Dr. Carl Hart on dopamine grifters, drug addiction, and the opioid crisis

Here’s a really enlightening discussion between Dr. Carl Hart and an acolyte (perhaps now former acolyte) of Andrew Huberman.

If you don’t know who Huberman is then firstly, lucky you, and secondly you can – should you so wish – get a whiff of his guff and grift in this episode of the Decoding the Gurus podcast – Andrew Huberman: Forest Bathing in Negative Ions.

Dr. Carl Hart, on the other hand, is a neuroscientist and psychologist. He grew up in the Carol City ‘projects’ neighbourhood of Miami Gardens, an area of Miami regarded as one of the most dangerous in the U.S. He’s now the Mamie Phipps Clark Professor of Psychology (in Psychiatry) at Columbia University and the author of two best-selling books: High Price: Drugs, Neuroscience, and Discovering Myself and Drugs Use for Grown-Ups: Chasing Liberty in the Land of Fear.

Dr. Hart’s neuroscience expertise specifically involve dopamine, including the role of dopamine depletion in Parkinsonism. At around 1 hr 9 mins into the video he responds to Huberman’s claims regarding dopamine. He doesn’t pull his punches.

But I recommend watching the video in its entirety.

‘Neurotransmitter’ discourse (‘serotonin this’, ‘dopamine that’, etc.) and Huberman’s manosphere ‘optimiser’ drivel are dealt with summarily – in a word, “Fraud!”

The lesson is simple:

“Whenever someone tries to distil complex behaviours to a single neurotransmitter you can stop listening.”

But ‘neurotransmitter discourse’ is symptomatic of a wider and far more serious problem of public misunderstanding of ‘drugs’ and their role in complex behaviour and social issues, which Hart deals with in the discussion with great patience and clarity.

‘Drugs discourse’ entails a set of misunderstandings that are deeply entrenched in all our societies and are among the root causes of a range of our worst global crises, not least because they continue to hinder long overdue reform to laws on drug control.

And whether through ignorance or downright dishonesty, all too many of us in the world of cannabis and other ‘nice drugs for nice (mostly white) people’ – ‘spiritual’ psychedelics and MDMA or ‘natural and ancient’ medicines like mushrooms and ayahuasca – are complicit in perpetuating these misunderstandings and the resultant hellscape:

Mass incarceration, massive flows of illicit money, corruption, civil war and state collapse in Central and Southeast Asia, racialized policing, over-prescription, and the greatest and most appalling of the horrors created by the War on Drugs, one most of the media have been content to pass by in near total silence…

Which is the reality that the decades-long Manichean quest against opiates on which America has led the world means that around 75% to 80% of the humanity has been denied access to adequate medication to treat chronic and acute pain.

That 80% is the world’s poor, naturally…

Meanwhile 92% of the global morphine supply goes to just 17% of the world population: Europe, Canada, New Zealand, Australia, and the United States

Perhaps just pause for a moment to really take in just what this very real state of affairs entails, when some 5.5 billion people lack access to proper pain relief treatment.

When where you’re born decides whether you get to undergo conditions such as endometriosis or liver cancer with adequate palliative care or experience them in all their raw agony…

Where moral righteousness and a Hobbesian approach to the world’s ills can wind you up….

Now ask yourself whether perhaps in some small way you’re complicit….

Those of us who are in one way or another progressive or enlightened on the topic of ‘drugs’ need to realize that a lot of this is on us. The War on Drugs is rooted in foundational myths which most of us believe to this day, despite ample research proving they’re largely based on fictions and ignorance.

‘Opium plagues’ and the ‘Opium Wars’ ravaged China in the 1800s, we are told – a classic case of the half-truths and ‘half-court tennis’ that informs western understanding of Asia to this day.

Most of us will know some version of this history.

Famine in China. La famine en Chine. Illustration for Le Petit Journal, 3 March 1907

But how many of us know about the vast famines, droughts and floods, civil wars, and epidemics of cholera that laid waste to China’s towns and villages decade after decade through the 1800s, waves upon waves of catastrophes that saw millions of ‘peasants’ in the countryside starve and die, selling their children (daughters, always) for food, while the survivors filled the slums of cities like Shanghai and Canton, half-dead, traumatised, and wracked with dysentery. This devastating spectacle was beheld and utterly misunderstood by Evangelist Christians on a mission to end (not without reason) Britain’s predatory narcocolonialism, and who put two and two together and came up with a brilliant, morally righteous solution: deprive these people of the one medicine that had kept them alive. Ban opium!

Or the ‘last plague’ of Egypt and the scourge of opium and heroin that ruined the Fellahin ‘peasantry’. Nowhere to be seen in the received wisdom on this sister foundational myth of the ‘Drug War’ is there talk of the perennial irrigation systems introduced to 1800s Egypt or the sudden resulting surge in Bilharzia from around 5% to anywhere up to 80% of the population, reducing the nation’s ‘peasantry’ to crippling, chronic ill health. Again, the same inspired solution, this time championed by Egypt’s modernising urban ‘Effendi’ elites: ban opium! And ban cannabis too!

