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The Columbia professor Carl Hart spent his career studying the effects of drugs, and uses heroin himself. In his book Drug Use for Grown-Ups, he argues that not only can drug use be safer, but that it’s our right.
This week on The Experiment: how villainizing drug use interferes with our right to life, liberty, and the pursuit of happiness.
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This episode was produced by Alvin Melathe and Katherine Wells, with help from Gabrielle Berbey. Special thanks to Michelle Ciarrocca. Fact-check by William Brennan. Sound design by David Herman. Engineering by Alexander Overington.
A transcript of this episode is presented below:
(Synthetic whale calls reverberate in a lush, beachy, lo-fi environment—the sounds of waves crashing, the gentle hum of a passing car.)
Julia Longoria: I’m Julia Longoria, and this is The Experiment. This week, we’re handing it over to producer Alvin Melathe.
(The music cuts out abruptly.)
Alvin Melathe: I want to introduce you to Dr. Carl Hart.
Melathe: So maybe … Well, let’s just start by you telling me, uh, who you are.
Carl Hart: I’m Carl Hart. I’m a professor at Columbia University. I am also a research scientist at the New York State Psychiatric Institute.
Melathe: Carl’s a neuroscientist, but he’s recently become really interested in one of our founding documents.
Hart: It’s really important for us to think about the Declaration of Independence, because I was ignorant—like most Americans—and I hadn’t read it as an adult. And so, when you read it as an adult, you realize, This is profound!
(A full, rich bed of chords, saxophone-esque and xylophone, softly emerges.)
Hart: This is the original promise to American citizens. This is what it means to be an American.
Melathe: Carl is a big fan of the Declaration of Independence. And he’s been on a crusade to get other people to read it too.
Hart: I feel like whenever I have these conversations—particularly when I invoke the Declaration of Independence—people say, “Yeah, yeah, yeah,” as if they know what’s in the Declaration, when, in fact, I know they don’t, because there’s no reason for you to read it, because nobody required you to read it.
(The music develops. A rhythm of claps and percussion builds.)
Melathe: And the reason he wants people to read it is that he thinks there is one big part of American life where we aren’t allowing people to do the basic stuff that the document declares: to exercise the rights to life and liberty and the pursuit of happiness.
Hart: It means that you have the right to live your life like you see fit, as long as you don’t prevent others from doing the same. And, in the third sentence, it says that government should be created to secure these rights, not restrict them!
That’s profound to me, because we are doing precisely the opposite when it comes to drugs, and nobody seems to give a shit.
(The music resonates for a moment, then fades out to be replaced by strummed electric guitar, bumpy percussion, and synthesizers.)
Longoria: The story we tell ourselves about drugs in our country is often really simple: “Drugs are dangerous, and so are the people who use them; just say no.” Dr. Carl Hart spent his career doing research that supported that story—until he learned it’s just not that simple.
I’m Julia Longoria. This is The Experiment, a show about our unfinished country.
(The music ends.)
Melathe: Carl grew up in Miami in the ’70s and ’80s.
Hart: I grew up in a predominantly Black neighborhood—what some would deem “resource-poor.”
Melathe: And he got a very clear message about drugs.
Hart: People talked about drugs in the very same way as they talk about drugs now: “Drugs are bad.” “Don’t do drugs.” “Drugs are the source of our suffering.” “Drugs cause addiction.” “Drugs are the reason that people die prematurely.”
Melathe: Plenty of people in his neighborhood drank, or smoked cigarettes or weed, but there were drugs that seemed out of bounds—ones that people warned him about: drugs like crack and heroin.
Hart: It was nothing to see a public service announcement with someone like Pee-wee Herman.
Pee-wee Herman: (From an old TV broadcast.) This is crack. Rock cocaine.
Hart: Pee-wee Herman would be talking to kids, saying something about …
Herman: (From an old TV broadcast.) Everybody wants to be cool.
Hart: “Hey, you want to be cool, like me.” Um, “I don’t do crack, because doing crack is like putting a loaded gun in your mouth and pulling the trigger.”
Herman: (From an old TV broadcast. A pulsing heartbeat plays in the background.) You’d be dead wrong. (A heavy sound effect plays, like the dropping of a bomb, distorted by the crackly TV audio.)
Hart: And that stayed in my mind for a long time.
