Miacopa, I sucked up, and you never
have any qualms with doing that. And we all do
we I mean, we all screw up, but we don't
take responsibility for screwing up. But you always have done that,
(51:44):
and that's one of the sort of important lessons that
I have taken from you. Thanks a lot. Okay, Carl,
you take care and have a good trip. Okay, Great
to see you, bro. Psychoactive is a production of I
Heart Radio and Protozoa Pictures. It's hosted by me Ethan Naedelman.
It's produced by Katcha Kumkova and Ben Cabrick. The executive
(52:05):
producers are Dylan Golden, Ari Handel, Elizabeth Geesus and Darren
Aronovski for Protozoa Pictures, Alex Williams and Matt Frederick for
I Heart Radio and me Ethan Nadelman. Our music is
by Ari Belusian and a special thanks to a Vivit Brio,
sph Bianca Grimshaw and Robert Beatty. If you'd like to
share your own stories, comments, or ideas, please leave us
(52:28):
a message at eight three three seven seven nine sixty.
That's one eight three three psycho zero. You can also
email us as Psychoactive at protozoa dot com or find
me on Twitter at Ethan Nadelman. And if you couldn't
keep track of all this, find the information in the
(52:49):
show notes. Tune in next time when I talk with
Pat Denning, a longtime friend who's working at the cutting
edge of harm reduction drug Tree. When we had prohibition
in this country, the law of the land said alcohol
is so dangerous, it's so poisonous, that no one should
(53:09):
ever be allowed to consume it, And thirteen years later
we made it legal again. To make that make any
sense at all, we had to adopt this idea that
there's this disease called alcoholism and some people have it
and some people don't. That's an insane way of reintroducing
a drug into society is by saying, oh, well, ten
(53:31):
percent of you can't drink at all, and the rest
of you can drink as much as you want to.
It's a political ideology, it's not settled science. Subscribe to
Psychoactive now see it, don't miss it.
Hi, I'm Ethan Natalman, and this is Psychoactive, a production
of I Heart Radio and Protozoa Pictures. Psychoactive is the
show where we talk about all things drugs. But any
views expressed here do not represent those of I Heeart Media,
Protozoa Pictures, or their executives and employees. Indeed, heed, as
(00:23):
an inveterate contrarian, I can tell you they may not
even represent my own and nothing contained in this show
should be used as medical advice or encouragement to use
any type of drug. Hello, Psychoactive listeners. Today is kind
(00:45):
of fun for me because my guest today is somebody
who have been friends with for almost twenty years now
and have huge admiration and respect for. That's Karl Hart,
the Columbia professor who's written a very important book Drug
Used for Growing Ups and follow his first other kind
of semi autographic called book High Price. So Carl, thanks
a lot for doing this. It's good to see you man.
(01:07):
Yeah you too, Carl. Let's start off with this. You're
in some hotel, maybe about to give a talk, and
you got the book, and you got somebody says, hey, man,
I saw you got that book. What's it about. Well,
the book is called Drug Used for grown Ups and
the subtitle is Chasing Liberty in the Land of Fear.
I'm just trying to get people to think about their
(01:29):
own liberty and what it means to be free. That's
that's it. And I'm using the subject that I know
best as a vehicle to help people to think about
their liberty. Uh. And I don't mean liberty in this
kind of Trumpian sense um, where your liberty Trump's everybody
else's and you can do whatever the funk you want
(01:50):
to do. That's not what I mean. I mean your
liberty in that you're not bothering anybody, so why should
people care what you do? As long as you are
responsible a dope man. I'm using drug use as as
a topic so people can think about their liberty not
only in this subject, but also with just other subjects.
I mean, from prostitution to a range of things. We
(02:12):
have over police people's personal behaviors and we don't even
think about it anymore. And in this book, I'm trying
to get people to think about why do we do this?
Stupid ship? M hmm, we you don't. I mean, look,
you were on my board of the Drug Policy Alliance
for ten years at the beginning in two thousand and seven,
maybe more than that. And so in terms of what's
wrong with the war on drugs, in terms of mass
(02:34):
incarceration and a deporation of rights and all the harms,
I mean, we're very much together on that. What's unusual, though,
is for you to put the argument of liberties so
front and center. And I say unusual because typically it's
something that libertarians do, civil libertarians do. And I will
tell you something that as me, as a white man
(02:55):
advocating on these principles of liberty, I would get a
lot of ship for this, you know, like, oh, you
can talk about your liberty, yeah, but what about poor
people suffering, black and brown people suffering the ghettos? You know,
what's liberty for them? You know that this is the
rich man's How do you how do you respond to
that or how do you deal with that? Because I
love the fact that you did this, but I want
to know the experience of coming out in that argument
(03:17):
for you. Well, you know, in our country in the US, uh,
people think of liberty as a construct owned by the libertarians. Uh.
And those people don't understand the founding principles of the country.
The founding promise of the country is that we are
all guaranteed life, liberty in the pursuit of happiness. Doesn't
matter who you are, You're guaranteed those freedoms, those rights.
(03:40):
And so I'm trying to reclaim liberty for the American
people and not only for the libertarians. This is an
American principle, not a Libertarian principle. But it's a hard
one for people to understand. And I get it. I
get the fact that some political groups have kind of
owned these kind of principles and and other people who
(04:01):
have been shut out as a result. But this is
liberty for all, and I'm asking us to live up
to our principles. Make our practice match our promise. That's
all I'm asking you. Go man, I'll tell you years ago,
I got asked to speak at some kind of progressive
economics conference and it was all people on the left,
progressive liberals, unions, whatever. And I spoke on the second day,
(04:21):
and I get a big speech and I say, you
know something, I've been here for over the whole day, right,
and I share overwhelming the values that the people are here.
