Latest / Uncomfortable Conversations with Josh Szeps / "The Case For Heroin" with Dr. Carl Hart

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"The Case For Heroin" with Dr. Carl Hart · Uncomfortable Conversations with Josh Szeps

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G'day, humans! Welcome to the safe space for unsafe conversations. This is your refuge from
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the black and white world of right wing blowards and left wing complainers. This is the place beyond
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the echo chamber of your social media feed and the partisan mainstream press. It's a place without
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good guys and bad guys where the only thing that's banned is taking offense at a true statement.
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And I suppose black and white world views as well. I'm not welcome here. There are no taboos,
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there are only good arguments and bad arguments. I'm here to sniff them out. Change doesn't happen
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in an echo chamber, friends. Welcome to uncomfortable conversations.
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Today on the show, have you ever taken a mind altering substance, especially an illicit one?
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Dr Karl Hart has does, advocates for the responsible use of mind altering illicit drugs,
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including heroin and other such boogie man compounds. I don't say that entirely satirically or
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snarkily, but I have been in close contact with people, friends, colleagues, interview subjects
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whose lives have been deranged and ruined by drug use. And so this was a difficult and
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sort of interesting conversation to have and a difficult and interesting mind to probe.
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Karl is a professor at Columbia University. He's one of the first
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tenured African-American professors of sciences at Columbia. He's a psychologist and neuroscientist,
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and he's renowned notorious, I might say, for his research on drug abuse and drug addiction.
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And he's a strong and vocal advocate for decriminalizing recreational drugs, for believing that
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drug use isn't necessarily bad. And for essentially coming out of a closet as drug users,
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he has, he does, he wants other people to as well. He thinks that we would all have a much more
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healthy relationship to the way that we understand drug use in our society. If it wasn't so
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cloaked in secrecy and sometimes shame, I don't agree with everything that Karl says, but G,
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it's lovely to have conversations with someone who just totally doesn't give,
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I mean, he gives zero Fs, so to speak, about what other people think and about what other people's
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assumptions about him and his habits are. His most recent book is called Drug Use for grown-ups,
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Chasing Liberty in the Land of Fear. The New York Times book review called it powerful and timely,
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saying when it comes to the legacy of this country's war on drugs, we should all share
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Karl-Hot's outrage. I hope you enjoy its conversation with Dr. Karl-Hot.
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Sorry about that, I, of course, look. Oh, no. Yeah. Oh, man. How did you do it?
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I'm getting old. I was working out. It's embarrassing, actually. I had to drop weights on it.
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My wife had to come rescue me. Oh, no. Just between you and me. Just stuck there with your hand
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under a weight. Yeah. My mom actually just had a fall. It's been pouring with rain across the East
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coast of Australia. There are huge floods and she had the great idea of going outside and
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walking to the chemist by herself and fell over and fractured her shoulder. It's happening all over
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the place. Yeah, man. I'm sorry to hear that. I hope she's okay. She's fine, but my dad's
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getting Alzheimer's, so she already has, I mean, he's fine. He's at the early stages, so he's
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still, you know, still knows what's going on, but it makes life difficult for her where she
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already has to take care of it all the time. Now she has to get one handed for six weeks.
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I'm interested to begin with in what the past couple of years have been like for you. What's the
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pandemic been like? Where have you been? The past couple of years, what has that been like? Wow.
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It's been a lot more traumatic than I thought it would be. It's been hell because I,
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the book came out in 21, January 21, and before the book came out, I thought I'd be touring and
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doing these sort of things because I really like being in front of audiences. But then we all
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had this pandemic, and so I had to basically be sequestered without seeing people. And then on top
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of that, having relatives die, people close to you die, particularly in earlier stages of the
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pandemic. And so it's been hard just missing human contact and disrupting everybody's routine was
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disrupted. Of course, and my routine has been like really physical activity, like working out,
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nose kind of things. But in a gym, and of course couldn't do that during much of the pandemic.
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And so that's what I have used for my mental health is like working out. And then when you don't
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have that, it just becomes difficult. But I recognize a lot of people had a lot worse than me because
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I still had a job at least. And so I'm grateful for that. Otherwise,
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it's been painful. Were you able to keep teaching? I was on sabbatical for until
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this past fall. So it was 21 fall, which was nice. And I went back into teaching September
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21. And I was in person. And so that made life better. I guess sabbatical is always nice. But
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there are nicer times to have a sabbatical than when the world is locked down during a pandemic. Exactly.
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Exactly. As a friend who did a sabbatical and came to Australia for a year, you couldn't
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be doing that in 2020-2021. Exactly. But it's nice to be back in person with students at least
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for even though we're still wearing masks in the classroom. So I tell a joke and I'm already
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not funny. And then so it just falls flat and then has- Or in the world, that was a joke, kids.
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That was a joke. Exactly. Exactly.
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Should I be able to take heroin, Kyle? I don't know. What's your skill sets?
