After five years of deliberation, Drug Enforcement Agency (DEA) has officially rejected a petition that would have reclassified marijuana under the Federal Controlled Substance Act. The drug is currently listed on Schedule I, meaning that it is viewed as having “no acceptable medical use in treatment,” and is therefore banned in the United States.

The proposed change would have moved marijuana to Schedule II, making it available by prescription nationwide. That would have been good for patients and scientists, and it would have represented a major step toward resolving the hypocritical mess that characterizes our current laws on marijuana.

Despite many peoples’ assumptions to the contrary, the current law does not ban scientific investigation into the harms and benefits of the drug, so moving marijuana to Schedule II won’t lead to major changes in research activity. It’s true that scientists studying marijuana must jump through multiple bureaucratic and regulatory hoops. But the same requirements apply to many other Schedule II substances. Nevertheless, dozens of scientists — myself included — have been engaged in such research for decades.

That is how we know, for example:

that the drug stimulates appetite in HIV-positive patients, which could be a lifesaver for someone suffering from AIDS wasting syndrome,

and

that marijuana is useful in the treatment of neuropathic pain, chronic pain, and spasticity due to multiple sclerosis.

It is therapeutic benefits such as these that have compelled citizens to vote repeatedly over the past two decades to legalize medical marijuana at the state level.

Today, 24 states and the District of Columbia allow patients to use marijuana for specific medical conditions. And yet Federal law still technically forbids the use of medical marijuana.

The inconsistency of Federal laws with these other programs and initiatives, and with the increasing number of studies demonstrating the medical usefulness of the substance, makes marijuana’s Schedule I status seem like medical and/or governmental hypocrisy, undermining peoples’ trust in the relevant federal agencies.

In fact, there is now a general sentiment among scientists that the failed war on drugs has biased the DEA against acknowledging any therapeutic potential of marijuana.

The agency has been sitting on the rescheduling petition for half a decade, and has only just now responded. It is hard to avoid the impression that the DEA’s leadership was stalling in hopes that the American public would forget about the petition.

Recently, DEA commissioner Chuck Rosenberg described the very concept of medical marijuana as “a joke.”

Perhaps it’s also a joke that a law enforcement agency has the final word on a medical issue.

As a scientist and educator, I am worried that we have lost credibility with many young people and with those seeking treatments for a variety of medical conditions because our current scheduling of marijuana ignores the scientific and medical evidence.

When we make decisions based on factors other than the available empirical evidence, we are less than objective, which means we are no longer acting as scientists.

As a result, I am further concerned that individuals most in need of our help and objective advice will reject other drug-related information from “official” sources, even when the information is accurate.

This can contribute to patients being more susceptible to seeking quackery in lieu of proven medicine, which can put them at unnecessary health risks.

It’s time we lessened the outsized influence of a law enforcement agency on medical decisions and started to rebuild our credibility as scientists on the marijuana issue.

Original post appears in Scientific American

Read More: www.drcarlhart.com.

After dozens of people in Brooklyn, NY had an adverse reaction to K2, I was invited on Errol Lewis’ NY1 show to talk about what we should do when something like this happens.

Watch and share this video if you care about public health, drug education, drug safety, and rational drug policy.

Originally published at www.drcarlhart.com on July 14, 2016.

Dr. Carl Hart is the Dirk Ziff Professor of Psychology in the departments of Psychology and Psychiatry at Columbia University. He is also the Chair of the Department of Psychology.

Talk to me @drcarlhart.

Required training will decrease the number of physicians willing to prescribe these medications, making it more difficult for patients to obtain opioids when medically indicated.

The New York Times asked me this question: Should Opioid Training for Doctors be mandatory? Below is my response.

Consistent with the long American tradition of avoiding the real issues when it comes to euphorigenic drugs, mandatory opioid training for physicians serves as another fantastic distraction but does not address the real problems.

The major concerns related to prescription opioids are overdose deaths and addiction. While it is possible to die from an overdose of an opioid alone, this is rare. Only about a quarter of the thousands of opioid-related deaths each year occur as a result of a single drug.

Combining an opioid with another sedative such as alcohol or a benzodiazepine causes the vast majority of these deaths. Public service announcement campaigns are needed with a clear message:

Don’t combine opioids with other sedatives!

In addition, the opioid overdose antidote naloxone should be made readily available to patients who are prescribed opioids. Naloxone now comes in multiple forms, including nasal spray, making it easier for family members, friends and caregivers to administer.

A less publicized but related concern is acute liver failure. Popular prescription medications Percocet, Vicodin and Tylenol 3 all contain a relatively low dose of an opioid in combination with a considerably larger dose of acetaminophen.

