Carl Hart: Heroin, Cocaine, MDMA, Alcohol & the Role of Drugs in Society | Lex Fridman Podcast #233

the following is a conversation with. carl hart department chair and professor. of psychology at columbia university. he's the author of several books on the. topic of drugs including his most recent. called drug use for grown-ups that. challenges us to quote use empirical. evidence to guide public policy even if. it makes us uncomfortable. his research on drugs including hard. drugs like heroin and cocaine challenges. much of what we think we know about. drugs and their role in society.

his main thesis is that drug addiction. has less to do with the drugs themselves. and more to do with co-occurring. psychiatric disorders such as depression. and schizophrenia and socioeconomic. factors such as unemployment. underemployment and resource deprivation. within the community. in addition he believes that we should. legalize all drugs so if people choose. to use them they could do so responsibly. and openly and get help if needed in a. controlled safe environment.

his ideas are controversial but are. fundamentally grounded in empirical data. and rigorous scientific studies. i don't know if his conclusions are. right but they are at least worth. thinking about. so i ask that you consider these ideas. with an open mind and as always make. sure you exercise your critical thinking. skills in making decisions about. substances you put in your body. you are a free thinking being.

the main character if you will the hero. in a story that's being written by you. so at the end of the day you are. responsible for the choices you make so. choose wisely. this is the lex friedman podcast to. support it please check out our sponsors. in the description and now here's my. conversation with carl hart. i think it is bold and powerful to admit. to using in your private life the drugs. that you study in your research. including heroin and cocaine so let me.

ask. what is the experience of taking heroin. like what happens to the body what. happens to the mind when you take it. well you know i take mdma cannabis and. all the rest of these drugs too i've. tried those drugs um the experience in. the body and the mind i i don't really. know what people want to know and in. that regard it's like saying what is the. experience of having an orgasm. in the body in the mind or or some other. sort of event that you really enjoy.

um so i don't really know what people. say what poetry is for for describing. these kinds of experiences i mean i. guess. uh given mdma given psilocybin. in the full context of that maybe it's. more useful to say. what are the. differences in experiences that your. mind goes through uh like chemically. biologically. uh so it's like keeping it strictly to. the sort of the. the the biology of it versus the full. environmental human experience yeah see.

this is a mistake that people make all. the time they try to act as if biology. is the only determinant of drug effects. and that's just not how it works uh you. need the environment you need the cage. as they say if you don't have the cage. you don't get the full extent of the. effects and so like you can take mdma. and have an awful time you can have a. time in which uh which you get paranoid. and so forth and then. you can take it that drug under the.

right conditions and it'd just be like. one of the best moments you've ever had. it certainly enhanced. um a number of my relationships but i've. also had some times with mdma that. haven't been so lovely when the people. who you are hanging out with. you don't know them you're distrustful. and all of those kind of things so. it's important to put context in it now. we can talk about drugs at a biochemical. level at a biological level and we kind. of do that in this country with this. fascination with neuroscience.

and um. that's an inappropriate kind of. fascination the way in the way we talk. about it so we can talk about opioids. and then we can talk about. endogenous opioid system in the brain we. can talk about dopamine and other sort. of. monoamine transmitters and and what uh. opioids are doing to them and we can do. the same thing with mdma um and. we won't be any closer to understanding. the sort of uh. experience that is induced by these.

drugs certainly the experience that we. all seek you know what i'm saying so. getting a positive experience or getting. a negative experience is strongly. defined by the environment strongly. dependent upon that but the environment. is a very. it's a short word that can describe a. lot of things. so. would you say the environment is. important are the people. where you are currently in your life. or is it also dependent on the full. trajectory of your psychology of your. life experiences of your parents or the.

people you came up with of the trauma. you've experienced of the hopes and. dreams that were crushed or or or not or. the opposite or the success levels or. all those things like what. what are the interesting sort of uh. landscape of experiences that contribute. to how you actually. feel when you take a drug right on. so all of those things are important but. you know like if someone had trauma in. childhood and they did the work and they. dealt with it that's not so important in. this case but if they didn't deal with.

it and that trauma is being triggered in. that event. in that moment. then it's important but let's just take. somebody like me. i'm 54 years old i'll be 55 this month. actually and um. you know i've done a lot of work in. terms of figuring out who i am and i'm. comfortable with myself. and i know how to set limits for. whatever it is i'm doing. um and so.

i know i need to work out i know i need. to eat well i know i need to sleep well. i know i need to be in an environment. with people within my trust. and then if all of those things are met. oh it's likely to be a good time you. know what i'm saying but if i haven't. slept if i haven't worked out if i don't. feel good. it won't be a good time but. i try and be responsible and take care. of my. eating habits sleeping habits make sure.

my responsibilities are taken care of. and so when i'm in that moment. i just. enjoy that moment i'm there i'm not. thinking about a bill that i didn't paid. i'm not thinking about. oh i forgot to do this for my kid i'm. not thinking about that because all of. those things are taken care of if. they're not taken care of it will impact. the experience and it may negatively. impact the experience. well that is the counterintuitive even. controversial finding from your recent.

book so we should kind of. i know it seems obvious to you but i. think a lot of people hearing this would. think it's quite non-obvious so um. in your new book uh drug use for. grown-ups you write. for the findings section i discovered. that the predominant effects produced by. the drugs discussed in this book are. positive. i it didn't matter whether the drug in. question was cannabis cocaine heroin. methamphetamine or psilocybin.

overwhelmingly consumers express feeling. more altruistic empathetic euphoric. focused grateful and tranquil. they also experience enhanced social. interactions a great sense of purpose. and meaning and increased sexual. intimacy and performance this console. this constellation of findings. challenged my original beliefs about. drugs and their effects. i had been indoctrinated to be biased. toward the negative effects of drug use. but over the past two plus decades i had.

