Carl Hart

"empirical evidence is frequently ignored when drug policy is formulated."

"a great deal of pathological drug use is driven by unmet social needs, by being alienated and having difficulty connecting with others."

"The real connection between drugs and violent crime lies in the profits to be made in the drug trade."

"When it comes to drugs, most people have beliefs that have no foundation in evidence."

"I grew up in the hood. And so, when we think about these communities that we care about, the communities that have been so-called devastated by drugs of abuse, I believed that narrative for a long time. In fact, I’ve been studying drugs for about 23 years; for about 20 of those years, I believed that drugs were the problems in the community. But when I started to look more carefully, started looking at the evidence more carefully, it became clear to me that drugs weren’t the problem. The problem was poverty, drug policy, lack of jobs—a wide range of things. And drugs were just one sort of component that didn’t contribute as much as we had said they have."

"one of the things that shocked me when I first started to understand what was going on, when I discovered that 80 to 90 percent of the people who actually use drugs like crack cocaine, heroin, methamphetamine, marijuana—80 to 90 percent of those people were not addicted. I thought, “Wait a second. I thought that once you use these drugs, everyone becomes addicted, and that’s why we had these problems.” That was one thing that I found out. Another thing that I found out is that if you provide alternatives to people—jobs, other sort of alternatives—they don’t overindulge in drugs like this. I discovered this in the human laboratory as well as the animal laboratory. The same thing plays out in the animal literature."

"Just like any other drug, most of the people who use these drugs do so without a problem."

"when we think about alcohol, about 10 percent of the people—10 to 15 percent of the people who use alcohol are addicted or meet criteria for alcoholism; for crack cocaine, about 15 to 20 percent—the same sort of thing when we look at the numbers. And we’ve known this in science for at least 40 years, we’ve known this sort of thing, but we haven’t told the public."

"the criteria, to me—the way we judge whether someone is an addict is whether or not they have disruptions in their psychosocial functioning. Are they going to work? Are they handling their responsibilities? Or are they overindulging in the activity? And when we think about drugs like alcohol, wine every day, people can drink alcohol every day and still meet their responsibility. The same is true with crack cocaine. The same is true with powder cocaine. The same is true with marijuana. Think about it this way. The three most recent presidents all used illicit drugs, and they all have met their responsibilities. They’ve reached the highest levels of power. And we would be proud if they were our children, if they—despite the fact that they’ve all used illegal drugs."

"when people overindulge, like every day multiple times a day, it’s going to disrupt some of your psychosocial functioning. Now, that is a small number of people. Only a few people engage in behavior like that. And I assure you that if they engage in behavior like that, that’s not their only problem. They have multiple other problems."

"People get addicted for a wide range of reasons. Some people have co-occurring or other psychiatric illnesses that contribute to their drug addiction. Other people get addicted because that’s the best option available to them; other people because they had limited skills in terms of responsibility skills. People become addicted for a wide range of reasons. If we were really concerned about drug addiction, we would be trying to figure out precisely why each individual became addicted. But that’s not what we’re really interested in. We are interested, in this society, of vilifying a drug. In that way, we don’t have to deal with the complex issues for why people really become addicted."

"I marvel at what we are learning about how the brain works, in general. And so, we are not anywhere near being able to explain drug addiction with our brain science yet. But that doesn’t mean that we shouldn’t continue to try and figure out what’s going on in the brain."

"when we think about the numbers of African Americans who are in neuroscience and why—they’re low—and why the numbers are low, that’s an issue that the society hasn’t grappled with. And it’s related to some of this marijuana talk that we’re talking about. You played something about Kennedy earlier. Those kind of people, they sicken me, quite frankly, when we think about the role that racism has played in our drug enforcement, and those people don’t knowledge that? Those kind of—those types of practices have played a role in why African Americans are not in many areas in the United States."

"if we continue the same sort of drug enforcement policies, one in three African-American males born today will spend some time in jail."

"When we think about the dangers of marijuana, they are about the equivalent of alcohol. Now, I don’t want to somehow talk about the dangers of alcohol or to besmirch the reputation of alcohol, because I think that every society should have intoxicants. We need intoxicants. And every society has always had intoxicants. So alcohol is fine...(intoxicants) make people more interesting, decreases anxiety. Alcohol is associated with a wide range of health-beneficial effects—decreased heart disease, decreased strokes, all of these sorts of things. The same can be true of a drug like marijuana—helps people sleep better, can decrease anxiety at the right doses."

"We have automobiles. They are potentially dangerous, particularly if you’ve been in New York City in these past couple of days, the icy roads and so forth. Now, in the 1950s, automobile accidents were relatively high. We instituted some measures—seat belts, speed limits, all of those sorts of things. That rate, even though we have more cars on the road, has dramatically decreased. If people are really concerned about the dangers of marijuana, we’d be teaching people how to use marijuana and other drugs more safely, because they’re not going anywhere."

