Carl Hart is a neuroscientist, drug researcher, Columbia professor, and unabashed heroin user. His recent book, Drug Use for Grown-Ups, mixes personal anecdote (heroin is hardly the only taboo drug he’s enjoyed) with his research findings, arguing that the media portrayal of a one-hit-to-addict pipeline is overblown and thus recreational drugs are most often used recreationally. “Seventy percent or more of drug users, whether they use alcohol, cocaine, prescription medication, or other drugs, do not meet the criteria for drug addiction,” writes Hart. “Research shows repeatedly that such issues only affect 10 to 30 percent of those who use even the most stigmatized drugs such as heroin or methamphetamine.”
In his three decades researching drugs, Hart writes, “I discovered that the predominant effects produced by the drugs discussed in this book are positive. It didn’t matter whether the drug in question was cannabis, cocaine, heroin, methamphetamine or psilocybin.” He takes umbrage at the notion of the “opioid epidemic,” asserting that overdose from a single opioid drug is responsible for only a quarter of opioid-related deaths. Far more frequently factoring into said deaths are contamination and the combination of opioids with another downer (like alcohol).
Hart appeared on Tuesday’s episode of Tamron Hall to discuss his book, as well as the backlash to his provocative argument, which he frames as a kind of activism.
“I came out of the [drug user] closet because I know there’s a risk,” Hart told Hall. “But if we think about all of our heroes—Rosa Parks, Martin Luther King—all of those people put their bodies on the line so that we could be free. The same is true here when we think about drugs, I’m trying to educate the public. I’m trying to show them where the real dangers are at.”
Those dangers include tainted drugs—heroin cut with fentanyl, for example, is more likely to cause an overdose than pure heroin since it takes far less fentanyl to get high. Hart argues for drug-testing facilities, suggesting that knowing exactly what was in his junk could have saved the life of Prince.
Hart’s book details the racism implicit in the ongoing drug war—Black and white people take and sell illegal drugs at similar rates, yet Black people are far more likely to be prosecuted and jailed as a result. The drug war, he writes, is a $35 billion industry, and so it does not behoove the powerful to dismantle it. His prescription for doing so involves destigmatizing drug use by having people discuss theirs openly; the memoir aspect of Hart’s book finds him being the change he wants to see in the world.
“I recommend...respectable middle-class drug users stop concealing their use,” he writes. “If more people followed this advice, it would be extremely difficult to pigeonhole all users as irresponsible, troubled members of our society...My perspective had been heavily influenced by King’s ‘Letter from Birmingham Jail,’ in which he made a compelling case for disobeying unjust laws. I urge them to get out of the closet and to blatantly disregard laws that prohibit adult drug use because such laws are ruthlessly unjust. I...hope my writing and speeches inspire massive civil disobedience among the privileged class.”
Hart’s book is compelling and well-argued. It’s one of those zeitgeisty books that manages to perform iconoclasm while outlining the unspoken obvious, detailing a lifestyle that many hold but few admit to publicly. I don’t think it’s perfect, though. Sometimes it feels like he’s gilding the lily, like when he describes his mild experience in kicking heroin after doing it several days in a row. He essentially engineered an experiment for the sake of content, and never injected heroin, at that. It’s little wonder, then, that withdrawal wasn’t such a big deal to Hart, but he nonetheless dismisses Trainspotting’s grueling portrayal of kicking as “bullshit.” Never mind that Irvine Welsh, who wrote the book on which Trainspotting was based, was himself an 18-month heroin user and wrote from his experience. Never mind the misery Keith Richards describes when he recounts his own kicking in his memoir Life. Hart dismisses one anecdotal account in favor of his own, which just happens to align with his thesis that for the majority of users, drugs are actually no big deal.
Hart’s biases were well detected in the New York Times’ nonetheless positive review of his book. He tends to wear them on his sleeve. Psychonauts—people who use psychedelic drugs in the hope of expanding their minds, understanding of the world, and promoting empathy—are “elitists,” according to Hart, who have elided stigma via claiming that the goal of their drug use is not to get high. “If your aim is to seek relief from emotional or physical ailment or to achieve spiritual transcendence or to find your God, cool. But if you merely want to have a good time, not cool,” Hart writes. This paints the use of psychedelics with too broad a brush. It’s not about not getting high—anyone who’s done a heroic dose of cubensis mushrooms and experienced ego death knows that they were high as fuck. It’s about not using the drugs to party, about a more cerebral intention. When it gets to the point where Hart appears to be complaining about the decriminalization of mushrooms in a handful of states, it feels like he’s lost the thread entirely. Isn’t the book predicated on the belief that drugs should be destigmatized and legalized? I understand a certain sense of impatience as some drugs become more socially acceptable (though hardly, as Hart puts it, destigmatized) leaving others to wallow in the dust of taboo, but the unlearning that Hart preaches is bound to be a slow process. His beef with psychedelics and their users is surprisingly poorly reasoned.
(I also have no idea who the psychedelic elitists are because Hart’s writing is vague there. Those involved in research? People describing their trips on Reddit? Kids hanging out in a park looking at clouds? That section is underwritten and seems guided by Hart’s own prejudices as he openly states that psychedelics aren’t his thing. He argues that PCP and Ketamine get little love in the psychonaut community, despite them both being [sometimes] classified as psychedelics, but he fails to mention a crucial distinction: PCP and Ketamine are dissociatives whose effects differ greatly from LCD and mushrooms. While I agree broadly with his path to destigmatization, I don’t think his community logic here is as obvious as he presents it, and nonetheless not mentioning the dissociative properties of PCP and Ketamine is a misleading omission.)
This is nitpicking; Hart’s book is provocative and necessary. It exists as a counterpoint to hype and distortion (but even as such did have me playing devil’s advocate in my head while reading: “If hard drugs are so great, why do so many people want to get off them?”). Drug Use for Grown-Ups has been controversial, but given Hart’s conscious transgression, that would seem to be part of his calculation. To Hall, Hart talked about the way his writing has been sensationalized, like in the New York Post article that ran in February with the headline, “Columbia professor: I do heroin regularly for ‘work-life balance.’”
Hall asked Hart how his life has changed as a result of publishing his book.
“My life hasn’t changed at all,” said Hart. “I’m selling more books...I’ve been studying drugs for 30 years but I’ve been saying this for at least 10 years. People know that it’s right. When you read the book and go beyond the headlines, it makes sense. It’s clear.”