gained a deeper more nuanced. understanding. these words are very counterintuitive to. a lot of people. um. i think like you also mentioned in the. book and elsewhere you know people have. come around to maybe psilocybin. uh being one such drug maybe cannabis. being once this drug but you also. mention other drugs like cocaine heroin. methamphetamine. um can you just linger on this point. how.

do we get the positive effects of those. drugs and why in the media and the. general conception we have of these. drugs is that they were going to. make a bad life worse or ruin a good. life. well so your first question was how do. we. harness the positive effects how do we. increase the likelihood of getting the. positive effects again like i said we. want to make sure that people are. responsible and they've handled their. responsibilities make sure they eat well. sleep will exercise all of those sorts.

of things play an important point role. and also if they know exactly what. they're getting and then they're not. paranoid about oh it's something. contaminated in some adulterant. in my drug um so you want to make sure. you know exactly what you have once you. satisfy those kind of things you. understand the dose and potency you. understand all those things to decrease. any sort of anxiety you might have about. the substance itself. it increases the likelihood that you. will have a better time so anxiety is.

the big one you need to remove the. anxiety anxiety is critical. it's huge. many of the negative effects that we see. with drugs have to do with anxiety and. not necessarily anxiety because the drug. induced it it's the anxiety that the. situation induced a lot of times. and then you ask like well why does this. sound counter-intuitive why. does the media. report uh differently. well because it's money in reporting the.

negative effects almost exclusively. think about. writing a newspaper article. it's really easy to get the population. all genned up about something like an. opioid crisis overdoses and you don't. even have to tell people. how to keep people safe if you're. talking about overdose you don't even. have to say why people are dying from. overdoses like overdoses in our country. happen largely because people get. contaminated drug because people are.

combining sedatives and they don't know. that this enhances the respiratory. depressing effects of drugs they don't. know but when you read these newspaper. articles they don't say this they don't. say how to keep people safe all they do. is frighten the population. there's money in that and then we think. about people who write tv shows um the. people who write movies uh most of the. stuff written by drugs is just bullshit.

um i think about i love going to watch. comedians and the comedians when they. talk about drugs again most of the. things that they say about drugs. is bullshit i mean you can say the. stupidest things about drugs and be. believed you can. write a movie and you don't even have to. develop your characters if you throw. drugs into the mix you say oh he's a. drug dealer you don't have to say. anything about that person's background. or about that person being developed as. a character uh because the population.

think they know and when and and the. writer uh is lazy and does not do any. sort of development just just think. about any. oh let's think about the sopranos for. example uh you know they they have a new. program coming out so let's think about. them for a second. the sopranos is a show in which um the. league character tony kills people for a. living that's what he does right. this character actually made a.

sympathetic for him. when he is. besmirching and. denigrating his nephew christopher for. using a drug and we feel. sympathy for tony the character. who just killed somebody. who is a horrible person but. being a drug user is a worse person. that's what the show wants us to believe. tony's a racist.

uh murderer all of these things but we. feel sympathy for him but we don't feel. sympathy for anyone who uses drugs. that's some crazy shit i mean and the. american public buys into it that is. that's wild to me and that we all bought. into this crap and that's what we do in. damnit everything. that's in film on television and it's. like what's wrong with you people. so. why aren't there not more stories of.

grown-ups using drugs. the full spectrum of drugs that we're. talking about why isn't there so we. talked offline about joe rogan he's. somebody who started smoking weed later. in life which is an interesting story. like when he's already very successful. and he has a very interesting way of. describing his experience with weed that. it was like enhancing this productivity. it actually i think he says like it. increases anxiety a little bit in a way. that. was productive like paranoia and not. anxiety. and so that's an interesting story of an.

adult talking about the use of weed for. for but for productivity purposes. but you don't get those stories very. often why. um i think fear people are afraid that. they will be uh belittled uh dismissed. all of these things that's a drug addict. or some negative thing but cannabis is. lightweight come on uh you can you can. admit cannabis these days and the fact. that. i don't know when joe started but if he. did start later in life that's cool i.

mean you are mature developed um you. have developed some. responsibility skills all of these kind. of things this is a good thing um you. don't want people to. engage in any kind of behaviors. when they're young and immature that. might put them in harm's way and so we. want people to be. developed at least. i mean whether it's. being in a relationship with a a partner.

uh or whether it's driving an automobile. all of these things that can be. potentially harmful but. uh extremely beneficial if you are. responsible enough to handle them um you. want people to be mature so that's a. good thing so. how are you supposed to like somebody. like me somebody like joe how are you. supposed to understand what the dangers. are what the negative effects are so you. said automobile. relationships. i think i have uh.

a reasonably it's crappy but. reasonable understanding of all the. troubles i can get with in relationships. and what things to avoid same thing with. driving a car i have no idea i'm in the. dark in terms of what. are the things to be careful about what. to avoid with drucke with drug use. when we're talking about the heavy drugs. have you ever drank alcohol yes. i know i drink a lot but i understand. that because culturally i came up.

i was taught a lot of like this is what. you don't do and this is what you do. yeah this is when you drink a lot i mean. you see the effects you see the there's. a lot of negative examples there's. positive examples of social stimulant. there's examples of great artists using. uh. alcohol to sort of. i don't know. to help be the catalyst for that magic. moment for you know all of that i don't. i have some examples now. especially in america the same with weed.

more and more you're starting to get a. lot of stories on uh sec of the. psychedelics of different kinds there's. um. psilocybin where you have. uh mushrooms or even mdma used. sort of positively there's kind of like. negative. stories from the past about acid about. lsd being used. ultimately for productive like. uh for productive ends but it destroyed. the person that's kind of how the story. goes it was like a trade-off you take uh.

it's like uh what is it robert johnson. sold his soul to the devil to learn. guitar like it's a trade-off you could. take the drug you're going to create. some good stuff but you have to pay for. it those are the stories that's some. bullshit we tell children come on. that's exactly right you're exactly. right these fairy tales these cautionary. tales that we tell people. we have to grow up that's what the book. is about drug use drug use for grown-ups. um you know we tell people. pinocchio.