But there's two words I have not heard mention in
the entire first day, day and a half of this conference.
And that's of the words freedom and liberty. Right, what
is the left wing seating these these words and these
values to the right. And so I think for you
(04:43):
coming out on this thing is incredibly important. Now, what
I also liked was, you know, not often does one
see Jerry Garcia, the Grateful Dead Maestro and Martin Luther
King put together making essentially the same argument. So just
elaborate on that one. Yeah, you know, this is a
thing that I wish people read the book because then
(05:05):
we can see how much overlap, how much connection we
all have in this country in terms of our heroes.
Jerry Garcia was influenced by Martin Luther King, and Martin
Luther King was influenced by the Row and all of
these people were influenced by what Thomas Jefferson wrote. And
we know Thomas Jefferson had his problems. Uh And and
(05:25):
of course I I talked about that a little bit.
But the point is the ideals which these people espoused,
they are ideals that are bigger than the people who
are espousing these ideas. And so I'm trying to get
the reader to think about these ideas and then if, if,
if we could maybe live up to these ideals, then
we would be a better country. We will be a
(05:46):
more compassionate country. Yeah. You reference went at one point
to a letter from a Birmingham jail by marlou Uther King,
which is something I used to sign to my students
back when I was teaching a princeton on law in society.
Why did you reference that piece? Yeah, I referenced that
piece because us where King dealt with in that letter
were his allies coming at him. The white ministers were
(06:08):
coming at him, asking him to go slow and saying
that his actions were maybe not prudent. And so he
talked the time and patients to explain why it's so
important to move in the way that he was moving.
In the way that he was moving was simply that
black people in this case deserved their humanity, deserved to
(06:29):
be respected just like everybody else's humanity. And um, there
is no such thing as moving too fast when you
want to make sure people's humanity are respected, and that
that's the same thing with drugs. We say things like
let's start with this one here, M D M A,
but not heroine here, it's like who gave you the right?
(06:50):
You know, you go back and you talk about the
history of the criminalization of drugs, about the Chinese and
the opium bands and blacks and their wine, and also
about you know, cocaine and the crazed negro drug fiend. Right,
the story going back a hundred years, and how it's
manifesting today. Right. I mean you wrote that very powerful
(07:10):
at been in New York Times a while back about
George Floyd and how the cops trying to say, hey,
because he was on drugs, right, And so do you
think that more people, and especially more black people are
beginning to wake up to the things about the anti
drug piece of this thing when they see so many
I mean one after another. I mean black people are
being killed by the cops, and the cops saying it
(07:31):
was because of the drug, because he was selling drugs
and he was using or whatever it might be. Do
you see a change happening there? I think so. I
think when you have George Floyd and you have Brianna Taylor,
particularly with someone like Brianna Taylor, um, she was not
in the game, and but the justification was that her
ex boyfriend was in the game and they were just
(07:52):
the cops were justified to come in and kill her.
And I think people are finally starting to see that,
wait a second, this is crazy. No matter how many
drugs this particular person was selling, the were alleged to him,
So you shouldn't be able to kick someone's door down
and then murder them. And so I think people are
starting to see. People are starting to put together Philando
(08:14):
can still uh he had marijuana and that cop of
shot him to death. Um, we think about Lakwan MacDonald,
the seventeen year old kid in Chicago where they said
that he had PCP in the system and he was
shot sixteen time. I think people are putting it together,
particularly now in this age where we see the police abuses,
(08:37):
and people are starting to see that drugs are always
used as this convenient scapegoat to justify this awful behavior.
And so on the one hand, I'm really happy that
people are starting to see. On the other hand, it
makes me um profoundly sad that we have to steal
deal with this particular issue when it goes all the
(08:59):
way back to the turn up the last century, the
turn up the twentieth century, and we're still dealing with it.
So that makes me profoundly sad. Yeah, yeah, I don't know.
I almost don't know where to go from there. I mean,
it's the question of, well, let me put it this way.
You know, sometimes I think we know and you and
I have both been out there talking for years and
(09:20):
you can speak to it from a much more personal
basis about the role that race and racism has played
in the war on drugs going back to the early years,
and the multiple levels at which it plays down, and
so we know that racism permeates this. It permeates why
blacks get treated different than white It's like the crack
powder laws and tougher penalties on crack. It permeates on
so many different levels. But you know, sometimes I put
(09:42):
out there that there's another ism that we're not even
willing to deal with, and for lack of a better term,
it's druggism, right that there is. Now it's not longer possible,
at least publicly to say racist things. I mean, now
on the trumpet begins to become possible again. But basically
that's been delegitimized and you can lose your job. There's
all sorts of things for making a comment that sounds
at all racist, right, But when it comes to druggism,
(10:03):
when it comes to disparaging addicts junkies, when it comes
to making assumption about them, that seems to be one
of the last remaining really legitimate prejudices, and not just
on the right, even across the political spectrum. No, you're
absolutely right when we speak about this language in terms
of the role of rais and uh drug policy or
drug policy being used to subjugate like black people, for example.
(10:27):
The thing that I have to be careful about is
I have to not be lazy, and when I'm lazy,
I might say that drug policy is used to subjugate
black people, when in fact that's just an example of
how drug policy is used. But drug policy is really
used to subjugate the powerless, the people on the margins
of our society. And then I can give an example
(10:50):
of how black people are disproportionately arrested, but I can
give another example to talk about white folks in Oklahoma
who use methamphetamy, they are also disproportionately subjugated. And I
can talk about the users in the Philippines. They're being
subjugated for the same reasons. And so um, that's why
I have to be careful so that people understand that
(11:12):
this is a universal sort of thing that's going on
with drug policy. It's not unique to black people. But
in the United States, um our drug policy. Because we
have this conspicuous difference in our race, it makes it
easier to point to it. But don't get it twisted.