Excessive acetaminophen exposure is the leading cause of acute liver failure in the United States. Some individuals, seeking a heroin-like high, unwittingly risk liver damage by taking too many of these pills.

The problem here is not the opioid; it’s the acetaminophen.

Acetaminophen should be removed from opioid formulations. In the meantime, users need to be made aware of this potential fatal outcome.

Watch Video: morphine and heroin are same drug & other opioid facts.

“To be clear, the vast majority of opioid users do not become addicts, but a small number do.” -Dr. Carl Hart

To be clear, the vast majority of opioid users do not become addicts, but a small number do. One’s chances of becoming addicted increases if they are young, unemployed and have co-occurring psychiatric disorders. That is why, it is critically important to conduct a thorough assessment of the patient prior to prescribing opioids, paying particular attention to these factors.

The proposed training will not address these concerns. It will, however, place an additional burden on physicians. This will, in turn, decrease the number of physicians willing to prescribe these medications; thereby making it more difficult for patients to obtain opioids when medically indicated.

Furthermore, it has been well documented that physicians are less likely to prescribe opioids to blacks than to whites. This effect will certainly be exacerbated if the required training is implemented.

Mandatory opioid training for physicians serves as another fantastic distraction but does not address the real problems.”-Dr. Carl Hart

If we stay focused on data and the real issues, we can tailor our inventions to enhance public health and safety while decreasing the likelihood of racial discrimination.

Originally posted in New York Times

Read more drug science at drcarlhart.com and follow me on Twitter.

Nancy Reagan, one of the most influential first ladies of the 20th century, died on Sunday, March 6, 2016 at the age of 94.

Below is my interview with The Takeaway about Nancy Reagan’s infamous campaign.

Nancy Reagan’s “Just Say No” campaign was successful for people currently making a lot of money off of the war on drugs. — Dr. Carl Hart

The vast majority of people that use any of these drugs that we’re talking about don’t have a problem,” Hart says. “That tells you that the problem is not the drugs. The problem lies elsewhere.”

The text below is posted as written on WNYC.org:

The “Just Say No” mantra has stuck over the years partly because the Reagan’s were such effective communicators, Hart says. When they spoke to America from a couch in the West Hall of the White House, they looked like “the national parents,” he says.

The campaign pushed by the Reagan Administration and by Mrs. Reagan herself was “horrible” for most Americans because it oversimplified the nature and realities surrounding drug use.

In Hart’s perspective, the problem of drug abuse is connected to opportunity and unemployment, and mental illnesses, among other things.

Originally posted in The Takeaway

I will be at SXSW on Saturday, March 12th, at 5PM talking about my new series DOPE SCIENCE. See my website, drcarlhart.com for more info about the video project & book signing.

This clip below has spurred much discussion. This is a good thing. The accompanying essay provides some nuance and further education.

The long subway ride from DC’s airport to Silver Spring was unusually pleasant. It had been about an hour since I had taken a low dose of methamphetamine. It was my 40th birthday — October 30, 2006 — and I was headed to a National Institute on Drug Abuse (NIDA)-sponsored meeting.

A friend, who had a prescription for the drug, had given me a couple of pills as a gift, knowing that I was an expert on amphetamines but had never actually taken any myself. I sat on the train feeling alert, mentally stimulated, and euphorically serene.

And when the effects had worn off after a few hours, I thought, “that was nice,” worked out, and enjoyed a productive two-day meeting. Well, maybe not enjoyed — it was a NIDA meeting after all. But I didn’t crave the drug or feel the need to take any more. I certainly didn’t engage in any unusual behaviors — hardly the stereotypical picture of a “meth head.”

SO WHY IS IT, THEN, THAT THE GENERAL PUBLIC HAS SUCH A RADICALLY DIFFERENT VIEW OF THIS DRUG?

Perhaps it has something to do with public “educational” campaigns aimed at discouraging methamphetamine use.

These campaigns usually show, in graphically horrifying detail, some poor young person who uses the drug for the first time and then ends up engaging in uncharacteristic acts such as prostitution, stealing from parents, or assaulting strangers for money to buy the drug. At the end of advertisement, emblazoned on the screen, is: “Meth — not even once.” We’ve also seen those infamous “meth mouth” images (extreme tooth decay),wrongly presented as a direct consequence of methamphetamine use.

These types of media campaigns neither prevent nor decrease the use of the drug; nor do they provide any real facts about the effects of meth. They succeed only in perpetuating false assumptions.

Swayed by this messaging, the public remains almost entirely ignorant of the fact that methamphetamine produces nearly identical effects to those produced by the popular ADHD medication d-amphetamine (dextroamphetamine). You probably know it as Adderall®: a combination of amphetamine and d-amphetamine mixed salts.

