Carl Hart and Heroin Use

[DynamicDidactic]

Anyone have a perspective on this and generally heroin use?

Meet Carl Hart: parent, Columbia professor – and heroin user

In a startling new book, Drug Use for Grown-Ups, the Ivy League professor argues that the dangers of recreational drug use have been wildly overstated

www.theguardian.com

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[WisNeuro]

Heard about him before. At least from a neurological POV low level recreational use of some substances is really not that harmful, it's usually heavy use, or the indirect effects that do you in. The issue with some substances though, is that many people who use, will not be able to maintain merely recreational use. I'm all for decriminalization and legalization of most substances, but I think it's a terrible idea to normalize use of some of these as recreational.

 

[bluecolourskies]

I think I saw some research or poll taken awhile back that said legalization of marijuana caused people to see it as less harmful then they did before.
So I could see someone pulling this example out and saying "but this professor with a doctorate does heroin!!" in the same vein as "but Bill Gates dropped out of school!!"
No lol

 

[PsyDr]

Weighing the evidence:

1) Opinions of a self admitted heroin dependent individual, who says that cocaine is not bad for your heart, because he's never seen a heart attack caused by cocaine use.

2) Decades of peer reviewed literature indicating that cocaine is cardiotoxic, as is the metabolite produced when cocaine is used in combination with ethanol.

This isn't the late 1800s, he isn't William Stewart Halstead.

 

[Sanman]

The legalities of drug use and the ability to be a functional drug user are two different things. Legalization of drugs is such a politicized issue that often has little to do with the public good. There is a reason that drugs grown in this country are legal (tobacco, alcohol, more recently marijuana) and that those that are not grown here (drugs coming from cocoa and poppy plants) are illegal.

In theory, any drug can be used responsibly. Modern medicine is based on this practice. The bigger issue becomes the judgement of the user. How many people that are willing to engage in an illegal practice to obtain a drug and risk the consequences (both social and legal) are using sound judgment otherwise? Likely some, but what is that percentage?

 

[Justanothergrad]

The Bill Gates and school drop-out metaphor is great.

Exceptions to rules don't make good rules themselves.

 

[R. Matey]

It must be nice to have money and no co-morbid health problems.

 

[cara susanna]

A lot of what he's saying in that article is contradicted by research, or at least something you can't conclusively claim. For instance:

“I know that large doses of cannabis given to inexperienced people can trigger anxiety and paranoia that looks like psychosis but there is no evidence to say that cannabis causes schizophrenia or psychotic disorder.”

I attended a conference with a presentation on this topic and the evidence on the link between marijuana use and psychosis in adolescents was pretty convincing.

 

[R. Matey]

“I know that large doses of cannabis given to inexperienced people can trigger anxiety and paranoia that looks like psychosis but there is no evidence to say that cannabis causes schizophrenia or psychotic disorder.”

It's also a bit misleading as proving causality conclusively is difficult.

 

[bluecolourskies]

A lot of what he's saying in that article is contradicted by research, or at least something you can't conclusively claim. For instance:

“I know that large doses of cannabis given to inexperienced people can trigger anxiety and paranoia that looks like psychosis but there is no evidence to say that cannabis causes schizophrenia or psychotic disorder.”

I attended a conference with a presentation on this topic and the evidence on the link between marijuana use and psychosis in adolescents was pretty convincing.

Yes that stuck out to me too! He really said "there is NO evidence to say that cannabis causes schizophrenia". But maybe "triggers existing genes" and "causing a psychotic disorder" are two different things.

 

[Ollie123]

Disclaimer: I've met Carl a few times and know several of his former trainees. I was aware of his drug use history (he has been open about that for years), but not ongoing use of anything besides cannabis. I'm mildly surprised, but far from shocked.

While the nature of the content is obviously wildly different than what we may be used to seeing, I think this is a classic case of academic overstating their case in a public messaging effort. Many of his points are backed by decades of rigorous science and have absolute merit. Many individuals can use illicit drugs without experiencing problems. Many "addicts" can make rational decisions regarding drug use. The neurobiological effects of drugs are often wildly overstated. These are all fundamentally true. The positive effects of drugs are downplayed or ignored in science and I think that is ultimately holding us back from making real progress on this issue. I could give a whole seminar on where I think NIDA and other similar entities have steered us wrong with regards to understanding and addressing problems related to drug use.

