Notes - Drug Use for Grown-Ups

Carl L. Hart | February 25, 2026

Chapter 1: The War on Us: How We Got in This Mess

Teaching at Sing Sing

Instruction at Sing Sing Correctional Facility involves navigating a dehumanizing environment where educators must surrender all electronics and undergo rigorous inspections. Guards often display icy indifference, forcing visitors to wait in small cages for up to an hour before they are permitted to proceed to classrooms. Inside, the student body is primarily black men, while the instructors are often white women. This setting highlights the obvious and fixable forces that hamper the economic mobility of black men. Finding a relative, such as a first cousin, serving twenty-five years to life for a drug-related homicide within this system underscores the personal toll of these social structures.

The Real Purpose of the War on Drugs

The campaign to eradicate psychoactive drugs is widely viewed as a failure because drugs remain as plentiful as ever despite a budget increase from $1.5 billion in 1981 to approximately $35 billion today. However, the war on drugs is a success for those it was designed to benefit: law-enforcement agencies, prison authorities, and parasitic organizations like drug-treatment centers and urine-testing outfits. Excessive drug arrests ensure overtime and job security for these entities. In states like New York, prisons are major employers for rural white communities, and in Pennsylvania, incarcerated individuals are counted as residents of the prison's jurisdiction to allocate financial resources, echoing a modern version of the three-fifths clause. Consequently, complex economic and social issues are reduced to "drug problems" to justify directing resources toward law enforcement rather than job creation or education.

Racial Differentiation in Drug Policy

The current response to the opioid crisis is often framed as a shift toward compassion because the public perceives white Americans as the primary victims. This results in treating drug use as a health problem rather than a crime, an approach not historically afforded to all citizens. During the "crack crisis" of the late 1980s, politicians called for draconian measures, including life sentences for selling small amounts and the deployment of military personnel. While most crack users were white, over 90 percent of those sentenced under harsh new laws were black. Media coverage at the time sympathetically portrayed white middle-class crack users as people managing stress, while black users were vilified. Similarly, the 1960s heroin crisis saw black users face mandatory minimum sentences under the Rockefeller drug laws, while white "patients" and returning Vietnam veterans benefited from an expansion of methadone maintenance programs.

The Reality of White Privilege and Racism

White privilege in the drug context allows affluent white individuals to travel with illegal substances with little fear of repercussion. Conversely, racism in drug-law enforcement leads to black people being four times more likely to be arrested for marijuana than white people, despite similar rates of use and sales. This systemic discrimination causes law enforcement to suspect nearly every black person of being a trafficker, regardless of their professional status or evidence to the contrary. Racism should be defined by actions that result in disproportionately unfair treatment of a specific racial group, regardless of whether malicious intent is present. Focusing on "implicit bias" can be a distraction that obfuscates obvious racism.

The Historical Right to Alter Consciousness

The Declaration of Independence guarantees the unalienable rights to life, liberty, and the pursuit of happiness, which arguably includes the right for autonomous adults to use substances to alter their consciousness. For most of American history, citizens were free to use over-the-counter concoctions containing opium and cocaine. Thomas Jefferson was a long-term user of opium-based drugs for both medicinal and mind-altering effects. Significant regulation only began when drug use became associated with "despised" groups: Chinese workers and opium dens, or black laborers and cocaine. Myths were created, such as the claim that cocaine rendered black men homicidal or impervious to .32-caliber bullets, prompting police to switch to .38-caliber weapons.

The Harrison Act and the Legislative Scapegoat

The 1914 Harrison Narcotics Tax Act was one of the first national drug laws and was passed by exploiting the myth of the "Negro cocaine fiend" to secure support from southern states. While the act sought to tax and regulate opium and coca products, its enforcement became increasingly punitive for those without social capital. This rhetoric has evolved over decades into modern narratives like "reefer madness" and "crack babies".

Misinformation in the Opioid Crisis

Sensationalistic media coverage of the current opioid situation often continues the tradition of vilifying specific members of society while restricting civil liberties. The risk of fatal overdose is frequently overstated; while possible with a single drug, many deaths involve contaminated substances or combinations with other downers like alcohol or nerve-pain medication. Addiction is also less common than suggested, affecting less than one-third of heroin users and less than one-tenth of those prescribed opioids for pain. Beating childhood trauma is often a greater challenge for individuals than beating heroin. Despite this, new "get tough" policies, such as murder charges for those who share drugs that lead to an overdose, are fueled by the mistaken perception that most traffickers are black or Latino. In reality, more than 80 percent of those convicted of heroin trafficking are black or Latino, even though most sellers are white.

Personal Insights and Practical Applications

Opioids like heroin, oxycodone, and morphine can produce a pleasurable calmness and facilitate bliss. For some, these substances function as a tool to mitigate the anguish of living in a society that imposes childlike status on black men through racism. Responsible drug use involves meeting parental, professional, and personal obligations while using substances that work for the individual. Prohibiting the pursuit of pleasure for baseless reasons is un-American and a violation of the foundational principles of liberty. Adults should have the legal right to sell, purchase, and use recreational drugs, with safety strategies and competence requirements similar to those applied to driving or gun ownership.

Chapter 2: Get Out of the Closet: Stop Behaving Like Children

The Stigma and Personal Risk of Disclosure

Publicly acknowledging the use of illegal drugs, especially for a professional in a field like neuroscience, carries immense personal and professional risks. Fear of being exposed as a drug user forced many responsible adults into a "closet," which allows society to maintain a caricature of drug users as troubled or irresponsible. Remaining in this closet feels like a cowardly act that dishonors the efforts of historical icons like Rosa Parks, who faced far greater dangers to challenge unjust laws. Black men, in particular, are frequently relegated to a childlike status due to systemic racism, making the requirement to conceal an activity they enjoy particularly difficult to stomach.

The Threat to Parental Rights

Disclosing drug use to medical professionals can trigger investigations by child welfare agencies, such as the Administration for Children’s Services (ACS), under the catchall term "parental neglect". ACS often seeks to remove children from their homes based solely on a positive drug test or acknowledged use, regardless of whether the parent is meeting all occupational, social, and parental responsibilities. In practice, a drug-positive urine test provides no information about a person’s level of intoxication or their actual ability to function as a parent.