And so were born the first systematic international systems of drug control, most notably in the 1920s at the League of Nations. Cut and pasted into the legislation of modern nation states, drug control laws pioneered in colonies such as Egypt and India brought us to where we are today, with systems of policing, ‘lunatic asylums’, surveillance, and prisons once used to discipline and punish the ‘natives’ now applied to the citizens of countries such as Britain or the United States – the dynamic of control and oppression of ethnic outgroups and the underclass nowhere more stark than in America, where mass incarceration is a nationwide phenomenon, and in states such as Alabama, de facto slave labour is alive and well.

This is what can be so tough for the righteous crusading progressive mind to grasp. Just as the rhetoric of Austrian libertarian bullshit is used as a front for systematic exploitation by tech corporations, its symmetrical inverse still addles the minds of most self-described liberals and enlightened lefties on the problem of drugs: every failing, ill, or shortcoming of the state, society, and even just the basic fucked-up mess of the human condition itself are liberally externalized onto whatever happens to be the ‘evil substance’ of our time. Once it was cannabis. Next it’s heroin. Now it’s meth and fentanyl. Track who ends up behind bars and what it’s really all about becomes all too clear. But still, we can’t quite get our heads round it….

There is a diagnosis for this psycho-political pathology of progressivism. Most of us still live on a diet of scare stories, studies (and stories based on them, such as the Sackler scandal) that only involve chronically addicted people and severely truncate the vast majority of human exposure to opiates, leaving us with a public understanding of these drugs and their ‘pathology’ that’s hopelessly biased and no more objective than the average racist’s views about immigrants or Muslims.

Prolonging that diet can result in conscious or unconscious refusal to engage with objective reality (past and present). Symptoms include an incapacity to objectively assess risk and a willingness to go along with unthinkably vast and sadistic infringements of human rights. How many books on the Sackler scandal give an account of the CDC definition of a “drug-involved overdose” and how those stats are compiled? How many mention what qualifications are required to become a coroner in US states? Do any mention how the crusade against opiates has led to withholding vital medicine from billions of the world’s poor – show a single footnote on what are, under international law, human rights abuses on a scale unequalled by any in history?

So, yes, we are still the Evangelicals taking away the opium from the skeletal ‘Chinaman’ for his own good. We are still the Effendis snatching away hashish from the Bilharzia-riddled farmer, because hashish is to blame for his condition.

Rumour has it that in severe cases of this ‘Drug War Progressivism’, individuals begin to believe that the real truth about these substances is being hidden from the public, there is a conspiracy afoot, and that electron microscopy of fentanyl, diacetylmorphine, or xylazine molecules would reveal orbiting clusters of tiny micro-witches, miniature top-hatted billionaires, little dancing black men, or even subatomic Jews….

You get the point….

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Absolutely nobody, nonexpert or expert, denies that some people develop problematic behaviours involving drugs or that the drugs themselves have objectively different characteristics, least of all neuroscientists like Carl Hart.

Some folks reading this are likely aware that in addiction psychiatry, in addition to the DSM and IDC definitions of addiction, there is a category ‘substance use disorder’. Most of us are likely to know someone who’s got a weed habit that the person themselves acknowledges is problematic (i.e., ‘disordered’ and ‘distressing’), and is ‘smoking their life away’….

Check current studies on Cannabis Use Disorder (CUD) and you’ll find the claimed range for CUD among cannabis users is anywhere from 10% to as high as 30%. In itself, that range is revealingly absurd. None of these problems reside in the substance themselves – and if they did, we’d all have CUD. But the crucial point to grasp is that seeking to reduce the behaviours involved in someone whose cannabis use is out of hand down to a single neurotransmitter or to an inherent property of cannabis itself serves only to narrow the focus away from whatever are the social and psychological problems that really need fixing – and can and should be fixed.

Addled thinking still afflicts even intelligent folks who are involved in this debate. They realize the urgent need to reform drugs laws, yet to varying degrees they’re still trapped in a ‘War on Drugs’ confusion that allows for any and every failing of government, society, education, or bad parenting to be projected onto drugs themselves. Try drawing a simple, rational, and objective comparison between the risk and deaths involved in drugs and those involved in driving a car or a skiing holiday and you’ll find it’s just too much for some folks – still…. Somehow or other drugs – some drugs; one decade this drug, the next decade another – belong in a class apart, the perfect scapegoat, the category of the intrinsically and irredeemably ‘Other’.

Sadly, what that means is these well-intentioned people are unwittingly in the service of the real criminals – the profiteers and sadists, whether the prison industry, militarized police, racist politicians, pharmaceutical corporations (including those looking to cash in on ‘nice drugs’ like MDMA or psilocybin), and last but not least the addiction industry – piling in on their bullshit a move in which all too many addicts (former or otherwise) are all too venally willing to comply, as are far too many of us in the world of cannabis, who can and should know better.

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Famine in China. La famine en Chine. Illustration for Le Petit Journal, 3 March 1907.

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