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What is your knowledge? You know, it's like somebody saying, should I be able to have sex?
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I don't know. Should you? Well, in general, we don't prohibit sex regardless of how dumb you are.
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Oh, I'm sorry. Oh, yeah. You mean should it be available? Certainly should be available
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to people who want to use it and know and hopefully they know how to do it safely.
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What does that mean? Know how to do it safely. Just like when somebody drives an automobile,
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you know, it's driving automobiles are available to us but we want to make sure that they know how
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to do it safely such that they don't hurt themselves or hurt someone else.
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Is there a way of doing heroin safely? I mean, obviously, there's a way of having heroin and not
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dying of it in the moment, but is there a way of doing it in a way that doesn't lead to a trajectory of-
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You know, of course there is. I mean, we've, of course there is. I mean, we could think about, I mean,
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there are many people in our world who use heroin in a way that enhances their life.
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And they enjoy themselves. But the problem is that we've told this narrow story about a drug
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like heroin like and that narrow story is that anyone who uses heroin has to do it every day in
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the drug hooks you and eventually it leads down this path to this path of destruction. That's the
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simple story we've told everyone. Now that story is nonsense. It certainly happens to some people,
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but that's a minority of people. Most of the people who use heroin like they do anything else
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like they may do on a vacation or have you do you engage in activities on your vacation
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that you may not do every day in your life because you need time to recover, you need
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or you don't want to overdo it for a variety of reasons. That's how most people do heroin,
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but that's not the story that we tell.
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How do they take it? Can you paint us a picture of the sort of archetypal person who you're talking
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about because I've never done heroin even though I've experimented with other illicit substances?
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And I think there's a, the reason I start with heroin right out of the gate is just because I do
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think that there's a perception that just as if you make a habit of borrowing cigarettes from
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friends at a party and having the occasional cigarette, there is a quite likely trajectory on
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which you end up being a smoker. There is a perception that if you make a habit of consuming heroin
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occasionally, there's a trajectory on which you're quite likely to end up in a really bad place.
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So who are these people who are not?
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So I think that perception is falls one. So if we think about people, you and I are talking and
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we had to coordinate our schedules in order to make this thing happen. And so I have a lot of
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things in my life like that where I have to like coordinate and schedule and that means that I
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have to inhibit other activities in order to meet this schedule or this obligation. Now people who
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do this routinely in their life, now if you add heroin to the mix or anything else, they'll just
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schedule time to include it just like any other activity. That's the normal trajectory of a
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heroin user, an alcohol user, a cocaine user, an MDMA user, any user. So we want to start with
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reality first. Too often these conversations start and deals exclusively in mythology that's
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been presented in film, in popular culture, in popular media. But that's not reality and I'm 55
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years old now. And I really am tired of dealing with these sort of mythologies and fantasies that
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have no grounds or limited grounds or in evidence or in limited foundations in reality.
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Is there a difference between the addictiveness of different substances though because I completely
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take your point about like the average user, let's take an easy case example like a psychedelic
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where, as I understand it and correct me if I'm wrong, they're not just not addictive, they're
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sort of anti-addictive that like you give a rat. Am I wrong? Okay, so let's start with that then.
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So I'll just articulate where I was sort of going with that, which is I can certainly imagine
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that people who like to take magic mushrooms occasionally will take them occasionally, but there is
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no there's no subsequent physiological draw that is drawing them back to them in a habit forming
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way that the way that they would be towards nicotine or the way that they would be towards opioids.
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Is that wrong? Okay, the first thing I like to do, man, make sure everybody reads my book,
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Drug Use for Grownals because I'm tired of having these conversations. I'm really excited
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way to reach people who haven't read the book. Yeah, no, I know, I know, but please understand,
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I'm 55, I've been studying drugs for 30 years and I'm trying to live like an adult and
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enjoy my life and I know it's like saying, you're a college professor, but we need you to teach
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children how to add. We need you to teach the two plus two. That's it's maddening, so please
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understand that these low level conversations they they wear on my soul. Well, we appreciate
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you taking time to rehash. Yeah, yeah, so you just need to understand that I'm a person and
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and people forget that sometimes. All right, so let's think about this sort of physical,
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the addictive nonsense that people talk about. Think about anybody who takes an anti-depressant
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every day where their mental health and it works and and they're able to live their life in
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in a manner that that satisfies them. Now, if that person abruptly discontinues their anti-depressant
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use that they've been doing for several months or so, they will experience physical withdrawal
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and that you know, there's an indication of physical dependence, but that doesn't worry us
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or concern us. That's just typical when you take a substance every day for months and you will
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without titrating down, without slowly taking down the amount of drug that you're taking,
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but that's a normal sort of physiological response, but that's not indicative of addiction.
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Addiction is defined medically by this thing where you have psychosocial disruptions where the
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people the person is not meeting their obligations like work or family obligations or other
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obligations that are important to them and the person is distressed by not meeting these obligations.