In one case, a mother of five had her children temporarily removed simply because she and her newborn tested positive for marijuana by-products, even though the infant was healthy and the children were thriving. ACS investigators attempted to turn the children into informants by interviewing them privately to ask if they had seen their mother smoking. While this specific case was eventually dismissed by a judge, it highlights how heartless bureaucrats can push families to the brink of disintegration over substance use that does not actually compromise parental duties.

Biological Parity and the Myth of "Killer" Drugs

Political rhetoric often falsely distinguishes between "soft" drugs like marijuana and "killer" drugs like heroin, but this is biologically ignorant. To produce an effect, a drug must bind to a unique receptor in the brain, and these receptors exist because the body produces its own endogenous chemicals that recognize them. Every human brain contains heroin-like (opioid) and THC-like (endocannabinoid) chemicals that perform vital life-sustaining functions, such as relieving pain, inducing sleep, and coordinating motor movements.

Neither heroin nor marijuana is inherently more "evil" than the other; rather, they produce different sets of potential positive and negative effects. For instance, while heroin is more likely to cause respiratory depression, marijuana is far more likely to cause temporary paranoia or disturbing perceptual alterations. In certain medical contexts, such as treating lethal dysentery, heroin is a life-saving tool. Classifying drugs based on a perceived moral hierarchy only decreases the likelihood that people will honestly report their use to professionals.

Decriminalization and the Portuguese Model

There is a critical distinction between decriminalization and legalization:

• Legalization permits the legal sale, acquisition, and use of a substance, much like current policies for alcohol and tobacco.
• Decriminalization, such as the model adopted by Portugal in 2000, keeps the sale of drugs illegal but ensures that acquisition, possession, and use for personal use (up to a ten-day supply) are not criminal offenses.

In Portugal, the number of heroin users dropped from 100,000 to 25,000 after decriminalization was implemented. Furthermore, Portugal now has the lowest rate of drug-induced deaths in Western Europe, with 6 deaths per million compared to 312 deaths per million in the United States.

Events like the Boom Festival in Portugal allow thousands of people to commune and use psychoactive substances without fear of arrest. Services like "Kosmicare" at these festivals provide "grounding" for those having intense experiences, focusing on safety and comfort rather than trying to "fix" the user. A vital, potentially life-saving service provided at such events is anonymous drug-purity testing, which allows users to identify dangerous adulterants in their substances.

Liberty and Individual Responsibility

Liberty is impossible without responsibility, which requires ongoing self-inspection and respect for the rights of others. Being a "grown-up" means meeting all life responsibilities—parental, occupational, and social—while planning drug use to minimize disruption to these activities. The alternative to this individual responsibility is a revolting level of government paternalism that dictates what adults can put into their own bodies.

The average person often chooses the illusion of safety over the reality of freedom, but any life worth living involves risk. The government’s role should be to provide accurate, unbiased information—such as ingredient lists and warning labels—to help citizens make their own risk-to-benefit calculations. Denying adults the right to make these decisions regarding recreational drugs is a Frustrating and hypocritical exception to the liberties protected by the Constitution.

Comparative Risks: Guns, Cars, and Alcohol

The justification for banning specific drugs is often based on "inherent danger," yet many legal activities are far more lethal:

• Guns: Specifically designed to kill, firearms cause approximately 40,000 deaths annually in the U.S., yet their ownership is a protected right.
• Cars: Driving is a potentially deadly activity that kills over 40,000 Americans each year, yet no one suggests banning automobiles.
• Alcohol: Nearly 100,000 Americans die from alcohol-related causes each year. Unlike heroin, alcohol can cause severe, fatal liver damage and carries the risk of death from withdrawal—a danger that does not exist with heroin withdrawal.

In 2017, heroin-involved deaths peaked at just over 15,000, a number significantly lower than both gun and alcohol deaths. Most of these heroin deaths were not caused by the drug itself but by contamination with potent fentanyl analogs or the dangerous combination of heroin with other sedatives.

The Danger of Forced Silence

The current prohibitionist regime impedes vital communication between drug users and health-care professionals. This silence leads to increased health risks because users are more susceptible to misinformation and less likely to receive life-saving data about drug potency and interactions. For example, many users unwittingly combine heroin with benzodiazepines (like Xanax) or other sedatives, which dramatically increases the risk of overdose. If drugs were legal and regulated, communication would improve, and quality control would eliminate many of the accidental deaths caused by street-market uncertainty.

Chapter 3: Beyond the Harms of Harm Reduction

The Problem with “Harm Reduction” Language

The current approach to assisting drug users is often labeled "harm reduction," which refers to strategies intended to minimize the negative consequences of drug use, such as providing clean needles to prevent infection or advising hydration when taking stimulants. While these measures are practical, the term itself carries heavy negative connotations, often evoking images of belligerent individuals in need of saving. By focusing exclusively on "harm," the language fails to capture the complexity of the experience and ignores the primary reason people use drugs: to enhance experiences and achieve euphoria or pleasure. This terminology effectively relegates drug users to an inferior status, implying that only "feebleminded" souls would engage in an activity that supposedly only produces harmful outcomes. A more multifaceted and flexible alternative is “health and happiness,” a phrase that recognizes the positive features of the experience while still prioritizing safety. This new framework aligns drug use with other adult activities, such as driving a car, where "health and happiness" strategies include wearing seatbelts and maintaining brakes. Pursuing happiness through certain substances is a discovery made by millions of Americans and is a right supported by the ideals of the Declaration of Independence.