This is the universal thing. And the people who are
in the middle classes, who have power, who are the
(11:35):
educated class, Um, they're not being subjugated in the same way.
In fact, they are so busy distancing themselves from the
methamphetamine users, from the heroin user, from the black user,
what have you, and so um, these laws are not
equally applied as we know. Yeah, you know, it's interesting
because it's another commonality we have in this thing. You know,
(11:56):
for many years, going back decades, I would go to
speak safety annual conferences of Normal the Marijuana Legalization Group,
which I support, and they were fighting for legalization and
they're my allies. But sometimes people we get up there
and say, you know, we gotta legalize marijuana so we
can crack down on the meth heads. And I with them,
lecture them and say no matter what you think of
mess and even if it is a more dangerous drug,
(12:18):
that's no basis for treating those folks differently. And make
the analogy to the First Amendment. The first a moment
doesn't just protect elevated speech, right, it also protects you know,
quote unquote ugly speech less elevated speech. We'll be talking
more after we hear this. Add what you do in
(12:47):
this book that I think really breaks some new ground
in different ways. Isn't talking about myth amphetamine, heroin, PCP
in a way that really, I mean, very few people have.
I know, I put my toe in the water, but
you take it many steps further. And so, you know,
(13:09):
and we see that with marijuana, right, we see that
Mariana legalization, we've radically changed that, you know, from reform
madness and brain on drug stuff and all that that's turned.
Now psychedelics is kind of opening up and changing people's
minds and things like that. But there's other drugs, the
ones who are most of what people are going to
prison for selling and possessing. You take on those one.
So let's just start off with meth amphetamine, because that's
(13:31):
something you've been studying for a long time, and you've
produced reports and studies on that thing. So can you
explain to our listeners, you know why what they may
think about methamphetamine is more or less flat out wrong. Yeah,
So when when I think about methymphetamine, Uh, it's important
for the listener to know one thing, Adderall the methymphetamine
(13:51):
are essentially the same compound adderall. Of course, it is
the medication that's used to treat attention deficit disorder. Methamphetamine
also is at the proved to treat attention deficit disorder
as well as obesity. UM. The only difference between the
active ingredients and adderall, which is d amphetamine. The only
difference between d emphetamine and methamphetamine is an additional methyl group,
(14:14):
and that method group, we have said in research makes
it easier for the methomphetamine across the blood brain barriers
such that it gets into the brain more rapidly, so
there's a more rapid onset of effects. Now, there is
no data in humans to prove that or show that
this is mainly uh kind of based on animal studies
(14:36):
and speculations about what that sort of increased lip solubilility means. Now,
we have said that that makes methamphetamin more reinforcing, that
is more addictive. Again, no evidence to show that, because
all of the evidence when you test methomphetamy against UH,
something like a d amphetamy UH in the same human
(14:58):
users they choose used to take the drugs on the
same number of occasions, and the self administration patterns look
the same. Humans can't distinguish between the two drugs on
the double blind conditions. So methamphetamine is essentially the same
drug that people are taking in adderall. Not that's not
to say that people should stop taking their adderall because
(15:20):
this is such a danger struct No, that's the same
that methemphetamine. It's f the approved for a reason because
it's effective, because it's a safe medication when used in
the doses when the medication is prescribed. So they are
essentially the same drug. Now, what people see in the
natural ecology is that methamphetamine use is primarily smoking or injection,
(15:44):
and so rout of administration certainly impacts the speed at
which the drug reaches the brain. It also impacts a
number of things the conditions under which the drug is taken.
So what people are really seeing is a function of
the legality of the drug, the route of administration, and
all of these sorts of things, but not the drug itself.
(16:05):
But they are attributing all these factors to the drug,
when in fact it's really about these sort of psycho
social characteristics are factors more so than the pharmacological factors.
So if I were to summon up by saying that
if you were to take that, I don't know ten million,
twenty million. However, many young mostly boys, are being prescribed
(16:25):
adderall today and substitute for that an equivalent dose of
oral meth amphetamine. Probably those kids would not even know
the difference, or it would be roughly comparable. And conversely,
if you were to crush up those kids adderall and
smoke or injected, it would be fairly indistinguishable from the
people using kind of underground illicit meth amphetamine smoking ejecting
(16:48):
that apart from maybe the effect of the contaminants in
the illegally produced stuff. Absolutely. And another thing about adderall
is that it has three amphetamines. There's an L, there's
a d UH and the L doesn't cross as well
as the D doesn't cross the blood brain barrier as well,
and so the adderall has more cardiovascular activity that I
(17:10):
don't really need um, and so UM, I think that
the D and methamphetamine is actually more ideal. You know,
I got my doctor to prescribed to me blow dose
five milligram dextro amphetamine. You know, I told him I
needed for jet lag, which is true, and you know
I use it occasionally. UM. And then at one time
I got a friend of mine to give me one
of his kids adderalls, and my sense was that adderall
(17:33):
was more kind of jagged e like. It almost felt
like the dextro amphetamine was a smoother one. And it
made me wonder, why aren't they using dexter amphetamine with kids.
Was there a possibility it actually might be better for
many young teenagers or is there some good reason not
to be doing that. Well, they do use a D
M fetamine dexterro emphetamine for kids. First it owned the
(17:55):
market of the tension deficit disorder UH and then Riddland.
Eventually they tuck over. But then adderall hit the scene
because Shire of Pharmaceuticals marketed and told physicians that, oh
it's a slower onset of effects and this is better,
and they had this big marketing campaign and that's why
people are prescribed adderall because of Shires effective marketing campaign,
(18:19):
not because of the effectiveness of the medication. So while
we're on the subject of big pharma, the one that's
most notorious, right is Perdue Pharma, right in the Sackler
family and their creation of of oxycontent, a drug that
appeared to be a really very effective pain controlled drug
for some people living with serious pain, but which then
(18:41):
you know, it appeared they over to marketed quite seriously.
