ADULT DRUG USE: LESS MORALISM AND MORE RATIONAL UNDERSTANDING, PLEASE. Carl L. Hart Chair and Professor, Department of Psychology Columbia University

Transcription

1 ADULT DRUG USE: LESS MORALISM AND MORE RATIONAL UNDERSTANDING, PLEASE Carl L. Hart Chair and Professor, Department of Psychology Columbia University drcarlhart.com

2 I once served in the U.S. Air Force ( )

3 I now give drugs to research participants

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5 1. Drug Miseducation is the Standard U.S. public bombarded with lurid misinformation calculated to terrify e.g., heroin education

6 Pick up heroin and you ll throw away everything you love

7 2. Drug use is rational (Yes, even heroin use) What does heroin do? Why might someone use heroin? What about addictive potential?

8 3. Most drug users do not become addicted

9 Drug users sometimes become President

10 A major points is

11 The points is most people who use drugs don t need jail or to be treated medically. They need to be treated humanely

12 The points is most people who use drugs don t need jail or to be treated medically. They need to be treated humanely simply knowing that a person uses a drug, does not provide enough information to tell whether that person meets their obligations

13 It also means Lynn Paltrow + drug test

14 The points is Lynn Paltrow + drug test - amount - frequency - addiction - neglect - abuse

15 Increasing Importance of Marijuana 29 states, plus DC, Guam, & Puerto Rico, allow patients to use marijuana for specific medical conditions 9 states allow adults to purchase and use the substance for recreational purposes

16 Assumption: Drug use inevitably harms developing fetus

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19 Led us to conduct a major review of the literature

20 Small number of researchers, but large number of measures research groups published studies cognitive measures

21 Major Findings Of the 402 cognitive measures: No group differences on 89% MJ-exposed group performed more poorly on 9% MJ-exposed group performed better on 2%

22 Major Findings Of the 402 cognitive measures: No group differences on 89% MJ-exposed group performed more poorly on 9% MJ-exposed group performed better on 2% Clinical/functional importance?

23 Control MJ-exposed normal range Statistical difference do not equate to deficit Measure of IQ * Non-exposed MJ-exposed A statistical difference? 85

24 Major Findings Of the 402 cognitive measures: No group differences on 89% MJ-exposed group performed more poorly on 9% MJ-exposed group performed better on 2% Clinical/functional importance? One study (Goldschmidt et al. 2008) found evidence of functional deficits on a quantitative reasoning test

25 Bottom Line The current evidence does not suggest that prenatal cannabis exposure alone is associated with clinicallyrelevant cognitive functioning deficits Most research conducted by few groups of researchers Research funded primarily by NIDA

26 Despite the empirical reality, researchers frequently warn women should be advised not to use these substances during pregnancy and that the exposed offspring may have long-term subtle deficits.

27 Erring on the side of caution? But, there are consequences Journalists write articles consistent with these half-truths Films and Public Service Announcements depict drug users based on these distortions Misguided drug policy often based on these exaggerations

28 Why the exaggerations? Because: Specific groups benefit» law enforcement, treatment providers, politicians, the media, scientists

29 Why the exaggeration? Because: Specific groups benefit» law enforcement, treatment providers, politicians, the media, scientists it allows us to avoid dealing with real problems of the poor» unemployment, substandard education, low income

30 Why the exaggeration? Because: Specific groups benefit» law enforcement, treatment providers, politicians, the media, scientists it allows us to avoid dealing with real problems of the poor» unemployment, substandard education, low income it allows us to target people we don t like without explicitly saying so

31 4. Racial discrimination (racism) is rampant in drug law enforcement

32 Defining Racism an action(s) that results in disproportionately unjust or unfair treatment of persons from a specific racial group

33 Defining Racism an action(s) that results in disproportionately unjust or unfair treatment of persons from a specific racial group Intent is not required

34 Crack & powder cocaine are the same drug Powder Cocaine Crack Cocaine

35 Now Infamous Federal Cocaine Laws Anti-drug Abuse Acts of 1986 & years no parole 10-years no parole Crack 5 grams 500 grams Powder 500 grams 5 kilos 1-to-100 Ratio

36 More than 80% of individuals sentenced for crack cocaine are black Clear example of racism

37 New Federal Cocaine Laws Fair Sentencing Act of years no parole 10-years no parole Crack 28 grams 280 grams Powder 500 grams 5 kilos 1-to-18 Ratio

38 Opioid crisis provides another opportunity to exert racism in drug law enforcement While not solving the problem

39 Gov. of Maine (LePage) on Heroin traffickers

40 NEW FLASH!!! The drug problem has little to do with drugs Has everything to do with:» Economic opportunities» Subjugation of despised groups» Apathy (even contempt) towards the less fortunate

41 Otherwise policy would be based on pharmacology We would disseminate lab practices to keep ppl safe

42 Basic drug education: Specific drug combinations increase lethality Dose crawl before walking Route of administration edibles vs. smoked User s experience (set) importance of developing tolerance Environment (setting) drug use alone OR with experienced people

43 Otherwise policy would be based on pharmacology We would disseminate lab practices to keep ppl safe policy would be based on respect for persons Drugs availability would be treated like sex, cars, or guns

44 Recap Drug miseducation is the standard Drug use is rational Most drug users do not become addicted Assumption that prenatal cannabis use inevitably produce detrimental cognitive effects should be reevaluated Racism is an important tool in drug law enforcement

45 What can you do? Change drug education Change the narrative about drug users You may have to get out the closet Implement strategies to deal with real problems May include changing legal status of all drugs, etc. Constantly evaluate the risk-benefit ratio

46 What can you do? Change drug education Change the narrative about drug users You may have to get out the closet Implement strategies to deal with real problems May include changing legal status of all drugs, etc. Constantly evaluate the risk-benefit ratio This is not a formula for popularity

47 The thing that makes you exceptional, if you are at all, is inevitably that which must also make you lonely. - Lorraine Hansberry

48 Website: drcarlhart.com