06/23/17 Carl Hart

Dr. Carl Hart, author of High Price and Asha Bandele of DPA conversation: "Everything You Know About Drugs Is Wrong" + Tris Tristone of KPOV in Bend Oregon re cannabis rights, cannabis tours

Cultural Baggage Radio Show
Friday, June 23, 2017
Carl Hart



JUNE 23, 2017


DEAN BECKER: I am Dean Becker, your host. Our goal for this program is to expose the fraud, misdirection, and the liars whose support for drug war empowers our terrorist enemies, enriches barbarous cartels, and gives reason for existence to tens of thousands of violent US gangs who profit by selling contaminated drugs to our children. This is Cultural Baggage.

Last week, the Drug Policy Alliance held a major online conference. It featured Asha Bandele, the Senior Director of the DPA, as well as the author of High Price, Doctor Carl Hart. We first hear Doctor Hart.

CARL HART, PHD: I have so many thoughts on the opioid crisis. First of all, I hate that language, opioid crisis, because we act as if -- I want to be careful here, because there are people who have certainly died and people who've become addicted to drugs. But we are in my view exaggerating the extent to which there's this thing called crisis.

I mean, when we think about crisis, let's just think about, we're talking about the number of people who use opioids, let's go specifically to something like heroin. When we look at the number of people who use heroin for example, we like to measure these things in a variety of ways, and one way we measure these things is we look at the number of current users, the people who have used the drug at least once in the past 30 days.

When you look at something like heroin, about 330,000 Americans used heroin --

ASHA BANDELE: In the whole country.

CARL HART, PHD: In the whole country, in the past 30 days. But, that's -- but when you compare that to something like marijuana, who used marijuana in the past 33 -- 30 days, 22 million Americans. And then you can see 22 million versus 300,000. It's not even comparable. Or and then you look at something like cocaine. How many Americans used cocaine in the past 30 days? About two million. Again, nowhere near the 300,000 people who used heroin.

But the point is, is that the number of heroin users is relatively low compared to other psychoactive drugs. It's always been the case, it's the case now. Now, people say, well what about opiate -- other opioids? Certainly, when we look at the number of people who used prescription opioid pain relievers, looking at the past 30 days, that number is nearly four million, about 3.7 million Americans used opioids in the past -- prescription opioids in the past 30 days.

That's lower than the 22 million marijuana users, and it's higher than the 2 million cocaine users. So, all right, you can say, well, that's a large number of people who are using prescription opioids. That's right, that's -- that's somebody taking one pill, at least one pill, in the past 30 days. Now, it's a pharmaceutical grade pill, and it contains a relatively low amount of opioids, which is a good thing. It's certainly better than having people use illicit drugs, or street drugs.

ASHA BANDELE: Say more about why that is.

CARL HART, PHD: Why that's a good thing. It's a good thing because it's 100 percent pharmaceutical grade, we're not worried about adulterants in that drug, because we'll get to this. When we think about the so-called opioid crisis, when you really start to look at the numbers and what we're concerned about is deaths. That's the thing that we're really concerned about, and we find out that the deaths, a lot of the deaths, are being caused by adulterants.

The adulterant Fentanyl, that's the one we're kind of worried about. When we think about the prescription opioids, we don't have to worry about that. So the likelihood of people dying from prescription opioids is really low, and then when you look at the numbers, you -- that also bears out.


CARL HART, PHD: And so that's a good thing. So --

ASHA BANDELE: And when they do die, it's if they're not being monitored properly, or -- can you say more about that?

CARL HART, PHD: So, now, when we think about, okeh, let's -- now you're asking me to get to the real issues, and that's, this is what the newspaper articles and the people who are retweeting those articles and passing those articles around don't do.


CARL HART, PHD: Let's look at the real concern. If the real concerns are deaths related to drugs, that, the New York Times did an article last week, talked about the rising numbers. But when you really look at the actual numbers, we'll talk about that in a second, and why people are dying, they're dying because they're combining an opioid with another sedative. And, because -- another sedative like alcohol, benzodiazepine, or a long acting or really sedating antihistamine. Those are the major sort of concerns. And they're dying because of the fentanyl thing.