Opioid Crisis: Flaws in Data Collection and Reporting

Sensationalist media headlines frequently claim that opioids were responsible for the vast majority of global drug deaths, but the evidence for these claims is often weak. In the United States, mortality data is collected from death certificates filled out by investigators with vastly different levels of training. While medical examiners are physicians specialized in forensic pathology, many jurisdictions rely on coroners, who are elected officials often required to have no medical training at all. These systemic defects lead to significant variations in how cause-of-death data is reported. Furthermore, most drug-related deaths involve more than one substance, and since concentrations are often not determined, it is nearly impossible to attribute a death to a single drug. An "alternative math" is sometimes used where a single death involving three drugs is recorded as three separate overdoses, which artificially inflates the death toll. Additionally, death certificates frequently omit specific drugs entirely or ignore the role of alcohol, which can cause fatal respiratory depression on its own or in combination with other sedatives.

The Fentanyl Scare and Contamination

Fentanyl is an FDA-approved medication that has been used safely and effectively for treating severe pain for nearly sixty years. Panic surrounding the drug ignores the fact that many recreational users intentionally purchase and enjoy fentanyl for its pleasurable and anxiety-suppressing effects. The primary danger of fentanyl is not the drug itself, but its extreme potency compared to heroin; as long as the user is aware of the dose, this potency can actually be a beneficial feature because smaller amounts are easier to transport. The real "opioid crisis" is a crisis of ignorance caused by the unscrupulous practice of illicit manufacturers adding fentanyl to heroin batches or counterfeit pills to save money. Unsuspecting users who believe they are ingesting a single opioid may accidentally take a fatal dose due to this contamination. Similarly, party drugs sold as MDMA sometimes contain dangerously high doses of the substance or are adulterated with unknown, toxic compounds.

Practical Solutions: Drug-Safety Testing

One of the most effective ways to prevent accidental deaths is to provide universal, free, and anonymous drug-safety testing services. This allows users to submit a sample, determine its actual contents and dose, and then make an informed decision about whether or how much to take. Although these services have been successfully implemented in countries like Spain, Portugal, and Switzerland, they are virtually nonexistent in the United States. Resistance to these services often comes from public health officials who worry that testing will be perceived as an endorsement of drug use. This moralistic perspective prioritizes the appearance of condoning use over the practical goal of saving lives. In the United Kingdom, organizations like The Loop conduct testing at festivals, but their effectiveness is limited because they often collaborate with police and only test confiscated or surrendered drugs rather than allowing direct submissions from all attendees. During the Parklife Festival, testing revealed that popular "Punisher" pills contained 250 mg of MDMA—more than double the typical dose—allowing volunteers to warn users about the unusual strength.

Four Pillars of Responsible Drug Use: Dose, Route, Set, and Setting

To facilitate health and happiness, drug users should focus on four critical factors: dose, route of administration, set, and setting.

• Dose: This is the amount of drug taken and is the most crucial factor in determining the outcome. While high-THC marijuana is often labeled as "dangerous" compared to the weed of the 1960s, most experienced users simply adjust by inhaling less, much like a person drinks less vodka than beer.
• Route of Administration: The speed at which a drug reaches the brain determines the intensity of its effects. Swallowing a drug is generally safer because it allows for stomach pumping in an overdose, but it is subject to "first-pass metabolism" where the liver breaks down some of the drug before it reaches the brain. Snorting, smoking, and injecting bypass the liver and provide faster, more intense highs, but injecting carries the highest risks of infection and overdose.
• Set: This refers to the individual’s internal state, including mood, physiology, expectations, and tolerance. Being well-rested and well-nourished increases the likelihood of a positive experience, while tolerance can actually serve as a protective factor against overdose.
• Setting: The environment in which use occurs—social, cultural, and physical—powerfully influences the drug experience. A supportive setting with access to medical aid and education leads to more enjoyable outcomes.

Drug Users on the Margins and Supervised Consumption

Mortality rates related to drug use are highest in economically distressed regions with low rates of education, suggesting that poverty and ignorance, rather than the drugs themselves, are the primary killers. Marginalized users often inject in unsanitary secluded places like alleyways or public toilets to avoid arrest, which increases the risk of abscesses, infections, and undetected overdoses. Supervised drug-consumption sites are a vital part of a continuum of care, allowing individuals to use substances under medical supervision where they can be saved if an overdose occurs. These facilities, currently available in Canada and Switzerland, provide clean kits and connect users to other essential health-care services. The ultimate goal should be to use knowledge of pharmacology and human behavior to support the health and happiness of all citizens, rather than forcing them into the shadows.

Chapter 4: Drug Addiction Is Not a Brain Disease

The Culture of Scientific Indoctrination

The National Institute on Drug Abuse (NIDA) funds nearly 90 percent of the world’s research on recreational drugs, and its director, Dr. Nora Volkow, is a fierce defender of the brain-disease model of drug addiction. Scientists who study drugs often feel pressured to rubber-stamp the positions of NIDA leadership for fear of losing grant funding or other professional perks. This environment encourages scientists to overstate the negative impact of recreational drug use on the brain while essentially ignoring any beneficial effects. Internal pushback against this narrative is rare; for instance, a senior NIDA scientist once privately praised a paper critical of methamphetamine brain research but requested that his support remain secret because it was "not popular" within the institute. Consequently, the behavior expected of these professionals often resembles that of children rather than autonomous adults.

Methodological Flaws in Brain-Imaging Studies

Brain-imaging techniques such as MRI, PET, and fMRI are frequently used to produce "sexy" images that claim to show drug-induced brain damage, yet these images rarely present actual data. A major problem in the scientific literature is that researchers often draw conclusions that go far beyond the data they collect. For example, many studies conclude that methamphetamine users are brain-damaged even when the evidence is weak. This overinterpretation is a "cardinal sin" in science. Furthermore, the simplistic idea that pleasure is solely the result of dopamine release in the nucleus accumbens has led many to wrongly assume there must be meaningful brain differences between drug users and non-users.

Challenging the Brain-Disease Model

The influential position that addiction is fundamentally a brain disease was solidified by a 1997 editorial in Science by then-NIDA director Alan Leshner. However, this "holy writ" of drug science is often contradicted by actual evidence. In a study comparing the effects of intravenous cocaine and cocaethylene, initial biased beliefs that cocaethylene was more dangerous were proven wrong, as it actually produced fewer cardiovascular effects. Additionally, participants in research who are labeled "addicts" frequently behave with an impressive level of responsibility, showing up on time and complying with rigid study rules, which conflicts with negative stereotypes. NIDA’s mission statement historically focused only on "abuse and addiction," which effectively creates tunnel vision that ignores the beneficial effects representing the majority of research findings.

