Speaker 1: Hi, I'm Ethan Natalman, and this is Psychoactive, a production
Speaker 1: of I Heart Radio and Protozoa Pictures. Psychoactive is the
Speaker 1: show where we talk about all things drugs. But any
Speaker 1: views expressed here do not represent those of I Heeart Media,
Speaker 1: Protozoa Pictures, or their executives and employees. Indeed, heed, as
Speaker 1: an inveterate contrarian, I can tell you they may not
Speaker 1: even represent my own and nothing contained in this show
Speaker 1: should be used as medical advice or encouragement to use
Speaker 1: any type of drug. Hello, Psychoactive listeners. Today is kind
Speaker 1: of fun for me because my guest today is somebody
Speaker 1: who have been friends with for almost twenty years now
Speaker 1: and have huge admiration and respect for. That's Karl Hart,
Speaker 1: the Columbia professor who's written a very important book Drug
Speaker 1: Used for Growing Ups and follow his first other kind
Speaker 1: of semi autographic called book High Price. So Carl, thanks
Speaker 1: a lot for doing this. It's good to see you man.
Speaker 1: Yeah you too, Carl. Let's start off with this. You're
Speaker 1: in some hotel, maybe about to give a talk, and
Speaker 1: you got the book, and you got somebody says, hey, man,
Speaker 1: I saw you got that book. What's it about. Well,
Speaker 1: the book is called Drug Used for grown Ups and
Speaker 1: the subtitle is Chasing Liberty in the Land of Fear.
Speaker 1: I'm just trying to get people to think about their
Speaker 1: own liberty and what it means to be free. That's
Speaker 1: that's it. And I'm using the subject that I know
Speaker 1: best as a vehicle to help people to think about
Speaker 1: their liberty. Uh. And I don't mean liberty in this
Speaker 1: kind of Trumpian sense um, where your liberty Trump's everybody
Speaker 1: else's and you can do whatever the funk you want
Speaker 1: to do. That's not what I mean. I mean your
Speaker 1: liberty in that you're not bothering anybody, so why should
Speaker 1: people care what you do? As long as you are
Speaker 1: responsible a dope man. I'm using drug use as as
Speaker 1: a topic so people can think about their liberty not
Speaker 1: only in this subject, but also with just other subjects.
Speaker 1: I mean, from prostitution to a range of things. We
Speaker 1: have over police people's personal behaviors and we don't even
Speaker 1: think about it anymore. And in this book, I'm trying
Speaker 1: to get people to think about why do we do this?
Speaker 1: Stupid ship? M hmm, we you don't. I mean, look,
Speaker 1: you were on my board of the Drug Policy Alliance
Speaker 1: for ten years at the beginning in two thousand and seven,
Speaker 1: maybe more than that. And so in terms of what's
Speaker 1: wrong with the war on drugs, in terms of mass
Speaker 1: incarceration and a deporation of rights and all the harms,
Speaker 1: I mean, we're very much together on that. What's unusual, though,
Speaker 1: is for you to put the argument of liberties so
Speaker 1: front and center. And I say unusual because typically it's
Speaker 1: something that libertarians do, civil libertarians do. And I will
Speaker 1: tell you something that as me, as a white man
Speaker 1: advocating on these principles of liberty, I would get a
Speaker 1: lot of ship for this, you know, like, oh, you
Speaker 1: can talk about your liberty, yeah, but what about poor
Speaker 1: people suffering, black and brown people suffering the ghettos? You know,
Speaker 1: what's liberty for them? You know that this is the
Speaker 1: rich man's How do you how do you respond to
Speaker 1: that or how do you deal with that? Because I
Speaker 1: love the fact that you did this, but I want
Speaker 1: to know the experience of coming out in that argument
Speaker 1: for you. Well, you know, in our country in the US, uh,
Speaker 1: people think of liberty as a construct owned by the libertarians. Uh.
Speaker 1: And those people don't understand the founding principles of the country.
Speaker 1: The founding promise of the country is that we are
Speaker 1: all guaranteed life, liberty in the pursuit of happiness. Doesn't
Speaker 1: matter who you are, You're guaranteed those freedoms, those rights.
Speaker 1: And so I'm trying to reclaim liberty for the American
Speaker 1: people and not only for the libertarians. This is an
Speaker 1: American principle, not a Libertarian principle. But it's a hard
Speaker 1: one for people to understand. And I get it. I
Speaker 1: get the fact that some political groups have kind of
Speaker 1: owned these kind of principles and and other people who
Speaker 1: have been shut out as a result. But this is
Speaker 1: liberty for all, and I'm asking us to live up
Speaker 1: to our principles. Make our practice match our promise. That's
Speaker 1: all I'm asking you. Go man, I'll tell you years ago,
Speaker 1: I got asked to speak at some kind of progressive
Speaker 1: economics conference and it was all people on the left,
Speaker 1: progressive liberals, unions, whatever. And I spoke on the second day,
Speaker 1: and I get a big speech and I say, you
Speaker 1: know something, I've been here for over the whole day, right,
Speaker 1: and I share overwhelming the values that the people are here.
Speaker 1: But there's two words I have not heard mention in
Speaker 1: the entire first day, day and a half of this conference.
Speaker 1: And that's of the words freedom and liberty. Right, what
Speaker 1: is the left wing seating these these words and these
Speaker 1: values to the right. And so I think for you
Speaker 1: coming out on this thing is incredibly important. Now, what
Speaker 1: I also liked was, you know, not often does one
Speaker 1: see Jerry Garcia, the Grateful Dead Maestro and Martin Luther
Speaker 1: King put together making essentially the same argument. So just
Speaker 1: elaborate on that one. Yeah, you know, this is a
Speaker 1: thing that I wish people read the book because then
Speaker 1: we can see how much overlap, how much connection we
Speaker 1: all have in this country in terms of our heroes.
Speaker 1: Jerry Garcia was influenced by Martin Luther King, and Martin
Speaker 1: Luther King was influenced by the Row and all of
Speaker 1: these people were influenced by what Thomas Jefferson wrote. And
Speaker 1: we know Thomas Jefferson had his problems. Uh And and
Speaker 1: of course I I talked about that a little bit.
Speaker 1: But the point is the ideals which these people espoused,
Speaker 1: they are ideals that are bigger than the people who
Speaker 1: are espousing these ideas. And so I'm trying to get
Speaker 1: the reader to think about these ideas and then if, if,
Speaker 1: if we could maybe live up to these ideals, then
Speaker 1: we would be a better country. We will be a
Speaker 1: more compassionate country. Yeah. You reference went at one point
Speaker 1: to a letter from a Birmingham jail by marlou Uther King,
Speaker 1: which is something I used to sign to my students
Speaker 1: back when I was teaching a princeton on law in society.
Speaker 1: Why did you reference that piece? Yeah, I referenced that
Speaker 1: piece because us where King dealt with in that letter
Speaker 1: were his allies coming at him. The white ministers were
Speaker 1: coming at him, asking him to go slow and saying
Speaker 1: that his actions were maybe not prudent. And so he
Speaker 1: talked the time and patients to explain why it's so
Speaker 1: important to move in the way that he was moving.
