Trust me: you need to read what a Black neuroscientist has to say about drugs and the drug war. And Dr. Carl Hart in particular. Dr. Hart has an impatient, cantankerous style but he says the things that other people are scared of saying. Like: that most people don't have problems with drugs. Like: pleasure is a perfectly acceptable reason to use drugs. Like: that our drug policies are STILL wildly racist for the most part. He's got the science and direct personal experience to back it up, and he takes the story from the world of addiction to the world of harm reduction at festivals to the world of going toe-to-toe with federal prohibitionists and everywhere else in between.

Full disclosure, I got this book via Netgalley because my professional life is in the world of drug policy reform and I know Dr. Hart personally. But I still think if you read one book about drugs at all, this one ought to be it.

Interesting Perspective Marred By Bias And Lack Of Scholarly Rigor. Let me state up front: I am a former Libertarian Party official at the State and local level, and an avowed anarchist to boot. I fully concur with Dr. Hart's position that all drugs should be fully decriminalized. And it was this agreement that had me initially wanting to rate this book at a full 5*.

But considering the actual arguments and the actual text presented, I cannot claim to be an objective judge of the merits of the books I'm reading if I did that. Because there are definite problems with this book that I've called out in no uncertain terms when I *didn't* agree with the author's positions - and thus I cannot ignore them here, when I do largely agree with the author's positions.

Specifically, there is quite a bit of anti-white "they're all just a bunch of racist pieces of shit" strawmen commentary in this text. Numerous cases where Hart blames racism rather than applying Hanlon's Razor or even looking for alternative, non-race based reasonings for his opponents' positions. And having been on both sides of this debate at different times in my life, I can testify as a fellow Son of the South (rural exurbs outside Atlanta vs Hart's coming of age in urban Miami) that there *are* several other rationales other than the racism Hart claims is at the heart of all anti-drug laws.

Further, barely 12% of this text is bibliography, despite Hart claiming numerous times "I know I'm going to have to present some evidence here since this is not a commonly held position". More often than not, rather than actually examining studies showing various harms from various substances, Hart dismisses them with the hand wave of a professor more concerned with getting his own point across, "there is no basis for that claim, we're moving on".

I actually enjoyed the less formal tone of the presentation here, as it made the book overall far more readable than some academics make their narratives. I simply wish the narrative were more substantive.

Recommended.

A fascinating and scientifically rooted treatment of drug policy that skewers politically (and racially) driven myths about drug use. Highly recommended.

Dr. Carl Hart has never met a recreational drug he did not like. All of them have their very positive aspects for him. They reduce stress, raise awareness, and induce respect, co-operation, empathy and intimacy. And then they wear off. He calls for a withdrawal of government from the drug-banning business. His constitutional rights preclude government interference, he says. His book, Drug Use for Grown-Ups is the distillation of years of research, plus lectures, speeches and feedback from them. It looks like a solid case.

Hart was chairman of the Psychiatry Department at Columbia University in New York. This both resulted from and continued to allow him to run studies on all kinds of drugs for all kinds of reasons. He could determine their effects from numerous angles. He found that they are not killers. He found (as many others have) that only 10-30% of drug users qualify as addicts. In his global travels as a respected academic, this has been supported and confirmed by his peers in countless panels and conferences.

Hart has made this his life’s work. Growing up in a high crime black area of Miami, surrounded by drug problems, he wanted to be part of the solution – meaning the elimination of all casual drug taking. Decades of intense research have led him to the precise opposite position. Throughout the book, he continually confesses his assumptions were wrong. And so are the blanket statements of so-called experts.

In addition to the studies, Hart uses himself as a test bed. He and his wife try them out, note their powers, and move on to others. He now freely admits he has done this all over the world in all kinds of contexts. For him, the drugs are unfailingly beneficial. The Harts use drugs to relieve stress and get more out of life. They can’t imagine stopping. Millions of Americans feel the same way. They are fully functioning adults who, because of government interference, must remain in the closet over their drug use. Their ability to totally hide their drug use is further proof to Hart that crippling addiction isn’t a necessary outcome, and 80% do not become addicted.

The drugs he describes are amphetamines, methamphetamines, cocaine, heroin and marijuana. He describes their chemical structures and their effects on him. He tells of impurities in manufacture, particularly of illegally made drugs. And of the users’ physical conditions that could lead to addiction or to death. It’s not a simple or straightforward relationship, as he says throughout. Far less causation than coincidence.

Readers might think the opioid crisis would be the end of Hart’s theory, what with 40,000 deaths a year from addiction. But Hart is up to the challenge. He shows that opioids do not cause addiction or death in the vast majority of users. Addiction occurs when users have other weaknesses, like a psychiatric condition, depression or other illness that might have them on other meds or simply lowered defenses. That would weaken the body so that opioids have greater effect than intended. Meds cannot simply be combined without unintended consequences. Similarly, co-morbidities like diabetes or other illnesses could lead to addiction and worse. The blanket condemnation of opioids as the cause of addiction, he says, is just wrong. In every case he examines, it turns out the drugs were not the cause of death, even though the media report it that way. Hart says “People are not dying because of opioids; they are dying because of ignorance.” Combine an opioid with alcohol, an anticonvulsive, an antihistamine, a benzodiazepine, or another sedative, and life itself is at risk.

