The professor Carl Hart has studied psychoactive drugs for more than three decades.
His new book lays out why he thinks all drugs should be legal.
Other experts stress limiting supply and putting more limits on big drug companies could help.
Carl Hart says he first tried heroin six or seven years ago.
At the time, he was already a tenured professor at Columbia University and "well over 40," according to his new book, "Drug Use for Grown Ups."
After doing that "short, thin line" with a friend, he said, he felt "a dreamy light sedation, free of stress."
He added that the two chatted, laughed, "called it an evening, and went home."
Hart, a psychology professor and neuroscience expert, had already worked (legally) with drugs including marijuana, cocaine, and heroin for more than 25 years, studying drug users and seeking to answer questions about the threats drugs pose to mental and physical health.
For most of that time, Hart was set on proving one point: Drugs are bad. Now, he just wishes he could do them legally and that you could too.
"My heroin use is as recreational as my alcohol use," Hart wrote in his book. "Like vacation, sex, and the arts, heroin is one of the tools that I use to maintain my work-life balance."
His book is a research scientist's love letter to drugs of all stripes and an argument for more even-handed drug policies across the US.
"This notion that people are not going to use drugs, that's silly and adolescent," he told Insider. "That's what this book is about: being grown up."
But other drug experts say the professor's ultimate goal of widespread legalization isn't the idyllic solution he suggests, even as they agree that the decriminalization he stumps for in his book is desperately needed.
Heroin is highly effective at treating pain, but long-term heroin use can trigger tolerance and physical dependence. Taking heroin can also lead to breathing problems and death. In the US, nearly a third of all opioid deaths involve heroin, and 15,000 people died from a drug overdose involving heroin in 2018.
Hart says he's 'better for' his drug use and believes society could benefit from it too
Heroin is part of a group of pain-relieving drugs called opioids (originally derived from the opium poppy), while methamphetamine is a synthetic chemical compound.
Hart's work has shown that a drug like meth provides some short-term cognitive benefits, including better visuospatial perception, more sustained attention, and faster responses. The cognitive benefits of this stimulant use have long been known.
Pilots in World War II took meth so they could stay awake for full days of flying. Today, methamphetamine is approved by the Food and Drug Administration as a medication for both attention-deficit hyperactivity disorder and obesity, as it's almost chemically identical to Adderall (amphetamine).
Hart says that his family supports his own recreational-heroin habit and that he continues to meet his responsibilities as an academic, husband, father, and taxpayer, writing in the book that he's "better for" his drug use.
"The most important thing we have emphasized as parents is: Just try and live like the person that you think you are - a moral, compassionate, global citizen," he told Insider. "My family would expect me to stand up on behalf of the people who have been castigated" for using drugs.
Making meth or heroin an everyday activity is a different story, though. Consistent, heavy drug use makes people more vulnerable to addiction, though that vulnerability varies. Long-term heavy use of methamphetamine is also toxic to neurons, Dr. Anna Lembke, the chief of the Stanford Addiction Medicine Dual Diagnosis Clinic, told Insider.
Hart disagrees with other experts about whether drugs can change your brain
Drug addiction is often described by researchers as a brain disorder, calling forth images from public-service announcements of the 1980s and '90s comparing "your brain on drugs" to a fried egg.
Dr. Nora Volkow, the director of the National Institute on Drug Abuse, explained this disorder model in a 2018 blog post, writing that "stark" differences in the brains of addicted individuals help explain the compulsive nature of their drug use.
Hart asserts that most studies of drug users show their cognitive abilities and functions rest within the normal range. (It's clear in the book that he disagrees with Volkow vehemently on this point.)
"Intelligent, informed people can disagree on the disease model of addiction," Lembke said, acknowledging Hart's argument.
She also says there's evidence that sustained, long-term drug use can alter your brain in a different kind of way than learning a new language or a musical instrument might. Piano players can stop hitting the keys whenever they want, without going through the painful, debilitating symptoms of withdrawal.
