Carl Hart: Drug Use for Grown Ups (Book Review)



Having enjoyed Michael Pollan’s “How to Change Your Mind” on psychedelics (in particular psilocybin), I was intrigued by a book that goes much broader on drug use: Dr. Carl Hart’s “Drug Use for Grown Ups.” Hart is a professor of psychology at Columbia and is basing this book on both his research and his extensive personal experience. While I have one criticism (more on that later), the book makes a very strong case that drugs should be decriminalized broadly: not just marijuana, but everything, including drugs with such terrible reputations as meth and heroin.

Here are three insights I came away with: First, the majority of drug related deaths come from drug interactions (e.g. people drinking a lot of alcohol and then also taking a drug) or from accidental overdoses due to much higher potency of mixed in / substituted drugs (e.g. heroin stretched with fentanyl). So if you can be responsible on drug interactions, and well-informed on what you are consuming, you can dramatically reduce risk. Same goes for getting started slowly on dosage on anything you don’t yet have a tolerance for.

Second, the existing drug laws and their enforcement are terribly racially skewed. I sort of knew some of that but the total amount of evidence provided by Hart makes that case forcefully. For example, at one point the mandatory sentencing threshold for crack was a hundred times lower (5 mg) than that for cocaine (500 mg), despite these being the identical drug just (Read more...)