Speaker 1: In the way that he was moving was simply that
Speaker 1: black people in this case deserved their humanity, deserved to
Speaker 1: be respected just like everybody else's humanity. And um, there
Speaker 1: is no such thing as moving too fast when you
Speaker 1: want to make sure people's humanity are respected, and that
Speaker 1: that's the same thing with drugs. We say things like
Speaker 1: let's start with this one here, M D M A,
Speaker 1: but not heroine here, it's like who gave you the right?
Speaker 1: You know, you go back and you talk about the
Speaker 1: history of the criminalization of drugs, about the Chinese and
Speaker 1: the opium bands and blacks and their wine, and also
Speaker 1: about you know, cocaine and the crazed negro drug fiend. Right,
Speaker 1: the story going back a hundred years, and how it's
Speaker 1: manifesting today. Right. I mean you wrote that very powerful
Speaker 1: at been in New York Times a while back about
Speaker 1: George Floyd and how the cops trying to say, hey,
Speaker 1: because he was on drugs, right, And so do you
Speaker 1: think that more people, and especially more black people are
Speaker 1: beginning to wake up to the things about the anti
Speaker 1: drug piece of this thing when they see so many
Speaker 1: I mean one after another. I mean black people are
Speaker 1: being killed by the cops, and the cops saying it
Speaker 1: was because of the drug, because he was selling drugs
Speaker 1: and he was using or whatever it might be. Do
Speaker 1: you see a change happening there? I think so. I
Speaker 1: think when you have George Floyd and you have Brianna Taylor,
Speaker 1: particularly with someone like Brianna Taylor, um, she was not
Speaker 1: in the game, and but the justification was that her
Speaker 1: ex boyfriend was in the game and they were just
Speaker 1: the cops were justified to come in and kill her.
Speaker 1: And I think people are finally starting to see that,
Speaker 1: wait a second, this is crazy. No matter how many
Speaker 1: drugs this particular person was selling, the were alleged to him,
Speaker 1: So you shouldn't be able to kick someone's door down
Speaker 1: and then murder them. And so I think people are
Speaker 1: starting to see. People are starting to put together Philando
Speaker 1: can still uh he had marijuana and that cop of
Speaker 1: shot him to death. Um, we think about Lakwan MacDonald,
Speaker 1: the seventeen year old kid in Chicago where they said
Speaker 1: that he had PCP in the system and he was
Speaker 1: shot sixteen time. I think people are putting it together,
Speaker 1: particularly now in this age where we see the police abuses,
Speaker 1: and people are starting to see that drugs are always
Speaker 1: used as this convenient scapegoat to justify this awful behavior.
Speaker 1: And so on the one hand, I'm really happy that
Speaker 1: people are starting to see. On the other hand, it
Speaker 1: makes me um profoundly sad that we have to steal
Speaker 1: deal with this particular issue when it goes all the
Speaker 1: way back to the turn up the last century, the
Speaker 1: turn up the twentieth century, and we're still dealing with it.
Speaker 1: So that makes me profoundly sad. Yeah, yeah, I don't know.
Speaker 1: I almost don't know where to go from there. I mean,
Speaker 1: it's the question of, well, let me put it this way.
Speaker 1: You know, sometimes I think we know and you and
Speaker 1: I have both been out there talking for years and
Speaker 1: you can speak to it from a much more personal
Speaker 1: basis about the role that race and racism has played
Speaker 1: in the war on drugs going back to the early years,
Speaker 1: and the multiple levels at which it plays down, and
Speaker 1: so we know that racism permeates this. It permeates why
Speaker 1: blacks get treated different than white It's like the crack
Speaker 1: powder laws and tougher penalties on crack. It permeates on
Speaker 1: so many different levels. But you know, sometimes I put
Speaker 1: out there that there's another ism that we're not even
Speaker 1: willing to deal with, and for lack of a better term,
Speaker 1: it's druggism, right that there is. Now it's not longer possible,
Speaker 1: at least publicly to say racist things. I mean, now
Speaker 1: on the trumpet begins to become possible again. But basically
Speaker 1: that's been delegitimized and you can lose your job. There's
Speaker 1: all sorts of things for making a comment that sounds
Speaker 1: at all racist, right, But when it comes to druggism,
Speaker 1: when it comes to disparaging addicts junkies, when it comes
Speaker 1: to making assumption about them, that seems to be one
Speaker 1: of the last remaining really legitimate prejudices, and not just
Speaker 1: on the right, even across the political spectrum. No, you're
Speaker 1: absolutely right when we speak about this language in terms
Speaker 1: of the role of rais and uh drug policy or
Speaker 1: drug policy being used to subjugate like black people, for example.
Speaker 1: The thing that I have to be careful about is
Speaker 1: I have to not be lazy, and when I'm lazy,
Speaker 1: I might say that drug policy is used to subjugate
Speaker 1: black people, when in fact that's just an example of
Speaker 1: how drug policy is used. But drug policy is really
Speaker 1: used to subjugate the powerless, the people on the margins
Speaker 1: of our society. And then I can give an example
Speaker 1: of how black people are disproportionately arrested, but I can
Speaker 1: give another example to talk about white folks in Oklahoma
Speaker 1: who use methamphetamy, they are also disproportionately subjugated. And I
Speaker 1: can talk about the users in the Philippines. They're being
Speaker 1: subjugated for the same reasons. And so um, that's why
Speaker 1: I have to be careful so that people understand that
Speaker 1: this is a universal sort of thing that's going on
Speaker 1: with drug policy. It's not unique to black people. But
Speaker 1: in the United States, um our drug policy. Because we
Speaker 1: have this conspicuous difference in our race, it makes it
Speaker 1: easier to point to it. But don't get it twisted.
Speaker 1: This is the universal thing. And the people who are
Speaker 1: in the middle classes, who have power, who are the
Speaker 1: educated class, Um, they're not being subjugated in the same way.
Speaker 1: In fact, they are so busy distancing themselves from the
Speaker 1: methamphetamine users, from the heroin user, from the black user,
Speaker 1: what have you, and so um, these laws are not
Speaker 1: equally applied as we know. Yeah, you know, it's interesting
Speaker 1: because it's another commonality we have in this thing. You know,
Speaker 1: for many years, going back decades, I would go to
Speaker 1: speak safety annual conferences of Normal the Marijuana Legalization Group,
Speaker 1: which I support, and they were fighting for legalization and
Speaker 1: they're my allies. But sometimes people we get up there
Speaker 1: and say, you know, we gotta legalize marijuana so we
Speaker 1: can crack down on the meth heads. And I with them,
Speaker 1: lecture them and say no matter what you think of
Speaker 1: mess and even if it is a more dangerous drug,
Speaker 1: that's no basis for treating those folks differently. And make
Speaker 1: the analogy to the First Amendment. The first a moment
Speaker 1: doesn't just protect elevated speech, right, it also protects you know,
Speaker 1: quote unquote ugly speech less elevated speech. We'll be talking
Speaker 1: more after we hear this. Add what you do in
Speaker 1: this book that I think really breaks some new ground
Speaker 1: in different ways. Isn't talking about myth amphetamine, heroin, PCP
Speaker 1: in a way that really, I mean, very few people have.
Speaker 1: I know, I put my toe in the water, but
Speaker 1: you take it many steps further. And so, you know,
Speaker 1: and we see that with marijuana, right, we see that
Speaker 1: Mariana legalization, we've radically changed that, you know, from reform
Speaker 1: madness and brain on drug stuff and all that that's turned.