if you lie your nose grow. who believes that who believes that. there are fairy tales but that's exactly. what these stories are they're in the. same vein as those kind of stories as. pinocchio um. you know like you said when you were. learning about alcohol you were told. what to do what not to do so forth the. same can be true with mdma with cocaine. with heroin the same is true because. there are some times when you there are.

some potential dangers that you should. avoid and um i wrote about some of them. um. certainly in my work just throughout all. of my writings we i talk about those. kind of things and other people talk. about these things. the problem is. is that we're getting our education. from bullshit sources from people who. believe in this kind of pinocchio thing. and it just does not fit with the. evidence and the evidence. we all publish in the scientific.

literature all these things that i'm. saying. it's there in the literature i mean at a. place like columbia we give these drugs. thousands of doses. every year. do you think. we would be doing this and we do this. with research grants that's public. that's funded by the public taxpayers. dollars do you think we would be allowed. to do this if these drugs were so. dangerous. it's just nonsense i mean and the drugs.

we're talking about. they are all. approved for medical use somewhere in. the world. and the studies you conduct are. basically asking what kinds of questions. so you take. uh the full range of drugs you're. talking about uh from from marijuana to. cell cybin to mdma to cocaine and heroin. what is the study looking at like what. the actual experience with the positive. and negative effects of the experience. on the drug are. in uh controlled conditions yeah so we.

did these kind of experiments with. alcohol. nicotine all these drugs in order to. have an empirical database. to tell people um. exactly what these drugs do and what. they don't do the conditions under which. the drugs will produce positive effects. the conditions under which the drugs. were more likely to produce negative. effects. all of this information is important for. a society to know. and we do know and and that's why we're.

collecting the data we're collecting the. data it to help us. with treatment if someone is having. problems with these data. hopefully we'll uh understand. more about the. how to. help them deal with their problems based. on some of the research that we're doing. so what kind of negative effects are we. looking out for like what what are the. properties of drugs we should be careful. about is it addictive properties how. addictive it is how. how uh destructive or painful whatever.

the uh. the. withdrawal processes. what kind of things are we looking out. for yeah those are certain kind of. questions we certainly have asked. because like uh something like cry. cocaine versus alcohol or. heroin when it comes to uh withdrawal of. physical dependence like cocaine has a. very limited sort of uh withdrawal. symptoms i mean it's hard to see uh same. is true with methamphetamine but uh with.

heroin you certainly can see a. withdrawal syndrome that's displeasing. that's unpleasant. but with alcohol that would draw. can actually kill you so heroin is. unpleasant and not lovely but with. alcohol withdrawal that's the one that's. the most dangerous i mean all of these. kind of questions we want to know um. answers to uh and and so when we think. about uh heroin or some other drugs and. you say like what kind of negative. effects negative effects we don't talk. about much in the society the main thing.

that really concerns me about like. heroin use really is constipation so if. people uh are using uh heroin on a. regular basis and then they have a sort. of slowing of their gut motility they're. in they're likely to increase. constipation and that's not good i mean. for your general health but we never. talk about that in this society and. that's probably the most important thing. aside from the fact that people get.

contaminated street drugs and that sort. of stuff and increase the likelihood of. maybe dying from some contaminant or. people who are inexperienced and they're. mixing heroin with other sedatives. that's not good but the constipation. is a huge one um and then other sort of. drugs negative effects um like the. amphetamines all of the amphetamines. they differ they disrupt sleep food. intake all of these things are so. critical for sustaining human life.

but we never talk about that because. it's not as sexy as this nonsense that. people write about like addiction. addiction has almost nothing to do with. the drugs themselves and i make that. comment because um the vast majority. abuser for users for any drug. never become addicted and so if the vast. majority of users don't become addicted. then you have to move beyond the drug. when you're talking about the phenomena. interest in this case addiction and and. so when we think about addiction it has.

much more to do with our psychosocial. environment than the drug itself. but that's not sexy. so addiction is even the property of the. environment not a property um a result. of the environment it certainly can be. there are people who are. suffering from uh uh co-occurring mental. illness like uh depression anxiety i. mean that's within the person of course. and that increases the likelihood for. addiction so that could that's um.

not so much the environment but there. are people who. for example they have chronic. unrealistic expectations heaped on them. and those people are more likely to have. some problems with drugs. there are people who are just immature. not. develop having developed responsibility. skills they are likely to have some. problems if they. engage in some of these behaviors there. are people who lost their jobs covert. factories went away a wide range of. things and those people used to have.

standing in their community now they. have none um those people might be. susceptible to having a drug related. problem if they indulge. all of these kind of issues are far more. important than the drug itself. so they could seek escape in a. particular drug i mean there is a. biochemical thing to each of these drugs. and some more some pull you in harder. than others when you need the escape. right when you're not doing well in life. what evidence you have for that belief i.

don't i yeah because there is none there. is absolutely none i mean people say. stuff like that and um. that's the problem that's precisely the. problem see i'm operating from limited. personal evidence. well this is a problem though but we. have a scientific database yeah we don't. need personal evidence for this we have. in my book i try to go through some of. the science so people could unders. understand it's like. uh when you have a math problem you. don't want people saying well you know i.

feel like this fuck what you feel what. does the data say. so. one of the problems with the data so one. day it is the the there's the studies. that you're doing this is excellent. research work but there's some of the. drugs are illegal yes and some are legal. um so you have just. it's unfortunate that some of the drugs. are illegal or how whatever you believe. but there's not enough of a data set of. uh public in the open use that's like. you in the wild data set it'd be nice to.

do you know thousands of people and see. from all the different kinds of. environments and all that kind of stuff. to get an understanding i think we have. a substantial a substantial database but. people just ignore it got it. that said. let me ask you the question of. legalization. so. should in your view all drugs be. legalized. the drugs that people seek certainly. should be legally. regulated and available to adults so.