Some of my assumptions were that a drug like crack cocaine was so addictive, one hit is all that was required for the user to become addicted; everyone who smoked crack cocaine eventually became addicted; and then, about the people who use drugs, I thought they were horrible people. I thought that they were irresponsible people. I thought that they could only focus on getting another hit of their drug.
It would take me a good 15 years to start questioning the story that I was telling myself.
Melathe: Is it fair to say you were scared of drugs?
Hart: Yeah, it’s fair to say that I was absolutely scared of drugs. I believed those messages, so much so, I decided to study drugs, and try and figure out how I could help people who were drug-addicted.
(Plunky electronic music plays, sparse like plucked strings in an empty room. More strings enter the room over time.)
Melathe: In the ’90s, Carl studied science. He eventually went on to get a master’s and a Ph.D. in neuroscience and psychology.
Hart: That was deemed “the decade of the brain.”
Melathe: He wanted to find out how drugs affected the brain.
Hart: I would look at these brain cells in this region called the “nucleus accumbens.”
Melathe: He looked specifically at dopamine cells, which he thought might be responsible for drug addiction.
Hart: And so I was under the illusion that if I could manipulate these cells in the right way, then I could stop people’s desire, so that the person would no longer want cocaine.
Melathe: One of the ways he studied this was, he would bring people into the lab and give them drugs.
Hart: Like cocaine, like methamphetamine, like marijuana.
Melathe: And then he’d watch what would happen.
Hart: The effects on their blood pressure, on their heart rate, on their social interactions. We monitored the effects on their brains.
Melathe: In the lab, he started learning some things that didn’t quite line up with those messages he got as a kid.
Hart: I’ve learned early on that the body does not distinguish between hard and soft drugs. That’s a sort of human phenomenon. Although heroin withdrawal is unpleasant … but the likelihood of somebody dying from heroin withdrawal is low compared to the likelihood of someone dying from alcohol withdrawal.
(The music fades out.)
Melathe: Hmm. I’m curious about this, because I’ve been sort of led to believe all my life that, say, heroin is an incredibly dangerous drug—that it is, like, an order of magnitude different than marijuana. Is it—is what you’re saying that the science doesn’t say that?
Hart: Yeah. Uh, what I’m saying is that it’s not useful to say that heroin is a killer drug, whereas marijuana is not so harmful. That’s not useful, because we can think of situations where marijuana is more dangerous than heroin. Let’s just think of somebody who is susceptible to—I don’t know—being anxious and paranoid. You give that person a dose of marijuana, and you trigger paranoia. You can trigger anxiety—a panic attack.
A similar dose of something like heroin wouldn’t do that sort of thing.
It all depends on what effects you are looking at when you think about trying to determine “Oh, this drug is far more dangerous than that drug.”
(Ambient music builds out of the quiet. It’s gentle and reflective.)
Melathe: Opioids like heroin do kill tens of thousands of people a year. But what Carl was finding in his research was that our ideas about the harmfulness of drugs aren’t necessarily related to the science.
Take our ideas about addiction. We generally think of hard drugs as more addictive than so-called soft drugs. But that’s not necessarily true. For example, in the United States, about 15 percent of the people who drink alcohol become dependent on it, which is the same rate as cocaine. About a third of people who try tobacco become dependent, which is actually a higher rate than for people who try heroin.
Hart: All of these pieces of evidence conflicted with what I thought.
Melathe: Even so, by the late ’90s, Carl was firmly in the mainstream when it came to ideas about drugs. He’d finished his graduate program and got a really prestigious job as a researcher at Columbia University. He sat on important committees, was given multimillion-dollar research grants by the National Institute on Drug Abuse.
Hart: I continued to believe that most of the people who took these drugs were addicted, that drug users were some of the most irresponsible people in our society. I believed all of this misinformation for a long time.
(The music changes, as though it is moving through layers of water, and then fades out completely.)
Melathe: When he did start questioning the story, he went back into the history. He wanted to know where these ideas came from.
Hart: The idea that heroin is so much more dangerous than marijuana, for example? That idea has its roots back in the early 20th century. The early 1900s, opioid drugs were associated with Chinese Americans who had come over to help build the railroads after the Civil War, and they brought with them their practice of smoking opium.
There were some people in our society who were upset that these Chinese folks had opened up these opium dens, because women would frequent these places, and these places were doing well financially. And one way to ensure that they didn’t do as well is that you make up these wild stories about the effects of opium. You say things like, “The Chinese are corrupting our good white women, and so therefore we need to pass legislation to curtail the number of opium dens. We need to pass legislation that forbid the mixing of the races in these establishments.”