Hart says going through heroin withdrawal was incapacitating
Hart knows what it feels like to go through opioid withdrawal.
In the book, he documented some of his experience with what he called mild heroin withdrawal, which he said he had gone through more than once after he used "for no more than about 10 consecutive days at a time."
Hart described common withdrawal symptoms like the flu: chills, runny nose, nausea, vomiting, diarrhea, all starting about 12 to 16 hours after the final dose. For hours, it would be so incapacitating that he couldn't sleep.
"It was a pain that I would not easily forget. It was a new pain, unlike any I had previously experienced. It was so intense that it radiated throughout my entire body," Hart wrote in the book, describing one of his worst experiences going through withdrawal.
Because Hart is a drug expert, he sprang into action, crushing up a bit of sedative and knocking himself out for several hours, until the pain subsided to more manageable aches and a runny nose. Hart was relieved to feel more minor, flu-like symptoms when he woke up.
Researchers say this painful withdrawal period can be one of the most "powerful factors" driving opioid dependence and addictive behavior. People who become addicted to drugs may also develop a tolerance for the substances they use, requiring more and more of a drug like meth or heroin to feel good.
"We all have the potential to become addicted," Lembke said. "It's in our DNA to pursue pleasurable activities, to avoid painful ones."
'Accept the fact that people will do drugs'
Hart is convinced the US must regulate and license recreational drugs and then teach people how to use them safely.
The first thing Hart wants President Joe Biden to do is decriminalize possession, an initial step on the pathway toward more open, legal drug use of all kinds.
"You could have a massive public-service-announcement campaign that says 'If you're going to use opioids, don't use alcohol as a background or other sedatives in combination, because it increases the likelihood of respiratory depression and death,'" Hart said.
It's virtually impossible for people without access to a lab to test the purity of these drugs.
Hart's view is that many of the 60,000-plus drug overdose deaths across America each year could be eliminated with better education and a cleaner supply. He envisions a system in which people can submit samples of their drugs and learn what they contain, reducing the risks of use.
"Our founding document guarantees us at least three birthrights: life, liberty, and the pursuit of happiness," he said. "Those ideals are profound. It means that you can live your life as you choose. And it's nobody's business, as long as you do not interfere with anybody else doing the same."
Some experts say his view ignores some inconvenient truths - that access to drugs often leads to more overdoses, more emergency-room visits, and more potent consumption. Racial divides in drug arrests don't go away when drugs become legal, either.
Keith Humphreys, a Stanford University psychiatry professor who worked as a White House drug-policy advisor for both President George W. Bush and President Barack Obama, told Insider that Hart's views on drug regulation discounted the role of money in politics.
"What is naive about this is that it's basically saying we can trust multibillion-dollar corporations to do the right thing," Humphreys said. "That's the road we have taken with alcohol, and tobacco, and opioids. And I would say we can't do that."
Just 'a few lines by the fireplace at the end of the day'
Hart doesn't use heroin every day now, nor does he say he craves it. But it is his drug of choice.
What is so wrong, he wonders in the book, about indulging in a short, thin "few lines by the fireplace at the end of the day"?
He said he's frustrated when he sees people glorify psychedelics, as if they are some special class of drugs and not simply the chemicals of choice for white, recreational drug users.
"Heroin allows me to suspend the perpetual preparation for battle that goes on in my head," he wrote. "I am frequently in a state of hypervigilance in an effort to prevent or minimize the damage caused by daily living in my own skin."
When asked about how to keep legalization safe, Hart said: "The regulators should just do their damn job."
If you or someone you know is dealing with substance use or mental health issues, confidential, free help is available 24/7. Call the National Helpline at 1-800-662-HELP to be connected to treatment information.
Correction: A previous version of this story classed methamphetamine as an opioid. It's not. It's a synthetic stimulant that was originally developed in a lab.
Read the original article on Insider