Drugs Are Actually Good, Says Columbia Professor

[Imaginarium]

Thanks for the reply and question. I can't speak on Dr Hart's behalf, however, I'll respond based on my interpretation of the book and Vice article linked in the original post.

When you say

So when you search your name there's 100s of puff pieces about your book and your headline grabbing sentences about drugs not being that bad,

Unfortunately, that's one of the challenges when engaging with numerous media outlets, who will often post articles and interviews with sensationalist headlines. The Vice article is inconsistent and misleading as it does not accurately reflect what is described in Dr Hart's book or in the interview. Language and the words we use matter., especially in the context of drug use. The idea of 'good' and 'bad' drugs (or 'hard' and 'soft' drugs) only perpetuates stigma and discrimination again people who use drugs, noting these individuals often include some of the most marginalised in society. I don't interpret his position as 'drugs not being that bad', instead he suggests that the use of drugs doesn't always have to have negative outcomes, as is often portrayed in the media. Similar to Engel et al. (2021)'s research based on Bluelighter's experiences, Dr Hart highlights that there is positive experiences and pleasure associated with drug use.

Language can also contribute to stigma through the use ofiaccurate terminology. The most obvious example of this the frequent conflation of the terms dependence and addiction. [see here for a differentiation between the two terms] as well as Szalavits (2021). I raise this because, in his book, Dr Hart explicitly states that he was not addicted, and did not meet the DSM-V criteria for opioid use disorder.

I can't comment on 'all those people', but I don't think Dr Hart trivialises the idea of opioid addiction, as he states in this book, “going through opioid withdrawal wasn’t a particularly pleasant experience. And I don’t have plans to do it again anytime soon”.

but under ever article in the comments or on Reddit and other discussion based platforms are many many people thinking you trivialise the idea of heroin addiction and arrive at conclusions on data that just doesn't have any relation to a real addict, what do you think about all those people?

I'm not active on many other forums, so I can't comment on threads or comments on Reddit and the like. But I don't assume that drug use inevitably has negative physical, psychological, or behavioural consequences. Personally, I don't see him trivialising the idea of heroin addiction (or opioid use disorder per the DSM-5), but rather him advocating strongly for appropriate treatment options to be provided for persons with a heroin addiction (OUD).

When you say

Because realistically those are actual addicts

In my opinion, 'real addicts' (I find this term discriminatory and I'm unsure what's qualifies someone as a 'real addict' - noting the difference between dependence and addiction?) should receive an evidence-based and person-centred treatment option which affords them the opportunity to live a healthy and happy life.

 

[Lysosomalstorage]

It's a shame really as those headlines bury any real debate about yo- his research. I guess that's the price of having easily sensationalised research topics. When you just see the parts about him being able to overcome casual heroin usage etc.

You see that here all the time, people have maintained functional heroin usage for years until one day they don't. I don't think legalisation would change that, if anything the lack of cut would just make things worse. Still you seem VERY aquatinted with Dr H's research and if you think that notion is reactionary based on sensationalism I'd be inclined to believe you.

 

[Jabberwocky]

I have mixed opinions on Dr. Hart. I actually created a reddit post which got a bunch of attention and I was heavily criticizing some things he said on Joe Rogan podcast.

Oddly enough, Hamilton Morris of all people read my reddit post and then discussed the post, and the criticism towards Dr. Hart, 2 weeks later on Joe Rogan.

Hamilton was kinder than me and brought a new perspective that I have now.

I think Dr. Hart is a good thing overall for the mission, he is very brave for what he is doing (as Hamilton put it), however he does occasionally say some things which sound incredibly dubious (and a lot of times it's because he doesn't clarify what he means).

 

[Jabberwocky]

first 2 minutes they talk about it, they mention my reddit post at 0:43

(to clarify my reddit post was criticizing Dr. Hart for several things, not just his casual way of talking about heroin and meth use)

I almost creamed my pants knowing Hamilton read my post he's my hero

 

[Imaginarium]

It's a shame really as those headlines bury any real debate about yo- his research. I guess that's the price of having easily sensationalised research topics. When you just see the parts about him being able to overcome casual heroin usage etc.

It really is a shame! Fortunately, we can have engaging and constructive discussions (and debates) in places like here.

You see that here all the time, people have maintained functional heroin usage for years until one day they don't

That's an interesting observation. Personally, working with people who use drugs in an environment of poverty, socioeconomic obstacles and substantial barriers to healthcare, non-problematic heroin use for a prolonged period of time is uncommon.

 

[Lysosomalstorage]

I think that's the point though, it's the people who aren't facing poverty and have a work life balance like Dr Hart who can maintain functional heroin use for extended periods, but even the most careful users seem to slip up eventually due to the wildely varied product available.