I mean, how much do you hold Perdue Pharma sort
of responsible for the kind of starting phase of this
significant expansion of opioid related fatalities in the beginning of
this century. They certainly deserve some responsibility here because they
got the FDA to schedule oxycotton at a lower level.
(19:04):
It wasn't a scheduled too, I think it was scheduled three,
whereas other opioids were scheduled too. They said it was
less addictive than the other opioids, which was not true. Uh,
And so they deserve some responsibility there, of course. But
when we think about, uh, the fact that people are
dying from drug related overdoses. Uh, An important reason that
(19:27):
people are dying from drug related overdoses is because people
are getting contaminated drugs on the street, and that's an
easy fix. You can just make sure that people have
a clean supply or safe supply, or make sure that
they have access to drug checking so you can check
and see what's contained in your your substance. That's an
easy fix. And we as an American public, we haven't
(19:49):
done that. But yet we're blaming the pharmaceutical company for
that which they have nothing to do with that. And
we also blamed the pharmaceutical company for like addiction rates,
when the fiction um has nothing to do with the
drug itself. Addiction is mainly related to all these other
psycho social factors, like beginning in the nineteen seventies and
(20:09):
continuing in the eighties, when all of these factories left
the Midwest, they left the rust belt places, and people
who once had jobs that paid the middle class salaries
they no longer had it. They once had standing in
that community, they no longer had it. That increases the
likelihood that people will become addicted to have all kinds
(20:29):
of problems. And we see that sort of thing, but
we don't talk about all of these other sort of
issues that are involved. Instead we just say perdue, Yeah, Carl,
I mean, well you're talking about, obviously is what people
have referred to as these deaths is to spare right,
the high rates of alcoholism, opioid misused suicide happening in
parts of the country, you know, whether black, brown, or white,
(20:50):
where people have been struggling, and especially sometimes where people
are downwardly mobile. But the other thing I think when
you're talking about is the thing about the pharmaceutical companies.
I mean, obviously they're all really aggressive. Promoting of this
stuff created a problem, as did ignorant doctors and ignorant
nurses and patients wanting to pop a pill, and insurance
companies not wanting to pay for this stuff, all those things.
(21:11):
But interestingly, when they were getting it there, those drugs
were relatively pure, and once they started once and started
to crack down for some good reason on the pharmaceudical companies,
people started turn to even more black market drugs, first
heroin and then fenton al And so there was a
paradoxical thing where the crackdown the pharmaceutical companies may have
(21:31):
actually made the overdose epidemic even worse than or otherwise
would have been. Yeah, we know that when you have
the crackdown in the legitimate source, then you have the
illegal sources pop up. Absolutely. Um just I have to
be careful when we talk about this thing we're calling
the opioid crisis, and we're talking about overdoses. In the book,
(21:53):
I try to help the reader understand that these things
that we're calling overdoses and we're blaming opiates for, we
don't really know that opioids are the actual causal agent
for the overdose. UH and I try to walk the
reader through how medical examiners and corners do their death
(22:14):
investigations and the level of education that's needed to be
a corner in most locations are high school diplomas. That's
all you need and a few hours of a death
investigation course. And there's no uniformity in terms of how
these death investigations are done. Most of the people who
(22:36):
die from drug related overdoses have multiple drugs in their system,
and then there is no levels that are measured to
determine what drug might have been the causal agent, and
in some cases they don't even get biological confirmation that
that was actually opioids in the system. And so UH,
(22:57):
I asked the reader to really think about what's going on,
Because dying from a single opioid like heroin, it's not
the easiest thing to do, particularly something like fantonol. Of course,
a single drug one can die from more readily. I mean, basically,
what you're saying is that the large majority of what
are called over those fatalities are really fatal drug combination fatalities, right,
(23:22):
I mean, it's that mix, and that the media and
sometimes the corners, you know, rather what I didn't saying, oh,
this was a fatal drug combination, or saying this was
a benzo death or an alcohol death or a set
amath and death. They just call it an opioid death
because that's easy. That's what the media wants to report.
Or even if the small print doesn't say that, that's
what the headline writers put up there. That's exactly it. Now,
(23:43):
it also seems to me that what you're saying about federal, though,
is that federal is in a bit of a special category.
They've given that it's what fifty times more potent per
milligram or whatever than heroin. People can die just from
a straight federal way in a way that was unusual
with heroin or oxyes or things like at Now that
seems to me to maybe present one of the strongest
(24:04):
arguments for some form of legalization or safe supply of opialities. Absolutely,
people will use opioids. People will use drugs. The question
before us as a society is how do we best
keep people safe? And it seems as though we have
been comfortable and pretending that people won't use drugs and
(24:26):
allowing people who do use these drugs to uh engage
in this precarious activity of taking drugs that are purchased
on the list of market. To me, that's not what
responsible society should do, particularly one that claims to be
proponents of life liberty in the pursuit of happiness. Now,
(24:47):
you talk a fair bit in the book at many
places about drugs safety testing, right, testing the quality of
what the pills are, and just explain why that's so important. Yeah,
we call that drug checking or drug purity checking, drug
purity checking um. It occurs in a number of countries
including Portugal, the Netherlands, Austria's, Spain, Colombia, uh and none
(25:11):
of these countries have so called opioid overdose crises or
any overdose crises. Drug checking what it does is that
it allows UH drug users to submit anonymously UH small
samples of their drug UH and then get a print
out of what's contained in that sample. These subances are
free and they're done with the primary goal of keeping
(25:34):
people safe, so people are not exposed to UH poisons, adulterants,
or other toxins that might be in UH the illicit
drug supply. And so I have been advocating that we
do the same thing in this country. We have the technology, UH,
we certainly have the resources, but we haven't and we
(25:55):
have one of the biggest sort of overdose concerns, but
yet we have not made these services available to our people.