The Misuse of Technical Terms

Understanding the limitations of brain imaging requires distinguishing between structural and functional imaging.

• Structural Imaging (MRI): Provides high-resolution pictures of anatomy but offers no information on how the brain functions; the size of a structure does not determine its ability to accomplish a task.
• Functional Imaging (PET and fMRI): Provides information on brain activity but not anatomy.

A critical error in this literature is the use of terms like "alterations," "atrophy," or "deterioration" based on scans taken at a single time point. It is impossible to determine if drug use caused a difference unless multiple scans are completed over time for each participant, as the differences could have existed before drug use began.

Bias in Marijuana and Prenatal Research

A 2014 study claimed that even casual marijuana use could change the brain, yet the reported differences in the size of the nucleus accumbens were so small that experts could not reliably distinguish between the groups. The study failed to include behavioral or cognitive measures, meaning it could not comment on the actual functioning of the participants. Similar biases exist in prenatal drug exposure research. Studies often pathologize findings even when drug-exposed adolescents perform equally as well as controls on working-memory tests. Researchers frequently ignore their own data to tell a story consistent with the "drugs are bad" bias.

A Rigorous Example: The Johanson Study

One well-conducted NIDA-funded study compared methamphetamine addicts with non-addicts using PET imaging and cognitive tests. It found that while dopamine binding was 10 to 15 percent lower in methamphetamine users, there was significant overlap between the groups, meaning images could not be used to distinguish one from the other. Most importantly, the methamphetamine users were cognitively intact, and their performance was within the normal range for their age and education. Because the researchers used non-biased and cautious terms rather than sensationalistic speculation, the study received little media attention.

The High Cost of Fearmongering

Politicians and journalists often use "drug problems" to arouse public fear and garner influence. Addiction is frequently the sole focus of media coverage because it is "sexier" than responsible use, which is perceived as boring. This sensationalism has led to horrific outcomes, such as Philippine president Rodrigo Duterte justifying extrajudicial killings by claiming methamphetamine shrinks the brain. In the United States, unsubstantiated "neuro" claims helped justify the 100:1 sentencing disparity between crack and powder cocaine, a policy that predominantly targeted black citizens despite the fact that most users were white. The scientific community has largely ignored this racial discrimination, as researchers are overwhelmingly white and middle-class and do not live with the consequences of their biased arguments. [i]

Chapter 5: Amphetamines: Empathy, Energy, and Ecstasy

The Global Misunderstanding of "Shabu"

The public perception of methamphetamine, often called "shabu" in Southeast Asia, is dominated by extreme narratives that justify brutal drug-control strategies, such as extrajudicial killings in the Philippines. Philippine president Rodrigo Duterte has claimed that using the drug for a year or more will "shrink the brain," rendering users incapable of rehabilitation. These claims are used to justify a deadly campaign that has resulted in thousands of deaths. In Thailand, the perceived severity of the drug is so extreme that methamphetamine violations are punished ten times more severely than heroin violations. For example, one woman began a twenty-five-year prison sentence for possessing just one and a half pills, totaling about 35 mg of the drug. This dose is actually lower than the maximum daily dose of 60 mg approved for children in the United States to treat ADHD. Thailand now has the highest female-incarceration rate in the world because of such harsh drug laws. Despite these political narratives, there is no scientific evidence that typical doses of methamphetamine lead to violence or permanent brain damage.

The Adderall Comparison

A non-obvious fact is that methamphetamine and d-amphetamine, the active ingredient in the popular ADHD medication Adderall, are chemical siblings. The chemical structure of the two drugs is nearly identical, with methamphetamine possessing only one added methyl group. In the late 1990s, it was widely believed that this added methyl group made the drug more addictive by allowing it to enter the brain more rapidly, but human evidence has shattered this faith-based belief. In double-blind laboratory studies, experienced users could not distinguish between the effects of intranasal methamphetamine and d-amphetamine. Both drugs increase energy, enhance the ability to focus, and reduce the subjective feelings of tiredness or cognitive disruptions caused by sleep deprivation. Because they produce nearly identical effects, both have been used by militaries to manage fatigue and by professionals to enhance well-being. It is a practical reality that if a rapid onset is sought, snorting or smoking produces intense effects, but this intensity is a result of the route of administration, not a unique property of the drug itself.

The Myth of "Meth Mouth" and Immediate Addiction

The phenomenon of "meth mouth," characterized by extreme tooth decay, is often wrongly presented as a direct pharmacological consequence of the drug. While dryness of the mouth is a side effect of methamphetamine, it is also a side effect of Adderall and several antidepressants, yet these medications are not associated with reports of dental problems. Dental issues attributed to the drug are actually caused by nonpharmacological factors like poor dental hygiene and media sensationalism. Similarly, the idea that a person can become addicted after "only one hit" is a ridiculous claim with no foundation in evidence. Distortions in popular media, such as the show Breaking Bad, perpetuate false assumptions about the drug's effects and the nature of addiction. For instance, it is often falsely claimed that users get hooked because the drug fails to produce euphoria after the first couple of uses, leaving them only with their addiction. In reality, methamphetamine continues to produce euphoria and is an FDA-approved medication for treating obesity and ADHD.

Methamphetamine and MDMA: Overlapping but Distinct

While methamphetamine and MDMA (ecstasy) share an identical chemical makeup except for a methylenedioxy ring, they produce divergent effects on human behavior. In a laboratory setting, both drugs elevate blood pressure, heart rate, and euphoria, which are prototypical stimulant effects. However, MDMA tends to diminish the ability to focus and concentrate, whereas methamphetamine improves cognitive performance and speech. Outside the sterile laboratory, users report that MDMA is unique for producing intense feelings of connectedness, emotional openness, and empathy. A specific phenomenon known as "rolling" or "the waves"—intermittent intense feelings of pleasure and gratitude—is unique to MDMA. In an intimate setting, MDMA facilitates a level of empathy and openness that is far more pronounced than that produced by methamphetamine. These distinct effects suggest that MDMA is better suited for emotional exploration, while methamphetamine is preferred for alertness and mental stimulation.

