Drug Use for Grown-Ups - Carl T. Hart

Purpose
- Present more realistic image of typical drug user as responsible professional using drugs in pusuit of happiness
- Make the case that a benevolent govt should not forbid adults from choosing to alter their consciousness (if it doesn’t infringe on rights of others)
Myths and gaps in science
- Drug use is not the direct cause of poverty and crime
- “Marijuana as gateway drug” theory conflates correlation and causation
- Research shows that recreational drugs can have negative impact on mental functioning of infrequent users, but less clear are effects on frequent, experienced users
Flaws in government drug policy
- Large racial discrepancies in marijuana arrests, dealer similar rates of using across races
- Bias towards only researching negative effects
- Disproportionate focus on addiction in discussing drugs, despite this being a minority of effects
Bottom line: most drug use scenarios cause little or no harm, and some responsible scenarios can benefit human health and functioning
- Caveats: this book does not apply to those with mental illnesses, experiencing acute emotional distress, with drug addictions

War on drugs in reality is a war on racial minorities
- White drug problems treated as public health crisis, vs Blacks & Hispanics as crime
- Privileged treatment of the former comes at the expense of the latter
When addressing racism, doesn’t help to speculate on motivations, implicit bias— impossible to prove
- Instead, keep focus on people’s actions
For much of American history, much more freedom over mind-altering drugs
- Jefferson was a big fan of opium-based drugs
- Early 1900s, regulation began in response to racist idea that these drugs caused Black people to commit crimes

Responsibility and liberty go hand in hand— government doesn’t go around telling you what to eat, because it’s our personal responsibility to make decisions on our interest
- It is the role of govt to provide comprehensive info on composition, nutrition, valid research, etc. to help people make those decisions
- More oversight and transparency of drug use would likely make them less harmful, bc educate users, test purity of substances
Makes no sense that heroin, marijuana, etc. would be criminalized when alcohol (which has its own dangers, just as “extreme”) and guns are deemed “okay”

The term “harm reduction” skews towards only negative effects of drugs, obscuring that most people take them for pleasure-inducing reasons
- Instead: use terms like common sense, prevention, education
More widely available drug-safety testing (of actual substance) could prevent may overdoses
- Fentanyls = used as medication, stronger than heroin & often used (without knowledge of user) to extend supply

Much of research showing negative effects of drugs on the brain are based on flawed interpretations of imaging data (that is rarely replicable)
- Claiming “changes” in brain structure/function due to drugs when comparing two different groups of people (not longitudinal)
- Ignoring confounding factors of alcohol and tobacco use
- Referencing behavioral effects without doing any cognitive or behavioral tests
Exaggerated claims of effects of drugs → misguided policy → harmful & detrimental outcomes, intense racial discrimination (ex. crack vs cocaine)
- Compounded bc easier to get funding if you’re looking to find negative effects

Methamphetamine use (a common drug used to treat ADHD) punished extremely harshly in Thailand, Phillipines
Amphetamines can enhance pleasure, openness, intimacy, energy, etc.
- MDMA, d-amphetamine (Adderall), and methamphetamine produce similar effects (with MDMA potentially having most pleasurable outcomes), but regulated so differently
- Important to consider role of set vs setting in user’s experience: expectations, mindset, mood, etc.

Harsh drug restrictions actually lead to synthesis of new alternatives with less well-known risks, which can be more dangerous
Synthetic cathinones = “bath salts” can have similar positive effects like amphetamines
Synthetic cannabinoids → bind to endocannabinoid receptors like THC & produce similar effects
- Started being banned in US in 2011, leading to cat-and-mouse game of new alternatives (usually more risky), new bans; lack of transparency about what was actually being sold

Marijuana does not cause psychosis or aggression
- Studies claiming it does conflating correlation & causation
Used as excuse for racial discrimination → murder and imprisonment of black people, mothers losing custody of their children
There are more nuanced ways of thinking about drug use than either discouraging or promoting it!

Becoming more “mainstream,”
Sometimes viewed as superior to other drugs bc of spiritual/medical justification, but still laying groundwork for more widespread rights to use

Crack is not any more addictive or harmful than powder cocaine (they’re the same drug)
Exaggerated, false portrayals of crack in the media have ruined more lives than the drug itself
Police killings, almost amounting to genocide, Brazil (vs crack users)

Heroin is actually one of the safest options for an antipsychotic
Heroin maintenance tx for people dependent on it leads to them having actually pleasant lives (offered in Switzerland, but not even a possibility in US)
Most deaths actually caused by taking opioids with other drugs, esp sedatives, but this is never reported

Chasing Liberty in the Land of Fear