So when politicians say that they care about the opioid
crisis or the health of the public, and they are
not advocating for these services, then you know that they
really don't give a ship. Well, let me I say,
(26:15):
can these testing services checking services also detect the potency
of a sample? Yes, UH, they can detect the potency,
They can detect the amounts UH and all of the substance.
Because our seeing now, I think especially the harm reduction
programs either on the US right doing these sentinel testing strips.
Since you're trying to detect the presidents of fentanyl. Na, No, no, no,
(26:37):
that's a joke. Man. That ship is a joke. I mean, obviously,
if that's all you got, Okay, I get it. But
for a country like ours with so many resources, for
the people who have to revert to using fentanyl strips,
that's a shame. I mean that this is a shame
because it only detect fentanyl and some pentonel and not
(26:59):
any other of compounds that might be uh contained in
the substance. And and we have the technology, so to
pretend that that's a fix, or to pretend that that
that's what we should be doing, it's insulting, particularly when
they're doing this in Colombia, in Austria. It's a joke.
I mean, it's it follows in a long line, right
(27:19):
of opposing needle exchange programs because it might encourage people
to say shooting drugs is safe. Of opposing the lock
zone because it might make people feel safe for using opioids. Right,
it's that whole thing or where the politicos and the
public health folks are scared if even when they know better,
I mean, if even goes back to a hundred years
ago when they used to talk about giving how condoms
to soldiers, and people say, how can you do that?
(27:40):
It's gonna make it safer to have extramarital sex or
illicit sex or whatever. That's the thing that is remarkable
to me, and that why should I care what someone
else is doing? As long as they're not bothering other
folks and long is that they are not preventing other
people from enjoying their rights. Who am I to say
(28:00):
what they should be doing? They are adults. You know,
you're talking the book about the novel psychoactive substances, things
that became known as bass salts or these synthetic cathinones
are synthetic cannabinoids and things like that where it seems
like the drug checking would be incredibly valuable because often
has people have no idea what their getting. Yeah, we
vilified the cathinones, uh, these bath salts. Again, we lied
(28:23):
about the effects of these cathinones. Many of these captain
oons produce effects similar to M D M A and
similar to cocaine um. But we said that these catherinons
make people bite other people's faces off, And of course
that's not true. And I detail that story of the
Miami cannibal and how that person never had any cathinones
(28:47):
in the system. But that's not what the press said. So, UM,
don't believe the hype about the catanones. Uh. Many of
these cathinones produced in D M A like effects, and
they produce cocaine like effects. You wrote in the book
about assuming at one point that you could do a
double blind test and that people taking extra amphetamine and
m d m A would have the same response to it,
(29:10):
and then being somewhat surprised that that actually wasn't the case.
The reason why I thought that they were produced nearly
identical effects is because when you look at them chemically,
they looked nearly identical. M d M A has a
methyline dioxy ring added to the methomphetamine structure. I thought
(29:30):
that they were produced effects that would be nearly identical,
and sure enough, when we looked at some cognitive tests,
they produced a lot of overlapping effects. Uh, some different
effects whereas m d m A disrupted some performance, methomphetamine
improved performance, but they produced a lot of overlapping effects.
(29:51):
But that's not what people say. In the natural ecology
and the natural ecology people say that nah, M B
M A, there's nothing like it. You know, this empathy,
the openness, this connection with others. And at that point
in my career I had tried me them fettermy, but
I hadn't tried M D M A. But then I
tried M D M A and then I saw like, oh, well,
(30:12):
maybe our lab measures are the problem in that we
just are not capturing the unique bits of M D
M A. Let's take a break here and go to
an ad M. Carl And I know you gave a
(30:35):
lot of thought to this one part of the book,
and it's the one that's gotten a lot of attention,
which is the way you talk about heroin. Just gonna
read a few of the good quotes you had in there.
At one point you say, there aren't many things in
life that I enjoy more than a few lines by
the fireplace at the end of the day. I think
you said, listen to Billie Holiday, And then you said
Heroin enhances my ability to feel and think. You said,
(30:57):
I also want to ensure that others are afforded safe
out tunity needs to benefit from the serene bliss opioids
can offer. Should they so choose now I will admit
that heroine's always scared me. I mean, I've tried it
a numerous times to see what it's like. I mean,
the last time I did it was with you and
another friend in Europe a few years ago, you know,
so you know, and my friends always made sure that
(31:18):
I took just a low dose, and they were watching
al for me and say, you know, look, if you're
gonna have a drink afterwards, be moderate. But I got
to admit there was something about heroin that scared me
almost not unlike the way that tobacco and nicotine scare me.
That there's a stickiness to those drugs that if you
start to like them too much, they just make the
hard to detach yourself from. And you describe going through
(31:41):
a withdrawal experience. What I love about it is you're
out there saying, you know, for all you marijuana and
psycholic exceptionalists, it's not just the political principle that shouldn't
be exceptional, it's actually a way we think about these
drugs and understanding that they actually can play a beneficial
role in your life. So just say more about you're
coming from on that and how you feel about that,
(32:02):
and if you feel like talking about how people have
responded to that. Yeah, what heroin is the boogeyman drug
of course in the United States. And so h your
point about liking it too much and then getting attached
to it, think about that for a minute. You know,
there still is nothing better than the sexual orgasm. But
(32:23):
do we hear people saying ship like m, I better
stay away from this orgasm because I might get too attached.