"Without welfare, I wouldn’t be here."

"while in England, I got quite an education about American racism. In England, they have programs on a regular basis like the U.S. PBS series Eyes on the Prize. And I learned a lot about the U.S. sort of civil rights movement and history while in England. And the British were not bashful in their criticism of American racism."

"Scientists’ first goal is not communication, it seems. It seems like their first goal is not to be wrong. And we’re missing an opportunity to help educate the American public about how to decrease harms related to drugs."

"I make sure that I educate my kids on how to be safe in driving their car, how to be safe when they have sex. The same is true with drugs. I make sure I let them understand the potential positive effects, the potential negative effects, and how to avoid the potential negative effects. I’ve written about this on AlterNet, a letter to my son about how to use drugs safely or what you need to be aware of."

"Everybody knows that the war on drugs, as has been fought since the 1980s, has had a disproportionate negative impact on specific community: black communities, Latino communities. Everyone knows that. So, what Jeff Sessions is doing is engaged in—or he’s advocating being engaged in racial discrimination. So let’s call Jeff Sessions what he is. Jeff Sessions is a racist, if he takes on this action. It’s clear. We know it. So let’s stop playing around with it...Jeff Sessions is allowing us or is using drug policy to separate the people who we like from the people who we don’t like. And it provides a way to go after those people we don’t like, usually poor minority folks, without explicitly saying we don’t like those people. And that’s how drug law—that’s how drug law or drug policy has been enforced in this country. And so, if we allow Sessions to turn back the hands of time, then shame on all of us. The blood is on all of our hands, because we know the consequences of his proposed actions."

"It’s a proven fact that this mandatory minimums policy wasted billions of dollars, and, more importantly, many human lives were wasted in this action in the past."

"If we’re really concerned, for example, like the opioids and heroin, we need to tell people how to stay safe, if we’re worried about overdose there. About 13,000 people die every year from heroin-related overdoses, whereas 35,000 people die from automobile accidents. We don’t ban automobiles. Instead, we have regulations, and we try to make sure that people stay safe. We have speed limits. We have seat belts. We have all of these sorts of things. But with the opioids, we’re talking about arresting people. And by the way, for the opioids, at the federal level, 80 percent of the people who are arrested are Latino and black."

"when we think about the deaths themselves, most of the people are dying in large part because they combine opioids with another sedative, like alcohol, like a benzodiazepine. A benzodiazepine is something like Xanax. They also combine opioids with older antihistamines. Those sorts of things, they increase the risk associated with opioids...Much of the heroin on the street today is now being tainted with this drug called fentanyl. Fentanyl is about 50 to a hundred times more potent than heroin, just simply means that less of the drug is needed to produce the required effect. But unsuspecting users may take the amount that they usually take with heroin, thinking that it’s heroin, when in fact it’s fentanyl."

"What we can do, we can simply set up free drug purity testing sites. They do this in Spain. They do this in the Netherlands. They do this in Switzerland...That way, when people understand what’s in their drug, they can scale back their use or not use it. Free drug purity testings would tell you the complete composition of the drug that you have. So if you want to save lives, you can set that up easily."

"I’m concerned that if we add more money, we will send most of the money to law enforcement. And when we do that, we know what happens. We saw it with crack. We saw it with opioids before, in the 1960s. What happens is more black and brown people will be arrested. Do not forget that."

"I worry that people who need prescription opioids for their pain will not be able to get their prescription opioids, because we are getting crazy about opioids, in general. Opioids are excellent medications to treat pain. And we can’t forget that. We also have seen, even before this—we know that, for example, black people are less likely to be prescribed opioids even when they need it, less likely than their white counterparts. And so, all of these sort of unintended consequences, they always happen when we get crazy about drugs. And we don’t even save people."

"I wrote a piece in The New York Times in August where I pointed out that this isn’t new. Even with crack, there were white—more white users, and those white users got treatment, whereas the brothers and sisters, black brothers and sisters, went to jail. The same sort of thing is happening in this case. Eighty percent of the people who are being currently arrested for the opioids are black and Latino, even though they don’t use those drugs at rates higher than their white brothers and sisters. And so, this is just the American pattern of dealing with drugs. It’s not new. And we continue the same thing. So I’m asking people: let’s not get crazy; let’s just focus on the real problems."

"Only about a quarter of the people who use something like heroin will become addicted. That means the vast majority are not addicted. But one way we can deal with the deaths, the major concern—another way we can deal is just make naloxone, which is an opioid blocker, make it more available. One of the things that has happened in recent years is that pharmaceutical companies have jacked the price up of naloxone, an old drug that’s been here since the 1960s. I mean, if Congress really wanted to do something, if the president really wanted to do something, he would hold those pharmaceutical companies accountable for increasing the price of naloxone, when the price of naloxone should be really cheap."

"people are focused on the money and not focused on being smart."