Speaker 1: Now psychedelics is kind of opening up and changing people's
Speaker 1: minds and things like that. But there's other drugs, the
Speaker 1: ones who are most of what people are going to
Speaker 1: prison for selling and possessing. You take on those one.
Speaker 1: So let's just start off with meth amphetamine, because that's
Speaker 1: something you've been studying for a long time, and you've
Speaker 1: produced reports and studies on that thing. So can you
Speaker 1: explain to our listeners, you know why what they may
Speaker 1: think about methamphetamine is more or less flat out wrong. Yeah,
Speaker 1: So when when I think about methymphetamine, Uh, it's important
Speaker 1: for the listener to know one thing, Adderall the methymphetamine
Speaker 1: are essentially the same compound adderall. Of course, it is
Speaker 1: the medication that's used to treat attention deficit disorder. Methamphetamine
Speaker 1: also is at the proved to treat attention deficit disorder
Speaker 1: as well as obesity. UM. The only difference between the
Speaker 1: active ingredients and adderall, which is d amphetamine. The only
Speaker 1: difference between d emphetamine and methamphetamine is an additional methyl group,
Speaker 1: and that method group, we have said in research makes
Speaker 1: it easier for the methomphetamine across the blood brain barriers
Speaker 1: such that it gets into the brain more rapidly, so
Speaker 1: there's a more rapid onset of effects. Now, there is
Speaker 1: no data in humans to prove that or show that
Speaker 1: this is mainly uh kind of based on animal studies
Speaker 1: and speculations about what that sort of increased lip solubilility means. Now,
Speaker 1: we have said that that makes methamphetamin more reinforcing, that
Speaker 1: is more addictive. Again, no evidence to show that, because
Speaker 1: all of the evidence when you test methomphetamy against UH,
Speaker 1: something like a d amphetamy UH in the same human
Speaker 1: users they choose used to take the drugs on the
Speaker 1: same number of occasions, and the self administration patterns look
Speaker 1: the same. Humans can't distinguish between the two drugs on
Speaker 1: the double blind conditions. So methamphetamine is essentially the same
Speaker 1: drug that people are taking in adderall. Not that's not
Speaker 1: to say that people should stop taking their adderall because
Speaker 1: this is such a danger struct No, that's the same
Speaker 1: that methemphetamine. It's f the approved for a reason because
Speaker 1: it's effective, because it's a safe medication when used in
Speaker 1: the doses when the medication is prescribed. So they are
Speaker 1: essentially the same drug. Now, what people see in the
Speaker 1: natural ecology is that methamphetamine use is primarily smoking or injection,
Speaker 1: and so rout of administration certainly impacts the speed at
Speaker 1: which the drug reaches the brain. It also impacts a
Speaker 1: number of things the conditions under which the drug is taken.
Speaker 1: So what people are really seeing is a function of
Speaker 1: the legality of the drug, the route of administration, and
Speaker 1: all of these sorts of things, but not the drug itself.
Speaker 1: But they are attributing all these factors to the drug,
Speaker 1: when in fact it's really about these sort of psycho
Speaker 1: social characteristics are factors more so than the pharmacological factors.
Speaker 1: So if I were to summon up by saying that
Speaker 1: if you were to take that, I don't know ten million,
Speaker 1: twenty million. However, many young mostly boys, are being prescribed
Speaker 1: adderall today and substitute for that an equivalent dose of
Speaker 1: oral meth amphetamine. Probably those kids would not even know
Speaker 1: the difference, or it would be roughly comparable. And conversely,
Speaker 1: if you were to crush up those kids adderall and
Speaker 1: smoke or injected, it would be fairly indistinguishable from the
Speaker 1: people using kind of underground illicit meth amphetamine smoking ejecting
Speaker 1: that apart from maybe the effect of the contaminants in
Speaker 1: the illegally produced stuff. Absolutely. And another thing about adderall
Speaker 1: is that it has three amphetamines. There's an L, there's
Speaker 1: a d UH and the L doesn't cross as well
Speaker 1: as the D doesn't cross the blood brain barrier as well,
Speaker 1: and so the adderall has more cardiovascular activity that I
Speaker 1: don't really need um, and so UM, I think that
Speaker 1: the D and methamphetamine is actually more ideal. You know,
Speaker 1: I got my doctor to prescribed to me blow dose
Speaker 1: five milligram dextro amphetamine. You know, I told him I
Speaker 1: needed for jet lag, which is true, and you know
Speaker 1: I use it occasionally. UM. And then at one time
Speaker 1: I got a friend of mine to give me one
Speaker 1: of his kids adderalls, and my sense was that adderall
Speaker 1: was more kind of jagged e like. It almost felt
Speaker 1: like the dextro amphetamine was a smoother one. And it
Speaker 1: made me wonder, why aren't they using dexter amphetamine with kids.
Speaker 1: Was there a possibility it actually might be better for
Speaker 1: many young teenagers or is there some good reason not
Speaker 1: to be doing that. Well, they do use a D
Speaker 1: M fetamine dexterro emphetamine for kids. First it owned the
Speaker 1: market of the tension deficit disorder UH and then Riddland.
Speaker 1: Eventually they tuck over. But then adderall hit the scene
Speaker 1: because Shire of Pharmaceuticals marketed and told physicians that, oh
Speaker 1: it's a slower onset of effects and this is better,
Speaker 1: and they had this big marketing campaign and that's why
Speaker 1: people are prescribed adderall because of Shires effective marketing campaign,
Speaker 1: not because of the effectiveness of the medication. So while
Speaker 1: we're on the subject of big pharma, the one that's
Speaker 1: most notorious, right is Perdue Pharma, right in the Sackler
Speaker 1: family and their creation of of oxycontent, a drug that
Speaker 1: appeared to be a really very effective pain controlled drug
Speaker 1: for some people living with serious pain, but which then
Speaker 1: you know, it appeared they over to marketed quite seriously.
Speaker 1: I mean, how much do you hold Perdue Pharma sort
Speaker 1: of responsible for the kind of starting phase of this
Speaker 1: significant expansion of opioid related fatalities in the beginning of
Speaker 1: this century. They certainly deserve some responsibility here because they
Speaker 1: got the FDA to schedule oxycotton at a lower level.