What people -- fentanyl, by the way, is an opioid. It's about a hundred times more potent than heroin, meaning that it -- the amount required to produce the amount -- produce the effect that people are seeking is lower. A hundred times less than what you would do -- use heroin. If someone is unsuspectingly -- they unsuspectingly take fentanyl, thinking that it's heroin, they may snort or inject too much fentanyl and kill themselves. And that's a concern. But that's an easy fix.

ASHA BANDELE: Tell us about the fix.

CARL HART, PHD: It's an easy fix, if the public is really committed to dealing with these deaths. We can do simply what the people in Spain and other countries have done, when it comes to adulterants that they're concerned about. Simply set up free drug testing purity sites, so people can send their drugs to these places anonymously, and have it tested, and if it contains something like fentanyl, then you know that you have to really scale back the amount of drug that you use, or don't use it.

It's kind of simple. That's really simple, but you never hear any of these newspaper articles talking about how do we fix this? I mean, people talk about narcan, or naloxone, they, and that's a good thing, but --

ASHA BANDELE: They reverse the effects of an overdose.

CARL HART, PHD: That's right, naloxone is the opioid antagonist that blocks the effects of an agonist like fentanyl or heroin, and it can reverse the overdose. That's exactly right. But no one's talking about setting up just free drug testing purity sites, and you deal with this issue, as opposed to getting hysterical and crazy about what's going on. But, there's a reason that we get hysterical about this sort of thing.

ASHA BANDELE: That's what I was going to say, I mean, I think that we have it in our world, that we can somehow magically have a drug free society, and we have a lot of sort of moralistic, often religiously based sort of judgments about people who use drugs, and about drugs, and when it comes to heroin in particular, there's a specific drug that Richard Nixon targeted and linked to black people, right, when he started the drug war, back in 1971.

CARL HART, PHD: Yeah, so, when I said there's a reason that people, that we have this hysteria, you have to understand that people's motivations for the hysteria vary. For example, you think about various communities, you think about the black community, and I understand that it's not some uni-dimensional sort of place, I understand that, it's complex, but if we just think about it in simple terms, the motivation might be, for a drug free society, a religious based sort of motivation to stop people from having fun. I think that's what religion is designed to do, I don't know.

But that might be one way that, that's one motivation. Then we think about the federal government's sort of motivation, or, I mean their motivation might be to put more cops on the street, or to enhance the budgets of law enforcement to deal with this sort of thing. Then you think about the various treatment communities, their motivations to fan the flames of this hysteria might be to get more money for treatment. Even though the vast majority of people who use opioids don't need treatment.

ASHA BANDELE: How many people, that's an important number, Carl, of the hundred percent of people who use heroin, roughly how many in that number actually have problematic or chaotic use?

CARL HART, PHD: So, when we think about heroin, about, less than a quarter of the people who actually use heroin will meet criteria for an addiction, based on the DSM, the Diagnostic Statistical Manual of the American Psychiatric Association. So about less than a quarter. So that means that the vast majority of people who use heroin don't have a problem.


CARL HART, PHD: But when we start to look at them motivations for people whose -- for fanning the flames of hysteria, then you start to really start to get at why this is going on. And then you start to look at what are -- what are they proposing? You know, so like when you think about putting more cops on the street, people are going to always use drugs, and that's not going to help people who are dying from adulterants. That's not going to help.

And then you think about, again, the people who are saying drug free society. People have always use drugs, since humans have inhabited earth, and they will always use drugs.

ASHA BANDELE: That's right.

CARL HART, PHD: And that's a fact. And I actually want them to always use drugs, and you know, and this is someone who studies drugs, and, because I understand that drugs have an important role in our society. And we can think about those roles, and we think about all of us being at boring ass functions, and that sort of thing, drugs enhance those functions.

