Drug Policy

Carl Hart: Drug Use for Grown-Ups

The Columbia neuroscientist talks frankly about using heroin responsibly and "chasing liberty in the land of fear."


Even among proponents of drug legalization, Columbia University neuroscientist Carl Hart stands apart for his unflinching honesty.

"I am now entering my fifth year as a regular heroin user," the 54-year-old full professor writes in Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear. "I do not have a drug-use problem. Never have. Each day, I meet my parental, personal, and professional responsibilities. I pay my taxes, serve as a volunteer in my community…and contribute to the global community as an informed and engaged citizen. I am better for my drug use."

In a wide-ranging conversation with Nick Gillespie, Hart makes the case that responsible adults should be free to buy, sell, and use whatever substances they want to and that policy discussions about drug use have been polluted by bad information and moral posturing. He marshals an impressive body of academic research showing that virtually all currently illegal drugs can be and are used safely by millions of people, that drug prohibition has little or nothing to do with public safety, and that the United States would be a better place if its citizens were allowed to consume a much broader set of substances for pleasure.

"The Declaration of Independence guaranteed life, liberty, and the pursuit of happiness for all of us, as long as we don't disrupt anybody else's ability to do the same," says Hart. "That means we get to live our life as we choose, as we see fit. Taking drugs can be a part of that and is a part of that for a lot of Americans."

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  1. Isn’t it known as chasing the dragon?

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  2. His autobiography (from 2014) is terrific. It’s an inspiring account that weaves together science and medicine with his personal and professional life. He’s a real pioneer.

    1. If Carl Hart was a white professor the cops would shoot his dog and throw him in a cage.

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      2. Yeah man for sure, the cops are notorious for under-enforcing the war on drugs in black communities.

  3. One thing I like about Hart is he absolutely rejects the idea that “addiction is a disease”. I’ve been pushing back on that since it first started popping up in the 90s.

    Addiction is real, it’s a problem for many people, but it’s not a “disease”.

    1. No more a disease than depression, or any other neurological condition, by that logic.

      1. By calling something a disease, you suddenly get billions of $ in grants for research and treatment. Doesn’t matter if the treatments don’t work, or even if it’s not a disease at all. Then Congress and POTUS can tell the Karens “look at us, we care and are doing something about it!!!”

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    2. Now explain to me why it’s real and distinct enough to deserve there being a word for it.

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    3. Generally, those of us in recovery (I’m a formerly homeless meth addict) consider addiction to be a disease because it shares some significant qualities with the major diseases like cancer and diabetes.

      It’s considered abnormal, as it is a deviation from a person’s “normal” state.

      It’s progressive, meaning that without an intervention, it gets worse over time, never better.

      It’s chronic, meaning that without an intervention of some sort, it will kill you.

      I’m not a scientist, so not offering any clinical perspective, and I agree that there is significant incentive for people profiting from the “industry of addiction” to classify it as a disease, but don’t believe that is a reason to completely dismiss the notion of disease.

      There is also a lessening of stigma associated with addiction under the disease model, which may also be why so many have bought in. This doesn’t remove the responsibility of the addict to do something about the addiction – just like a person with cancer shouldn’t smoke, and a person with diabetes shouldn’t be stuffing their face with Twinkies – but it does provide a possible explanation about why some people behave the way they do in regard to drugs and alcohol.

      1. That’s not what chronic means. Chronic just means it persists for a long time or recurs repeatedly (eg, chronic migraine sufferer), not that it will kill you.

        1. You’re correct, my bad.

          Chronic in that it lasts over a long period of time, and fatal if left unchecked, similar to the cancers and diabetes of the world.

          Thanks for checking me on that.

          1. Now you’re using the word, “fatal”… no, that’s not what “chronic” means. Look it up, please.

            1. Reason (the mental faculty) is not automatic.

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      2. If it helps you to get your life together to think of it that way, then that’s great. Especially since the 12 step programs seem pretty good at not letting you escape personal responsibility (which seems like one big potential pitfall of calling it a disease).
        But formally speaking, I tend to agree that disease isn’t really the right word.

      3. Addiction is not a disease, and what you “consider” a disease does not matter. Your arguments for why it’s a disease are specious.

        Congratulations for giving up your habit, but let’s not do further damage to the English language. Take pride for having some self-control instead.

  4. He’s not really going to get anywhere if we switch society to “blaming GM” for drug addiction instead of “heroin”. He takes a good idea– change the way we treat addiction, and then tries to turn it into an impossible-to-solve-or-quantify meta social remedy.

    1. General Motors? General Manager? Grand Ma?

  5. I misplaced by comment above but seriously, how long would this guy keep his job as a tenured professor if he was white?