The Crucial Role of Set and Setting

Drug effects are not determined by pharmacology alone; they are shaped by the interaction between biology and the environment, often referred to as "set and setting". "Set" refers to the individual’s mindset, personality, expectations, and physiological state, such as being well-rested and nourished. "Setting" encompasses the physical and social environment where the drug use occurs. Laboratory studies often fail to capture the true potential of amphetamines because they take place in sterile environments with strangers, which does not inspire the openness or intimacy users report in private, comfortable settings. For example, the empathy-enhancing effects of MDMA are most apparent when the drug is taken with an intimate partner in a sanctuary-like environment. Proper self-care, including regular exercise and nutritious eating, significantly increases the odds of experiencing primarily enjoyable drug effects while minimizing negative outcomes. Understanding these contextual factors is vital for any responsible adult seeking to use these substances to enhance their pursuit of happiness and well-being.

Chapter 6: Novel Psychoactive Substances: Searching for a Pure Bliss

The Experience of 6-APB

6-APB (6-[2-aminopropyl]benzofuran) is a novel psychoactive substance that is structurally similar to MDMA. It is described as a "nurturing" and "protective" drug that helps users embrace vulnerability and focus on things that truly matter rather than insignificant daily annoyances. The high is characterized as an "unadulterated joy" and "pure bliss" because it is incredibly gentle and long-lasting. Unlike many other substances, it allows for patient and intent listening, facilitating a state where the mind is open even when the mouth is shut.

Defining Novel Psychoactive Substances (NPS)

The term novel psychoactive substance is a catchall category for a wide array of compounds, including synthetic cannabinoids, synthetic stimulants, and other little-known mood-altering chemicals. These substances typically share two features:

• They resemble "classic" or "established" drugs like amphetamine or marijuana in their chemical structure and psychological effects.
• They are relatively new and often unknown to authorities, meaning they are frequently legally available through the internet and other sources.

Proliferation and the Dangers of Prohibition

A fundamental insight regarding these substances is that overly restrictive drug laws actually contribute to the proliferation of NPS. When a classic drug is banned, demand does not dissipate; instead, illicit manufacturers synthesize and sell novel alternatives to circumvent the law. For example, mephedrone is sold as an alternative to MDMA because they produce similar effects, though mephedrone's duration is shorter.

This proliferation carries significant health risks:

• Unknown Risks: Because these drugs are new, their associated risks are not as well-documented as those of established substances.
• Deceptive Substitution: New drugs are sometimes deceptively sold as established ones. If their pharmacological profiles differ significantly, the results can be fatal, such as when the potent opioid carfentanil is substituted for heroin.

The Spanish Model: Energy Control

In Barcelona, Spain, an organization called Energy Control provides an innovative and humane model for drug policy. They offer free, anonymous drug-safety testing services using gas chromatography to inform users of the exact chemical constituents in their substances. This approach respects adult autonomy and emphasizes safety over infantilization. In Spain, all drugs have been decriminalized since 1973, and responsible professionals often maintain personal stashes of tested pharmaceuticals without fear of criminal prosecution.

Synthetic Cathinones ("Bath Salts")

Synthetic cathinones, often referred to in the United States as "bath salts," are derivatives of cathinone, the psychoactive component of the khat plant. They produce stimulant-like effects similar to amphetamine, cocaine, and MDMA.

The "Zombie Drug" Myth

The 2012 "Miami cannibal" attack, where Rudy Eugene bit a man's face, was widely and falsely blamed on bath salts by police and the media. Toxicology results later showed no synthetic cathinones in Eugene’s system, only minute amounts of THC. The "zombie drug" narrative was likely used as a distraction to bury the racial angle of a police shooting involving a Black man. In reality, no recreational drug creates "superhuman strength" or incites that type of irrational violence.

Practical Application: Hexedrone (Hex)

Hexedrone (Hex) is a synthetic cathinone that produces effects strikingly similar to cocaine, including euphoria, energy, and increased sociability. Because its effects are not overwhelming or disorienting, it can facilitate substantive discussions and is considered useful for increasing affability at social events.

Synthetic Cannabinoids (K2 and Spice)

Originally synthesized for research into the endocannabinoid system (which regulates appetite, mood, pain, and sleep), these chemicals became popular as "legal" alternatives to marijuana.

The Cat-and-Mouse Game

The government’s response to these drugs has created a dangerous cat-and-mouse game. When authorities detect and ban one compound, such as JWH-018, manufacturers replace it with a more potent and less understood version to stay ahead of the law. This pattern jeopardizes user health because:

• Replacement drugs are often significantly more potent than the ones they replace.
• Package labeling rarely reflects the actual dose or drug contained inside.

The Brooklyn "Zombie" Outbreak

In 2016, a mass intoxication incident in Brooklyn was blamed on "synthetic marijuana" and dramatized by the media as a "zombie movie" scene. The actual culprit was AMB-FUBINACA, a synthetic cannabinoid 85 times more potent than THC. This outbreak of negative reactions is virtually unheard of in states where marijuana is legal, suggesting that expanding legal cannabis access is the most effective way to reduce the use of dangerous synthetics.

Political Hypocrisy and Societal Harm

The enforcement of restrictive drug laws often ignores scientific evidence and facilitates racism in law enforcement. Former Speaker of the House John Boehner serves as an example of political hypocrisy; he opposed marijuana legalization for thirty years, contributing to the criminalization of many, only to become an advocate for legalization after joining the board of a cannabis firm for profit.

Practical Application: Emotional Catharsis

Beyond recreational use, NPS like 6-APB can serve as a tool for nourishing the dispirited soul. It has been used to facilitate catharsis and healing following intense emotional distress, such as experiencing racial discrimination or the death of a loved one. Experiences with this drug can leave users feeling replenished and magnanimous, leading to the insight that such experiences could help people treat each other more humanely.