when i say the drugs people seek like. cannabis mdma cocaine heroin um. those drugs certainly should be. available and some of the psychedelics. that people seek um now the thing about. it is that. some people uh. think that oh we'll be a free fall these. drugs are available to everyone that's. not true i mean it will be there will be. age requirements and maybe other. requirements but they should be.

available and. we should also do like what we do with. alcohol we can put enough alcohol in a. bottle to kill you but we don't so we. regulate it such that the amount that's. in the bottle uh enhances the safety and. minimizes the potential harms. we can do the same thing with these. other drugs and we can also say okay we. won't be selling intravenous. preparations of any of these drugs these. the drugs that the routes of.

administration will be oral and i don't. know let's say uh. uh intranasal. again routes of administration the dose. that you have in each unit um. all can minimize harm based on how you. do these things and we can do that we. have the technology we have the know-how. so you're actually making me think about. alcohol a little bit so if i were say. the drugs become legalized in the way. you're describing and me.

lex wanted to. as an adult explore some of these drugs. what are some procedures do you think. for sort of safe. positive exploration of those drugs. the reason i say i'm thinking about. alcohol because i don't think. besides not putting enough alcohol in a. bottle to kill you. i don't think anyone ever gave me. specific instructions i think it's kind. of word of mouth and examples of people. doing the wrong thing you kind of get it.

through osmosis that way yeah is that. basically what we would do this kind of. free exploration of use no we have to. change our education about these things. i mean. um let's just take a drug like cocaine. cocaine is a stimulant. and you want to make sure people. understand that they shouldn't be taking. cocaine their bedtime and you know they. need to get a certain amount of. hours of sleep. and um they need to get up in the. morning cocaine probably isn't a drug. for you at night certainly not.

um certainly not amphetamines at night. for most people and also if you want to. make sure that you they need to. understand that cocaine. can also disrupt your food intake not as. much as the amphetamines but all of. these kind of things people need to know. so they can have. proper nutrition and they can. time their drug use around these other. important functions that's the same. human night so we have to make sure that. we um educate people we can't just uh.

throw people in a while that's stupid. i gotta tell you i mean for me. and even given your book and for people. listening to this it's still. it's still tough to hear that the thing. we should be concerned about with. cocaine. is the same as with caffeine. don't take it before bed and the thing. we should be concerned with heroin. is constipation yeah. okay.

but. the questions i keep wanting to ask you. i should be asking the same things of. alcohol. but when you're not doing well. psychologically in the ways you describe. when the environment is not right. there's some aspect in which saying that. drugs can be used responsibly and. effectively and mostly positive. can uh give those folks a pass. to use it instead of working on.

themselves and fixing their environment. first. i i don't know what what do you want me. to say to that i mean they have access. to alcohol they have access to them. you know we live in this country called. the united states where our declaration. of independence says that. we are free to live like we want to live. so long as we don't uh disrupt other. people from doing the same. um but it's remarkable to me how we try. to control the behaviors of other people. that's just. remarkable.

yeah. and uh that's partially what your book. is about i mean it's not just about. drugs it's about freedom that's the. bigger issue that we can't get to it's. like. this issue of. freedom and freedom comes with a. tremendous amount of responsibility i am. responsible for my neighbors my brothers. i mean. i can't. impede their freedoms like some people. think that their freedom supersedes. everybody else's freedoms no and that's. what i'm trying to remind people in this. book.

i am. uh responsible to you um as a citizen um. and. we're in this together. and i tried to make that point in the. book and people. have conveniently ignored things like. that. do you think the war on drugs. has done more positive or negative for. the world. depends on which world you live in the. war on drugs has been hugely beneficial. to law enforcement.

to the media. to people who make bullshit tv shows um. uh the sopranos the what the wire all of. those shows they benefit from this kind. of nonsense um. um. who else have benefited people who. provide treatment many of them benefit. from the war on drugs the folks who do. urine testing for drugs they've all. benefited they're making mad money. people who run prisons.

the phone companies who charge the. prisoners on the people who run the. hotels that are around the prisons where. people's family have to come and stay. the restaurants they they're making out. like bandits. but many of us are getting screwed as a. society. we. in general we're getting screwed but. there are people who are just benefiting. handsomely that's why it continues. politicians benefit i mean whether. you're democrat or republican you have.

the same stance on drugs anyway so you. they all benefit from this. so many questions i want to ask you. because you're challenging a lot of. beliefs that people have. about drugs about society in general so. it's difficult for me to ask the right. questions here but. if you could if you were uh with a. sort of uh snap of a finger change the. world. what from a policy perspective. would you and from just a i don't know a.

human to human perspective what would. you like to see in the united states of. america. in terms of that fixes some of the. problems we're discussing here first of. all i would not we wouldn't be arresting. anybody for drugs anymore that would go. away. um the folks who are imprisoned for. drugs that would go away their records. would be a sponge that would just go. away. and then we work on a system. to make sure that uh responsible adults. can. legally attain obtain these substances.

and we will have a corresponding. educational system to teach people how. to do this um. that's where i would start initially. yeah the the arresting for drug use. or anything drug related is absurd. especially in the context of how. destructive alcohol is and tobacco. alcohol can be destructive to some. people but alcohol also is a. hugely beneficial drug to be honest. which i couldn't have gotten through.

uh many of the sort of receptions and. functions i had to go through as the. chair of the department um without. alcohol yeah you have a line i really. liked um the vast amount of predictably. favorable favorable drug effects. intrigued me so much so that i expanded. my own drug use to take advantage of the. wide array of beneficial outcomes. specific drugs can offer the the part. that entertained me was this to put this. in personal terms my position as. department chairman from 2016 to 2019.

was far more detrimental to my health. than my drug use ever was i mean there. is there is a standard we're treating. drugs certain kinds of drugs that's. completely different understand we're. treating everything else in our lives. yeah i mean. it's it's almost difficult to snap out. of it as i'm listening to you and and. reading your work um. it's it's uh. it's difficult because it's like. why is everybody living this. idea that certain drugs.