Speaker 1: It wasn't a scheduled too, I think it was scheduled three,
Speaker 1: whereas other opioids were scheduled too. They said it was
Speaker 1: less addictive than the other opioids, which was not true. Uh,
Speaker 1: And so they deserve some responsibility there, of course. But
Speaker 1: when we think about, uh, the fact that people are
Speaker 1: dying from drug related overdoses. Uh, An important reason that
Speaker 1: people are dying from drug related overdoses is because people
Speaker 1: are getting contaminated drugs on the street, and that's an
Speaker 1: easy fix. You can just make sure that people have
Speaker 1: a clean supply or safe supply, or make sure that
Speaker 1: they have access to drug checking so you can check
Speaker 1: and see what's contained in your your substance. That's an
Speaker 1: easy fix. And we as an American public, we haven't
Speaker 1: done that. But yet we're blaming the pharmaceutical company for
Speaker 1: that which they have nothing to do with that. And
Speaker 1: we also blamed the pharmaceutical company for like addiction rates,
Speaker 1: when the fiction um has nothing to do with the
Speaker 1: drug itself. Addiction is mainly related to all these other
Speaker 1: psycho social factors, like beginning in the nineteen seventies and
Speaker 1: continuing in the eighties, when all of these factories left
Speaker 1: the Midwest, they left the rust belt places, and people
Speaker 1: who once had jobs that paid the middle class salaries
Speaker 1: they no longer had it. They once had standing in
Speaker 1: that community, they no longer had it. That increases the
Speaker 1: likelihood that people will become addicted to have all kinds
Speaker 1: of problems. And we see that sort of thing, but
Speaker 1: we don't talk about all of these other sort of
Speaker 1: issues that are involved. Instead we just say perdue, Yeah, Carl,
Speaker 1: I mean, well you're talking about, obviously is what people
Speaker 1: have referred to as these deaths is to spare right,
Speaker 1: the high rates of alcoholism, opioid misused suicide happening in
Speaker 1: parts of the country, you know, whether black, brown, or white,
Speaker 1: where people have been struggling, and especially sometimes where people
Speaker 1: are downwardly mobile. But the other thing I think when
Speaker 1: you're talking about is the thing about the pharmaceutical companies.
Speaker 1: I mean, obviously they're all really aggressive. Promoting of this
Speaker 1: stuff created a problem, as did ignorant doctors and ignorant
Speaker 1: nurses and patients wanting to pop a pill, and insurance
Speaker 1: companies not wanting to pay for this stuff, all those things.
Speaker 1: But interestingly, when they were getting it there, those drugs
Speaker 1: were relatively pure, and once they started once and started
Speaker 1: to crack down for some good reason on the pharmaceudical companies,
Speaker 1: people started turn to even more black market drugs, first
Speaker 1: heroin and then fenton al And so there was a
Speaker 1: paradoxical thing where the crackdown the pharmaceutical companies may have
Speaker 1: actually made the overdose epidemic even worse than or otherwise
Speaker 1: would have been. Yeah, we know that when you have
Speaker 1: the crackdown in the legitimate source, then you have the
Speaker 1: illegal sources pop up. Absolutely. Um just I have to
Speaker 1: be careful when we talk about this thing we're calling
Speaker 1: the opioid crisis, and we're talking about overdoses. In the book,
Speaker 1: I try to help the reader understand that these things
Speaker 1: that we're calling overdoses and we're blaming opiates for, we
Speaker 1: don't really know that opioids are the actual causal agent
Speaker 1: for the overdose. UH and I try to walk the
Speaker 1: reader through how medical examiners and corners do their death
Speaker 1: investigations and the level of education that's needed to be
Speaker 1: a corner in most locations are high school diplomas. That's
Speaker 1: all you need and a few hours of a death
Speaker 1: investigation course. And there's no uniformity in terms of how
Speaker 1: these death investigations are done. Most of the people who
Speaker 1: die from drug related overdoses have multiple drugs in their system,
Speaker 1: and then there is no levels that are measured to
Speaker 1: determine what drug might have been the causal agent, and
Speaker 1: in some cases they don't even get biological confirmation that
Speaker 1: that was actually opioids in the system. And so UH,
Speaker 1: I asked the reader to really think about what's going on,
Speaker 1: Because dying from a single opioid like heroin, it's not
Speaker 1: the easiest thing to do, particularly something like fantonol. Of course,
Speaker 1: a single drug one can die from more readily. I mean, basically,
Speaker 1: what you're saying is that the large majority of what
Speaker 1: are called over those fatalities are really fatal drug combination fatalities, right,
Speaker 1: I mean, it's that mix, and that the media and
Speaker 1: sometimes the corners, you know, rather what I didn't saying, oh,
Speaker 1: this was a fatal drug combination, or saying this was
Speaker 1: a benzo death or an alcohol death or a set
Speaker 1: amath and death. They just call it an opioid death
Speaker 1: because that's easy. That's what the media wants to report.
Speaker 1: Or even if the small print doesn't say that, that's
Speaker 1: what the headline writers put up there. That's exactly it. Now,
Speaker 1: it also seems to me that what you're saying about federal, though,
Speaker 1: is that federal is in a bit of a special category.
Speaker 1: They've given that it's what fifty times more potent per
Speaker 1: milligram or whatever than heroin. People can die just from
Speaker 1: a straight federal way in a way that was unusual
Speaker 1: with heroin or oxyes or things like at Now that
Speaker 1: seems to me to maybe present one of the strongest
Speaker 1: arguments for some form of legalization or safe supply of opialities. Absolutely,
Speaker 1: people will use opioids. People will use drugs. The question
Speaker 1: before us as a society is how do we best
Speaker 1: keep people safe? And it seems as though we have
Speaker 1: been comfortable and pretending that people won't use drugs and
Speaker 1: allowing people who do use these drugs to uh engage
Speaker 1: in this precarious activity of taking drugs that are purchased
Speaker 1: on the list of market. To me, that's not what
Speaker 1: responsible society should do, particularly one that claims to be
Speaker 1: proponents of life liberty in the pursuit of happiness. Now,
Speaker 1: you talk a fair bit in the book at many
Speaker 1: places about drugs safety testing, right, testing the quality of
Speaker 1: what the pills are, and just explain why that's so important. Yeah,
Speaker 1: we call that drug checking or drug purity checking, drug
Speaker 1: purity checking um. It occurs in a number of countries
Speaker 1: including Portugal, the Netherlands, Austria's, Spain, Colombia, uh and none
Speaker 1: of these countries have so called opioid overdose crises or
Speaker 1: any overdose crises. Drug checking what it does is that
Speaker 1: it allows UH drug users to submit anonymously UH small
Speaker 1: samples of their drug UH and then get a print
Speaker 1: out of what's contained in that sample. These subances are
Speaker 1: free and they're done with the primary goal of keeping
Speaker 1: people safe, so people are not exposed to UH poisons, adulterants,
Speaker 1: or other toxins that might be in UH the illicit
Speaker 1: drug supply. And so I have been advocating that we
Speaker 1: do the same thing in this country. We have the technology, UH,
Speaker 1: we certainly have the resources, but we haven't and we
Speaker 1: have one of the biggest sort of overdose concerns, but
Speaker 1: yet we have not made these services available to our people.
Speaker 1: So when politicians say that they care about the opioid
Speaker 1: crisis or the health of the public, and they are
Speaker 1: not advocating for these services, then you know that they
Speaker 1: really don't give a ship. Well, let me I say,
Speaker 1: can these testing services checking services also detect the potency
Speaker 1: of a sample? Yes, UH, they can detect the potency,
Speaker 1: They can detect the amounts UH and all of the substance.
Speaker 1: Because our seeing now, I think especially the harm reduction
Speaker 1: programs either on the US right doing these sentinel testing strips.
Speaker 1: Since you're trying to detect the presidents of fentanyl. Na, No, no, no,
Speaker 1: that's a joke. Man. That ship is a joke. I mean, obviously,
Speaker 1: if that's all you got, Okay, I get it. But
Speaker 1: for a country like ours with so many resources, for
Speaker 1: the people who have to revert to using fentanyl strips,
Speaker 1: that's a shame. I mean that this is a shame
Speaker 1: because it only detect fentanyl and some pentonel and not
Speaker 1: any other of compounds that might be uh contained in
Speaker 1: the substance. And and we have the technology, so to
Speaker 1: pretend that that's a fix, or to pretend that that
Speaker 1: that's what we should be doing, it's insulting, particularly when
Speaker 1: they're doing this in Colombia, in Austria. It's a joke.