Chapter 7: Cannabis: Sprouting the Seeds of Freedom

Personal Benefits and Cognitive Effects

Marijuana can narrow focus to a single engaged activity by minimizing cognitive intrusions. For those navigating the perpetual mental war preparation required to face the perils of being black in the United States, cannabis helps place those anxieties in abeyance so they can be in the moment and enjoy it. The drug brings the music alive, allowing a listener to hear every instrument that might remain silent in a sober state. Contrary to stereotypical portrayals of the "stoner" as lazy or forgetful, research participants who smoke multiple joints daily have demonstrated impressive levels of responsibility, showing up on time for appointments and complying with stringent study rules that require planning and the inhibition of inconsistent behaviors.

Selective Enforcement and Deadly Justifications

In the southern United States and beyond, law enforcement and their supporters often oppose liberalizing cannabis laws because claiming to detect the odor of weed is one of the easiest ways for officers to establish probable cause. Judges almost never question this testimony. Officers have frequently cited the fictitious dangers of cannabis to justify the use of deadly force against defenseless black citizens. For example, the smell of weed was claimed as a sign of "imminent danger" to justify the shooting of Philando Castile, even though he had a permit for his firearm. Similar bogus defenses were used in the killings of Michael Brown and Keith Lamont Scott. Interactions with law enforcement initiated under the pretense of cannabis suspicion also led to the deaths of Ramarley Graham, Rumain Brisbon, and Sandra Bland.

Debunking the Intoxication Myth: The Case of Trayvon Martin

During the trial of George Zimmerman, the defense team utilized the "marijuana-crazed Negro" script to claim seventeen-year-old Trayvon Martin was aggressive and paranoid. However, his toxicology report showed only 1.5 nanograms of THC per milliliter of blood, a level suggesting he had not ingested marijuana for at least twenty-four hours. This amount is significantly lower than the sober, baseline levels of approximately 14 ng/mL found in daily users and far below the 40 to 400 ng/mL levels found necessary in experimental research to induce intoxication. Despite this scientific evidence, the introduction of the toxicology results created a sufficient "smokescreen" for the jury to acquit Zimmerman.

Reefer Madness Redux: The Psychosis Myth

The claim that "marijuana causes paranoia and psychosis" is misinformed rhetoric rather than empirical evidence. Psychosis is a clinical disorder characterized by a loss of contact with reality, yet most studies in this area do not involve clinical assessments by psychiatrists; instead, they rely on brief questionnaires that may count common experiences—like feeling uncomfortable in public—as "psychotic symptoms." While there is a correlation between marijuana use and psychosis, correlation does not equal causation. For instance:

• There is a stronger link between tobacco use and psychosis than there is for marijuana.
• Cat ownership in childhood is significantly more common in families where a child is later diagnosed with schizophrenia.
• A tenfold increase in marijuana use in the United Kingdom between the 1970s and 2000s was not associated with an increase in psychosis rates. The evidence suggests that individuals susceptible to psychosis are also susceptible to other problem behaviors, including early and heavy substance use, rather than the drug causing the disorder.

Challenging the Prenatal Exposure Stigma

While excessive drug use should be discouraged during pregnancy, the negative health consequences of prenatal marijuana exposure are frequently overstated. These exaggerations harm women by increasing the unwarranted stigma that can lead to the removal of children from their mothers or the incarceration of the mothers themselves. The totality of scientific evidence shows that on the overwhelming majority of measures, the cognitive performance of marijuana-exposed children does not differ from control subjects. Even when statistical differences are observed, they rarely equate to deficits or impact daily functioning. Placing children in foster care can be far more harmful to their development than their mother's cannabis use. Many parents who use drugs are good parents, and their children are clearly better off with them.

The Path to Legalization and Personal Liberty

There is a growing movement to liberalize weed policies, driven in part by the fact that marijuana is America's most widely used banned substance, making it difficult for the government to peddle distorted claims to a public with its own conflicting experiences. Federal law remains duplicitous, listing marijuana as a Schedule I substance with "no acceptable medical use" while the government simultaneously supplies pot to a select group of patients through a federal medical program. Support for legalization is at an all-time high, with 66 percent of Americans in favor as of 2018. Practical applications of legalization include:

• Tax Revenue: Colorado's marijuana taxes generated nearly $1 billion for its citizens between 2014 and 2018.
• Public Safety: Legalization ensures quality control, whereas unregulated markets lead to users consuming unknown substances.
• Social Justice: Ending the prosecution of marijuana possession helps reduce the racial discrimination inherent in drug-law enforcement. Marijuana high not only enhances pleasant moods but also promotes prosocial behaviors such as sharing, openness, and friendship. Enacting laws that forbid access to this pleasure-producing plant is both foolish and infantilizing to responsible adults.

Chapter 8: Psychedelics: We Are One

The Modern Appeal and Drug Exceptionalism

Psychedelic drugs have recently become fashionable among middle-class conventionalists who often frame their use as "spiritual journeys" or "plant medicine" rather than getting high. This "drug exceptionalism" involves mental gymnastics intended to distance psychedelic users from other drug users, a trend that is often magnified if the experiences occur in exotic locations under shamanic leadership. This elitism is problematic because it suggests psychedelics are a superior class of drug, yet many users do seem to become better, more conscientious people who sense a deeper connectedness with fellow humans. The term "psychonaut" is itself often used as a device to dissociate middle-class users from those labeled with disparaging terms like "crackheads" or "dope fiends".

Therapeutic Potential and Personal Freedom

Research over the last fifteen years has demonstrated that substances like ketamine and psilocybin produce beneficial outcomes, such as reducing depressive mood states and provoking personally transformative experiences. While microdosing has become a popular fad for treating ailments and improving performance, there is currently a lack of solid scientific evidence to support these specific applications. A common but arbitrary distinction exists in popular culture: using psychedelics for medicine or spiritual transcendence is seen as "cool," while using them simply to have a good time is not. This distinction ignores the reality that the alleviation of pain and the achievement of sacred insights are often indistinguishable from feelings of intense well-being and happiness. Jerry Garcia and the Grateful Dead embodied the idea that psychedelic use was a way to explore freedom and the unalienable right to pursue happiness. Garcia used various drugs, including cocaine and heroin, and believed that the pursuit of happiness was the ultimate basic freedom.