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That's addiction. You might have some withdrawal, but that's not a requirement. You might have
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some tolerance, but that's not a requirement. The main thing is the disruptions and your distress
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by the disruption. That's addiction. So if we start there and we think about like people, the
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sacred town, now the psychedelics, we think about psychedelics. Certainly people can experience
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addiction with psychedelics, but the vast majority of people never do. The same is true with
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the vast majority of people who take something like emphetamine or even cocaine or those drugs.
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They even heroin. The vast majority of people do these drugs. Don't become addicted, but there
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are some who do become addicted and we can talk about the minority who become addicted if we like,
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but the point is is that if the vast majority of people don't become addicted, then you can't blame
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the drug for addiction. You have to look elsewhere. So let's talk about, instead of calling
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an addiction, then let's just clarify and then we can move on to the legal components of this,
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which may be more interesting to you than rehashing common misconceptions about addiction and dependency.
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Let's just talk about the waning effect of drugs because there's a phenomenon that people will
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be familiar with that I've reported on a lot when I've spoken to like ex-meth addicts that I've
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experienced in my own life with people close to me who've been alcoholics or smokers. There's this
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phenomenon of like the first cigarette gives you a big head rush, so you know the subsequent ones
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you kind of want because it gives you this little high feeling, but gradually that high feeling
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gets replaced by just sort of vague itchiness about wanting another cigarette and you're not entirely
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sure why. And that is something that I've seen mapped onto friends who've gone who become
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compulsive users of meth or ice, where it starts out feeling really, really great, but the hundreds
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of times that they're doing it, they're not so much doing it because it feels great, they're sort
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of doing it, they're not entirely sure why, but they kind of feel the need to do it and that's
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obvious from the outside that this is some sort of a compulsion that's no longer giving them the
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reward that they originally got from the high. What's going on there? You don't have to call
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the addiction, but what is it? Well I mean there certainly is certainly true that people can experience,
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I mean they experience this thing we call tolerance where you will take, you need more of the drug
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than you initially had taken in order to experience the sort of desired effect, whatever that might be,
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that's just tolerance and that's a normal pharmacological response. That's what they mean, that
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that certainly happens and that certainly can happen with repeated use, you get tolerance and so
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many people who are experienced using any drug including alcohol, you just simply take drug holidays,
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you take breaks, I mean most people do, they don't take drugs on a daily basis, most people,
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you don't drink alcohol on a daily basis, I don't some do, but most don't, but if you do it's
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some real simple thing to deal with, just take drug holidays. Why have we gotten to a situation
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then where some drugs like the antitropressants you were just talking about, not only legal but
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advertised and profitable and others are so illegal that you can lose your whole life and be
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locked in a cage for the rest of your life for selling them. In the US we know like our drug policy,
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the first national drug policy happened in 1914 and the motivation for that policy and subsequent
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policies that's always been because the drug use had been associated with an undesired group or
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undesired groups and so that's the major motivation for our drug prohibitions in the United States,
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not pharmacology but because the drug was associated with these undesired groups. For example,
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in 1914 when we banned opioid drugs and we banned cocaine, we did so because there were
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these stories about Chinese Americans, Chinese who had come over to the US to help build
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the railroads and they brought with them the habit of smoking opium and there were a number of
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American business people who would tell us about the opioid dins that were being run by the
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Chinese Americans and so there were lies being spread about how these Chinese were corrupting
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good white women and then there were about the same time there were lies about how black
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American men were engaging in heinous crimes when they took cocaine like rape, raping white women
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and all of these kind of stories contributed to the United States banning those drugs at the
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federal level and subsequent drug laws have a tangent of the same sort of spirit for the reasons
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for banning these drugs. When you say it has nothing to do with pharmacology perhaps it didn't
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originally but what is the rationale that authorities use now for recategorizing new drugs when
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they say all right well you know here's some new compound or some new substance or maybe something
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that we haven't seen proliferate in our society before like Ayahuasca which is becoming