That’s one of the reasons that you believe what you believe about heroin and other opioids, and we can consistently and continuously wed the bad behavior of some group that we don’t like to a drug. And then we can vilify that group without actually saying it. We’re saying we’re vilifying the drug, but, really, we’re vilifying that group.
Melathe: Carl says a similar thing happened with cocaine. There was a time when it was legal in America. It was even an ingredient in the original formula for Coca-Cola! But then a story was told in the media that Black people used cocaine and it made them violent.
Hart: For example, there were reports that Black men were raping white women after having taken cocaine. There were reports that Black men, once they had taken cocaine, they could not be stopped by 32-caliber bullets. And so this forced some police forces to move away from the 32-caliber weapon to a larger-caliber weapon, the 38, in some cases. And it also forced Congress to pass—for the first time—national legislation that would ban drugs. And this legislation is known as the Harrison Act of 1914, which—in effect—banned opioids and cocaine.
Melathe: This pattern still repeats itself today. We still associate supposedly bad drugs with people at the margins.
Hart: Let’s think about, uh, ketamine versus PCP.
Chemically, these drugs are nearly identical. People take ketamine in search of some higher spiritual plane. PCP, on the other hand, is associated with cop stories, stories that indicate that if you take PCP, the user will develop superhuman strength, and it will take police—um, I don’t know—48 bullets to kill the person.
Another sort of example of this—and this is related to class, and not race: Methamphetamine and Adderall are essentially the same drug. But when we think about the narrative surrounding methamphetamine, we think of poor white people who are having problems, because [Parodying someone who believes what he is saying.] “this drug is so dangerous and so evil, it’s turned these people into social degenerates.” [Back to regular speech.] Whereas Adderall use, uh, is expected among our high-achieving people in our society. The point is, is that the narratives that have developed around these drugs—the differential narrative, it’s just not—just not justified.
Melathe: If what you’re saying—that, like, a lot of the differences chemically in these drugs are somewhat negligible—I’m trying to figure out, like, aren’t there other people like you in research laboratories, looking at the chemical makeup of these drugs?
Hart: Yeah, there is a ton of data that’s been generated in laboratories like ours at Columbia. And the researchers themselves, they all know, privately. Whether they say anything publicly, that’s a whole different story. Another sort of key reason that researchers, um, may not say anything, is because there are researchers who genuinely believe that it’s better to err on the side of caution. That is, it’s better to frighten the public about drugs, and that way you really decrease the likelihood of anyone using these drugs, because these drugs do carry some risks.
Melathe: Why are we so afraid? What are we actually afraid of?
Hart: We are afraid of the unknown.
(A light beat of music. Discordant beats continue to play over the sound of running water.)
Hart: It is so much easier just to say no than to inform yourself. As a parent, you don’t have to learn anything about marijuana, cocaine, or anything. All you have to do with your children, as part of their drug education, is to say, “No.” Just say no. You can remain ignorant about drugs, and you will have been considered a good parent.
(A long moment with only discordant music.)
Melathe: The problem with this fear, Carl says, is not just that we’re not being honest about the real risks of drug use. It’s that exaggerating the danger of drugs leads to harmful policies.
(The music fades out.)
Hart: Those policies are repressive and draconian, and they bolster our drug war.
Our drug war is one of the most effective jobs programs that we have in the country. It’s an effective way to hire more cops. Well, and you can justify it by saying, “We’re going to get these drugs off the streets.” The prison industry benefits. Companies that do urine testing, they benefit, because we test people’s urine as opposed to looking at their behavior.
Politicians benefit. They can simply say to their constituents, “We’re going to put more cops on the streets and get drugs out of your community.”
That’s so easy to do. Never mind that you’re not dealing with the real problems that people face, like unemployment, poor education, lack of health care. You don’t have to deal with any of that stuff. All you have to say is “I’m going to put more cops on the streets.” Everyone benefits.
Melathe: Is that … [Sighs.] Does that help explain …? Like, is there something about America specifically that you think lends itself to this paranoia, or this fear?
Hart: Yeah, there’s something about America that lends itself to drug paranoia. Let’s just think about George Floyd, who was killed this past summer, and we all saw it on video. Derek Chauvin put his knee on George Floyd’s neck. We all saw it.
But the defense is that “George Floyd had fentanyl in his system. George Floyd had, uh, methamphetamine in his system. He had marijuana in his system.” Those are the causal agents for his death.