Just keeping it real, being honest. And we know this, right? We know this kind of thing. So, so you think about the motivations of all of these people, and then you say, well what are they proposing to deal with the real concern? And the real concern is the number of people who die from opioid related deaths.


CARL HART, PHD: And so, if they don't have a proposal to deal with that that's realistic, then you should actually dismiss them.

ASHA BANDELE: Right, yeah, that's -- and in all of these reports, there's almost like no -- there's no kind of service reporting, right? So if you want to end the deaths, the actual deaths, they've offered no reporting on drug testing, they've offered no reporting on harm, any kind of harm reduction aspect of it, so it makes you think, like, do you really want people to live?

I remember reading something in the New York Times where they were saying, they were examining how white women had been dying in the midwest for 10 years at higher rates than they ever had before, and I thought, so they just let you die, like, they watch your drug use, your alcohol use go on for ten years, and just let you die. That's not a government that's concerned about its people.

CARL HART, PHD: Well, I think black people have known that for some time.

ASHA BANDELE: Exactly. Exactly. It usually isn't just using, you're probably not going to overdose if you're -- if you're using pure heroin, that's probably not going to kill you.


ASHA BANDELE: But it's often -- usually the combination of that and alcohol, right?

CARL HART, PHD: About 75 percent of the people who die from an opiate or related death, also have another sedative on board. So it's from this drug combination, this is what we think is going on. So it's rare to have an opioid only involved in a death. So that's rare. That's --

ASHA BANDELE: You would think that, you know, departments of public health would begin to put out some of the information about this stuff, so that people would even -- would even know, because I don't think --

CARL HART, PHD: Why would we think that? I'm sorry.

ASHA BANDELE: Well, because, I mean, ostensibly, ostensibly. Is that -- that's a zinger back for the Mario Cuomo thing. So ostensibly, the public health departments would be saying, if you use drugs, this is what you should know.

CARL HART, PHD: Right. Right on. Right on.

ASHA BANDELE: Right? And, you know, that doesn't seem to happen.

CARL HART, PHD: Okeh, so, that's right. That's exactly what they should be doing, the public health message is clear. If you're going to use an opioid, don't combine it with another sedative. That should be an easy, simple message. But, you know, by fanning the flames of hysteria, saying this thing that we're in a crisis, their budgets are increased. It helps their budgets to be increased, and so let's not get that twisted.

We -- the country now is concerned about the opioid crisis. That means we're going to put more money in health department budgets, and these other folks. But that's an easy fix. But let's go back to this comparison with automobile deaths. So we've got 35,000 people who die on American highways every year, 33,000 Americans who die from an opioid related death, I mean, that's opioids combined with other drugs included.

Now, are we talking about banning automobiles? More people die on the roads, on the highways, from automobile deaths than opioids.


CARL HART, PHD: But are we talking about banning automobiles? Not no, but hell no. We're not because automobiles, we understand that they also have potential positive effects, they help us get to places that we need to get quicker, and so forth. And instead what we do is we understand why people are dying, they're dying because of lack of seat belts, speeding, and alcohol. Those are the major reasons. And so our education is built around those sort of three major concerns. Why not take the same approach with opioids?

ASHA BANDELE: That's the moral piece, right, that's the moral piece that has people judging what one -- what, you know, you can do and what's appropriate behavior in a society, and it seems like we'd rather host that sort of morality than actually host life, and ensure that people live, and you know, let me ask you about yourself. You've been very open about your own drug use, which I think was exceptionally brave, you know, given the position you hold in society, not just in this society, but in the world, you consult with literally heads of state around the world. You know, can you talk a little bit about why you made the choice to be open about your own drug use?

CARL HART, PHD: Well, you know, I don't know if it's brave, but, you know, but thank you for saying that, but I don't think of it that way. I think of it this way: one of the things that's happened in our society is that we have made a caricature of what the drug user looks like. Right? We only go to the frame of the person, the poor person who's having problems related to their drug use, when we think of drug users.