are so horribly destructive and others. are not. and we just kind of fix that idea and. then there's this narrative. um. i hate to be so cynical to think that. there is just like a system that just. propagates narratives. i always kind of think that uh truth. wins out. truth is the best narrative i believe. that too obviously that's why i'm out. here and putting subjecting myself to. this sort of criticism and so forth but. because i believe that truth.

ultimately wins out but i might be wrong. but uh i have to live my life. like it's true otherwise then i have no. hope then why be here well kind of if. you can steal man or at least show. respect to a criticism you've i'm sure. received. uh quite a bit of criticism for your. work i i've heard quite a bit of bs. criticism sort of ignorance. stuff that don't actually pay attention. to your work. but is there some serious like is there.

some pushback that makes you think. uh twice. people say like i'm presenting a too. rosy picture of drugs you know like um i. don't want to do that or i don't want. people to think that i'm not aware of. the potential negative effects of any. activity including drug use um and so. i do acknowledge that uh there are. potential harms associated with drugs i. acknowledge that in the book.

but the fact remains the beneficial. effects far outweigh the potential. harmful effects and we have technology. information to help people to minimize. the likelihood of the negative effects. but. this sort of approach that we have where. we. say we're only exclusively presenting. the harmful effects and that should make. people keep people safe i just have a. problem with that but i i certainly i. i take the point that um people say.

there are negative effects absolutely i. absolutely agree. what do you if i can just talk about. specific drugs um what's the difference. between opioids and. benzos for example. specifically. i mean these are drugs. that you often read about being misused. at scale i mean the misuse is the. problem right yeah. no matter what the drug is yes. and that's actually what you're pushing. for is education and it should be it.

should be legal and should be good so. people should know what's the difference. between um. proper use. positive use and misuse. i mean one public figure who has been. going through this is uh jordan peterson. he's been public about his struggle of. getting off benzos the withdrawal he's. going through i mean what are your. thoughts about. um. the misuse of benzos or opioids and so. on the epic epidemic that people talk. about.

yeah i don't know. jordan's specific case but certainly. with benzodiazepines in general we. talked about withdrawal earlier when i. said that with alcohol withdrawal you. can die so benzos and alcohol they're. closely related so benzoyl withdrawal. too can kill you. just like alcohol so when we think about. the effects that. benzodiazepines produce think about the. effects that alcohol produce they're. comparable or similar and so i know. that it's a difficult one to.

wean yourself off if you develop the. dependence but we we have uh protocols. for that. and i hope he's okay. it's interesting to say we have. protocols for that but from my. understanding was that. like the protocols aren't standardized. it feels like. a lot of doctors aren't as helpful as. they could be in this process like it's. a bit of a mess. certainly with withdrawal they're more. uh standardized than anything so. uh like if someone is going through. alcohol withdrawal there is a standard.

protocol that most physicians in this. business they follow and the same is. true with uh. benzo withdrawal but the thing where it. gets murky is when they're treating. addiction itself so when you're thinking. about the substance use disorder in the. dsm not just withdrawal but the entire. addiction that's where you have this. sort of uh. divergence or. diversity diversity in terms of. approaches and many of those approaches.

are rubbish. what uh can you just elaborate. like technically what the term addiction. means that you're referring to when i. use the term addiction i'm referring to. the diagnostics this statistical manual. of the american psychiatric association. number five now the dsm-5 that's never. been wrong right oh. no. i'm just kidding oh you're right. that's that point is well taken and your. point is that um um.

their definition of substance use. disorder that's addiction that's what. i'm talking about but that definition. continues to evolve and so you're right. they still. are working it out we're getting new. information from scientific studies and. so forth and so it's supposed to be. incorporated into the dsm but uh there. are some problems with the dsm like for. example um they also have this sort of. once an addict always an addict thing.

and there's no evidence to support that. um but it's evolving and it's the. definition. that people in science and medicine use. and so we all know we're talking about. the same language when we call someone a. substance use disorder patient or. someone who meets criteria for addiction. we all are speaking the same language. we're not saying that simply because. this person used heroin they are an. addict that's not what we're saying you. have to meet these criteria where you.

have. disruptions in your psychosocial. functioning that's one and two uh you. the person are distressed by this these. dis these uh disruptions so people have. to meet those two basic criteria before. we say they are addicted. so once an addict owes an addict this. idea. uh so i've. i mean some of it is always mapped to. the person all right but i've just.

the people i've interacted with who have. struggled with alcohol addiction i i. don't know if what the proper term is it. seems like with alcohol anonymous. the process of. putting that addiction behind you. is a very very long process it's. surprisingly long to me that almost. seems like a whole life like he's not. always an addict but it takes decades. it seems like uh. what is that. what. can you maybe just.

from your understanding as a scientist. from your understanding is a human who. studies human nature why does it take so. long to treat. to. to to deal with that. uh addiction well you you cited alcohol. anonymous right and so. i don't think of alcohol anonymous as. like a. a a treatment that i would send any. relative to you know like for a. drug-related problem you know i think. alcohol anonymous a-a is really good for.

social interactions um making sure. people um. have a social group and they have peers. i mean that's a good thing we all need. that social interaction. but i don't think they know much about. drugs that's not that's uh it's like. saying uh. well you know my uncle broke his knee. and uh he he has his support group and. they said this. um. and then we follow that uh that doesn't.

make any sense but in our society. judges even sentence people to go to a.a. uh are you kidding me uh but but that's. the kind of thing that has been allowed. to happen in this society because we. think of drugs. as this moral failing or drug drug. addiction as it's moral failing. and any idiot can provide treatment and. no disrespect to aaa because i think. what they do.

is a lot more than what some people do. because at least they have the social. these social interactions you have a. social group um that's better than what. a lot of these other idiots out here do. well in that social support group. unrelated to the drug it helps cure some. of the environment issues you might be. in that's the whole point absolutely so. we kind of coupled the drug to the. environment but the reality is as as you. argue. most the problems come from the. environment certainly with people who.

