Prof. Carl Hart saw drugs as destroyers of communities. Then he saw the positive side. “We have miseducated the public,” he said.
Carl L. Hart, a neuroscientist at Columbia University, fielded questions the other day about his new book, which makes an unconventional case for drug use.
Dr. Hart, are you on anything now?
“No. I’m in interview season now,” he said on a recent afternoon. “Why would you waste your substance on an interview? You have to concentrate and focus.”
Uh, to deal with the stress or boredom of interviews?`
Well, perhaps if we were at an academic reception, he said. “Now, you might take something that will help you get through it,” he said. “Like a low dose of opioids and a low dose of stimulant, or something of that nature.”
Dr. Hart, 54, one of the first tenured African-American science professors at Columbia, is a gadfly among drug researchers and a rock star among advocates for decriminalizing drugs. In “Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear,” he confides that he has used heroin regularly for the last four years and describes the time he took morphine daily for three weeks in order to experience withdrawal.
Every adult, he said, should have the freedom to do the same. “The pursuit of happiness, liberty,” he said.
In a telephone interview from his home in Westchester County, where he is on sabbatical, Dr. Hart lauded New York’s new law legalizing marijuana as a sign that some drug taboos are waning. But others, he said, remain deep-seated.
In Minneapolis, defense lawyers for Derek Chauvin, the former police officer on trial in the killing of George Floyd, emphasized Mr. Floyd’s drug use to conjure a stereotype that Dr. Hart calls “the crazed Negro drug fiend.”
For Dr. Hart, it was an old story.
“This happens all the time when a Black person is killed by police,” he said. “Drugs are the ideal scapegoat, because most Americans believe drugs make people crazy and it makes them less than human. Or superhuman.”
Dr. Hart argued that most of what you think you know about drugs and drug abuse is wrong: that addiction is not a brain disease; that most of the 50 million Americans who use an illegal drug in a given year have overwhelmingly positive experiences; that our policies have been warped by a focus only on the bad outcomes; and that the results have been devastating for African-American families like his own.
Much of the blame, he said, falls on his own profession. “We in the field are overstating the harmful effects of drugs,” he said. “We have miseducated the public, and that is wholly un-American and wrong.”
Critics of Dr. Hart — and there are many — call these assertions both wrong and dangerous.
“He is fast and loose with the science to advance the case,” said Bertha K. Madras, a professor of psychobiology at Harvard Medical School and director of the Laboratory of Addiction Neurobiology at McLean Hospital in Belmont, Mass.
“You don’t ignore the adverse consequences — the parents, the families, the spouses who’ve had to live and deal with opioid use disorder. Traffic fatalities, workplace errors, absenteeism, workman’s compensation, drug-fueled violence, school dropouts, drug-related crimes and murders. I just don’t see Carl ever wanting to address these things.”
Dr. Hart began his relationship with drugs growing up in the Carol City neighborhood of Miami Gardens, Fla. Like many of his peers, he dabbled in selling drugs and carried a gun. He was also an accomplished athlete and party D.J.
After he left that environment — first for the Air Force, then for college and graduate school — he blamed drugs for the crime and social decay in the community. With a doctorate in neuroscience, he set out to understand the problem of addiction and to improve life in places like Carol City.
At Columbia, he began conducting experiments with drug addicts, recruiting them through ads in the Village Voice. With grants from the National Institute on Drug Abuse, Dr. Hart and his colleagues administered millions of dollars’ worth of crack, methamphetamine, cannabis and other drugs in laboratory settings.
He expected his subjects to be like the people he heard about at conferences on drug abuse, or the crazed zombies in movies about addicts, he said: “Somebody who was essentially a slave to the drug. And that person I had never seen in all of my research.”
Instead, he said, subjects were diligent in reporting on time for the experiments, and when offered alternatives to drugs — a dollar in one experiment, $5 in another — they made rational choices, rather than compulsively feeding their addictions.
“But that’s the mythology in the field,” he said. “Then I started to pay attention to our data, and you start to see that people are actually happy, and they are responsible. They show up for these demanding schedules.”
It led him to ask different questions: If most drug users had few or no negative consequences, what was the best way to alleviate the suffering of those who did?
“If people have a co-occurring psychiatric illness, then that’s where the focus should be,” he said. “Not on the drug the person is taking. Or if this person now doesn’t have a sense of worth because they lost a job that was placing that person’s family in the middle class. If the treatment doesn’t focus on making sure that is replaced, then the treatment is a waste of time.”
So began his war on the war on drugs. It turned his career around, moving him away from heavy lab work and toward legal advocacy.
After receiving regular research grants totaling more than $6 million from the National Institute on Drug Abuse, Dr. Hart found himself cut off after 2009. “Because I’m asking questions that do not focus on pathology, it’s harder to get funding,” he said.
A spokeswoman for the agency said it did not comment on its decision-making process for grants.
As he drew criticism from the scientific mainstream, he attracted a new, receptive audience, including private donors for his research. “For harm reductionists or prison abolitionists, or policing abolitionists, he is a hero,” said Dorothy E. Roberts, a law professor and director of the Penn Program on Race, Science & Society at the University of Pennsylvania. “He’s been willing to say, with a lot of expertise backing him up, that these policies are harmful.”
Unlike past academic advocates for drug use, like Timothy Leary and Baba Ram Dass, who both experimented with L.S.D. at Harvard University, Dr. Hart rejects as “self-serving” the distinction between so-called good drugs, like psychedelics, and more maligned substances, like heroin and methamphetamine. All, he said, have their place.
Some parts of the world may be starting to agree. On Feb. 1, Oregon decriminalized possession of small amounts of all drugs. But Dr. Hart objected that decriminalization alone does little to make the drugs safe. If people do not know what they are buying, they cannot use it without risking overdose.
A next step, Dr. Hart said, should be setting up testing sites nationwide where users can determine the purity and strength of their drugs — anathema to researchers like Dr. Madras, who say that anything that “normalizes” drug use leads to more use by adolescents — but essential for saving lives, Dr. Hart said.
He held out little hope that such sites would appear any time soon.
But he noted a twist during his time in the field. When he started, his students wanted to explore the dangers of drugs. Now they see more harm in drug prohibitions, he said.
“So I have to be the person to push them in the direction that they’re not going,” he said.