Speaker 1: I mean, it's it follows in a long line, right
Speaker 1: of opposing needle exchange programs because it might encourage people
Speaker 1: to say shooting drugs is safe. Of opposing the lock
Speaker 1: zone because it might make people feel safe for using opioids. Right,
Speaker 1: it's that whole thing or where the politicos and the
Speaker 1: public health folks are scared if even when they know better,
Speaker 1: I mean, if even goes back to a hundred years
Speaker 1: ago when they used to talk about giving how condoms
Speaker 1: to soldiers, and people say, how can you do that?
Speaker 1: It's gonna make it safer to have extramarital sex or
Speaker 1: illicit sex or whatever. That's the thing that is remarkable
Speaker 1: to me, and that why should I care what someone
Speaker 1: else is doing? As long as they're not bothering other
Speaker 1: folks and long is that they are not preventing other
Speaker 1: people from enjoying their rights. Who am I to say
Speaker 1: what they should be doing? They are adults. You know,
Speaker 1: you're talking the book about the novel psychoactive substances, things
Speaker 1: that became known as bass salts or these synthetic cathinones
Speaker 1: are synthetic cannabinoids and things like that where it seems
Speaker 1: like the drug checking would be incredibly valuable because often
Speaker 1: has people have no idea what their getting. Yeah, we
Speaker 1: vilified the cathinones, uh, these bath salts. Again, we lied
Speaker 1: about the effects of these cathinones. Many of these captain
Speaker 1: oons produce effects similar to M D M A and
Speaker 1: similar to cocaine um. But we said that these catherinons
Speaker 1: make people bite other people's faces off, And of course
Speaker 1: that's not true. And I detail that story of the
Speaker 1: Miami cannibal and how that person never had any cathinones
Speaker 1: in the system. But that's not what the press said. So, UM,
Speaker 1: don't believe the hype about the catanones. Uh. Many of
Speaker 1: these cathinones produced in D M A like effects, and
Speaker 1: they produce cocaine like effects. You wrote in the book
Speaker 1: about assuming at one point that you could do a
Speaker 1: double blind test and that people taking extra amphetamine and
Speaker 1: m d m A would have the same response to it,
Speaker 1: and then being somewhat surprised that that actually wasn't the case.
Speaker 1: The reason why I thought that they were produced nearly
Speaker 1: identical effects is because when you look at them chemically,
Speaker 1: they looked nearly identical. M d M A has a
Speaker 1: methyline dioxy ring added to the methomphetamine structure. I thought
Speaker 1: that they were produced effects that would be nearly identical,
Speaker 1: and sure enough, when we looked at some cognitive tests,
Speaker 1: they produced a lot of overlapping effects. Uh, some different
Speaker 1: effects whereas m d m A disrupted some performance, methomphetamine
Speaker 1: improved performance, but they produced a lot of overlapping effects.
Speaker 1: But that's not what people say. In the natural ecology
Speaker 1: and the natural ecology people say that nah, M B
Speaker 1: M A, there's nothing like it. You know, this empathy,
Speaker 1: the openness, this connection with others. And at that point
Speaker 1: in my career I had tried me them fettermy, but
Speaker 1: I hadn't tried M D M A. But then I
Speaker 1: tried M D M A and then I saw like, oh, well,
Speaker 1: maybe our lab measures are the problem in that we
Speaker 1: just are not capturing the unique bits of M D
Speaker 1: M A. Let's take a break here and go to
Speaker 1: an ad M. Carl And I know you gave a
Speaker 1: lot of thought to this one part of the book,
Speaker 1: and it's the one that's gotten a lot of attention,
Speaker 1: which is the way you talk about heroin. Just gonna
Speaker 1: read a few of the good quotes you had in there.
Speaker 1: At one point you say, there aren't many things in
Speaker 1: life that I enjoy more than a few lines by
Speaker 1: the fireplace at the end of the day. I think
Speaker 1: you said, listen to Billie Holiday, And then you said
Speaker 1: Heroin enhances my ability to feel and think. You said,
Speaker 1: I also want to ensure that others are afforded safe
Speaker 1: out tunity needs to benefit from the serene bliss opioids
Speaker 1: can offer. Should they so choose now I will admit
Speaker 1: that heroine's always scared me. I mean, I've tried it
Speaker 1: a numerous times to see what it's like. I mean,
Speaker 1: the last time I did it was with you and
Speaker 1: another friend in Europe a few years ago, you know,
Speaker 1: so you know, and my friends always made sure that
Speaker 1: I took just a low dose, and they were watching
Speaker 1: al for me and say, you know, look, if you're
Speaker 1: gonna have a drink afterwards, be moderate. But I got
Speaker 1: to admit there was something about heroin that scared me
Speaker 1: almost not unlike the way that tobacco and nicotine scare me.
Speaker 1: That there's a stickiness to those drugs that if you
Speaker 1: start to like them too much, they just make the
Speaker 1: hard to detach yourself from. And you describe going through
Speaker 1: a withdrawal experience. What I love about it is you're
Speaker 1: out there saying, you know, for all you marijuana and
Speaker 1: psycholic exceptionalists, it's not just the political principle that shouldn't
Speaker 1: be exceptional, it's actually a way we think about these
Speaker 1: drugs and understanding that they actually can play a beneficial
Speaker 1: role in your life. So just say more about you're
Speaker 1: coming from on that and how you feel about that,
Speaker 1: and if you feel like talking about how people have
Speaker 1: responded to that. Yeah, what heroin is the boogeyman drug
Speaker 1: of course in the United States. And so h your
Speaker 1: point about liking it too much and then getting attached
Speaker 1: to it, think about that for a minute. You know,
Speaker 1: there still is nothing better than the sexual orgasm. But
Speaker 1: do we hear people saying ship like m, I better
Speaker 1: stay away from this orgasm because I might get too attached.
Speaker 1: I mean, it's it's just a matter of when we
Speaker 1: have these drugs be illegal, then we have to go
Speaker 1: through all of these various obstacles to get the substance,
Speaker 1: and that plays a role in terms of the addictive
Speaker 1: potential of the something. And so I don't think heroin
Speaker 1: is particularly addictive. Of course, it can produce physical dependence,
Speaker 1: so two can alcohol, So too can your antidepressant. A
Speaker 1: number of these drugs can produce physical depends. But the
Speaker 1: majority of people who use heroin are not addicted to
Speaker 1: the substance. But they just don't say that they use
Speaker 1: heroin because of this negative sort of view that we
Speaker 1: have of heroin. You alluded to how people have responded
Speaker 1: to me admitting to having used heroin. In fact, people
Speaker 1: would like to dismiss me simply because I've used heroin.
Speaker 1: And so imagine that somebody like me who published more
Speaker 1: than a hundred scientific papers, three books, and people are
Speaker 1: trying to dismiss me. Imagine what they will do to
Speaker 1: other people who don't have such a record. So I
Speaker 1: I get it. I understand why people don't say they
Speaker 1: use heroin, and so it gives this impression that certainly, uh,
Speaker 1: this drug is so addictive that you shouldn't do it.