are experiencing drug related problems. with most of the people not all but most. there are differences. like that psychedelics. and uh like psilocybin has versus. alcohol yeah i personally think. uh you know i've enjoyed both. experiences in different ways i. is it possible or is this are we getting. into the realm of poetry. to describe the benefits like how it. alters the how the different drugs alter.

the mind. and the places it can take you that. produce a positive experience yeah. no it's very real you know like. some drugs uh take people in places that. other drugs can't and that's that's very. real. i have friends uh some of them you know. they um. they for example say that they've never. had an experience like the one they had. with ayahuasca and they've done a number.

of sort of things. but they did the ayahuasca in a setting. with. a shaman and. this group and. they felt like. they actually began to heal or solve. some problems that they were trying to. solve for some years and that's that's. great that's great for them. and nothing else does it for them like. that and that's absolutely fantastic um.

all i. argue is that um. if that kind of thing happens for you. with ayahuasca facili with psilocybin. with some other. psychedelic. why isn't it possible. that heroin does that for someone or. cocaine does that for someone else or. mdma does it for someone that that's it. that's interesting to imagine like a. shaman for heroin. like why not. and or cocaine you said creating an.

environment for yourself for use of. these different substances and that. environment has a. has a very. uh. strong impact on the actual experience. that you have. but i mean so um. cocaine is an upper. and then. yeah the way we define drugs like uppers. and down downers that's uh. that's a really uh. kind of inappropriate way but it's a. quick way but so we certainly say. cocaine is an upper or stimulant yes but.

um. you know it depends on the activity of. the person before they take the drug say. like if you're like really active before. taking a drug like cocaine it might. actually calm you you know so it all. depends on the activity of the person. before they take the drug i remember uh. i don't know if you know matthew johnson. is of course. he did all these studies on or. i remember just reading a paper i didn't. get a chance to talk with him much about. it but it was about condom use. and cocaine.

and then you know what like the doses. and whether people are more less likely. like the unsafe thing there. is the. using or not using or not using i guess. uh condoms during. sexual intercourse i don't know i just i. love that these drugs that have um. connotation probably because of. hollywood negative connotations are. actually being studied by science and. then they actual impact they have and. what are the negative effects again in. those studies often.

the positive effects are difficult to. quantify i think maybe i guess you can. from self-report and so on. but positive effects are not difficult. to quantify. you ask people about their euphoria. uh you can see how well people are. getting along like in our studies that. we have people. uh sometimes in groups and you see how. well they get along um on the various. drug conditions or placebo conditions uh. it's really.

it's not that difficult then you can see. these uh amazing studies with uh like. rick goblin like the looking at mdma and. combined with therapy. like how you can overcome certain ptsd. things or depression and so on. yeah it's really interesting it's uh. it's really interesting. i gotta ask you because you mentioned. the wire. do you think the wire using movies like. transporting do you think they're. ultimately destruct because okay. yes they celebrate murder right the.

godfather a little bit. yeah but another one i mean it's like. these racist ass motherfuckers. and they also are killing people but yet. they say we don't do drugs what kind of. shit is that yeah i mean people who are. doing drugs. psilocybin or whatever. the thing is we're trying to be better. people and trying to make our society. better and you're killing people and you. are. denigrating.

people for using are you fucking kidding. me and we let them get away with that as. a society do you see those movies i. apologize if i'm not sufficiently. informed you see them as denigrating. drugs of course i mean the godfather. yes that's right that's a good example. and the godfather sopranos is all about. that i mean christopher is using heroin. in the sopranos. and. they have an intervention at that one in. one one season and. they are.

they are denigrating him it's are you. kidding me you just cut somebody's head. off yeah but they're to be fair they. were denigrating i think all drugs. and then they're drinking alcohol in the. butter bean. yeah yeah. first of all they're killing people yeah. they don't have any space. none to denigrate somebody who's just. trying to. alter their consciousness are you. kidding me and not bothering anyone else. but you know there's a lot of other mob.

movies that you know scarface celebrates. the murder and the drugs equally. so i i mean it it doesn't. it celebrates all of the. just uh not just drugs or so on it's. those movies. you know i loved all those movies i'm. from miami i loved scarface i even liked. the sopranos that i started looking at. that shit with a critical eye and see. what it's doing yeah um. but scarface is dependent upon the.

american viewer. having a certain view of people who deal. in drugs and that view is that these. people are animals basically and in the. end uh the animal kills himself with too. much cocaine and he was high and that's. what they show and so it's like. what the fuck. so it's leveraging is playing into. not the better angels of our nature.

the question don't take away these great. movies for me but it's true you have to. think about them critically in the. continent wait wait wait wait wait wait. i like these movies it's not a matter of. taking away it's a matter of making the. writers. uh be more honest to the reality that's. that's it that's true that's really true. and the the writers the people the. culture all of it i mean they write. these things you you know i just think. about some some hip-hop artists they say. like this is real this is my experience.

and so forth. and that's how these movie writers they. write this bullshit and then say well. this is real um. anyway i i i get so upset talking about. it because i know the harm is doing and. i know those kind of movies are the. reason that we have this war on drugs um. and all of these people are going to. jail because of those kind of movies. in the epilogue of your book you quote. james baldwin you cannot know you will. discover on the journey what you will do.

with what you find or. what you find will do to you. so let me ask how has drug use or the. study of drugs change you as a human. being uh it just helped me think about. other people's experience right so. how other how we're all connected like. going to northern ireland i don't know. if you know much about the situation. with the troubles and. what those people went through. and so i see people there. northern ireland by the way is all white.

and you see those people there suffering. for the same reasons that people in. appalachian are suffering for um. neglected by politicians who told them. lies about drugs and not dealing with. the real problems like west virginia for. example. their water is polluted the factories. have gone away people are desperate and. they're blaming drugs are you kidding me. so. the politicians don't have to bring back.