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increasingly popular therefore we're going to try to slot it into one of these I suppose
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there they think of them as categories of harm in order to meet the punishment to the harm of the
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drug what's going on there? Well so Ayahuasca is not new and the act of ingredient certainly has
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been around forever DMT and in the US just as a phenomenon in Western societies where a whole
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bunch of Brooklyn hipsters get together overnight and do it. Yeah so it's been banned in the United
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States for a number of years but the tea these days people are turning a blind eye to some of
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these psychedelics in many of the states in the US because in part the people who are writing
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about psychedelics are opinion makers and they like psychedelics and so the reputation of psychedelics
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are being rehabilitated in the United States in large part because of the opinion makers are
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enjoying select group of psychedelic drugs Ayahuasca being one of them psilocybin being another
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and then you go to like various cities where they have selectively decriminalized some of these
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psychedelic drugs in large part because of the people who have influence in the culture like
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that class of drug and they have separated their class of drug from all other drugs to do this kind
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of thing we call exceptionalism. How do you define exceptionalism? Well when you think your drug is
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somehow unique and special compare with other drugs I mean let's just take psychedelics for example
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I like like people have now classified MDMA as a psychedelic MDMA it's an infetamine you make MDMA
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by basically modifying the methamphetamine chemical structure it looks almost identical to methamphetamine
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and it has a lot of overlapping effects with methamphetamine but we don't think of MDMA as an
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infetamine because many of the opinion makers like the effects of MDMA so you move your drug out of
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that category and call it a psychedelic. We think of something like ketamine ketamine they
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call a psychedelic but ketamine is made by modifying the PCP structure and they produce
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nearly identical effects except PCP is effects last a little longer but no one thinks PCP is a
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psychedelic and no one defends PCP but they defend ketamine and so it shows that these sort of
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categorizations or classifications are arbitrary and at some level and dependent upon who has the
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influence in our society. Kyle you mentioned earlier that the sort of cliche that we have in the
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public consciousness that's pushed by the media and pop culture of the kind of drug craze zombie
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the person who's fallen after the cliff that that being an inevitable end to the you know the drug
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users life. What in your experience I want to because you've had a lot of experience working with
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drug users and in at Columbia you've actually done experiments with drug users. Are you able to
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actually administer drugs to them and see how they respond? Yeah there are a number of people around
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the US at least and also in some other countries where we give these drugs from heroin to MDMA to
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cocaine, other smokeable cocaine cannabis, methamphetamine, a wide range of drugs. We give these
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drugs in order to better understand the conditions under which you're most likely to see positive effects
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versus negative effects and also to help us better understand so where people get in trouble with
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drugs, how to how to best treat them. So all of this of course goes this information goes into
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the scientific literature but the point is is that on a daily basis we give these drugs and some of
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our most prestigious institutions yet we have these narratives that these drugs are so dangerous
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you can't take one hit or you'll become addicted you know and and people just ignore that fact that
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we give these drugs on a routine basis in these institutions. You advertise for drug users to come
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into the lab and they knew that they were going to be able to get drugs and what did you do an
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experiment I've read somewhere that the experiment involved offering them you know small amounts
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of money versus the drugs and a surprisingly large number of them took the money which indicated
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to you that they're not slaves to the drug. Yeah the study that you just described was one of my
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earlier studies with crack cocaine for example we were trying to see whether or not taking crack cocaine
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was similar to any other behavior you know like so if you have an alternative to taking crack cocaine
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that's competitive you would it shift the behavior away from taking a drug to taking to this alternative
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and the alternative in this case was money we you know you give a range of monetary amounts and
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you can see where it should something as little as five dollars you when you present people with
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a choice between a hit of crack and something as little as five dollars they'll take drug and money
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about the same a number of occasions but when you increase the amount to some like 20 dollars they
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take the money on nearly every occasion it just it tells you that people who take drugs even if it's
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crack cocaine or methamphetamine they they can and do behave rationally well as rationally as