That said, I can't disagree with most of what has been posted either. Cocaine is indisputably cardiotoxic and can easily wreak havoc administered in the wrong dose to the wrong person. Carl absolutely knows this. I think he views this as politics and offering a counterpoint to the mainstream. Largely as a social justice issue because of the impact the broader discourse has had on already disadvantaged communities. I'm guessing - obviously only he can speak to his true motivations.

Maybe there is something to that, but I think he (significantly) oversteps in some of these statements.

 

[Sanman]

A lot of what he's saying in that article is contradicted by research, or at least something you can't conclusively claim. For instance:

“I know that large doses of cannabis given to inexperienced people can trigger anxiety and paranoia that looks like psychosis but there is no evidence to say that cannabis causes schizophrenia or psychotic disorder.”

I attended a conference with a presentation on this topic and the evidence on the link between marijuana use and psychosis in adolescents was pretty convincing.

Though I am not intimately familiar with the studies mentioned, I think a big issue in studying anything in the area is no one has any idea what is actually in these drugs aside from the ingredient that gets you high. So, I don't trust anyone that makes definitive statements in either direction.

 

[cara susanna]

Disclaimer: I've met Carl a few times and know several of his former trainees. I was aware of his drug use history (he has been open about that for years), but not ongoing use of anything besides cannabis. I'm mildly surprised, but far from shocked.

While the nature of the content is obviously wildly different than what we may be used to seeing, I think this is a classic case of academic overstating their case in a public messaging effort. Many of his points are backed by decades of rigorous science and have absolute merit. Many individuals can use illicit drugs without experiencing problems. Many "addicts" can make rational decisions regarding drug use. The neurobiological effects of drugs are often wildly overstated. These are all fundamentally true. The positive effects of drugs are downplayed or ignored in science and I think that is ultimately holding us back from making real progress on this issue. I could give a whole seminar on where I think NIDA and other similar entities have steered us wrong with regards to understanding and addressing problems related to drug use.

That said, I can't disagree with most of what has been posted either. Cocaine is indisputably cardiotoxic and can easily wreak havoc administered in the wrong dose to the wrong person. Carl absolutely knows this. I think he views this as politics and offering a counterpoint to mainstream. Largely a social justice issue because of the impact the broader discourse has had on already disadvantaged communities. Maybe there is something to that, but I think he (significantly) oversteps in some of these statements.

You summarized what I was thinking--I see his points but I think he's going a bit too far in what he's saying--much better than I could ever put it. Also, I would love to hear that seminar!

 

[foreverbull]

There is solid data backing the disproportionate convictions/lengthy sentences handed out to Black individuals vs. white with drug possession and/or related offenses, so I’m in agreement with him there.

I do think his argument sounds extreme and very controversial, perhaps as alluded here, intentionally so.

Do we throw out the biological addiction paradigm and just say “it’s not as bad as the government told you, so shoot up?”

The effects of drug addiction in poor communities (ie Appalachia, rural areas) and communities of color are far-reaching, which is an area Hart interestingly doesn’t touch in the article, if I recall correctly.

I’m not against legalization of marijuana or mushrooms/LSD for adults to use recreationally (no way to overdose on these and less convincing addictions research), I’m just not sure about the harder drugs that can kill you from underlying conditions or overdoses. Or you know, meth eating your insides out in real time.

The article just sounds unnecessarily extreme and dismissive of research and theory/experiences regarding addiction. But I don’t doubt this will garner a lot of attention. I’m not an extremist on this issue by any means, so I’d like to see a more balanced perspective.

 

[futureapppsy2]

Not to take away from the important and necessary conversation on drug policies and racism, but all I could think of was this: Meth Actually Not That Bad For You, Report Doctors Dismantling Stereo

 

[justalittlestar]

Thanks for this thread. Not in psychology but have endless curiosity about how some health professionals felt about the topic.