Speaker 1: And then the filmmakers, the documentary filmmakers, the TV filmmakers,
Speaker 1: the comedians, they need heroin as a foil because then
Speaker 1: they can describe drug addiction in this awful way and
Speaker 1: they use herible. And imagine if comedians didn't have these
Speaker 1: drugs to make fun of. Imagine if the documentary film
Speaker 1: had somebody like me who've used these drugs and go
Speaker 1: on with their life, take care of their family, have
Speaker 1: a happy life. That would be boring. And so we
Speaker 1: need heroin in this culture to vilify for all of
Speaker 1: these pop culture sort of reasons. You mentioned that I
Speaker 1: went through heroin withdrawal. It was intentional, so I could say, okay, um,
Speaker 1: it's something, it happens. But it's not life threatening like
Speaker 1: alcohol withdrawal, it's life threatening. I will never put myself
Speaker 1: intentionally through alcohol withdrawal because I would be afraid of
Speaker 1: the life threatening effects. But heroin withdrawal from most healthy people,
Speaker 1: it's not life threatening, and so that's why I did it.
Speaker 1: I haven't gone through heroin withdraw sense or before, certainly
Speaker 1: not in a way where the symptoms had me feeling
Speaker 1: like I described in the book. Then I can take
Speaker 1: heroin or leave it. And being that we've had this pandemic,
Speaker 1: for example, I've been stuck in the United States, so
Speaker 1: that meant that I wouldn't have access to good, pure heroin,
Speaker 1: So that meant that I couldn't use heroin. And it's
Speaker 1: no big deal. That's just like um, caffeine or some
Speaker 1: other substance that I choose to use or choose not
Speaker 1: to use. You know. Reading that parts of your book
Speaker 1: about heroin, it reminded me of one of the classic
Speaker 1: studies in the field, which was the Harvard professor Norman
Speaker 1: Zenberg Right, who many decades ago did a book called
Speaker 1: drug Set and Set It Right. And drug set and
Speaker 1: setting was the phrase that was coined by Timothy Leary
Speaker 1: and developed by Andrew Wild and then Norman Zenberg, professor
Speaker 1: Hart Medical School, tested it. And I think what he
Speaker 1: did was he put advertisements in the local Boston newspapers
Speaker 1: looking for people who said they used heroin but did
Speaker 1: not feel they were addicted. And hundreds of people came
Speaker 1: out of the woodwork, postal delivery workers and school teachers
Speaker 1: and people who are living rough on the streets, and
Speaker 1: people who had significant professions, and even coined the term
Speaker 1: I think chippers to describe people who used heroin occasionally
Speaker 1: without becoming addicted to it. Now, interestingly, between his writing
Speaker 1: that forty years ago or whatever and you're coming out,
Speaker 1: so little is actually said and written about this. And
Speaker 1: I wonder if one reason is that the key research
Speaker 1: funding agencies, so the government, naturally student on drug abuse,
Speaker 1: is just not interested in finding this sort of an
Speaker 1: information out. No, they're not, But you know, we know
Speaker 1: the role that NINER has played Nighter. It's the National
Speaker 1: Institute on Drug Abuse. Their primary mission certainly has been
Speaker 1: for most of its life to focus on the negative
Speaker 1: effects produced by drugs, so we know they're so to bias.
Speaker 1: I was on Night as advisory council. I'd served my term.
Speaker 1: I was a grant reviewer, I was a chair of
Speaker 1: a grant review session. I had grants myself, So I'm
Speaker 1: not speaking as someone who doesn't know. I mean, I
Speaker 1: was a part of the system. But I think it's
Speaker 1: it's a lot bigger than Nina. It's uh the people
Speaker 1: who do drug treat and they are so invested in
Speaker 1: this as well. They have come out really strongly against
Speaker 1: someone saying that you can use heroin occasionally, even though
Speaker 1: we know that heroin and noxycontin are essentially the same drug.
Speaker 1: We know that heroin and morphine are essentially the same drug.
Speaker 1: But heroin has this sort of additional uh vilification attached
Speaker 1: to it for some reason, because it has this important
Speaker 1: role in our society. It helps us to define us,
Speaker 1: and then we can uh persecute these people who use
Speaker 1: heroin because they are somehow morally less than we are. Something.
Speaker 1: It's playing some important role in our society that is
Speaker 1: far beyond the pharmacology of the drug. Yeah, although what
Speaker 1: you're saying about heroin was probably also true of meth
Speaker 1: and messi anthetamine back in the early two thousand's right
Speaker 1: that nobody could use it without being addicted. I remember
Speaker 1: when I go out and speak to people, and I
Speaker 1: let me give you this example. You know, an editor
Speaker 1: of a newspaper tells his reporter to go write a
Speaker 1: report about alcohol in the city, right, And the reporter
Speaker 1: goes out and he comes back with all these articles
Speaker 1: about twelve step meetings, you know, detox wards, jails, treatment programs,
Speaker 1: and the editor pulls open his drawer, pulls out his
Speaker 1: bottle of whiskey. From the drawing goes, what are you
Speaker 1: talking about? I understand that's one part of the story,
Speaker 1: but what about the people having a beer? What about
Speaker 1: the vineyards and the wine? What about you know, story
Speaker 1: not told? Same editor tells, same reporter, go, do me
Speaker 1: a story and meth amphetamine. The reporter goes out, goes
Speaker 1: to the jails, goes to the treatment programs, goes to
Speaker 1: that sort of thing, comes back and the editor goes,
Speaker 1: great job, and never stops to say, wait a second,
Speaker 1: aren't there people using meth there who are not this way?
Speaker 1: Who's actually attracting new meth users? Because it's not gonna
Speaker 1: be the guy who's down and out in teeth falling
Speaker 1: out all this sort of stuff. There has to be
Speaker 1: something else going on. But it doesn't even occur to
Speaker 1: people to think that way at all. That's exactly right,
Speaker 1: and that's one of the things I was trying to
Speaker 1: do with the book. I traveled around the world. Each
Speaker 1: chapter is kind of set in another country, and I
Speaker 1: tried to show people that the vast majority of folks
Speaker 1: who are using drugs are middle to upper class people
Speaker 1: who are captains of industries, who are famous, people who
Speaker 1: are important people in our societies, people who we love
Speaker 1: and respect. They are the vast majority of our drug users.
Speaker 1: And I tried to get people to understand that the
Speaker 1: illicit drug trade is a multibillion dollar industry, and a
Speaker 1: multibillion dollar industry could not be supported by people who
Speaker 1: are poor and down and out. That ship just doesn't
Speaker 1: make any sense. But we still believe that nonsense. I
Speaker 1: remember one time asking somebody who's middle class business owner
Speaker 1: or family, etcetera, who had taken method on daily because
Speaker 1: he had once had a heroin addiction, And I said,
Speaker 1: why don't you speak out publicly? I mean, you would
Speaker 1: help transform the image of who is a Method on consumer?
Speaker 1: He says, he's a Let me tell you something. I
Speaker 1: run a business. If one day I come in and
Speaker 1: I'm exhausted because my kid was up sick, or I
Speaker 1: was finding my wife and I put my head down.