YEAH, I KNOW. THIS STATEMENT REQUIRES SOME DEFENSE.

This is not to suggest that people who are currently prescribed Adderall should discontinue its use for fear of inevitable ruinous addiction, but instead that we should view methamphetamine rather more like we view d-amphetamine.

Remember that methamphetamine and d-amphetamine are both FDA-approved medications to treat ADHD. In addition, methamphetamine is approved to treat obesity and d-amphetamine to treat narcolepsy.

In the interest of full disclosure, I too once believed that methamphetamine was far more dangerous than d-amphetamine, despite the fact that the chemical structure of the two drugs is nearly identical (see figure).

In the late 1990s, when I was a PhD student, I was told — and I fully believed — that the addition of the methyl group to methamphetamine made it more lipid-soluble (translation: able to enter the brain more rapidly) and therefore more addictive than d-amphetamine.

It wasn’t until several years after graduate school that this belief was shattered by evidence not only from my own research, but also by results from research conducted by other scientists.

In our study, we brought 13 men who regularly used methamphetamine into the lab. We gave each of them a hit of methamphetamine, of d-amphetamine, or of placebo on separate days under double-blind conditions. We repeated this many times with each person over several days and multiple doses of each drug.

Like d-amphetamine, methamphetamine increased our subjects’ energy and enhanced their ability to focus and concentrate; it also reduced subjective feelings of tiredness and the cognitive disruptions typically brought about by fatigue and/or sleep deprivation.

Both drugs increased blood pressure and the rate at which the heart beat. No doubt these are the effects that justify the continued use of d-amphetamine by several nations’ militaries, including our own.

And when offered an opportunity to choose either the drugs or varying amounts of money, our subjects chose to take d-amphetamine on a similar number of occasions as they chose to take methamphetamine.

These regular methamphetamine users could not distinguish between the two. (It is possible that the methyl group enhances methamphetamine’s lipid-solubility, but this effect appears to be imperceptible to human consumers.)

It is also true that the effects of smoking methamphetamine are more intense than those of swallowing a pill containing d-amphetamine. But that increased intensity is due to the route of administration, not the drug itself.

Smoking d-amphetamine produces nearly identical intense effects as smoking methamphetamine. The same would be true if the drugs were snorted intranasally.

As I left DC and traveled home to New York, I reflected on how I had previously participated in misleading the public by hyping the dangers of methamphetamine.

For example, in one of my earlier studies, aimed at documenting the powerfully addictive nature of the drug, I found that when given a choice between taking a small hit of meth (10 mg) or one dollar in cash, methamphetamine users chose the drug about half the time.

For me, in 2001, this suggested that the drug was addictive. But what it really showed was my own ignorance and bias. Because, as I found out in a later study, if I had increased the cash amount to as little as five dollars, the users would have taken the money almost all of the time — even though they knew they would have to wait several weeks until the end of the study before getting the cash.

All of this should serve as a lesson on how media distortions can influence even scientific knowledge about the consequences of drug use.

It took me nearly 20 years and dozens of scientific publications in the area of drug use to recognize my own biases around methamphetamine.

I can only hope that you don’t require as much time and scientific activity in order to understand that the Adderall that you or your loved one takes each day is essentially the same drug as meth.

AND I HOPE THAT THIS KNOWLEDGE ENGENDERS LESS JUDGEMENT OF PEOPLE WHO USE METH, AND GREATER EMPATHY.

This essay was originally published on theinfluence.org. It and video can also be viewed at www.drcarlhart.com.

It is always a good time when I visit the Melissa Harris Perry Show on MSNBC. Recently I made another appearance to talk about Heroin, politicians, and opioid abuse.

If you like this video please share and help the science can spread. I’m on twitter and facebook.

Originally published at www.drcarlhart.com on November 19, 2015.

I went on All In With Chris Hayes to talk about drugs and drug hysteria. Below are a few topics we touched on:

1. Why did the NAACP team up with the KKK?
2. Did crack cause high unemployment?
3. What is the difference between a crack baby & a nicotine baby?
4. How did the hysteria around crack impact drug laws?
5. How many people use meth?
6. What is the difference between Meth and Adderall?

ANOTHER FACT: There is virtually no evidence that methamphetamine use causes tooth decay. — Dr. Carl Hart

You can find more drug facts on drcarlhart.com or you can catch me on Facebook at Carl Hart and Twitter @drcarlhart

An educated public is the way to defeat the war on drugs. Hit recommendation and share the data to inform others. Thanks.

