Thursday, February 4, 2021

In Praise of Dr. Carl Hart

Dr. Carl Hart

First of all, if you haven't read his book Drug Use for Grown Ups:  Chasing Liberty in the Land of Fear go pick it up right now.  If you enjoy this blog you will love the book even more.  You've probably seen Dr. Hart's warm, dreadlocked countenance in many a drug documentary discussing the harms of the drug war, the disparities of the crack and cocaine laws and the generally exaggerated response to the negative effects of various drugs.  But the info he drops about himself in this book is nothing short of a bombshell.  (Spoilers ahead).  

Dr. Hart--government researcher, neuroscientist with a military background, Ivy League professor, father, author and volunteer, is a poly drug user with an affinity for heroin.  He's been a smoker of it for over 5 years.  And claims his life is better for it.

I actually cried when I read this revelation because I never in my wildest dreams imagined heroin was his drug of choice.  Weed?  Sure.  Adderall or even a little meth?  The way he talked so positively about them in documentaries made me think he might have a soft spot for stimulants.  But heroin?  

This hit home because I'm a long-term opioid user who considers myself a conscious self-medicator rather than an "addict".  I don't have a doctor's blessing or prescription yet I've never overdosed, been to jail, stolen/pawned anything, sold my body or increased my dose in the 17 years I've been using.  And I've taken breaks of just over a year without so much as a craving.  It's just that my life feels more whole and meaningful with opiates than without.  I've never put an opiate in my veins or up my nose and don't intend to.  I use solely to feel normal and good, not to "escape reality" or be numb.  That distinction is vital when it comes to drawing a line between healthy use and hardcore addiction.  

Am I physically or even psychologically dependent?  Probably.  But that's a price I'm willing to pay in exchange for the benefits I get.  It's not unlike getting on a psychiatric medicine long-term:  You know that quitting is going to cause withdrawals and thus continue using it to prevent them, knowing that one day you may be forced to taper down or switch to something else.  But for now, it's working.  And I'm not hurting anyone.  I don't have kids, don't drive impaired, don't treat loved ones poorly or do other harmful things as a result of my substance use.  I use opiates in lieu of alcohol, tobacco or pot (except for microdoses) because those drugs don't agree with me.  At all.  I've often wished they did because that would be much easier to explain to people due to their social acceptability.  

Cover of Hart's book

And that's what Hart's book is focusing on:  the overwhelming majority of drug users--even those who dabble in "hard" drugs like meth, coke or heroin--who don't go on to become addicts or die of overdoses.  The ones who get zero media attention because it's not politically correct to tell the truth on this issue.  Only 1 in 4 heroin users becomes addicted.  Sharing that fact does NOT mean he's telling anyone to gamble with taking the drug; it does mean facts matter.  And lying about heroin is just as harmful as lying to kids about marijuana.  Here's why.

Even though we're in the midst of an opioid crisis that's very real, you'll see that the statistics have been twisted and given the Reefer Madness treatment if you look closer.  This is unforgivable.  Illicit fentanyl--a product of drug prohibition--is the sole cause of most opiate overdoses since about 2016 (when the FDA tightened opiate prescription laws) while the remainder of overdose deaths involve other depressants like benzos or alcohol in addition to opioids like heroin.  That means it's much less common for a single, unadulterated opioid to cause overdose though it's certainly possible.  But the media would have us believe all opioids are alike and equally dangerous, i.e. codeine is as deadly as carfentanil.  Their fear mongering headlines make no distinction.  Proper harm reduction education could greatly decrease opioid overdose deaths, as could legalizing and regulating the drug supply for purity.  But it's easier to just scream into the void about another drug scare than to take action to reduce death.  People are dying unnecessarily because it's not politically correct to do the right thing.  

THIS is why Dr. Hart's approach to truth-telling is so important, even if it's a bit jarring.  It's not about disrespecting families who have lost someone to drugs.  And it's got nothing to do with denying the reality of addiction.  What it does address is the population--a majority of drug users--who never go on to become addicts or die of overdoses and go completely unacknowledged by the media, the medical profession and society as a whole.  They matter too.  We matter.  

It's hard to overcome a lifetime of propaganda and brainwashing, especially while we're still in the midst of it.  We all like to think of ourselves as enlightened about drugs.  And for the most part we are... at least when it comes to cannabis, psychedelics and ketamine.  But harder drugs are still given the cold shoulder even in these enlightened circles.  And that needs to change.  Not for just moral reasons but scientific ones.  

Not all opiate, stimulant or other "hard" drug users need treatment or would be better off if they quit.  I know because I have quit for extended periods and was not better off.  Just as I've quit Prozac for long periods and my mental health just wasn't up to par.  (My motto is:  Life is gonna fuck you either way but going through it without drugs is like being fucked without lube).  Maybe one day I'll change my tune but for now that's where I stand.  And I shouldn't have to fear prison, social reprisal, judgment by the medical profession leading to sub-par treatment & other unfair consequences for being upfront about it.  Nor should any self-respecting adult.  

Yet despite my own long-term, responsible use of opioids and dedication to de-stigmatizing drugs on this blog, I still recoiled and gasped at Dr. Hart's admission of heroin use.  This just proves that nobody is immune to a lifetime of anti-drug propaganda.  So thank you Dr. Hart for kicking down the closet door on the drug issue.  Maybe one day I'll be brave enough to do the same using my real name even though I'm not a public figure like you.  Or a Black man in America, which is already a precarious spot to be in.  You deserve all the respect.  

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