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anyone else and is there a is there a way in which the narrative about the the drug slave the
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person who's crazed by their addiction plays into a neat kind of story about essentially police
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being good guys authorities being good guys the privileged being good guys especially when it comes
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to race you know there's all kinds of stories when you know for if an African-American dies at the
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hands of police then frequently the narrative afterwards will be that they were on drugs or that
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they were like they were exhibiting erratic behavior isn't there even some class of psychiatric
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condition that doesn't exist that the police put on forms I'm blanking on what that is you
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know what I'm talking about where they say that the subject was in a state of something or
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other that excited delirium excited delirium that's the word he was in an excited delirium meaning
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that like you know it was impossible to control so of course we had to kneel on his neck or
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shoot him or something and that that that psychiatrist is still like I'm I'm not actually sure that
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that's a thing yeah it's not a thing it's it's from I don't know maybe 60 70 years ago it used
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to be a term that was used in psychiatry but it's not used anymore and and it's not well defined
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but somehow the police education it hasn't gotten updated and it just goes to show how outdated
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police training is when it comes to these issues but you were raising really important issues
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one of those issues is that the thing that people have to realize certainly as it relates to drug
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enforcement in the United States commonly known as the war on drugs is that the war on drugs is
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it's a jobs program and the jobs program there are a number of people and a number of occupations
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that have benefited and police certainly have benefited financially they get their budgets
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increased because of this sort of war on drugs prison authorities benefit people who do drug
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urine testing they benefit they're even people people who write movies they benefit because
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you just say something somebody's a drug dealer and then you don't have to develop that character
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a number of television programs benefit because you just simply say that the person is addicted to
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heroin you don't have to know anything else about the person you don't have to do to develop
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that character you say the person's a drug dealer and immediately that means the person's a bad
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person you don't have to say anymore all of these people benefit from this mythology and so that's
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that sort of war on drugs is this big jobs program and so if we change how we're dealing with drugs
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in a society we have to see the impact that it'll have on police budgets and these other people's
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budgets and those people they certainly know the impact that it will have so they fight to keep
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this narrative people in the media fight to keep this simple narrative because you can get your
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stories published in prestigious places by simply focusing on someone who is addicted and even
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though it's not representative of the users can you imagine if if you brought into the story about
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someone who was addicted to alcohol to one of the more prestigious sort of I don't know daily
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publications and they tell you yeah not interesting but if you brought a story to them about someone
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who is addicted to heroin that's interesting even though it's not representative and so
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this whole sort of our views about drugs it's such an important function in our society
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and that's why people don't want to give up this mythology do you know people who have
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absolutely no attraction to mind altering substances at all I'm sure there are those people in life
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and I can think about particularly younger people who they when you say mind altering substances
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I'm thinking about caffeine I'm thinking about MDMA I'm thinking about cocaine I'm thinking about
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all substances that are psychoactive yeah there are people who say I just simply want to
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make sure that I watch everything that go into my body because I am a super athlete for example
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and I don't and if I get if there's something in my body I might be disqualified and so I understand
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that I mean there are there is the super athlete component but I'm I'm interested in people who
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I don't know just sort of don't like the feeling of their consciousness being altered in any way
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anyway I have two friends I can think of who don't drink they've tried drinking and then I like it
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and they've tried coffee and then I like it I don't think they've ever tried anything harder than
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alcohol but they're just like I don't want to lose control I don't want to feel like my
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consciousness is being tweaked I just like sitting in the the consciousness mode that I have
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and then I know other friends who are just hungry craving for any different
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psychoactive experience that they can find who are drawn you know almost pathologically to
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finding different doors of perception that they can explore and as you say most of these people
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do it in healthy ways in my experience I mean it doesn't it doesn't have any knock-on effects that