The Arbitrary Nature of Drug Classification

The way drugs are categorized is frequently discretionary and serves the purposes of those doing the classification. For example, MDMA is structurally an amphetamine, but it is categorized as a psychedelic by middle-class white professionals because they enjoy its empathy-enhancing effects. Conversely, methamphetamine is reviled as a "white-trash drug," even though it can produce transcendent moments and visual hallucinations at high doses similar to MDMA. Many seek visual changes like "trails"—discrete images following moving objects—from MDMA, though these typically only occur at large doses exceeding 250 mg. At typical recreational doses of 75 to 125 mg, MDMA primarily produces euphoria and empathy.

PCP: History, Science, and Myth

Phencyclidine (PCP), also known as angel dust, was developed in the 1950s as a safe and effective intravenous anesthetic, though it produced lingering depersonalization in some patients. It functions as a selective blocker of N-methyl-D-aspartate (NMDA) receptors, which are a subtype of glutamate receptors in the brain. Ketamine was developed by altering PCP and is also an NMDA receptor antagonist, but its effects are shorter-lived, making it more practical for medical use. While ketamine is now a breakthrough treatment for depression—working within twenty-four hours compared to the weeks required for traditional antidepressants—PCP has been largely abandoned due to unsubstantiated claims of extraordinary violence.

The Violent "PCP Fiend" as a Deadly Legend

The urban legend of the uncontrollably violent PCP user with "superhuman strength" and an immunity to pain is not supported by scientific evidence. A clinical review of nearly one hundred cases where PCP was alleged to cause violence found no actual connection between the drug and the violent acts. Despite this evidence, the myth persists and is used repeatedly as a police defense for the use of excessive force against black men. In the 1991 Rodney King incident, officers justified a savage beating by claiming King was "dusted" on PCP, though his toxicology only revealed alcohol.

Systemic Injustice and Forensic Failures

The case of Laquan McDonald, who was shot sixteen times by a Chicago police officer, highlights how the PCP myth is used to shield official misconduct. Initial police reports claimed McDonald lunged at officers with a knife while under the influence of PCP, but dashcam video later showed him walking away when he was shot. While PCP was found in his system, public reports failed to mention that false positives for PCP are common with various legal medications, including tramadol, venlafaxine, Xanax, and even Benadryl. Furthermore, the officer involved received a significantly reduced sentence—only six years and nine months—despite being convicted of second-degree murder and sixteen counts of aggravated battery. Similar justifications were used in the killing of Terence Crutcher, where video evidence clearly showed he was not being aggressive despite having PCP in his system.

A Responsibility for Advocacy

There is a troubling silence within the psychedelic community regarding the brutalization of fellow drug users targeted by the PCP myth. This silence may stem from a strategic desire to protect the reputation and legal progress of a select few "respectable" psychedelics like MDMA and psilocybin. However, true psychonauts have a responsibility to provide education and fight for the rights of all drug users, acknowledging that the freedom to experiment with one's own consciousness is a fundamental part of the pursuit of happiness. Organizations like the Multidisciplinary Association for Psychedelic Studies (MAPS) have been instrumental in pushing for the medical acceptance of psychedelics, motivated by the belief that these substances can help humans live more compassionately. Ultimately, the psychedelic community must reject drug elitism and recognize that they are part of a larger movement for liberty and humane treatment.

Chapter 9: Cocaine: Everybody Loves the Sunshine

The Brazilian Paradox

Cocaine use is often surrounded by a atmosphere of celebration and openness in certain high-status circles, such as in the VIP rooms of Bogota nightclubs where high-purity lines are shared among professionals. However, the reality of drug policy and its enforcement varies drastically by region and social class, a phenomenon best exemplified by the "Brazilian Paradox". In Brazil, a 2006 law was widely perceived as a progressive step that decriminalized all drugs, but in practice, it is a system of "depenalization" that remains a criminal offense.

The critical flaw in the Brazilian law is that it fails to quantify "personal use," leaving the distinction between a user and a trafficker to the discretion of street-level police officers. This lack of definition has led to a dramatic increase in drug-related arrests, which rose from 10 percent of all arrests in 2006 to nearly one-third of all arrests in subsequent years. The enforcement is heavily racialized: white individuals are often viewed as users and allowed to go home, while black and poor individuals are labeled as traffickers and sent to jail for months before ever seeing a judge. Consequently, while African-Brazilians make up about half of the general population, they represent 75 percent of the prison inmates.

Media and the Myth of the "New Jack"

In the United States, the response to crack cocaine in the 1980s followed a similar pattern of scapegoating a drug to avoid addressing systemic issues like unemployment and poor education. Cultural moralists used the perceived crack epidemic to delineate lines between "good and evil" and promote an us-versus-them mentality. A significant driver of this public perception was the 1991 film New Jack City, which dramatized sensational media reports and reinforced stereotypes of black youth as uniquely prone to savagery.

Interestingly, the "authentic" portrait of black urban crack use in New Jack City was written by Tom Wright, a white man from Idaho who was asked to stay home during the film's premiere to protect its marketing image. The script was later "massaged" by Barry Michael Cooper, who introduced the term "new jack" to describe a "calculated novice" and called for tougher drug laws, arguing that black youth were "immune to the harsh punishment for drug trafficking". This dehumanizing depiction helped set in motion the era of mass incarceration in the U.S., where 85 percent of those sentenced for crack offenses were black, despite most users being white.

The Realities of Crack and Powder Cocaine

Scientific research into cocaine contradicts the hysterical narratives used to justify punitive laws. Thousands of doses of crack have been administered to research participants without incident, showing that the drug's cardiovascular effects are generally comparable to intense exercise. Furthermore, nearly 80 percent of all illegal-drug users partake without developing problems like addiction.