ASHA BANDELE: Right, like with all the TV shows, that's all you see.

CARL HART, PHD: Oh, the bad TV shows, the bad documentaries, the bad films, all of those, they always get it wrong. We have this caricature of the drug user. The vast majority of people who use drugs are not addicted. They are responsible people in our society, they pay taxes, they take their -- they take care of their families, they do all these things.

ASHA BANDELE: Sometimes they get elected president.

CARL HART, PHD: Exactly. The last three, the last three presidents, who all used drugs. The current president has not admitted to it. Perhaps he should use drugs, because then he might be on his way to make America great again, you know, but the point is, there's a reason why I came out about my own drug use, it's because I wanted people to see that, the hypocrisy surrounding this.

And by the way, you talked about the heads of states with whom I interact on the global level. Many of them use drugs, and so, of course, I can't put them on blast because that wouldn't be right, but many of them do. And the notion that -- the notion that many of these successful people in our world are not using drugs is just naive and stupid.

Anybody who has to accomplish lots of work in short periods of time, I assure you, they are taking stimulants to -- particularly if they're traveling all over the world to deal with jet lag in some cases, you have to perform when you should be asleep. They are taking sedatives to help them sleep. They're taking anti-anxiety medications to help them deal with painful ass people, which we have to deal with on a regular basis. And so I assure you, they are doing it.

So the point becomes --

ASHA BANDELE: And not to mention or to exclude alcohol, and which we should -- one of the most powerful drugs that's out there, and everybody drinks.

CARL HART, PHD: But hold on, I am including alcohol as one of those anti-anxiety medications.

ASHA BANDELE: That's right.

CARL HART, PHD: Alcohol is one of the best anti-anxiety medications. So when I think about my own drug use, it's important for people to understand that I've been studying drugs for nearly 30 years. If I can't use drugs, and I can't admit to using drugs, who the hell can in this society? That would be wrong, that would be, I would be a hypocrite if I didn't come out and say, hey, this is how you do it safely, this is how you do it to optimize effects. This is how you do it to decrease harms. This is how you do it to decrease the negative effects associated with drugs.

ASHA BANDELE: Yeah, because it would seem to me that based on the research and based on the number of people we know who use drugs, and don't actually live a chaotic life, that the most dangerous interaction with people who are black is their interaction not with the drug but with police, and law enforcement.

CARL HART, PHD: Well, you know, you know I've written about this a long time ago, before it was popular, I was saying how I would much rather have my kids interact with drugs than the police, because I can keep them safe with drugs, because I know drug effects are predictable. That's the science of pharmacology. It's the -- that's what science is all about. But, the young black boys especially, or men, interaction with police is just not -- they're not predictable.

ASHA BANDELE: And, you know, we watched some course correction under the Obama administration, but now under the current administration, with Jeff Sessions, he's talking about rolling back the measures that we've pushed for so hard, reinstalling mandatory minimums, and really taking the -- and I think now, even talking about questioning marijuana that's used for medicinal purposes.

So, I wonder, if you had any thoughts or comments about Jeff Sessions, and the message to the people who are here, listening in, you know, at The Root? Because in some ways I think sometimes people think that, and this is something I want to pull apart, that if you don't use drugs, like maybe you don't even use alcohol or even, I don't know, coffee, maybe, that the drug war doesn't impact you, and that this isn't your issue. I don't believe that that's true, and I wonder about your thoughts on that and Jeff Sessions and the moment that we're in.

CARL HART, PHD: Well, I think you were generous with the Obama administration. Let's just be frank, you know, that's like some -- it frustrates me, because that was an opportunity for us to really educate the public about drugs, about race, and we missed that opportunity. In a major way. And it sets up people like Jeff Sessions. It allows people like Jeff Sessions to be taken seriously.