And so that’s one of the reasons that we have been less willing to look at the drug situation with clear eyes, because it provides a lovely scapegoat, and it provides an excuse for our racism.
(Lo-fi, looping music plays.)
Melathe: So Carl wrote a book that came out last year, called Drug Use for Grown-Ups. And, in it, he argues, essentially, that the story we tell ourselves about drugs—and drug users—simply isn’t true. The lie causes harm.
And so we need to have an honest, nuanced conversation. And he thought we could start by being honest about who uses drugs.
(A keyboard-synthesizer melody plays. It’s lushy and dreamy.)
Hart: The typical drug user is a middle-class, white American. I want the public to grapple with that fact. That’s why I’m asking people to come out of the closet, so we could change the view of what a drug user really is.
Melathe: Carl asked drug users to come out, to show themselves—and he started with himself.
Lisa Kennedy Montgomery: An eye-popping viral story in the past few days about a Columbia professor who says he uses heroin and other drugs to maintain a healthy work-life balance.
Unidentified commentator: This psychology professor is saying that he enjoys snorting heroin by the fireplace to relax. I’m sorry. What did this guy say?
Melathe: After the break—Carl finds out just how hard it is to have an honest conversation in America.
(Music out. It’s the break.)
(The intro music for the Breakfast Club talk show plays: “Wake that ass up! It’s The Breakfast Club.”)
DJ Envy: What do you guys think?
(A moment of crosstalk.)
DJ Envy: This is heroin we’re talking about! [Laughs.] It’s the most addictive drug. Like …
(Show audio fades out.)
Melathe: Carl Hart’s book features a lot of research about drugs, his own and others. But the media story about it became reduced to something else: a spectacle about a Columbia professor who does heroin.
(A media montage starts.)
Michael Smerconish: He has also regularly taken molly, ecstasy, and methamphetamine, saying they help manage the work-life balance.
Kennedy: The knee-jerk reaction from a lot of the country was “What the front?”
The Breakfast Club caller: I think that what he is saying is very irresponsible. There is no safe way to do heroin here in America.
(The montage ends.)
Hart: When I was writing the book, I understood that I had to share some personal details in order to make the reader care about my subject.
Melathe: Carl wrote in his book that he had done heroin. Not only that he’d done it, but, as of the writing of the book, he was entering his fifth year of being a regular heroin user.
Hart: Uh, and that brought all of this attention to this subject. But you distort it, and you make it become dishonest and untrue for people to pay attention. And it makes me sick.
(Disjointed notes play on an electric guitar over a repetitive beat.)
Melathe: He wrote this book to try to make people rethink the way we talk about drugs. But instead, he somehow became a symbol of the exact kind of false narrative he was fighting. It didn’t seem to matter that his argument was based on all this time he’d spent researching in the lab.
Hart: The fact that I’ve been doing this for 30 years? Nobody cares. They only care that some publication said that I shot up heroin every day.
Melathe: A few publications took shots at him, pulling out the sensational quotes without any of the research. One made sure to mention that he’s a father of three.
But Carl says he’s not addicted to any drugs. He functions in society. He does well at his job. And, anyway, his ideal world is not some exotic drug free-for-all. It’s regulation.
(The music builds and then fades out quickly.)
Hart: So my ideal world is that the government would step in and regulate heroin just like it regulates alcohol, just like it regulates tobacco. In this way—
Melathe: Well, that actually leads me into a question about the opioid epidemic specifically. You know, in the last, like, 20 years or so, I think the numbers are—are, like, roughly 400,000 people dying from overdoses that involve prescription or illicit opioids. The beginning of that was through a relatively regulated system, people getting prescriptions in doctors’ offices.
And I’m wondering, in a heavily regulated environment like that, and we still have some of that addiction and death—I’m wondering what you think about that in terms of your overall argument?
Hart: The fact is, people have died, uh, who got opioids from their doctors. That’s a fact. The point here is that we cannot be so naive to think that life is not without risks. People die. Forty thousand Americans died last year because of car accidents.
Melathe: But isn’t it true that, you know, everybody gets in a car, all the time. That’s, like … The—the scale of that should be different, shouldn’t it?
Hart: So we can think about a place like Portugal, where they decriminalized heroin, and the number of people who died from heroin dramatically decreased. So I am suggesting that if we legally regulate it, get rid of the contaminants, do a better job of education—of course, making sure that there’s a requirement before you can purchase the substance—I’m suggesting that the number would actually dramatically drop.