 

[Jabberwocky]

My whole issue with how Dr. Hart talks about his heroin use, well two:

- Mentions the heroin he was using was pure and tested. No normal person can get PURE heroin... at least in the US. Virtually impossible. This might lead naive people to think the heroin they buy on the dark net is "pure" and they end up doing fent... you see where I'm going.
- The way he just so casually explains how he doesn't feel compelled to keep using. Like it's absolutely nothing. Like it's coffee to him. My problem is not so much that the idea is impossible to me, it's not, but it's just the language he uses. It's almost feels dismissive of all the problems opioids cause in a way, at least how I hear it.

but I am admittedly very emotionally opinionated about heroin, it ruined my life. My opinion is just one of many.

 

[Burnt Offerings]

It's a shame really as those headlines bury any real debate about yo- his research. I guess that's the price of having easily sensationalised research topics. When you just see the parts about him being able to overcome casual heroin usage etc.

You see that here all the time, people have maintained functional heroin usage for years until one day they don't. I don't think legalisation would change that, if anything the lack of cut would just make things worse. Still you seem VERY aquatinted with Dr H's research and if you think that notion is reactionary based on sensationalism I'd be inclined to believe you.

I disagree. I think that if people received a measured, pharmaceutically-pure dose of a given drug, that would make a tremendous difference to their overall quality of life and relationship with the drug in question. I think there's evidence to support that in the programs where people receive drugs like hydromorphone or even diamorphine as part of their treatment for opioid use disorder

Would it solve all potential problems? No. Just look at alcohol: it's legal, widely available and people still are alcoholics, still drink themselves to death or act irresponsible while under the influence of alcohol. As I've said on this website time and time again: if you give someone freedom, there is ALWAYS the risk that they may use that freedom in a potentially reckless or irresponsible manner. Always. And that risk would be especially present in a social/environmental context in which someone saw no hope for their lives and fell into despair. But that has little to do with how intrinsically "wicked" this-or-that drug is, or how it'll hijack your brain or whatever, and much more to do with the social context that legal/illegal drug use occurs in. Hart is right to point this out and I admire him for it tbh, even if I think some of what he puts out there is pretty dumb or seems out-of-touch, like "dexamphetamine and d-methamphetamine are basically the same thing" or "I took a relatively low dose of morphine for a few weeks so I know what I'm talking about when it comes to opioid withdrawal"

 

[Jabberwocky]

I think that if people received a measured, pharmaceutically-pure dose of a given drug, that would make a tremendous difference to their overall quality of life and relationship with the drug in question. I think there's evidence to support that in the programs where people receive drugs like hydromorphone or even diamorphine as part of their treatment for opioid use disorder

You're right, if you look at Portugal and the other places who have pioneered this, the stats don't lie, it works. Giving out free, pure diamorphine. But they have to use it on-site. I think that in itself, forcing a very controlled way of use in a controlled environment, treating it like some sort of medical treatment for a disease, is the best approach. Maybe not in all cases, but in people with very serious addiction disease.

I do not think some random 18 year old kid who is drug naive should be able to walk into one of these places just to try heroin, as if it was som cannabis dispensary.... idk... see I'm getting emotional about it. I'm applying my own experience. Had IV morphine at 11 years old and then tried heroin at 14 and it was all over for me. I'm an exception tho, most kids aren't exposed that young.

 

[Lysosomalstorage]

Yeah alcohol seems like it would be a good analogue for comparison but the sheer quantity required to reach dependency makes it pale in comparison to heroin, even if it is clean measured doses. Plus removing the stigma would mean it reaches far larger audiences of people with proclivity to addiction that for whatever reason never came into contact with it before. On site administration is definitely a good idea but you know people would end up taking advantage of it somehow.

 

[Imaginarium]

Saying that

I am admittedly very emotionally opinionated about heroin, it ruined my life. My opinion is just one of many.

is completely logical, given the consequences and severity of harm problematic heroin use inflicted on your life. I empathise with you and value the input of your lived-experience.

Mentions the heroin he was using was pure and tested. No normal person can get PURE heroin... at least in the US. Virtually impossible. This might lead naive people to think the heroin they buy on the dark net is "pure" and they end up doing fent... you see where I'm going

I do get what you're saying here, however, as I mentioned in my above posts, not critically engaging with the original source could lead to misunderstanding of what is being presented. In his book, Dr Hart explicitly states that:

“When it comes to street heroin, far more concern should be focused on contaminants that may be contained in the substance. Today, illicit heroin is frequently adulterated with stronger opioids like fentanyl and its analogs. The adulterants are often much more dangerous than the heroin itself.”