So, when we think about somebody like Jeff Sessions, it's really clear, people ask me all the time, what can we do? And people say what can I do? White folks, black folks, Latinos, just Americans, good Americans, well intended Americans. We think about Jeff Sessions. What can you do? As a white American, for example. What can you do? Jeff Sessions is advocating, promoting policies that have been shown to have racially discriminatory effects. It's clear. We look at the crack powder, we look at the enforcement of drug laws, this is not even a question.


CARL HART, PHD: I mean, this is not up for debate, everybody agrees on this. These policies, and the enforcement of drug laws, have been determined to be racially discriminatory.


CARL HART, PHD: Anybody who has this evidence, as Jeff Sessions has, and many of us do, they have this evidence and in the face of this evidence they continue to support such actions, we call them racist in that domain. And so when white Americans and everybody talk about, well, what you can do, what you can do is you can call this guy out as a racist, because he is advocating actions that will disproportionately harm segments of our American society, and people who are not doing that, we should call them out.


CARL HART, PHD: Because it is clear. That's one thing, when we think about Jeff Sessions.


CARL HART, PHD: We think about Jeff Sessions in all kinds of ways. I mean, even beyond the sort of issues related to drugs, the guy recently, he testified yesterday, and then we had this sort of, it's clear the FBI has determined that the Russians interfered with our American democracy. It's -- and with the election and so forth. That's clear. When asked, did he follow up, did he get any information, did he read anything about this, as the number one law enforcement official in the country, he said no.

Now, I was in the military. I'm an ex-military, I spent four years in the military. What we call that? He's AWOL, he's, that's --

ASHA BANDELE: That's right, that's right.

CARL HART, PHD: He is not doing his job.

ASHA BANDELE: That's right.

CARL HART, PHD: Americans, all Americans, should call him out on that. And if you're not, then you might want to check your American citizenship at the door.

DEAN BECKER: Again, that was Doctor Carl Hart, author of High Price, as well as Asha Bandele, Senior Director at the Drug Policy Alliance. You can see and hear the full discussion at The Root, or the link is available at DrugTruth.net.

It's time to play Name That Drug By Its Side Effects!

ALEX TREBEK: A 2009 study recommended treating heroin addicts with diacetyl morphine, the active ingredient in this?

DEAN BECKER: The time’s up! The answer, from a recent edition of Jeopardy:


KAREN: What is heroin?




DEAN BECKER: Over the years, I've talked about our involvement with the Pacifica Radio Network, but we also have many affiliate broadcast stations around the country, heck up into Canada. One such individual, one such station, is up in Bend, Oregon, and the gentleman who helps run that program is with us today to talk about their involvement with the Drug Truth Network. I want to welcome Tris Tristone. Hey Tris, how are you doing?

TRIS TRISTONE: Hey, Dean, I'm doing real well, glad to be able to talk with you from up here in central Oregon today.

DEAN BECKER: Now, you guys are up there in Bend, is that correct?

TRIS TRISTONE: Yeah, we're Bend, we're on the east side of the Cascade Mountains. We're on the dry side here. We're up here at about 36, 38 hundred feet, right in that area, so a little different from what most people think about Oregon, over here on this side. Well, we're at -- I'm at KPOV, we're a community radio station, and we are in fact a Pacifica affiliate here in Bend, Oregon.

We just finished our twelfth year of broadcasting. We started off as an LP-FM, and then went to full power here, oh, three, four, five years ago, something like that now. And we've been carrying the 420 Drug War News here on my shows over the years since the very beginning of our station, and so we've been riding the trail, so to speak, with Dean Becker and the Drug Truth Network for, starting our thirteenth year actually this very week here in Bend, so we're proud to be on board, and so grateful for everything that you brought to our community, Dean.

DEAN BECKER: Well, Tris, thank you. I like to think that I've had a small part in the quote "reawakening" of people's attitudes, not just towards cannabis, but towards the whole of the drug war. Would you agree with that thought, sir?