I mean, it's it's just a matter of when we
have these drugs be illegal, then we have to go
through all of these various obstacles to get the substance,
and that plays a role in terms of the addictive
(32:44):
potential of the something. And so I don't think heroin
is particularly addictive. Of course, it can produce physical dependence,
so two can alcohol, So too can your antidepressant. A
number of these drugs can produce physical depends. But the
majority of people who use heroin are not addicted to
the substance. But they just don't say that they use
(33:07):
heroin because of this negative sort of view that we
have of heroin. You alluded to how people have responded
to me admitting to having used heroin. In fact, people
would like to dismiss me simply because I've used heroin.
And so imagine that somebody like me who published more
than a hundred scientific papers, three books, and people are
(33:30):
trying to dismiss me. Imagine what they will do to
other people who don't have such a record. So I
I get it. I understand why people don't say they
use heroin, and so it gives this impression that certainly, uh,
this drug is so addictive that you shouldn't do it.
And then the filmmakers, the documentary filmmakers, the TV filmmakers,
(33:51):
the comedians, they need heroin as a foil because then
they can describe drug addiction in this awful way and
they use herible. And imagine if comedians didn't have these
drugs to make fun of. Imagine if the documentary film
had somebody like me who've used these drugs and go
on with their life, take care of their family, have
(34:12):
a happy life. That would be boring. And so we
need heroin in this culture to vilify for all of
these pop culture sort of reasons. You mentioned that I
went through heroin withdrawal. It was intentional, so I could say, okay, um,
it's something, it happens. But it's not life threatening like
alcohol withdrawal, it's life threatening. I will never put myself
(34:34):
intentionally through alcohol withdrawal because I would be afraid of
the life threatening effects. But heroin withdrawal from most healthy people,
it's not life threatening, and so that's why I did it.
I haven't gone through heroin withdraw sense or before, certainly
not in a way where the symptoms had me feeling
like I described in the book. Then I can take
(34:55):
heroin or leave it. And being that we've had this pandemic,
for example, I've been stuck in the United States, so
that meant that I wouldn't have access to good, pure heroin,
So that meant that I couldn't use heroin. And it's
no big deal. That's just like um, caffeine or some
other substance that I choose to use or choose not
to use. You know. Reading that parts of your book
(35:16):
about heroin, it reminded me of one of the classic
studies in the field, which was the Harvard professor Norman
Zenberg Right, who many decades ago did a book called
drug Set and Set It Right. And drug set and
setting was the phrase that was coined by Timothy Leary
and developed by Andrew Wild and then Norman Zenberg, professor
Hart Medical School, tested it. And I think what he
did was he put advertisements in the local Boston newspapers
(35:39):
looking for people who said they used heroin but did
not feel they were addicted. And hundreds of people came
out of the woodwork, postal delivery workers and school teachers
and people who are living rough on the streets, and
people who had significant professions, and even coined the term
I think chippers to describe people who used heroin occasionally
without becoming addicted to it. Now, interestingly, between his writing
(36:02):
that forty years ago or whatever and you're coming out,
so little is actually said and written about this. And
I wonder if one reason is that the key research
funding agencies, so the government, naturally student on drug abuse,
is just not interested in finding this sort of an
information out. No, they're not, But you know, we know
(36:23):
the role that NINER has played Nighter. It's the National
Institute on Drug Abuse. Their primary mission certainly has been
for most of its life to focus on the negative
effects produced by drugs, so we know they're so to bias.
I was on Night as advisory council. I'd served my term.
I was a grant reviewer, I was a chair of
(36:45):
a grant review session. I had grants myself, So I'm
not speaking as someone who doesn't know. I mean, I
was a part of the system. But I think it's
it's a lot bigger than Nina. It's uh the people
who do drug treat and they are so invested in
this as well. They have come out really strongly against
(37:06):
someone saying that you can use heroin occasionally, even though
we know that heroin and noxycontin are essentially the same drug.
We know that heroin and morphine are essentially the same drug.
But heroin has this sort of additional uh vilification attached
to it for some reason, because it has this important
role in our society. It helps us to define us,
(37:29):
and then we can uh persecute these people who use
heroin because they are somehow morally less than we are. Something.
It's playing some important role in our society that is
far beyond the pharmacology of the drug. Yeah, although what
you're saying about heroin was probably also true of meth
(37:52):
and messi anthetamine back in the early two thousand's right
that nobody could use it without being addicted. I remember
when I go out and speak to people, and I
let me give you this example. You know, an editor
of a newspaper tells his reporter to go write a
report about alcohol in the city, right, And the reporter
goes out and he comes back with all these articles
about twelve step meetings, you know, detox wards, jails, treatment programs,
(38:16):
and the editor pulls open his drawer, pulls out his
bottle of whiskey. From the drawing goes, what are you
talking about? I understand that's one part of the story,
but what about the people having a beer? What about
the vineyards and the wine? What about you know, story
not told? Same editor tells, same reporter, go, do me
a story and meth amphetamine. The reporter goes out, goes
to the jails, goes to the treatment programs, goes to
(38:38):
that sort of thing, comes back and the editor goes,
great job, and never stops to say, wait a second,
aren't there people using meth there who are not this way?
Who's actually attracting new meth users? Because it's not gonna
be the guy who's down and out in teeth falling
out all this sort of stuff. There has to be
something else going on. But it doesn't even occur to
people to think that way at all. That's exactly right,
(39:00):
and that's one of the things I was trying to
do with the book. I traveled around the world. Each
chapter is kind of set in another country, and I
tried to show people that the vast majority of folks
who are using drugs are middle to upper class people
who are captains of industries, who are famous, people who
are important people in our societies, people who we love
(39:20):
and respect. They are the vast majority of our drug users.