My reading of the quote, is that he is emphasising the harms associated with the use of adulterated heroin or other drugs (i.e. fentanyl and its analogues) misrepresented as heroin.

Personally, regardless of the critiques, 'coming out the closet' as a person of colour in a prestigious position of employment, is incredibly brave - a revolutionary act, in my opinion. I strongly echo his sentiments that if more people in positions of power and privilege were honest about their drug use, societal views of drugs would change dramatically.

 

[Lysosomalstorage]

Now that's something I completely agree with. The number of pearl clutching repressed people who villify drugs and their users that would have a monumental reality shift if all their favourite actors, celebrities and political/religious leaders were all suddenly honest about their drug history. Not a day we will ever see unfortunately.

 

[Jabberwocky]

I do get what you're saying here, however, as I mentioned in my above posts, not critically engaging with the original source could lead to misunderstanding of what is being presented. In his book, Dr Hart explicitly states that:

“When it comes to street heroin, far more concern should be focused on contaminants that may be contained in the substance. Today, illicit heroin is frequently adulterated with stronger opioids like fentanyl and its analogs. The adulterants are often much more dangerous than the heroin itself.”

My reading of the quote, is that he is emphasising the harms associated with the use of adulterated heroin or other drugs (i.e. fentanyl and its analogues) misrepresented as heroin.

Personally, regardless of the critiques, 'coming out the closet' as a person of colour in a prestigious position of employment, is incredibly brave - a revolutionary act, in my opinion.

completely agree, and after I heard Hamilton, who was essentially defending him from MY own post, I really changed my mind

I have not read his book, have not looked at his work other than him making various statements on that podcast - and I think that's where most of people of my original opinion are getting lost simply due to lack of context.

When Hamilton mentioned how brave he was for what he ways saying, publicly to millions of people, jeapordizing his own career, I realized how much I was really wrong. He really is a pioneer and taking massive leaps into danger regarding his career. Very commendable indeed.

I strongly echo his sentiments that if more people in positions of power and privilege were honest about their drug use, societal views of drugs would change dramatically.

very true

 

[Burnt Offerings]

I'll probably revisit this thread to say more later, but, just in regards to how easy it is to become physically-dependent on heroin...in a hypothetical world in which heroin was legal and available, would that even really matter? If the drug that you "needed" was suddenly withdrawn from you, you almost certainly wouldn't die, at least if we're talking about heroin...you would just feel bad for a relatively-brief period of time, and in a world in which the drug was legal (with a price point that reflected this legality) you wouldn't need to go without if you didn't want to. It's admittedly difficult to imagine such a world, as obviously none of us have ever experienced it, but its been my position in the past that, in this hypothetical world, there would probably be a modest increase in the pool of "functional addicts" but that would be about the extent of it. Personally I don't believe that if there was suddenly a legalization of opioids that there would even be a large increase in the user base, much less the physically-dependent user base, but I know that other people feel differently about it and it's a hypothetical scenario anyway so whatever...I can see the argument for how a bunch of people today might decide to do loads of drugs if they had a chance, but I suspect that may have more to do with how shitty everything else is, rather than how great drugs are lol

The recklessness and chaotic attitude of the withdrawing heroin addict is much more a reflection of the context that the use takes place in IMO, especially the illegality of the drug and everything that goes along with that (i.e. fear of police repression on the part of both buyers and sellers, being unable to purchase the drug because of distortions in the market regarding price due to prohibition, etc etc). I think that a lot of the violence, duplicity etc. would wither away if it were simply a matter of going down to the local safe access point and receiving the drug for pennies on the dollar, basically

 

[thegreenhand]

hard drugs is "good"

Define hard drugs for me. I struggle to see how alcohol does not fit any definition you can provide. No medical value, high abuse potential, potentially lethal withdrawals. Heroin at least has medical value (and it very rarely is lethal upon withdrawal unless the individual has a previous medical issue that is relevant)

This "Dr" is a poser drug user ignoring statistics.

He is a PhD Neuroscience and never claims to be medical doctor if that’s what you’re hinting at. He has published a lot of those statistics you refer to himself in fact…

what I'd rather see you dig up is scientific studies showing recreational heroin use improving quality of life.