the jobs so we don't have to. really make sure they have clean. drinking water things of that nature and. so those people are connected to the. people in northern ireland they're. connected to the people in brownsville. they're connected to the people in other. places in the united states for the same. reason they're connected to the people. in. sao paulo uh brazil. same thing people are catching hell for. the same reason in the philippines for. the same reason and and that's why i.

feel so strongly about this thing. because i know. there are people getting paid and their. paycheck is predicated on subjugating. and the suffering of those other people. so when we hear about. the destructive effects of drugs. it's essentially. a scapegoat. for the failures of leaders and. politicians to help alleviate the.

suffering of people in those communities. absolutely it's so easy to say. i'm going to rid your community of drugs. i'm going to put more cops on the street. if you want a problem. not to be solved. just give it to the military or the cops. you had a tough childhood growing up in. miami like you said. one memory's. memory stands out in particular that was. formative. and helping make you the man you are.

that's so hard to you know. say. you know my grandmother was really. important. so maybe just her. trying to make sure that i think. critically that was i guess that's the. biggest one. so you moved in with her your parents. split. six seven yeah what have you learned. about life from her. be self-sufficient. be critical and keep your eyes open and. watch out for the okie doke you know and.

that's what. this whole drug thing is about it's the. okie doke people. um. it really boils down to. just simple thing we're all similar in. that we're all just trying to live our. life trying to take care of our kids we. want the best for our kids all of us but. yet. somehow. um we are being we've been made to. believe that we are different in in that. way but fundamentally we're all the same. so when people are.

seeking to feel pleasure to feel better. uh why don't we celebrate that instead. we denigrate people for that i mean if i. feel better i'm more likely to treat you. well. i gotta say still though you're going. against the grain. and uh you're a colombia. it takes a lot of guts to sort of speak. out about these ideas so boldly.

um i don't know how to ask this question. where do you find the guts. what uh. because it's also perhaps inspirational. to others in different disciplines that. are sort of taking on the conventional. wisdom of the day. and challenging it what does it take to. do that what advice would you give to. others. like you kind of a little bit afraid to. do so once you know you cannot not know. as they say and so i have to look in the. mirror and then looking in the mirror i.

have to face myself. have i lived honestly. and if i can't face myself then. uh what am i doing here um. you know that's how i i see it. one of the things that people don't. really talk about. with drugs and people who die from some. drug related death and. i've been thinking about this a whole. lot over the past couple years it's like.

some of these drugs can take you to a. place where you feel so optimistic and. positive about. humans our fellow humans. and you want to. do your best to contribute. and because you know the possibilities. of what we can be as a society. and then. you come up with resistance and you like. you say there are a lot there's a lot of. resistance and people just have a hard. time. and and so if you know.

humans can be better. and they refuse to be better. why be here. as someone who knows that they we can do. this better i certainly don't want to do. it the way we're doing it. so you kind of see drugs. as. mechanisms for potentially elevating the. human spirit sort of. making people feel better so you want to. communicate that message so it's that. plus.

the fact that drugs are used as. scapegoat to uh. to not alleviate the suffering of. certain communities so those two those. two things come up one one of the sort. of main points of the book two was to. try and get people to understand. um possibilities that we could have. if we embraced um uh certain drug use uh. if we allowed adults to do this sort of. thing uh. relationships uh can be better um a wide.

range of beneficial effects people would. be. or can learn to be more magnanimous um. all of these pro-social things that we. say we value. in your previous book high price you. talk about rap and djing chapter five. there's a nice picture of you djing from. 1983. so uh let me ask. who in your view this is the toughest. question of this interview uh is the.

greatest hip-hop artist of all time. maybe give some candidates oh wow who is. the greatest hip-hop artist so. you know i don't know if i'm qualified. to make that back because you you know. um. uh. when i. i have to go back to like gil scott. herron you know like people think of him. as one of the fathers of hip-hop um. that's my all-time favorite you know um. and people like chuck d from public. enemy some of the things that they were. doing i was really digging but even.

though. i was digging like public enemy um but. even they got it wrong on drugs even gil. scott herron got it wrong on drugs um. but. they were doing so much other good stuff. uh it helped me to develop as a person. and so. um. i think uh. like my son is a hip-hop artist now i. think those those folks who are in the.

game now they might be they are a lot. more qualified to talk about who's the. greatest hip-hop artist i i'm not. qualified the evolution i mean have you. tracked the evolution from sort of the. 90s with uh wu-tang and tupac and biggie. and then to uh what we have today so. there's there's just been a crazy amount. of progress that's like almost difficult. to track yeah i mean i really love what. they're doing i like what they accept. the part where. they get over 40 and they become fucking.

cops on tv i mean other than that i dig. what's that about. yeah i don't understand that you know. but that's what they do again those. uh this sort of glorious glorification. of cops. that's dangerous for a society. and and those cats who do that kind of. thing you know i have a problem with. that is it all sort of to push back a. little bit because i come from the. soviet union where there's a huge amount. of corruption and when i see what's. going on with cops in this country.

there's a lot of proper criticism you. can apply but like relative to other. places. this is well on in on so many ways this. country is incredible. uh is your criticism towards. cops or towards what cops are asked to. do yeah towards what cops are asked to. do. cops provide the shield for politician. and those in power uh absolutely because. i was in the military i spent four years. in the military and i did what i was.

told to do and i was ignorant and. and thought i was doing the right thing. and i. did what i was told to do and so just. like these guys are doing what they're. told to do. but no i my real beef is with the power. structure the folks who are telling them. what to do um and. also those those the the folks who go. play cops on on television um that. imagery that sort of um. glorifying cops that's a problem in a.

democracy. yeah all sides of the glorification of. the drug war is a problem yeah. if i can just linger in a little longer. in terms of the effects of drugs. on the the positive like mind expanding. uh components of it. um. what. have uh mind altering drugs teach you. about the human mind sort of from a. neuroscience not even like a. biochemical. but just like the human mind is amazing.