    I’m kinda surprised the Columbia administration, his colleagues and some snowflake students haven’t made an issue of it. Maybe Kamala Harris’ DEA will. I’d wager he’s not shooting up tar or playing fentanyl roulette and either has a stable source of pure Golden Crescent product (<1% of US seizures per annum) or is taking advantage of a Schedule I pharma diversion scheme.

    1. This. I have known a number of regular opiate users, but none that used for very long. It’s typically quit or die.
      And 5 years using isn’t long enough to determine long-term safety.

      Having said that, he can rock on as far as I’m concerned. Just understand that I don’t want to pay for his health care, his funeral or his family’s therapy.

  6. The key drug reform opportunity for Biden (or the Democrat controlled Congress) can/should be removing cannabis as a Schedule 1 Drug, and allow states to regulate.

    Opioid harm reduction is a much more complex public health and political problem, as there is zero political support for legalizing low risk opioid alternative for heroin addicts, even though doing so could prevent 25,000- 50,000 opioid overdose deaths each year (most of which are caused by fentanyl laced street heroin).

    1. While Hurt and probably several million other Americans have regularly used heroin without becoming addicted or harmed, another several million Americans have become hooked (i.e. daily or every several days) to opioids, often beginning with prescription pills.

      The abstinence only policies of drug treatment programs hasn’t been helpful either (as they insist recreational users are addicted, and won’t allow patients to use less harmful alternatives, including methadone).

      Meanwhile, Big Pharma and Big Medicine (with FDA approval) created the opioid drug addiction epidemic and are now trying to cash in solving the problem they created.

      1. I find it hard to believe the official statistics on addiction, since to the drug warriors’ minds, anyone who uses illicit substances is probably addicted. Given we talk about things like videogame addiction and gambling addiction, which don’t even involve substances, i find most statistics on addiction doubtful. Many of them likely are just recreational users misclassified by people who want to demonize the behavior.

      2. Actually it’s rarely starting with prescription pills. The number of people that get addicted to opiods from prescription is around.. 02%

        1. That .02% figure was from a study conducted on surgical patients, and has been repeatedly hyped by the same lobbyists Big Pharma funded in the 1990s to falsely claim that many more patients needed opioids for pain management, and that oxycontin and other opioid pills were NOT addictive.

          There was a massive increase in the number of opioid prescriptions from the early 1990s until 2010 (due to aggressive lobbying by Big Pharma, including lying to the FDA in order to obtain FDA approval for their drugs, their marketing claims and their lack of addiction warnings.

          That’s also why Perdue Pharma filed for bankruptcy, after they were sued by several dozen state AGs.

        2. So…just 1 in 5,000?


    2. Not sure if it’s a low risk alternative to opioids, but until early 1970s, you could buy codeine cough syrup and Tylenol 3 with codeine over the counter. Then I guess too many high school kids caught onto this and the govt yanked it off the shelves.

  7. Fondness for certain substances is a personality trait, like sexual orientation or gender identity. Different versions of the last two were once also considered diseases.

    1. Perhaps President Biden will mandate that every corporate board include a heroin user.

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  8. There’s a significant difference between a “drug user” and an “drug addict.”

    A drug user can actually use recreationally and still keep their shit together, even if a heavy user. He or she can also stop or moderate use without much effort.

    An addict will usually burn shit down. Sometimes slowly, sometimes quickly, but fire is almost always involved.

  9. “I am better for my drug use.”
    I don’t think I’ve ever heard anyone say that regarding heroin. Maybe Burroughs or Thomson. Psychiatric medication, maybe, but heroin? Really? Let’s see how he’s doing in another five years. Because what on earth problem did he have, that heroin was the best solution to it.

    1. A debilitating fear of needles?

  10. Heroin is the worst thing in the world. Heroin has nothing to defend. Heroin is bad pills that destroy society.

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  13. Okay and the addiction and of rates od deaths didn’t start to go up until the feds decided “to get tough on opiods” and punish doctors for helping patients.
    Perdue pharma got sued by the AGs because they had money and the AGs wanted it. They were a polotally Expediant target. If you think they did it out of a sence of justice your an idiot

  14. Irrespective of calling it a disease it is certainly a medical condition with severe consequences. Drugs like heroin literally rewire your brain. The neural pathways involved have at least partly been worked out.

    I am all for decriminalizing and do what you want. However this is more than a benign lifestyle choice.

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  17. He should consider switching to mushrooms…

  18. “I am better for my drug use.”

    Its questionable to argue that anyone who got where they are with drug use couldn’t have done it in another way without it. But OK.

  19. He has a lot of good things to say, but he kinda lost me right off the bat when he said he would still ban some drugs, but, of course, only the really dangerous ones. His example, MPTP, causes brain damage, but he admits no one even wants to take it because it has no psychoactive effects. But yet we still have to ban it because…???

  20. Great man #Dr.CarlHart I am fed up with this policy in this country as well and would move myself and my family if I could… Delta 8 Gummies

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