Also please define recreational use for me. It’s a tricky word imo. Dr. Hart states that he uses heroin to unwind and relax. That is arguably therapeutic, much like how I use cannabis the same way

Also consider that NIDA essentially only funds studies looking at harms from drugs so such a study is unlikely to exist in this day and age. Absence of evidence is not evidence of absence

 

[thegreenhand]

I would also encourage everyone to actually read his book (or listen to the audiobook)

Imo it’s a brilliant exploration of cognitive liberty in the early 21st century and every drug user would benefit from his ideas

 

[thegreenhand]

I think Dr. Hart is a good thing overall for the mission, he is very brave for what he is doing (as Hamilton put it), however he does occasionally say some things which sound incredibly dubious (and a lot of times it's because he doesn't clarify what he means).

I agree that some of his claims can be dubious. For example, he once said that meth and adderall are the same drug. While I agree that amphetamine is very similar to methamphetamine such a simplification as equating the two isn’t correct

That said, his book elaborates on claims like this and states the facts very succinctly imo


Also sorry folks, I’ve had a couple drinks so my posts may be a little erratic for the next few hours lol

 

[Jabberwocky]

I agree that some of his claims can be dubious. For example, he once said that meth and adderall are the same drug. While I agree that amphetamine is very similar to methamphetamine such a simplification as equating the two isn’t correct

That said, his book elaborates on claims like this and states the facts very succinctly imo

exactly

 

[LucidSDreamr]

I'll probably revisit this thread to say more later, but, just in regards to how easy it is to become physically-dependent on heroin...in a hypothetical world in which heroin was legal and available, would that even really matter? If the drug that you "needed" was suddenly withdrawn from you, you almost certainly wouldn't die, at least if we're talking about heroin...you would just feel bad for a relatively-brief period of time, and in a world in which the drug was legal (with a price point that reflected this legality) you wouldn't need to go without if you didn't want to. It's admittedly difficult to imagine such a world, as obviously none of us have ever experienced it, but its been my position in the past that, in this hypothetical world, there would probably be a modest increase in the pool of "functional addicts" but that would be about the extent of it. Personally I don't believe that if there was suddenly a legalization of opioids that there would even be a large increase in the user base, much less the physically-dependent user base, but I know that other people feel differently about it and it's a hypothetical scenario anyway so whatever...I can see the argument for how a bunch of people today might decide to do loads of drugs if they had a chance, but I suspect that may have more to do with how shitty everything else is, rather than how great drugs are lol

The recklessness and chaotic attitude of the withdrawing heroin addict is much more a reflection of the context that the use takes place in IMO, especially the illegality of the drug and everything that goes along with that (i.e. fear of police repression on the part of both buyers and sellers, being unable to purchase the drug because of distortions in the market regarding price due to prohibition, etc etc). I think that a lot of the violence, duplicity etc. would wither away if it were simply a matter of going down to the local safe access point and receiving the drug for pennies on the dollar, basically

I think the availability of an opioid and ease of attainment (cost) is a big issue on whether you see functional addicts exist or not.

Let's say all opioids are attainable easily. What your post and everyone else seems to neglect is the fact that you are rewiring your brain to be incapable of feeling happiness or pleasure in a way that eventually hits a brick wall and nothing will make you happy unless you raise the dose.

I've also taken opioids at the same dosage medically for long periods of time and It does really fuck with your ability to be happy, that's a personal and subjective metric (hapiness) but that's my experience.

This phenomenon of tolerance then brings ppl to start smoking then start I injecting. We all know how fraught with danger regular IV use is (infections etc.)

Besides coming to rely on an ever increasing dose of a drug as a precursor to even feel happiness, progress into IV usage for more recreation or "relaxation" as Dr. Hart calls it, there are the hormonal effects of opioids. It fucks your testosterone levels and diminishes your sex drive. You'll compromise your sex life possibly

There are so many other side effects that can happen that we don't think about, gynecomastia, narcotic bowel syndrome, chronic hyperalgesia, etc.

Dr. Hart seems to be referring to someone that casually uses heroin in a recreational fashion casually (let's say 2 times per month)...honestly guys what percentage of recreational opioid users have you ever known that successfully used opioids 1 X a month like it was mdma or something amd didn't get dependent?

 

[LucidSDreamr]

....since you guys want to defend recreational opioid use as ok or good. Let's try crack cocaine. What "therapeutic" and good use is there to be had? What is the chance someone is going to do crack on the weekend 1x per month and leave it at that....and that no dumb decisions will be made while on crack or coming down from it?

Trying to assign some kind of therapeutic psychological benefit to opioids and crack as if they are mushrooms is just flat out asanine.

Dabbling in crack and heroin might be dandy if you're very far from a drug addict as Hart seems to be...but what's the point then? If you have a shred of addictive propensity what's the risk of some IV heroin or crack experimentation? This author seems to just be taking a shit on addicts and the fact that millions of them exist by teasing that he can casually experiment with highly addictive drugs without consequence.