TRIS TRISTONE: Oh, absolutely, you know, and you came really into pretty friendly territory here in Oregon, as you probably well know. You know, when you started off with us in 2010 -- yeah, 2010, we were already a legal medical marijuana state, but I was even given grief when we first started our station for playing the 420 Drug War News during our afternoon drive time news programming, which I was in charge of at that time. Some people just didn't want to hear it, and it's amazing, over the years, Dean, I've watched those same people that were complaining, now being consumers of legal marijuana here in Oregon, now that anybody can access it here in the state.

And I know just that conversation that you brought to our community made it a lot easier for everybody to talk about it, and after time, after hearing the Drug Truth, it really changed minds, and so, whether you hear it on a daily basis, you in fact did help change the attitudes of many, and cannabis now is just a mainstream product here in Oregon. And you're part of that conversation there, my friend.

DEAN BECKER: Well, I'm glad to hear that, Tris. You know, I think about my next goal, one of my next goals, is to enlighten, embolden, educate, however you might want to say it, to the cannabis consumers to quit picking on opioid users, or meth users, to quit embracing the concept of prohibition, because you can't be a part time prohibitionist. Your thought there, Tris.

TRIS TRISTONE: Well, you're talking with a long time Libertarian on top of that, so, any form of prohibition is something that is just been fairly reprehensible in my mind, anyway, and people's choices are people's choices, and we need to respect those, and if people need help with their choices, you know, there are certainly people that are always going to be able to help those folks, but prohibition gives government the opportunity to put oppression upon the people, and it's not a very American concept, Dean.

DEAN BECKER: No, it's not. Well, I tell you what, Tris, I want to thank you, I want to thank your whole staff, heck, I want to thank the listeners of KPOV there in Bend for, you know, being a part of this effort to change our perspectives and end the madness of drug war. Any closing thoughts, Tris?

TRIS TRISTONE: Well, you know, basically, thank you for all you do, and I know you are in unfriendly territory that's getting friendlier down there. I'm the tour business up here, and just in the last week we had a fellow Houstonian present up here that just got a taste of what legal marijuana is like, and hopefully one of these days soon all Texans down there will have the freedom I know that you guys so much strive for, so, keep up the good work. I know you've gone a long way already, with some of the reforms that are happening down there, and we're proud of what you're doing, and we're proud of what you've given us, Dean, so keep it up, hang in there, and I look to seeing you in person again here one of these days down the road.

DEAN BECKER: Again, that was Tris Tristone up there in Bend, Oregon, the tour he was talking about that the Houstonian took, it's a two hour guided educational tour that spotlights their cannabis industry. You visit businesses, testing labs, accessories, gardening center, marijuana grow, and adult dispensaries. He says you can let your burning cannabis questions be answered by knowledgeable industry professionals and have a one of a kind experience, and light up your trip with one of these intriguing tours. You can learn more at BlazingTrailsBend.com.

I've known that Tris has been sharing the Drug War News for many years now, but I got a chance to meet him a few weeks back in Berkeley, at the Patients Out of Time conference. You may remember a portion of that discussion. And I got a chance to try some of that cannabis from Oregon, it was called El Chapo. If you make that visit up there, I think you'll really enjoy your time.

As we're wrapping up here, I want to underscore a bit of what Doctor Hart was saying about his open discussion about his drug use. I've been doing that here on the Drug Truth Network for 15, going on 16 years, and what's happened since then? I've become friends with our district attorney. I've influenced the state legislators and senators, and even the local police chief, and sheriff, have come on the show to talk about the failures of this drug war. There is an upside to being open and honest. I hope you'll do the same.

Again, I remind you, friends, that because of prohibition you don't know what's in that bag. Please be careful.

To the Drug Truth Network listeners around the world, this is Dean Becker for Cultural Baggage and the unvarnished truth. Cultural Baggage is a production of the Pacifica Radio Network. Archives are permanently stored at the James A. Baker III Institute for Public Policy. And we are all still tap dancing on the edge of an abyss.