Could the harm that results from recreational drug use and abuse be mostly caused by their criminalisation and demonisation rather than their physical effects?
When used responsibly, can drugs can enrich and enhance our lives?
These radical arguments are raised by Professor Carl Hart in his new book Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear.
He asks us to question how much of our reaction to illicit drug use is based in the pharmacological facts versus social coding and moral judgement.
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Carl Hart is the Ziff Professor of Psychology in the Departments of Psychology and Psychiatry at Columbia University and a world expert on neuropsychopharmacology and behavioral neuroscience.
He is open about the fact that he uses drugs himself, including heroin, methamphetamine and cocaine, however he tells Kim Hill the book is not intended to promote drug use.
“I want to make sure that people understand I’m not promoting drug use, I’m not saying drug addiction isn’t a real thing.”
Hart says that, growing up in the 1980s in a black community, he like other people thought crack cocaine was the scourge of the earth.
“I thought it was the reason for the problems we saw in a number of communities, including my own.”
Today he believes that those problems were actually caused by lack of employment, education, healthcare, discrimination along with the criminalisation of drugs.
One of the things Hart focusses on in the book is how drugs are scapegoated as a reason for bad behaviour and an explanation for criminality. For instance, when neighbourhood watch man George Zimmerman fatally shot 17-year-old Trayvon Martin, his defence claimed that Martin was high on marijuana which made him aggressive – even though audio tapes showed Martin was not aggressive and toxicology reports showed very low levels of THC.
“Drugs were used as a scapegoat in order to excuse a murder by George Zimmerman.”
Hart says many of our systems of assurances, such as drug testing pilots, are false assurances and it’s been found that many pilots have amphetamines in their systems because it helps them keep alert and awake.
“By the same token, those drugs are vilified when they’re used illicitly, so I am pointing out that we should really shore up our behavioural measures to make sure someone is capable of accomplishing a task at hand.”
Most drug overdoses, Hart says, are caused by people having multiple drugs in their system. Rather than a moral panic over a certain drug at the core of a spate of overdoses, he says we should be educating people that, if they take – for instance – an opioid, they should not combine it with another sedative like alcohol or benzodiazepines.
Another issue is that people seeking a certain drug, such as heroin, often ended up receiving adulterated substances that are much stronger, such as fentanyl.
“Then they take a certain amount that they usually take for heroin, but it turns out that if you take that same amount for fentanyl, it becomes deadly. I have argued that we need to have facilities where people can have their drugs tested for chemical analysis and, if it contains a contaminate which is dangerous, they won’t take it.
“Those are two simple solutions to deal with the very real problem of people dying from drug related deaths.”
Alcohol, a legal drug which causes a myriad of issues and deaths every year, receives public harm reduction campaigns, the benefits of which are arguable. But Hart says that doesn’t undermine his argument. He says life isn’t without risk and we don’t ban cars despite the fact that thousands die in accidents every year – we can only try enhance the safety of those activities.
“By forcing the multi-billion-dollar drug trade into the shadows, you have it in the hands of people who don’t necessarily care about your health and there’s no quality control when it comes to these substances.
“If you legally regulated these things, you can educate people, you can bring people out of the shadows. For people who need help, it would be less stigmatising. I am suggesting that the risk of our current approach is too great and the benefits would be enhanced if we legally regulated and had some quality control, decreased the stigma, I think people would be safer.”
Hart says that methamphetamine is a good example of a drug that is relatively benign if used sparingly or correctly, but can lead to major issues. He says amphetamines, which are more or less the same, are commonly used to treat ADHD, obesity, and are used by people in the military to stay aware and alert.
“If a drug like amphetamines are taken constantly, such that it’s disrupting people’s sleep and decreasing people’s food intake, those things can lead to some psychological difficulties. People can have psychological problems like paranoia, anxiety, and they can certainly be irritable because they’re not getting proper sleep or nutrition.
“If people are taking the drug on a chronic basis, yes they can certainly have some negative effects and they might misbehave. But I assure you, the vast majority of people who use amphetamines are not engaging in that type of behaviour.”
Many people have tried to describe Hart as a libertarian, but he says it’s a label that doesn’t exactly fit his world view.
“I try to take whatever approach works, and so I try not to be put into a camp because then it’s like you’re on a team and you have to always support that team even when that team does something stupid.
“I don’t like to think of myself as a libertarian, I like to think of myself as an American.”