And I tried to get people to understand that the
illicit drug trade is a multibillion dollar industry, and a
multibillion dollar industry could not be supported by people who
are poor and down and out. That ship just doesn't
make any sense. But we still believe that nonsense. I
(39:44):
remember one time asking somebody who's middle class business owner
or family, etcetera, who had taken method on daily because
he had once had a heroin addiction, And I said,
why don't you speak out publicly? I mean, you would
help transform the image of who is a Method on consumer?
He says, he's a Let me tell you something. I
run a business. If one day I come in and
I'm exhausted because my kid was up sick, or I
(40:06):
was finding my wife and I put my head down.
People go, oh, poor Joe. I guess he had a
rough evening when it was going on. If they knew
I was on method on, they would go, oh, Joe,
he must be nodding out. They'd make that negative assumption.
He goes, I can't come out, And so in your case,
I'm wondering. I mean, I remember back in two thousand seven,
I actually joined my board. I said, Carl, you're not
even tenured as yet, and you got, you know, a
(40:28):
drug war guy chairing your department, and you wrote me saying, Ethan,
as a matter of principle, I got to do the
right thing, even if it costs me a bit. Here
you're coming out, but you do have tenure now and
your kids are now going to college or graduated. Right
do you think you would have not done this when
you're an assistant professor, when your kids were younger. I mean,
there's something about this being a point both a point
(40:49):
of the broader culture, at a point in your life
where it felt safe to do so, relatively speaking, not safe,
but relatively speaking. But yeah, uh know, it's Uh, we
have to also understand that, you know, I was still
developing and I'm I am still developing and I'm still learning.
(41:09):
And so it's at a point in my life where
I am comfortable enough to deal with the bullshit that
I get because anybody talking about drugs and the subject
I can deal with because I noticed subject so well,
Whereas five years ago, ten years ago, I didn't know
the subject as well, and I couldn't deal with the
(41:29):
questions to pushbacks and and I just wasn't knowledgeable enough.
And so as I gained more knowledge, I gained more confident.
And so it really has to do with my confidence
and my ability to explain what I do and why
I do it now, not so much a political calculus.
That's not what's going on here, because as you know,
(41:53):
people are trying to dismiss me as crazy whatever. They're
still trying to do that. And people in my departments,
uh they I'm into departments. There are people who talk
shit about me about this, and they are they are plotting,
they're doing their things, and so there are consequences, uh
to this, and there have been consequences in terms of universities.
(42:16):
Are people who invited me to give talks, have disinvited
me as a result of me coming out of the closet.
I have been censored in all kind of ways. So
there are so many consequences that the public does not
see and does not know. But I don't really care
about that, because I would be a coward if I
didn't stand up and say this, given what I know now,
(42:40):
And so that's why I am speaking out my I
mean over the moon for the way you're handling this stuff,
because it is courageous. One of the things you stress
in the book is that this is a book for
growing ups, and you point out that a lot of
the advice and the margins of safety for using drugs
like matthian fetemine or heroin and are safe, responsible way
(43:00):
probably don't exist for tens of millions of American adults
who you know are struggling in one way or another.
So what do you say about the obligation? You know,
are there risks in which you're advocating for the tens
of millions of Americans who don't have it together to
do it responsibly. You're right, I did say that this
is a book for grown ups, and I just wanted
(43:21):
people to understand I had a definition of grown ups,
people who are responsible, take care of themselves and take
care of their families and so forth. But it's important
for people to understand too that being a grown up
it's a dynamics sort of process. It's one in which
it's not static. I mean, I'm struggling with that every day,
and many of us do. Then, So, UM, I don't
(43:43):
want to exclude people when I have my definition of
grown ups, because that's not the goal here. The goal
is inclusion. But then do you have this question that
you raise about, like what about the people who don't
have their life together to people who don't have the resources. Yeah,
there are those people. Um, that's like saying, though driving
a normal bill is a tremendous amount of responsibility. You
(44:04):
think about being on a two lane highway traffic going
in opposite direction. Uh, You've got cars coming towards you,
and all they have to do is just turn into
your lane and maybe injure you or injured themselves. Um,
but we have to um, trust them, and we do
that and they do okay. And so it would be
(44:24):
kind of arrogant of me to think that I can
say who should have access to these substances as long
as they don't violate our norms, that is, in terms
of preventing other people from enjoying their rights. I don't
have the right to say that they should be restricted, uh,
in their access. I think that's part of the problem
(44:47):
with society. We have these people who think that they
have the right to tell other people how they can
live their life, and that's wrong. You know, sometimes we
define it as um the majority of people of adults
who can responsibly use these drugs need to be prohibited
from doing so in order to protect the minority who
(45:07):
cannot use them responsibly. But in point of fact, and
one of the major divides in the legalization debate is
between those people who think that if many more of
these drugs were legally available, the number of serious addicts
quote unquote would increase dramatically, whereas other people who say,
you know what, even if a lot of the drugs
that are now illegal were legal, the fact of the
matter is the number of people getting addicted wouldn't go
(45:29):
up that much because there's already so many other drugs
available legally and illegally that they could already screwing up on.
In fact, some of the ones that they're not able
to get right now might actually be less problematic than
the ones that they're being prescribed by doctors are usually
legally over the counter. Absolutely, the notion that the availability
of these substances will cause society to fall apart. We're
(45:52):
living that experiment right now with cannabis. Remember what they
said about cannabis and how Washington, Colorado, those states will
fall apart. Not only have they not fallen apart, other
states are trying to damnus to emulate those states. Uh,
And so that just doesn't hold any water that sort
of notion. We think about alcohol, which is one of
(46:15):
the most potentially dangerous substances to HUGH known to humans.
But we we do that okay, because we control the
unit dose, We controlled the purity, the quality, the education.