"we are all concerned about mass incarceration in the country today. If you want to know how we got there, right now what we’re doing, with people like Jeff Sessions and that guy in the White House, is how we got there. And they’re trying to ensure that we go back there, in part because it’s going to affect primarily, negatively affect, black people and brown people in this country."

"Make sure we warn people not to combine opioids with another drug. Set up free drug purity testing sites. People who are addicted to opioids and who are having a problem, and they need treatment. We should look around the world, places like Switzerland."

"Clearly, many people consume psychoactive substances “in the pursuit of happiness,” a right the government was established to secure, to protect. So why then is our current government arresting one million Americans each year for possessing drugs? Why are so many drug users hiding in the closet? This reality does not align with the spirit of the Declaration"

"Attention-grabbing headlines claiming that opioids (or any other drug) are killing people are wrong. Ignorance and poverty are killing people, just as they have for centuries."

"The key is to keep the focus on people's actions, on their behaviors, rather than speculate about their motives. Trying to determine what's in a person's head or heart is a pointless distraction. It's impossible to know for certain the heart's inner secrets."

"the war on drugs is not a war on drugs; it’s a war on us."

"As with previous “drug crises,” the opioid problem is not really about opioids. It’s mainly about cultural, social, and environmental factors such as racism, draconian drug laws, and diverting attention away from the real causes of crime and suffering."

"Heroin and other opioids, such as oxycodone and morphine, bring me pleasurable calmness, just as alcohol may function for the drinker subjected to uncomfortable social settings. Opioids are outstanding pleasure producers; I am now entering my fifth year as a regular heroin user. 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 on a regular basis, and contribute to the global community as an informed and engaged citizen. I am better for my drug use."

"I wrote this book to present a more realistic image of the typical drug user: a responsible professional who happens to use drugs in his pursuit of happiness. Also, I wanted to remind the public that no benevolent government should forbid autonomous adults from altering their consciousness, as long as it does not infringe on the rights of others. (Author's Note)"

"After reading this book, I hope you will be less likely to vilify individuals merely because they use drugs. That thinking has led to an incalculable number of deaths and an enormous amount of suffering. I hope you will come away with an appreciation for the prodigious potential good derived from drug use and a deeper understanding of why so many responsible grown-ups engage in this behavior. (Author's Note)"

"all drugs can produce both negative and positive effects. So to act as if marijuana is intrinsically or morally superior to heroin-or any other drug, for that matter-highlights the ignorance of the holder of this belief. Such ignorance also decreases the odds of people honestly reporting the use of drugs other than marijuana because of the stigma attached to so-called harder drugs, such as heroin. (Chapter 2)"

"Each and every day, we all are faced with potential risks and must make risk-to-benefit calculations repeatedly. This is a basic fact of life. Our right to make decisions based on the outcome of these calculations is not outlawed by the government, except when it comes to certain recreational drugs. (Chapter 2)"

"I am an unapologetic drug user. I take drugs as part of my pursuit of happiness, and they work. I am a happier and better person because of them. I am also a scientist and a professor of psychology specializing in neuroscience at Columbia University, known for my work on drug abuse and addiction. It has taken me more than two decades to come out of the closet about my personal drug use. Simply put, I have been a coward."

"America's drug regime is a monstrous, incoherent mess."

"More and more, I came to realize that drug-abuse scientists, especially government-funded ones, focus almost exclusively on the detrimental effects of drugs, even though these are, in fact, a minority of effects. This has had a damning impact on how so-called recreational drugs are regulated and inevitably on your own decision as to whether or not to partake of them."

"Here's the bottom line: over my more than twenty-five-year career, I have discovered that most drug-use scenarios cause little or no harm and that some responsible drug-use scenarios are actually beneficial for human health and functioning. Even "recreational" drugs can and do improve day-to-day living."

"From my own experience-the combination of my scientific work and my personal drug use, I have learned that recreational drugs can be used safely to enhance many vital human activities."

"Addiction represents a minority of drug effects, but it receives almost all the attention, certainly the media attention. Think about that. Have you ever read a newspaper article or seen a film about heroin that didn't focus on addiction? Imagine if you were interested in learning more about cars or driving and could only find information about car crashes or information about how to repair a car after a crash. That would be ridiculous."

"Drugs are inert substances. The evidence tells us that we must look beyond the drug itself when trying to help people with drug addiction."

"A broader argument I make within these pages is that adults should be permitted the legal right to sell, purchase, and use recreational drugs of their choice, just as they have the rights to engage in consensual sexual behaviors, drive automobiles, and even purchase and use guns. Of course, all these activities carry some level of risk, including death. But rather than banning sex, cars, or guns, we have implemented age and competence requirements as well as other safety strategies, strategies that minimize harms and enhance positive features associated with these activities. This is already done, of course, with the widely used recreational drug known as alcohol. After reading this book, you will, I hope, come to the inescapable conclusion that the same should be done with other recreational drugs."