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The science of drug use

World expert on the effects of recreational drugs on the mind and body Dr Carl Hart explains the science of drug use.

February 25, 2021
5 min read

In this Braincare Clubhouse session, we discussed the science of drug use for adults with expert Dr Carl Hart.

Dr Carl Hart: Professor of Neuroscience & Psychology at Columbia University. Research Scientist at the New York State Psychiatric Institute. Author of 'Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear'. Known for his research in drug abuse & drug addiction.

Dan Murray-Serter: Co-Founder of braincare company Heights, and host of our Braincare Podcast

(Resources can be found at the bottom.)

Behind 'Drug Use for Grown-Ups'

This book is meant to help people understand how to better serve people who identify as drug users, and how to help them do this activity more safely. 

The typical drug user is a middle-class upstanding person who is responsible, but that isn’t the image the public has of the typical drug user.

'Drug Use for Grown-Ups' attempts to remove the social stigma and emotional baggage that society has brought to drugs. This book is not meant to encourage people to use drugs, but instead have a grown-up conversation about them.


Alcohol is seen as the ideal psychoactive substance because of its chemical and physical properties. It is made up of small molecules which get into the brain quickly and alter behaviour fast. 

Alcohol consumption is socially acceptable because of its chemical properties, but it does what all drugs do- it alters a person's consciousness.

Unlike alcohol, the lack of freedom to consume other drugs is the cause of extremes such as addiction and poor use. People are put on a path of responsibility with drinking at 18 in the UK, or 21 in the US. This allows them to get a handle on drinking, and learn by trial and error with no stigma attached to them for trying and failing.

Quality control

There is a level of quality control that alcohol consumers get, where they are assured that there are no contaminants in what they're drinking.

Drugs like MDMA, cocaine, and heroin are not legally regulated and have no quality control, and oftentimes people don’t know they contain contaminants. These contaminants are worse than the substances themselves, causing users to get injured and hurt.

Additionally, people aren't informed on the dose they should be taking. As a result, some may overdo it which can lead to problems, sometimes fatal. Quality control is needed to keep drug users safe.

What is a bad drug?

  • It’s important for everyone to know that drugs are not bad or good.  They are inert substances waiting for a biological system to interact with, and that's how they produce the effects. Those effects are dependent on a lot of things, like the environment in which the drug is taken, 

  • If you take cocaine in a comfy environment in a protected space negative effects are a lot less likely. If you take it next to the police and you are paranoid that's not going to be a good experience. Context is critically important.

  • The predominant effect of the thousands of doses that I’ve administered is positive. There are things that we can do to enhance the likelihood of people experiencing positive effects like making sure the drug is pure, administering the right dose, having a comfortable environment, and making sure the person is healthy.

Safe use

  • There might be specific things you want to do based on the class of drugs you're going to use. 

  • If you take a drug that is a diuretic that makes you go to the bathroom, like amphetamine, you want to make sure that you’re well hydrated.

  • If you take a drug that slows down your gastro-intestinal motility, like an opioid, you want to make sure that you’re getting enough fibre. 

  • All of these sorts of things you should know if you’re going to engage in this activity, and I describe some of these things in my book: Drug use for grown-ups.


Do drugs have a long-term effect on your brain? What about drug dependency? 

  • There is no evidence that the doses people take for recreational drug use negatively impact your brain function. 

  • Tabloids state that drug addiction or use causes brain diseases and abnormalities. In my new book, I demonstrate how there is no evidence to support that notion.

  • There is no biomarker that is predictive of whether or not someone will become dependent or develop a substance use disorder. 

What do you see as to where the direction is moving towards drugs?

  • In terms of the medical community, I am not optimistic that they'll be moving quickly. In general, these are some of the most conservative people in our society. I do not see the medical community making that change. Medicine has never been the front-runner for any sort of social progressive actions in a society. 

  • Not optimistic about the role of the physician in helping to change the view of people who use substances in our society. 

How do we destigmatize vilified drugs within the scientific community?

  •  If you look at data, in many cases, heroin is more effective at controlling things like psychotic symptoms and a number of psychiatric symptoms associated with various illnesses. Although the data is there, people don’t like to talk about heroines' potential therapeutic properties. 

  • It is going to require a huge effort. We all must show people in senior positions actual data. You have to be willing to face some opposition- because you certainly will experience a lot of it.

You can use the code "clubhouse10" for 10% off to give your brain the love it deserves.

Find out more


  1. Dr Carl Hart: “Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear”

  2. Dale Bredesen: The End of Alzheimer's: The First Program to Prevent and Reverse Cognitive Decline

  3. Documentary on the war on drugs: The House I Live in 

  4. David Smith: “Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial”

  5. Dr. Carl Hart’s ‘High Price: Drugs, Neuroscience & Discovering Myself

  6. David Smith’s ‘How B Vitamins & Omega-3s Reserve Cognitive Decline’ 

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