That's the part of being in a society. Let me
ask you how you respond when people ask me what's
the strongest argument I can think of against legalization, by
(46:38):
which I mean a legal, responsible legal regulation, And I say,
my biggest fear is when I look at what the
food companies have been able to do right The combinations
of sugar, fat, salt, a play on the brain that
are marketed effectively. And when you look at the dramatic
rise right in obesity and obesity related diseases in the
(46:59):
US and really through much of the world, right where
that where the humult of health consequences exceed those of
illicit drugs are illicit drugs, right. And I worry about
the power and the ability of major league, multinational companies
to devise interesting concoctions of all these drugs that are
adept at getting people to be dependent, even if they
(47:20):
can control it up to a point, and that ultimately
land up doing even more harm. That's my biggest fear
than in the capitalist world we live in. That may
be hard to prevent. You no, I agree, but what
you're describing is a problem with capitalism, not a pharmacological problem.
And so that's partly what happens when we have these
discussions about legalization, all of these issues get conflated, and um,
(47:43):
we we have some problems with our capitalism. I mean,
we can think about the billionaires that we have in
this country that pay no taxes, but that's not a
drug problem. That's a capitalism problem. That's like saying that, well,
ship we have the bad food because these people you
have these sophisticated ways of marketing these foods. It's like,
(48:04):
we're not gonna ban food. We need to check our capitalism.
We need to check the regulations that we have on
these companies. Uh. And we're trying to do that a
little bit with we do and on some of these
other drug companies. But that's capitalism, that's not the drug.
You know, in the earlier years of my studying drugs,
to the formative experiences, one was going to Amsterdam in
(48:28):
eighty nine and not just seeing the clannabis coffee shops
but also seeing their harm aduction stuff in action. And
the other one was going to Switzerland and ninety two
I happen to be there the day that this federal
government green lighted doing the heroin maintenance programs for people
who had not succeeded in method on programs, and then
going back a number of times to actually see these
programs in action. So you write about that in your book.
(48:50):
You write about the successful heroin maintenance programs there for
people which don't exist in the US. And now you
tell me tomorrow you're heading off to Switzerland again, so
you know, are we gonna see her coming back to
the U. S here you're giving up on this place here,
gonna gonna hanging Europe for a long time. I gotta
tell you, man, Like I remember in the board meetings
or I don't know, at some point, um in the
(49:13):
early two thousand's, I don't know when you you were
pretty enthusiastic about the results that they were achieving in
Switzerland with the heroin maintenance for people who were struggling
with heroin addiction. That you you helped me to understand
that early on. And um, and I think I remember
telling you many years later, like damn, you were right.
(49:35):
And I was actually embarrassed because here I am a scientists,
a pH d in this area, and I hadn't read
the studies that showed what you were so enthusiastically telling us,
and we were dismissing you, um and um. So it
was an embarrassing moment for me. And I don't ever
(49:56):
want to be embarrassed like that again. So you're right.
Who are right then? And you're right now about this
and so much so that I have decided to spend
half of my time in the US and half of
my time in Switzerland, not because I think the Swiss
are are somehow better than most people on the planet.
(50:17):
Not that's not It's just that they simply treat their
citizens better than we treat our citizens here. And I
have a scientific community that I can interact with, and
they are also close to Paris, and they and I
can get to Spain and other places in the European
Union that have better drug policies, and they are more
(50:40):
civilized about this issue, and so um staying in the
US for extended periods of time, it just makes me
a more angry person. And I don't want to be
that way. I like feeling like, uh, I have taken
M D M A. I like feeling like I have
taken six A p B because I'm more generous, I'm
(51:02):
more forgiving, I'm more magnanimous, and those are qualities that
we should encourage other people to be. Well. Carl Le,
let me just say, I so much value what you've
been doing with your life, with your books, with your teaching.
I value our friendship. I'm gonna miss you a bit
when we're out in Switzerland, but I do you know.
I love your man and wish you all the best
(51:23):
in these next steps. I love you too, man, and
you know. I learned from you a lot. But one
of the most important things is that you always say,
oh my bad, Miacopa, I sucked up, and you never
have any qualms with doing that. And we all do
we I mean, we all screw up, but we don't
take responsibility for screwing up. But you always have done that,
(51:44):
and that's one of the sort of important lessons that
I have taken from you. Thanks a lot. Okay, Carl,
you take care and have a good trip. Okay, Great
to see you, bro. Psychoactive is a production of I
Heart Radio and Protozoa Pictures. It's hosted by me Ethan Naedelman.
It's produced by Katcha Kumkova and Ben Cabrick. The executive
(52:05):
producers are Dylan Golden, Ari Handel, Elizabeth Geesus and Darren
Aronovski for Protozoa Pictures, Alex Williams and Matt Frederick for
I Heart Radio and me Ethan Nadelman. Our music is
by Ari Belusian and a special thanks to a Vivit Brio,
sph Bianca Grimshaw and Robert Beatty. If you'd like to
share your own stories, comments, or ideas, please leave us
(52:28):
a message at eight three three seven seven nine sixty.
That's one eight three three psycho zero. You can also
email us as Psychoactive at protozoa dot com or find
me on Twitter at Ethan Nadelman. And if you couldn't
keep track of all this, find the information in the
(52:49):
show notes. Tune in next time when I talk with
Pat Denning, a longtime friend who's working at the cutting
edge of harm reduction drug Tree. When we had prohibition
in this country, the law of the land said alcohol
is so dangerous, it's so poisonous, that no one should
(53:09):
ever be allowed to consume it, And thirteen years later
we made it legal again. To make that make any
sense at all, we had to adopt this idea that
there's this disease called alcoholism and some people have it
and some people don't. That's an insane way of reintroducing
a drug into society is by saying, oh, well, ten
(53:31):
percent of you can't drink at all, and the rest
of you can drink as much as you want to.
It's a political ideology, it's not settled science. Subscribe to
Psychoactive now see it, don't miss it.
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