Speaker 1: People go, oh, poor Joe. I guess he had a
Speaker 1: rough evening when it was going on. If they knew
Speaker 1: I was on method on, they would go, oh, Joe,
Speaker 1: he must be nodding out. They'd make that negative assumption.
Speaker 1: He goes, I can't come out, And so in your case,
Speaker 1: I'm wondering. I mean, I remember back in two thousand seven,
Speaker 1: I actually joined my board. I said, Carl, you're not
Speaker 1: even tenured as yet, and you got, you know, a
Speaker 1: drug war guy chairing your department, and you wrote me saying, Ethan,
Speaker 1: as a matter of principle, I got to do the
Speaker 1: right thing, even if it costs me a bit. Here
Speaker 1: you're coming out, but you do have tenure now and
Speaker 1: your kids are now going to college or graduated. Right
Speaker 1: do you think you would have not done this when
Speaker 1: you're an assistant professor, when your kids were younger. I mean,
Speaker 1: there's something about this being a point both a point
Speaker 1: of the broader culture, at a point in your life
Speaker 1: where it felt safe to do so, relatively speaking, not safe,
Speaker 1: but relatively speaking. But yeah, uh know, it's Uh, we
Speaker 1: have to also understand that, you know, I was still
Speaker 1: developing and I'm I am still developing and I'm still learning.
Speaker 1: And so it's at a point in my life where
Speaker 1: I am comfortable enough to deal with the bullshit that
Speaker 1: I get because anybody talking about drugs and the subject
Speaker 1: I can deal with because I noticed subject so well,
Speaker 1: Whereas five years ago, ten years ago, I didn't know
Speaker 1: the subject as well, and I couldn't deal with the
Speaker 1: questions to pushbacks and and I just wasn't knowledgeable enough.
Speaker 1: And so as I gained more knowledge, I gained more confident.
Speaker 1: And so it really has to do with my confidence
Speaker 1: and my ability to explain what I do and why
Speaker 1: I do it now, not so much a political calculus.
Speaker 1: That's not what's going on here, because as you know,
Speaker 1: people are trying to dismiss me as crazy whatever. They're
Speaker 1: still trying to do that. And people in my departments,
Speaker 1: uh they I'm into departments. There are people who talk
Speaker 1: shit about me about this, and they are they are plotting,
Speaker 1: they're doing their things, and so there are consequences, uh
Speaker 1: to this, and there have been consequences in terms of universities.
Speaker 1: Are people who invited me to give talks, have disinvited
Speaker 1: me as a result of me coming out of the closet.
Speaker 1: I have been censored in all kind of ways. So
Speaker 1: there are so many consequences that the public does not
Speaker 1: see and does not know. But I don't really care
Speaker 1: about that, because I would be a coward if I
Speaker 1: didn't stand up and say this, given what I know now,
Speaker 1: And so that's why I am speaking out my I
Speaker 1: mean over the moon for the way you're handling this stuff,
Speaker 1: because it is courageous. One of the things you stress
Speaker 1: in the book is that this is a book for
Speaker 1: growing ups, and you point out that a lot of
Speaker 1: the advice and the margins of safety for using drugs
Speaker 1: like matthian fetemine or heroin and are safe, responsible way
Speaker 1: probably don't exist for tens of millions of American adults
Speaker 1: who you know are struggling in one way or another.
Speaker 1: So what do you say about the obligation? You know,
Speaker 1: are there risks in which you're advocating for the tens
Speaker 1: of millions of Americans who don't have it together to
Speaker 1: do it responsibly. You're right, I did say that this
Speaker 1: is a book for grown ups, and I just wanted
Speaker 1: people to understand I had a definition of grown ups,
Speaker 1: people who are responsible, take care of themselves and take
Speaker 1: care of their families and so forth. But it's important
Speaker 1: for people to understand too that being a grown up
Speaker 1: it's a dynamics sort of process. It's one in which
Speaker 1: it's not static. I mean, I'm struggling with that every day,
Speaker 1: and many of us do. Then, So, UM, I don't
Speaker 1: want to exclude people when I have my definition of
Speaker 1: grown ups, because that's not the goal here. The goal
Speaker 1: is inclusion. But then do you have this question that
Speaker 1: you raise about, like what about the people who don't
Speaker 1: have their life together to people who don't have the resources. Yeah,
Speaker 1: there are those people. Um, that's like saying, though driving
Speaker 1: a normal bill is a tremendous amount of responsibility. You
Speaker 1: think about being on a two lane highway traffic going
Speaker 1: in opposite direction. Uh, You've got cars coming towards you,
Speaker 1: and all they have to do is just turn into
Speaker 1: your lane and maybe injure you or injured themselves. Um,
Speaker 1: but we have to um, trust them, and we do
Speaker 1: that and they do okay. And so it would be
Speaker 1: kind of arrogant of me to think that I can
Speaker 1: say who should have access to these substances as long
Speaker 1: as they don't violate our norms, that is, in terms
Speaker 1: of preventing other people from enjoying their rights. I don't
Speaker 1: have the right to say that they should be restricted, uh,
Speaker 1: in their access. I think that's part of the problem
Speaker 1: with society. We have these people who think that they
Speaker 1: have the right to tell other people how they can
Speaker 1: live their life, and that's wrong. You know, sometimes we
Speaker 1: define it as um the majority of people of adults
Speaker 1: who can responsibly use these drugs need to be prohibited
Speaker 1: from doing so in order to protect the minority who
Speaker 1: cannot use them responsibly. But in point of fact, and
Speaker 1: one of the major divides in the legalization debate is
Speaker 1: between those people who think that if many more of
Speaker 1: these drugs were legally available, the number of serious addicts
Speaker 1: quote unquote would increase dramatically, whereas other people who say,
Speaker 1: you know what, even if a lot of the drugs
Speaker 1: that are now illegal were legal, the fact of the
Speaker 1: matter is the number of people getting addicted wouldn't go
Speaker 1: up that much because there's already so many other drugs
Speaker 1: available legally and illegally that they could already screwing up on.
Speaker 1: In fact, some of the ones that they're not able
Speaker 1: to get right now might actually be less problematic than
Speaker 1: the ones that they're being prescribed by doctors are usually
Speaker 1: legally over the counter. Absolutely, the notion that the availability
Speaker 1: of these substances will cause society to fall apart. We're
Speaker 1: living that experiment right now with cannabis. Remember what they
Speaker 1: said about cannabis and how Washington, Colorado, those states will
Speaker 1: fall apart. Not only have they not fallen apart, other
Speaker 1: states are trying to damnus to emulate those states. Uh,
Speaker 1: And so that just doesn't hold any water that sort
Speaker 1: of notion. We think about alcohol, which is one of
Speaker 1: the most potentially dangerous substances to HUGH known to humans.
Speaker 1: But we we do that okay, because we control the
Speaker 1: unit dose, We controlled the purity, the quality, the education.