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are deleterious to the rest of their their lives but it does seem like there's something in them
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that is seeking either an escape or an adventure that puts them in a very different like
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personality type in my mind than the other people and I wonder if you have insights about what
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those two two differences are yeah so like the people who just don't have any interest in
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being psychoactively altered um yeah I mean I was one of those people I'm not long ago you know
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really because of this issue of my sort of desire and need to feel like I was always in control I
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couldn't I couldn't lose control um I was quite uptight and I had a lot of things to try to accomplish
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and then I didn't know any better in that and I didn't know the potential benefits of altering
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my consciousness and um the potential benefits in terms of being a better person being a more
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empathetic purpose I didn't realize all of those potential benefits and so yeah most of my life I
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lived as the friends who you described wanting to always be in control yeah yeah I so I get it I
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understand that and that's completely their prerogative and I think and I support them in their
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their and their quest and Kyle when you say that you used to be quite uptight how did you get out
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of being uptight um as you get older you know I'm 55 now and then you start to like and then
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you start to really think about what life is about and particularly when you have less of it to live
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and then you think about the various restrictions that you placed on your behavior
34:33
um and I tried to I thought about the rationale for those restrictions and the ones that didn't
34:40
make much sense um I I changed it that's all just constant introspection constant checking
34:49
in on who I am as a person and constantly checking in on my so the the impact of my behavior on
34:56
other people that's that's all I that's and it was it's always a great sort of exercise because
35:03
that continued to grow as a result hmm and when did you start doing drugs um you know like most people
35:12
I guess I did a little cannabis try cocaine and in my you know teen years little cannabis and
35:22
early 20 try cocaine and then for the next 20 25 years uh almost really nothing but
35:28
size like a a hit of cocaine at a waiting reception or something or a hit of cannabis at some
35:36
special occasion that's about it for like 25 about 25 years or so and then in my 40s um that's when
35:45
you know I had accomplished a lot of things and had gotten really good at um tempering my behavior
35:56
or really good at meeting obligations and that sort of thing so I really developed a lot of skills a
36:03
lot of uh so I was prepared so I felt prepared to do um anything basically and and so the more I
36:13
studied drugs the more I learned about drugs the care more carefully I looked at our research
36:17
participants and saw that after they took something like MDMA you know they were really having a
36:24
really good time and and um and then I wondered like I'm what a hell doesn't don't I know what that
36:32
feels like and then uh uh at the learning what it like really felt like it's like well why was I
36:38
waiting all these years to try this hmm and then so do you use heroin now uh that's like saying
36:48
do you have sex now I mean no it's not car because because almost nobody doesn't have sex
36:57
lots of people don't use heroin no so well okay it's more like saying um do you do doggy
37:04
style now you know so it's like that's uh it would be like a sexual position you know it's uh
37:13
but the society don't recognize that it's like of course I alter my consciousness and then I use
37:20
whatever uh whatever the mood might strike me for that moment or my significant
37:27
other for that moment it's not you know it's a it's a deeply personal thing and it's um and
37:35
it's a it's a thing that's not not difficult to understand um but I know we we have made this thing
37:44
seem so uh it's kind of salacious how we talk about it in society so that's why I'm giving you
37:50
this response to kind of highlight the ridiculousness of this no I get it I mean one reason why it's
37:57
maybe not salacious but certainly kind of elusive and uh interesting and intriguing to people like me
38:05
is that just logistically it's very difficult for me to even consider experiencing something like
38:10
heroin because I just don't even know how I would get it in a way that I would trust it you know
38:14
it means even if I even if I wanted to make that decision you clearly have access to compounds that
38:19
I don't so it's no that's a really on the table that's a great point that's a good no that's a
38:23
different question there so like that I mean because I don't have access um I may have access more
38:30
than many people but I I live in a lab that has heroin and you know the lab the drugs in the lab
38:39
are tightly controlled I would not ever think about ever taking a drug from the lab or anything
38:45
like that we have the titers controls and then that would be unethical I wouldn't do that sort of
38:50
thing and also you have to understand too that you know I wrote a book about uh me being a drug
38:59
user and asking people to get out of the closet and so that means that I can never break the law
39:06
as it relates to drugs because then it then it's like people would say oh you see that person's
39:13
an addict he couldn't even control himself so in the United States out drug enforcement of
39:18
drug laws are so repressive and so restrictive I don't I really don't have access in the United
39:25
States like that and so I actually try to live between the United States and Switzerland
39:32
where they have this thing called drug checking where you can check the quality of your drugs by
39:39
submitting small samples of it and getting a printout a chemical printout of the chemical
39:46
components in the substance so I really don't have that kind of access in the US and US I don't
39:53
feel free to really do drugs because I don't want to ever go a foul of the law and then
40:01
to have someone to say oh you see how irresponsible he is he's addicted or he's whatever
40:08
whatever negative comments they would like to say I don't want to give people that kind of energy
40:16
I mean they say that anyway don't they yeah some people would say that I mean with no evidence
40:22
but I don't really care about that that that's ridiculous I mean when but if I am arrested or
40:29
something like that and then they would have they didn't that would give them more sort of credence
40:34
but what they're saying when they say that and they just say it that that's right I don't listen
40:40
to those people yeah so you need to be cautious I mean and also I don't have the resources or the
40:44
level of interest to be flying a Portugal or Switzerland or some jurisdiction where I can
40:49
where I can partake of these of these things it's not that higher priority for me but
40:56
let's be clear that's that's not the priority I mean that did to the go to Switzerland I