right yeah the places it can go. have. like are there some insights you've. learned yeah from studying drugs about. the mind. yeah. can i start from a neurochemical. perspective first and then we'll go. larger just from a neurochemical. perspective i mean everything i know. about the brain i learned through drugs. you know because of my interest in drugs. so i learned a lot about dopamine. neurons in certain regions of the brain. about neuropathy neurons and.

a wide range of other sort of how neural. transmission happens because of drugs. and so that's a really. valuable tool lessons for me uh but then. when we think that we. uh move out a bit and we think more. globally what have i learned in terms of. the mind. from drugs. i have really learned. how to be more forgiving of people. and myself.

and. um. tolerant and more tolerant of people. and. certainly learned a lot more about. empathy as a result of. drug use. uh and like i said earlier. i'm. learning what we can be as a species and. it's quite incredible uh but because of. drugs. yeah there's a certain property of drugs. in different ways they take you out of.

your body like. they help you evaluate yourself from. like a third person perspective it's. almost like you have a consciousness in. here and you get to step outside of it a. little bit. i mean that's kind of what meditation. does too all of these processes that's. what a hell of a good workout does too. it makes you evaluate yourself and that. somehow. that allows you to. um be forgiving to yourself and. forgiving to others. sort of empathize he trains that part of. your brain so stepping outside of.

yourself not taking yourself too. seriously yeah that that process and. different drugs do that. in different ways obviously i don't know. from personal experience than some of. them but. i'm i'm now curious you know it it um. it's unfortunate that the the. hollywood and different stories we have. uh demonize certain drugs and sort of. basically. i don't know make it difficult for. people like me to explore those ideas. but then. i'm really thankful for people like you. who are pushing the science forward and.

are unafraid to talk about this kind of. stuff. because i'm really fascinated with. consciousness on the engineering side i. really want to build robots that are. that have elements of intelligence. emotion even consciousness and for that. we need to understand ourselves and. drugs is. all the different kinds of drugs if you. safely seems like an incredible tool to. understand ourselves and if we're. limiting ourselves from certain drugs. because of certain political games that. being played.

it's sad. and people know this. a lot of middle to upper class people. know this the illicit drug trade. business. is a multi-million dollar industry. multi-billion dollar industry. that could not be supported by people. who are poor. and so and that and that has to be. supported by a lot of customers. and a lot of people around the world. know this. they're in the closet and in the book i.

call for them to get out of the closet. so. we can start being more honest and we. can take the pressure off of those. people. who are not as privileged. like i said you're brave you're bold i. gotta ask you for some advice what. advice would you give to a young person. today high school. maybe undergrad and college. thinking about their career. thinking about how to live a life they. can be proud of. yeah whatever career they choose.

just make sure. that they dedicate themselves to and be. the best at what they do first that's. what you have to do first uh like people. see me. um advocating for this position. 30 years of science is in. these opinion this view um and trust me. i would be dismissed if i didn't know my. shit if i was not yeah you did the work. you proved yourself you're legit and by. by the people in the eyes of the people.

who know absolutely so that's the main. thing that i would encourage people to. do really know your craft if you know. your craft um and then maybe you will be. a service to. your fellow citizens. there are so many people out here faking. the funk and they don't know their craft. and they're not a service to the people. that they claim to serve and that's a. problem and when you have. a fair number of people like that in.

positions of power. your society is going to crumble. what about the scientific path. you recommend people get a phd. not necessarily you know. like my own children i don't recommend. that. so um. uh science came certainly my science can. be a bit very petty sort of space to be. in um. but it was the only sort of path that i. had. and so i i had to do it uh but uh no i.

um i would really encourage people to. just. do something that they enjoy. and something that makes them happy. because the greater number of happy. people in our society. the better off we all are. all right since you mentioned happiness. gotta ask you about the pursuit of. happiness and the. the ridiculous question about meaning. do you think this life has meaning. what do you think is the meaning of life.

i'm sorry i certainly hope it has. meaning i mean i'm i'm certainly trying. to live mind like it has meaning you. know um i really love my life now i just. got back from geneva um i. spent the summer abroad in europe and. trying to be in a more civilized place. where you can. enjoy yourself as a responsible adult. and then it allowed me to decompress and. then come back here um the thing about.

coming back here is that you have to be. ready to fight and i don't want to fight. anymore you know i just want to be able. to help a society and people. and so i'll have to like keep a place in. europe to go and decompress and then. come back to be able to tolerate the. situation so. life for me has a lot of meaning i'm i'm. enjoying life. this is like um the the greatest the. best part of my life ever right now at. this moment it's just a joy.

but you also enjoy the fight a little. bit or no i don't really i'm tired of. that you know it's like uh. why you. you're trying to i'm trying to help. people to see. how they can be happy. and then people are fighting me on that. i don't want to be happy i want to be. ignorant leave me alone that's what. people are saying. well so what is the source of joy for. you when you decompress. mdma is a source um you know in a place.

where you don't have to worry about laws. that's like europe you can feel really. free yeah heroin can even be a nice uh. space if i'm in my own head. but with others mdma is great um. so uh but good friends good food um. yeah yeah. family love yeah that's right carl. you're an incredible human being you. really make me think everyone listens to.

this um. you're i mean uh i'm really glad you. exist um i know you say you don't like. the fight but i'm really glad you're. fighting the fight because it's gonna. help a lot of people it's gonna help at. the very least. help a lot of people think and challenge. the conventions of the day. and maybe challenge them to find joy. i really appreciate you spending your. valuable time with me this was an. awesome conversation thank you so much. for talking thank you for having me man. thanks for listening to this.

conversation with carl hart. to support this podcast please check out. our sponsors in the description and now. let me leave you with some words from. frank zappa. a drug is not bad a drug is a chemical. compound the problem comes in when. people who take drugs treat them like a. license to behave like an asshole. thank you for listening and hope to see. you next time.

you.