Inevitably, race plays a major role in the book. Hart is black, and blacks are outrageously disproportionate residents of American prisons for their use of drugs. In the world of drug busts, White means victim and Black means addict/criminal. In Baltimore from 2015-17, he says, there were 1514 arrests for marijuana possession. Of those 1450 were black – 96%.

To make his point about both race and drugs, Hart looks at a number of famous racial killings by police, where cops claimed the victims were on drugs, and so they feared for their lives. This is the drug-crazed black syndrome, a bogus accusation made by whites for decades. In the Trayvon Martin case, for example, Hart explains the toxicology report on Martin. It shows he was not high and had not used even marijuana for a day or two before his murder. Nonetheless, the jury bought the drug-crazed argument, and the killer, claiming to be a police surrogate for his neighborhood, and fearing for his life, went free.

Race also hits Hart where he lives. In a triple race discrimination event involving his son’s private school (where Hart pays $50,000 a year for tuition), the administration refused to accept blame and then infuriated him by asking the Harts to rewrite the school’s policies for them. It’s an old trick that is as insulting as it is insincere. To deal with the stress, the Harts took drugs so they could deal sensibly and empathetically with their son. Of course, they did not involve their son in their drug use to help him reduce his own stress in the same situation that affected him first and foremost, a bit of parental hypocrisy that Hart does not even see.



The comparison of drugs to alcohol is a longstanding one. Hart says alcohol’s negative effects far outweigh those of drugs, yet alcohol is legal, and so is drinking yourself to death. During Prohibition, the government itself required the lacing of alcohol with methanol, in an attempt to dissuade drinkers. Instead, up to ten thousand died. Government is not competent to manage casual drug consumption, is Hart’s takeaway.

The government’s broad and complete banning of recreational drugs goes back to heroin before World War I. Heroin’s medical uses are well known, and Hart, who uses it for pleasure, says the effects are wonderful. But government will not budge. Not even its testing is allowed in the USA.

All kinds of doctors and other authorities continually testify that drugs kill, cause uncontrollable rage and other nefarious conditions. They have no scientific evidence behind their claims, but the media back them up, always on the lookout for the drug angle to tie up a story and forget about it. Hart calls them out when he can, but American society has it so ingrained that drugs are bad that the frauds are believed without question. It’s one of those “everyone knows” facts, continually reinforced by those in power.

In 1937 when marijuana was banned, Fiorello LaGuardia commissioned report on it. The report found “Individuals who have been smoking marijuana for a period of years showed no mental or physical deterioration which may be attributed to the drug,“ and that concerns about catastrophic effects were unfounded. But the ban stayed, and remains. And millions have been jailed for it.

The total failure of the “war on drugs”, which Hart says cost taxpayers $1.5 billion in 1981 and now costs $35 billion a year, annoys him. Despite all the expense and prison terms, there is a much larger menu of drug choices and far more Americans using them, successfully, and in secret. Hart is incensed by every aspect of that state of affairs. He wants government to get out of that business.

Instead, the government doubles down. It bans new recreational drugs as soon as it can define and name them. The list grows annually. The menu is far larger today than ever, as synthetic drugs, no longer simply derived from opium, have exploded in the marketplace. Hart presents a list of new bannings just from this decade, in case readers might want to keep up with what is new and hot.

Another reason for drug deaths is impurity. Hart says the illegality of drugs means there is no quality control. Impurities in drugs can kill. Lacing heroin with fentanyl may enhance it, but it kills. If the user knows it is there, s/he can take a smaller dose, but no one ever knows what they’re buying when it’s illegal to begin with. It was the same story with bathtub gin and hooch during Prohibition. Make it illegal, and risk rockets. Doesn’t stop anyone, and lives would be saved if the government stopped its failing, incorrect and pointless pursuit.

Even legal drugs can kill. Hart says just two days of too much acetaminophen can cause liver disease. It’s all very complicated, and users cannot be expected to know all the possible outcomes from combinations of drugs, let alone the side effects.

He emphasizes that the book is really about freedom, and not a drug user’s guide to bigger and better things. But the freedom message is simple and easy to absorb. The meat of the book is the vast knowledge Hart has about what the drugs do and don’t do, alone and mixed with others. That’s what it will be remembered for, and used for.

And although Hart is certainly right – recreational drugs should not be forbidden by law – it is clear not everyone can handle them as rationally and inquiringly as he does. He knows more about them than the drug companies (and labs) that make them. He is therefore the exception that proves the rule.

David Wineberg