41:01
I'm going to Switzerland in the usual I don't know I go to Switzerland because it's people leave
41:07
you the alone and they take care of their citizens and it makes me a better person so that's
41:15
that's be clear about that right right no but I mean if I were to go I'm just thinking through the
41:20
kind of the decision tree right that I would face if I wanted to embark or any any Australian or
41:25
person in a Western Western democracy that participates in the war on drugs if we wanted to embark
41:30
on in an on an adventure on a mind-altering adventure then the hurdles that are in our
41:36
way to participate in it are are intense unless you're talking about basically the things that
41:42
middle-class Australians like to do all the time which is I guess cannabis and MDMA and cocaine
41:49
probably but I mean even that even that outside of North America cocaine is a very very difficult
41:56
thing to find in any kind of pure form I don't know what people are putting up their
41:59
noses when I see them do it at parties in Australia and much of Western Europe but by many accounts
42:05
it's it's not very pure cocaine do you do you want to have can I get your thoughts about kind of the
42:10
the contamination I suppose of these compounds into things that may give people skewed ideas
42:17
about what they do yeah I don't know yeah but what you're saying about cocaine it makes sense in
42:23
terms of not getting high quality cocaine in Australia but I don't I don't know what people will
42:29
be cutting it in a place like Australia but that's the major concern that I have for for me using
42:36
anything or anybody else you have to make sure that you actually have what you think you have
42:42
because the the dangers surrounding drugs have to do mainly with the adulterance and not the drug
42:48
that people are typically seeking so yeah that's an important point and with the expense I guess I
42:55
mean the fact that the drugs are illegal means that at least certain drugs I mean good just staying
43:01
on the on the topic of cocaine in a place like Australia I just cannot even understand how much
43:05
money people must flush down the trainer up their nose rather on cocaine in Australia where it's
43:10
as I understand it like four or five times what it costs in the United States and probably one fifth
43:16
the purity and I mean if you're an incredibly high-flying lawyer then I suppose that's fine and
43:22
you can do that recreationally but I've seen many cases where people lose their income or they
43:27
get a divorce or you know I said a lot of sudden they have big child subsidy payments or something
43:30
like that and they don't have the income that they used to have and that then forces them either
43:35
off cocaine and on to meth or onto something else and then their lives do spiral out of control
43:40
I know that you'll say well that's not causal you know that could have happened to anyone from
43:44
anything but it certainly seems to be more common than not well I'm glad you said that I know you'll
43:50
say no that's because you know the concern that you raise I'm not concerned about that the vast
43:59
majority of people who use drugs are middle to upper class people I mean in the US a long you know
44:08
like this industry is a billion dollar industry to elicit drug trade and it couldn't be supported
44:15
by poor people primarily it's middle to upper class people and so those people who are
44:20
who are purchasing substance as they have the money and the ones who like you describe that person
44:26
who somehow it's having problems and they're still doing drugs I assure you those
44:32
those people have problems before their drug use and so I don't pretend to act like I care
44:40
about them I'm worried about the price because I'm worried about these people losing their shirt
44:48
that's not where my interests are I mean that's my interest is more that the society has restricted
44:55
access to these things and as a result they've made the activity a lot more dangerous because of
45:03
the potential adulterance and there's no quality control in terms of the substances that's what
45:09
I'm primarily concerned about and there is I should add a big movement in in Australia well certainly
45:16
in the state that I live in in New South Wales to introduce pill testing at you know festivals and
45:21
big parties and mighty grand things like that where where you would be able to present your pill
45:26
which is which would usually be ecstasy or MDMA and have it tested to see whether or not it's
45:31
going to harm you and not to be in fear of you know of the police when you do that and then there
45:38
are some people who say well that just encourages and condones drug use and then there are other people
45:42
who say this is a way of encouraging drug users to actually interface with health professionals
45:47
and make sure that they're they're doing things safely so I don't even think I need to ask you
45:51
about that because it's clear what side of that argument you would come down on um yeah but those
45:56
people that say that this encourages drug use just think about those people who said that about
46:01
condom use you know it's the same thing you hand out condoms when you're trying to prevent
46:07
sexually transmitted infections you're encouraging sexual behavior and people who are not married
46:14
they set the same sort of thing it's like saying you give people education they might use it okay
46:21
yeah right uh they're you so I mean I completely take all of your criticisms about the caricatures
46:27
that people make of drug use and drug addicts and addiction but your critics also say that you
46:34
sort of have a caricatured a polyano vision of what the average drug user is is like I don't
46:41
know if you know Bertha Madras who who runs the laboratory of addiction neurobiology at McLean
46:45
Hospital in Massachusetts and she says that you just ignore the adverse consequences she writes
46:51
the parents the families the spouses who've had to live and deal with opioid use disorder
46:56
traffic fatalities workplace errors absenteeism workman's compensation drug-fueled violence
47:01
school dropouts drug-related crimes and murders she says you don't want to address those things do you
47:07
oh my god okay I don't know where to start um so let's start with the workplace for example
47:20
in my sort of career I've gotten multi-million dollar grants from the National Institute on Drug
47:28
Abuse and a couple of those grants was called drugs in the workplace and it focused on drug effects
47:34
in the workplace so and my publications have you know we've modeled the workplace where I um
47:43
check out the effects of drugs on work performance and those sort of things so I have a I have
47:50
dozens of publications focused on that alone so Bertha's comment there is just not informed by
47:59
any evidence and then her sort of comment about I don't know what happens in communities you know
48:06
I grew up in the place you know the hood as they say in the US in a predominantly black community
48:14
where drugs were blamed for many of the problems that that we experienced in our community like
48:23
I am unemployment rates um maybe some crime and these kind of things I started studying drugs
48:30
because of all of these kind of concerns and so Bertha has never lived in a place like I've lived
48:37
and and my family still lives in that that place you know and so um I
48:46
you know her ignorance in that comment it's only surpassed by those who actually
48:53
think that it has some credibility um so I don't I don't know what to say I mean I've
48:59
my first book uh the high price focused on many of these issues uh on my current book drug
49:07