Speaker 1: That's the part of being in a society. Let me
Speaker 1: ask you how you respond when people ask me what's
Speaker 1: the strongest argument I can think of against legalization, by
Speaker 1: which I mean a legal, responsible legal regulation, And I say,
Speaker 1: my biggest fear is when I look at what the
Speaker 1: food companies have been able to do right The combinations
Speaker 1: of sugar, fat, salt, a play on the brain that
Speaker 1: are marketed effectively. And when you look at the dramatic
Speaker 1: rise right in obesity and obesity related diseases in the
Speaker 1: US and really through much of the world, right where
Speaker 1: that where the humult of health consequences exceed those of
Speaker 1: illicit drugs are illicit drugs, right. And I worry about
Speaker 1: the power and the ability of major league, multinational companies
Speaker 1: to devise interesting concoctions of all these drugs that are
Speaker 1: adept at getting people to be dependent, even if they
Speaker 1: can control it up to a point, and that ultimately
Speaker 1: land up doing even more harm. That's my biggest fear
Speaker 1: than in the capitalist world we live in. That may
Speaker 1: be hard to prevent. You no, I agree, but what
Speaker 1: you're describing is a problem with capitalism, not a pharmacological problem.
Speaker 1: And so that's partly what happens when we have these
Speaker 1: discussions about legalization, all of these issues get conflated, and um,
Speaker 1: we we have some problems with our capitalism. I mean,
Speaker 1: we can think about the billionaires that we have in
Speaker 1: this country that pay no taxes, but that's not a
Speaker 1: drug problem. That's a capitalism problem. That's like saying that, well,
Speaker 1: ship we have the bad food because these people you
Speaker 1: have these sophisticated ways of marketing these foods. It's like,
Speaker 1: we're not gonna ban food. We need to check our capitalism.
Speaker 1: We need to check the regulations that we have on
Speaker 1: these companies. Uh. And we're trying to do that a
Speaker 1: little bit with we do and on some of these
Speaker 1: other drug companies. But that's capitalism, that's not the drug.
Speaker 1: You know, in the earlier years of my studying drugs,
Speaker 1: to the formative experiences, one was going to Amsterdam in
Speaker 1: eighty nine and not just seeing the clannabis coffee shops
Speaker 1: but also seeing their harm aduction stuff in action. And
Speaker 1: the other one was going to Switzerland and ninety two
Speaker 1: I happen to be there the day that this federal
Speaker 1: government green lighted doing the heroin maintenance programs for people
Speaker 1: who had not succeeded in method on programs, and then
Speaker 1: going back a number of times to actually see these
Speaker 1: programs in action. So you write about that in your book.
Speaker 1: You write about the successful heroin maintenance programs there for
Speaker 1: people which don't exist in the US. And now you
Speaker 1: tell me tomorrow you're heading off to Switzerland again, so
Speaker 1: you know, are we gonna see her coming back to
Speaker 1: the U. S here you're giving up on this place here,
Speaker 1: gonna gonna hanging Europe for a long time. I gotta
Speaker 1: tell you, man, Like I remember in the board meetings
Speaker 1: or I don't know, at some point, um in the
Speaker 1: early two thousand's, I don't know when you you were
Speaker 1: pretty enthusiastic about the results that they were achieving in
Speaker 1: Switzerland with the heroin maintenance for people who were struggling
Speaker 1: with heroin addiction. That you you helped me to understand
Speaker 1: that early on. And um, and I think I remember
Speaker 1: telling you many years later, like damn, you were right.
Speaker 1: And I was actually embarrassed because here I am a scientists,
Speaker 1: a pH d in this area, and I hadn't read
Speaker 1: the studies that showed what you were so enthusiastically telling us,
Speaker 1: and we were dismissing you, um and um. So it
Speaker 1: was an embarrassing moment for me. And I don't ever
Speaker 1: want to be embarrassed like that again. So you're right.
Speaker 1: Who are right then? And you're right now about this
Speaker 1: and so much so that I have decided to spend
Speaker 1: half of my time in the US and half of
Speaker 1: my time in Switzerland, not because I think the Swiss
Speaker 1: are are somehow better than most people on the planet.
Speaker 1: Not that's not It's just that they simply treat their
Speaker 1: citizens better than we treat our citizens here. And I
Speaker 1: have a scientific community that I can interact with, and
Speaker 1: they are also close to Paris, and they and I
Speaker 1: can get to Spain and other places in the European
Speaker 1: Union that have better drug policies, and they are more
Speaker 1: civilized about this issue, and so um staying in the
Speaker 1: US for extended periods of time, it just makes me
Speaker 1: a more angry person. And I don't want to be
Speaker 1: that way. I like feeling like, uh, I have taken
Speaker 1: M D M A. I like feeling like I have
Speaker 1: taken six A p B because I'm more generous, I'm
Speaker 1: more forgiving, I'm more magnanimous, and those are qualities that
Speaker 1: we should encourage other people to be. Well. Carl Le,
Speaker 1: let me just say, I so much value what you've
Speaker 1: been doing with your life, with your books, with your teaching.
Speaker 1: I value our friendship. I'm gonna miss you a bit
Speaker 1: when we're out in Switzerland, but I do you know.
Speaker 1: I love your man and wish you all the best
Speaker 1: in these next steps. I love you too, man, and
Speaker 1: you know. I learned from you a lot. But one
Speaker 1: of the most important things is that you always say,
Speaker 1: oh my bad, Miacopa, I sucked up, and you never
Speaker 1: have any qualms with doing that. And we all do
Speaker 1: we I mean, we all screw up, but we don't
Speaker 1: take responsibility for screwing up. But you always have done that,
Speaker 1: and that's one of the sort of important lessons that
Speaker 1: I have taken from you. Thanks a lot. Okay, Carl,
Speaker 1: you take care and have a good trip. Okay, Great
Speaker 1: to see you, bro. Psychoactive is a production of I
Speaker 1: Heart Radio and Protozoa Pictures. It's hosted by me Ethan Naedelman.
Speaker 1: It's produced by Katcha Kumkova and Ben Cabrick. The executive
Speaker 1: producers are Dylan Golden, Ari Handel, Elizabeth Geesus and Darren
Speaker 1: Aronovski for Protozoa Pictures, Alex Williams and Matt Frederick for
Speaker 1: I Heart Radio and me Ethan Nadelman. Our music is
Speaker 1: by Ari Belusian and a special thanks to a Vivit Brio,
Speaker 1: sph Bianca Grimshaw and Robert Beatty. If you'd like to
Speaker 1: share your own stories, comments, or ideas, please leave us
Speaker 1: a message at eight three three seven seven nine sixty.
Speaker 1: That's one eight three three psycho zero. You can also
Speaker 1: email us as Psychoactive at protozoa dot com or find
Speaker 1: me on Twitter at Ethan Nadelman. And if you couldn't
Speaker 1: keep track of all this, find the information in the
Speaker 1: show notes. Tune in next time when I talk with
Speaker 1: Pat Denning, a longtime friend who's working at the cutting
Speaker 1: edge of harm reduction drug Tree. When we had prohibition
Speaker 1: in this country, the law of the land said alcohol
Speaker 1: is so dangerous, it's so poisonous, that no one should
Speaker 1: ever be allowed to consume it, And thirteen years later
Speaker 1: we made it legal again. To make that make any
Speaker 1: sense at all, we had to adopt this idea that
Speaker 1: there's this disease called alcoholism and some people have it
Speaker 1: and some people don't. That's an insane way of reintroducing
Speaker 1: a drug into society is by saying, oh, well, ten
Speaker 1: percent of you can't drink at all, and the rest
Speaker 1: of you can drink as much as you want to.
Speaker 1: It's a political ideology, it's not settled science. Subscribe to
Speaker 1: Psychoactive now see it, don't miss it.