Melathe: Hmm. You know, one of the things in reading your book that I don’t know quite how to square is, your book is premised as a conversation for grown-ups—people who are adults and who, uh, are ready to have this kind of conversation. And yet, I mean, I think you said it was somewhere between 10 and 30 percent of people who are going to get addicted.
And, you know, there are kids who are undoubtedly going to listen in to this type of conversation. What, in your mind, is a responsible way to build out a policy that acknowledges that not everyone is going to be in that 70 percent who will maturely use drugs as instructed?
Hart: I’m trying—It’s like saying, “There are kids who are not ready for sex, so should we not have adults engage in this behavior? Should we not have this conversation?”
The thing that’s important here is that if the vast majority of the people who are using a drug are not becoming addicted, then those who become addicted, it requires us to look beyond the drug.
So addiction has almost everything to do with the person and what’s going on in their life and their environment. Uh, it has a lot to do with the society, but it almost has nothing to do with the drug.
But it’s too easy to say, [Parodying.] “Oh, you’re addicted to crack cocaine. So we need to remove crack cocaine.” That’s not the—that’s not the move. We need to figure out why the person is addicted to crack cocaine and then help that specific person deal with their specific problems.
Melathe: That’s fair. I—I think the thing I’m trying to think through is, I think I see your point, but I am wondering—that if we don’t fix any of the attendant problems in our society, and we do make a change like the ones that you’re suggesting for drugs—if there aren’t potentially bad ramifications to that. I’m just wondering if you’ve grappled with that.
Hart: Of course I think about the risk-benefit ratio of what I’m talking about. I think it would be far more beneficial for us to stop—today—arresting anybody for drugs. You would solve so much misery by just simply doing that. You don’t even have to legalize drugs, or legally regulate it. Just stop arresting Americans for drugs. The pluses would outweigh the negatives in that case.
Melathe: It’s interesting. One of the reasons I wanted to talk to you is that, in a country that’s premised on sort of liberty and freedom, there are actually all of these invisible third rails. You know, the things that we aren’t actually allowed to talk about in public. And I wanted to talk to you, because I’m curious if, as a holder of—I don’t think I’m going out on a limb here to say it—an unpopular opinion, do you feel like you’ve been getting a fair hearing? And what have you learned about the process of that?
Hart: So I expected not to get a fair hearing, but it doesn’t mean that it’s not maddening when it actually happens in real time.
(Quavering, dissonant sounds quietly surround the narration.)
Hart: Since writing the book, I read the Declaration of Independence at least once a week because I’m having these conversations. But, um, before, like, really writing the book, I—I didn’t think about the Declaration of Independence. I just thought, Oh, it’s some nice flowery words by some dead guys who had problems of their own. And they weren’t very good people. Uh, and so I kind of dismissed it.
But we may dismiss those guys for whatever reason—they were slave owners—whatever reason. Um, but we can’t dismiss the principles that are espoused in the document, because they laid out what it means to be an American.
They didn’t say anything about displaying a—a flag, or wearing a flag on your lapel jacket. Those were not considered patriotic. What’s patriotic is protecting the rights of other citizens.
We are promised, all of us, at least three birthrights: life, liberty, and the pursuit of happiness. That means that we can live our life however we choose—including putting what we want in our bodies, as long as we don’t bother anyone else, as long as we don’t prevent other people from doing the same.
(Drums enter. A light guitar melody slithers through the soundscape.)
Hart: And so my ideal world is that we just simply live up to our original promise. That’s it!
And that’s what I want. I want Americans to say, “We’ve been lied to.”
And now, the question is, what do you do?
(A light keyboard harmony plays, making the music deep and full.)
Gabrielle Berbey: This episode was produced by Alvin Melathe and Katherine Wells, with help from me, Gabrielle Berbey. Special thanks to Michelle Ciarrocca. Fact-check by William Brennan. Sound design by David Herman. Engineering by Alexander Overington.
Music by Tasty Morsels and Nelson Nance, with additional music by Joe Plourde.
Our team also includes Julia Longoria, Tracie Hunte, Emily Botein, and Natalia Ramirez.
If you enjoyed this episode, please be sure to rate and review us on Apple Podcasts or wherever you listen.
The Experiment is a co-production of The Atlantic and WNYC Studios. Thanks for listening.
(Even fuller now, an entire symphony of synthesizers and percussion and bass plays up and out. The episode ends.)