municipal grownups deals with um try to help people to under how to separate like what's really
49:15
going on let's say with the opioid sort of concern in the United States um when you look at people
49:22
who die from a drug related death would that uh you we know that most people have multiple drugs
49:31
in their system and I've been advocating that we uh actually measure uh the levels of these
49:38
drugs in people's system so we can determine what if any what was the causal agent and I've been
49:45
advocating for making sure we have um some sort of quality control that people understand what
49:55
they're taking so they don't take contaminants that potentially harm them and kill them um so
50:02
her comment is it's ignorant that's all I can say what do you make of the changes
50:09
called that have happened in the past decade to the legalization of especially cannabis but now
50:14
I think in some states you've also got psilocybin and magic mushrooms being legalized is it in Oregon
50:20
maybe and I mean I was living in California when medicinal cannabis uh came in and then gradually
50:26
evolved into recreational cannabis is this do you see this is part of a a broader trend that
50:31
could engulf all drugs or is this middle class people playing around with their middle their
50:35
favorite middle class things but it'll never uh it'll never reach out of that bubble
50:39
you know it's hard for me to predict because uh you know I I was in California living in
50:45
California in 1996 when um they were the first date along with Arizona to pass medical cannabis
50:53
you know and I voted in that election and um so uh but I would have never predicted the sort of
51:03
legalization of recreational cannabis use in the United States now we have nearly 20 states that
51:09
have legalized cannabis for adult use I would have never predicted that so as I think about
51:14
Oregon who recently not only do they have legalized cannabis but they recently decriminalize
51:22
all drugs uh meaning that people won't be arrested for possession of drugs or using drugs
51:30
drugs sales still remain illegal but just possession they won't be arrested for um I would have
51:37
never predicted these things so it's hard for me to say um where we're headed uh I hope
51:46
all I asked Americans to do is to think about the original promise of the country and that is
51:54
each of us were guaranteed life liberty in the pursuit of happiness um as long as we don't prevent
52:01
other people from enjoying these rights uh we are guaranteed these birth rights and so as part of
52:08
that people should be able to alter their consciousness as they see fit and if we were really living
52:15
according to our original promise um then these things would be available um in uh at the in the in
52:27
um um um um ways that we knew the quality uh and um in ways that would enhance the safe
52:37
use of these substances and so I just asked people to just live up to the original promise
52:44
if you just think of that this all becomes really simple hmm a final question about harm
52:51
Carl I didn't interview on my radio show with uh a representative of the police force about
52:58
there's a rule in Australia where in New South Wales where they can if they stop you at a random
53:04
breath test and they do a drug test as well they can test for drugs that are in your system I think
53:10
it's up to two weeks that are two weeks old now the point of the random drug test on the side of the
53:15
road was presumably to give police the authority to prevent hazardous driving but I basically got
53:21
the uh like the representative of the police force to admit that what they were actually doing was
53:26
just stopping you for a random drug test and they didn't actually care like I was saying does it
53:31
matter even whether or not the person's driving is impaired and he sort of confessed that no it
53:36
it doesn't I mean the test is going to pick up even if you had certain compounds you know
53:40
that you ingested 10 days ago it's still going to test positive and you're still going to be
53:45
arrested for that which made me wonder whether or not harm is really what we're trying to
53:52
oppose here not just in random drug tests but in the whole war on drugs because new drugs will come
53:57
along that have a very low harm profile but if they have a high mind altering profile then there
54:04
seems to be an opposition to them which it strikes me is driven more by maybe a puritanical
54:10
resistance to the experimentation with consciousness than with any clear-headed calculus about harm
54:18
and I wonder if you've noodled on where that comes from like why are we objecting
54:24
I understand all the harm arguments I understand people who are worried about their kids I understand
54:28
people who you know who don't want to who want to reduce addiction I want to reduce the burden
54:33
on the health system whatever all that is that I get all of that but putting all of that aside
54:36
this still remains this kind of I don't know this accretion of concern that people have about the
54:42
whole enterprise of altering our consciousness like society will fall apart or something if people
54:48
are allowed to tinker with their with the way that their mind perceives the world do you see that
54:53
and where does that come from yeah so that's why it's so important for you to actually deal with
55:01
the other harms like when the kids the addiction it's so important to discredit those or address
55:10
those so we think about kids we worry about kids with drugs that's absolutely true but the drugs
55:18
we're talking about are for adults and so like we worry about kids particularly unmarried kids having
55:27
sexual behavior or sexual intercourse but we don't ban sexual intercourse for adults because we're
55:33
worried about kids and but we do that with drugs and we allow that to happen with drugs is so it's
55:40
like if you do if you allow that to happen with drugs you allow this sort of irrationality occurs
55:48
why are you surprised then the cop tells you that no we're really just we want to know if you're
55:55
using drugs because this is a puritanical moralistic sort of pursuit the argument about the kids
56:02
already tell you that the argument about addiction already tell you that because the vast majority
56:08
of people who use alcohol just like the vast majority of people use heroin are not addicted but
56:14
yet we don't ban alcohol but we're banning heroin and we allow that to happen and so if we
56:21
allow that to happen with heroin and wow we surprise when the cop says that what this is really
56:29
about that's what we are that's what I've been trying to say that's why all of these arguments
56:36
they fall apart and so if this is purely about we want to be able to tell you which drugs you can
56:47
use in terms of psychoactive substances we want to be able to tell you which ones you can use
56:54
versus which ones you can't use if that's what this is about well then let's say that's what that's
56:58
this about and most of us would say wait a second that's like telling me again which sexual
57:06
positions I can use versus which ones I can't use it's exactly the same thing
57:11
hmm Carl I'm going to let you go and take care of your injured hand I hope against
57:17
better soon and I want to encourage you to stop thinking of 55 as being old you're making me
57:23
anxious you say 55 like it's 80 it's 55 years young Carl no no no I know that I enjoy it but I
57:30
just can't do the same weightlifting that I used to do at 25 that's all that's it thank you mate
57:37
good to talk to you take care
57:44
uncomfortable conversations is produced by Stefan Postuma follow me Josh Zeps on Twitter and
57:49
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57:56
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