“Marijuana has BEEN legal, it’s been legal for CERTAIN segments of our society and not other segments of our society.” — Dr. Carl Hart

I enjoyed this comical yet serious discussion about marijuana legalization with Larry Wilmore, Adam Carolla, Roland Martin, and Michelle Buteau

Originally published at www.drcarlhart.com on October 16, 2015. Follow me on Twitter and facebook.

Women’s bodies are highly policed in today’s society. Pregnant women’s bodies are even more policed. Long time African American model Beverly Johnson revealed in her biography how she once took drugs while she was pregnant. She also lost custody of her daughter. We might jump to judge her because we are told by doctors, politicians, social workers and others that everything you consume while pregnant can damage your child.

Prosecutors all over the country have targeted pregnant women who have taken drugs, in the interest of protecting their fetuses.

But what if the science of how drugs impact our body was not as solid as we might think?

Originally published at www.drcarlhart.com on October 9, 2015.

It was a balmy Miami night in early fall 1983, when I was just fifteen. Two of my friends — Derrick and Ed — decided that they were going to get me high. Ed drove us to the spot in Opa-Locka where he bought his weed. Then we parked at the end of some deserted street and smoked a couple of joints, listening to the mellow sounds of the Quiet Storm on 99.1 WEDR.

“Shit, I don’t feel nothin’,” I declared. “This ain’t shit.”

Derrick and Ed looked at me and then at each other. Laughing, someone said,

“Yeah, he fucked-up.”

I continued to insist I was fine and that I really didn’t feel any different than usual, but both of them just laughed and repeated,

“That nigga fuuuucked-up.”

Everything I said, every time I laughed or simply looked at one of them only confirmed — in their minds — that I was actually high. Of course, I didn’t think so.

In fact, I didn’t notice anything unusual at all until I got home. My sister Joyce took one look at me and said,

“Damn, you must be fucked-up.”

I brushed her off, as I had heard that earlier from my friends. In retrospect, I must’ve been acting a bit cautious and tentative, not like my usual bold self. My eyes were probably red or maybe I reeked of weed. I didn’t yet understand how marijuana affects consciousness and behavior.

Things started getting strange when I got to my room. I put on some music and tried to fall asleep but couldn’t. Suddenly, I felt like I was inside the beat. Feeling slightly panicked, I wondered what was happening. The song was surrounding me, throbbing, inescapable. It was a familiar track but I heard unfamiliar instruments. Every sound in the song was acute and intense. That wasn’t the way music was supposed to sound, or so I thought. My heart, too, seemed to have speeded up. I felt as though it was keeping time with the R&B rhythm. Was it unhealthy if it did that? Could it kill me?

This experience was thoroughly disconcerting. I knew I wasn’t usually so conscious of my heartbeat; I knew I didn’t usually find music so intense. I didn’t understand at all that this experience was supposed to be enjoyable.

My friends hadn’t briefed me on how to detect marijuana-related pleasurable effects or any other effects. All I knew was that I didn’t like having my senses or consciousness altered; it felt uncomfortably beyond my control. I found it disorienting and even slightly frightening.

As a result, I didn’t smoke marijuana again for at least two years.

But many more years would pass before I was taught how to detect and experience marijuana-related pleasurable effects. If only I were introduced to Becker’s work much earlier.

Becker’s major proposals are that people become regular marijuana users only when they learn to:

(1) smoke the drug in a way which will produce real effects;

(2) recognize the effects and connect them with drug use; and

(3) enjoy the sensations s/he perceives. Perhaps these ideas were controversial in 1953.

They aren’t today, as they not only apply to marijuana, but to all recreational drugs. Otherwise, it makes little sense to take a drug if it has no pharmacological effects.

And when it does have an effect — whether it is heroin or LSD or cocaine — the user needs to be made aware of the desired effects as well as the negative effects because they often accompany each other. But, with sufficient knowledge, one may be able to minimize less desired effects while enhancing the pleasurable ones.

The key, however, is knowledge. Becker’s emphasis on users gaining a deeper understanding of drug effects, as well as novices using in the presence of more experienced users, increases the likelihood that drug users will remain safe. It’s not difficult to see how these ideas extend beyond marijuana use.

Consider, for example, the country’s current focus on opioid overdoses. The likelihood of fatal drug overdoses decreases substantially if there are others present, so that timely medical attention can be received.

In my view this is the real contribution of Becker’s work, especially in light of the fact that people will always continue to get high.

In fact, each year in the U.S., more than 20 million Americans report regular illegal drug use. The most important concern for me is keeping users safe. The findings from Becker’s research more than 60 years ago go a long way in achieving this goal.

Originally published at www.drcarlhart.com on October 4, 2015.