Pharmacologically, crack and powder cocaine are the same drug; the only difference is the route of administration (smoking versus snorting or injecting). Despite this scientific reality, the 1986 Anti–Drug Abuse Act established penalties one hundred times harsher for crack than for powder cocaine, a disparity that was only reduced to 18:1 in 2010—a change that still lacks scientific justification.

"New Jack Rio" and Cracolândias

Brazil is currently repeating the mistakes of the U.S. by targeting "cracolândias" (crack lands) in urban slums. These areas, typically located in favelas, are abandoned by the government and lack basic services like medical care and sanitation. Instead of providing aid, the state uses military and civil police to invade these communities under the guise of "public security".

The violence perpetrated by the state is extreme: in 2018, Brazilian police killed more than 6,100 people, a rate six times higher than in the U.S.. In Rio alone, police kill an average of four to five people daily, 70 percent of whom are of African descent. This state violence is encouraged by political leaders like Jair Bolsonaro, who suggested suspects should be shot "like cockroaches," and Wilson Witzel, who urged police to "aim at their little heads and fire!".

Hypocrisy and the Sunshine of Cocaine

There is a glaring hypocrisy in how cocaine is regulated for the powerful versus the marginalized. In the "Helicoca Incident," a helicopter belonging to a prominent senator’s family was found with half a ton of cocaine; the pilot was jailed, but the owners faced no prosecution and received their helicopter back. Similarly, a member of President Bolsonaro’s military detail was caught with 39 kg of cocaine in 2019.

For the poor, cocaine may provide a brief respite from the suffering of abject poverty and the cognitive dissonance of living in an obscene social landscape. When used responsibly, cocaine can be "sunshine to brighten up your day," increasing affability and euphoria. A practical tip for assessing cocaine quality is that wetter samples often indicate higher purity. Ultimately, the scapegoating of cocaine allows authorities to increase law enforcement budgets while avoiding the meaningful work of increasing educational and economic equity.

Chapter 10: Dope Science: The Truth about Opioids

The Complexity of Opioid Realities

The common verdict on opioids—that they ravage the country by causing immediate addiction and vast numbers of unexpected deaths—is far more complex than popular narratives suggest. A deliberate experiment with voluntary opioid withdrawal revealed that the experience is often sensationalized and misunderstood. Initial biases, even among scientists, often lead to uninformed assertions that chronic heroin use inevitably produces physical deterioration and body damage without actual evidence. Insights from medical professionals in Geneva, Switzerland, challenge these views, suggesting that heroin is actually one of the safest drugs when pharmacological considerations like dose and tolerance are carefully managed.

Heroin as a Medical Treatment

Heroin, which is morphine with two added acetyl groups, was originally marketed by Bayer Laboratories in 1898 as a nonaddictive cough suppressant. While it is now known that all opioids—including methadone, oxycodone, and fentanyl—can produce physical dependence, heroin remains an effective medical tool for pain relief in countries like Ireland and the United Kingdom. In clinical settings, heroin has been observed to be more effective at controlling psychotic symptoms, such as hallucinations, than traditional antipsychotic medications because it produces fewer debilitating side effects and generates positive feelings of well-being. Unlike antipsychotics, which are often "blunt tools" that cause heavy sedation and lethargy, heroin binds to mu (μ) opioid receptors to provide a dreamy sedation that can quiet voices in the heads of psychiatric patients.

Challenging the Myths of Addiction

The current narrative suggesting a high risk of addiction from medical use is largely false, as addiction rates among people prescribed opioids for pain range only from less than 1 percent to 8 percent. Furthermore, the vast majority of heroin users do not meet the criteria for addiction. Factors that actually increase the risk of addiction include being young, being unemployed, or having co-occurring psychiatric disorders. Heroin-assisted treatment (HAT) programs in Switzerland demonstrate that when medical and mental-health issues are addressed alongside social services like housing and employment, patients live responsible, productive lives. These individuals are reliably on time for their twice-daily treatments and function well as citizens, yet they are unfairly saddled with the lifelong label of "addict in remission" due to current diagnostic standards in the DSM-5.

The Reality of Opioid Withdrawal

Popular media depictions, such as those in the film Trainspotting, reinforce incorrect and harmful stereotypes by portraying opioid withdrawal as a near-death experience or a source of agonizing pain that drives users to savagery. In reality, mild heroin withdrawal is often comparable to a twenty-four-hour flu, involving chills, a runny nose, nausea, vomiting, and diarrhea. While the experience is unpleasant and can involve intense abdominal pain, it is not life-threatening, which stands in stark contrast to alcohol withdrawal, which can actually be fatal. Withdrawal symptoms do not equate to addiction; just as one would not label a person an "antidepressant addict" for experiencing symptoms after stopping medication, experiencing withdrawal from opioids does not inherently mean a person has a substance use disorder.

Practical Applications and Safety Warnings

The majority of opioid-related deaths are not caused by the opioid itself, but by ignorance and contamination. Fatalities are frequently the result of combining opioids with other sedatives like alcohol, benzodiazepines (Xanax), or antihistamines. For example, the concoction known as "lean" or "purple drank" is particularly dangerous because the combination of codeine and promethazine (a sedating antihistamine) dramatically increases the risk of fatal respiratory depression. Another non-obvious danger is the acetaminophen found in prescription pills like Percocet and Vicodin; excessive exposure to this additive is the number one cause of liver damage in the United States and can be more lethal than the low dose of opioid in the formulation.

Responsible Use and Public Policy

Responsible adult drug use is often a deliberate tool for maintaining work-life balance and mitigating the harms of stressful, pathology-producing environments. When used responsibly, opioids can enhance a person's ability to be empathetic, forgiving, and tranquil. Legalization would ensure quality control and uniform standards, virtually ending the consumption of contaminated drugs purchased on the illicit market. In the interim, providing free, anonymous drug-purity testing services is a practical approach to decrease accidental overdoses by informing users of harmful adulterants like fentanyl analogs. Ultimately, the first priority of law enforcement and public health officials should be to keep users safe rather than to arrest or infantilize them.