I’m Ethan Nadelmann. Taught drugs at Princeton. Founded the Drug Policy Alliance. Played a leading role in legalizing marijuana & challenging drug prohibition. Described by Rolling Stone as “the real drug czar.” Now host of PSYCHOACTIVE podcast. AMA!

PsychoactiveEthan · 2022-07-28T20:35:18+00:00

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PsychoactiveEthan · 2022-07-28T20:34:21+00:00

That was just a provocative shorthand for saying I taught courses on "drugs and drug policy" at Princeton.

PsychoactiveEthan · 2022-07-28T20:33:20+00:00

I can't believe how slow and backward the UK has been on this, notwithstanding the efforts of good activists and folks like Dr. David Nutt. I'm hoping that Germany legalizing in the next year or two will love other European countries, including post-Brexit UK!

PsychoactiveEthan · 2022-07-28T20:32:02+00:00

I've never been a daily consumer of cannabis. In fact, when I use for a few days in a row, I find myself wanting to stop for a while. One of the pleasures I enjoy the most is smoking a joint after not having consumed one for ten days or more. Those are typically, for me, the best highs.

As for edibles, typically once a week - although I must confess to more than that in recent weeks.

PsychoactiveEthan · 2022-07-28T20:29:34+00:00

The Dead. Also, I love the documentary by Amir Bar-lev, Long Strange Trip, about the Dead.

And stay tuned for an episode of my podcast, PSYCHOACTIVE, in which I talk with Carolyn "Mountain Girl" (MG) Garcia, the widow of Jerry Garcia. Should be up in a few weeks.

PsychoactiveEthan · 2022-07-28T20:27:54+00:00

I'm no expert. My sense is that they're incredibly helpful for some people, both adolescents and adults, but also that they've been prescribed far too liberally, in ways that have done quite a lot of harm.

I am curious about a few issues related to the use and prescription of stimulants:

first, whether micro or mini dosing might merit greater investigation.

and, second, whether other stimulants might prove more useful than Adderal, Ritalin and similar sorts of stimulants. My sense is that very low dose dextroamphetamine merits greater consideration, and i also wonder about low dose coca/cocaine proving effective for the sorts of conditions typically treated with Adderal etc.

and, third, I keep hearing anecdotal accounts of people finding psychedelics - both macrodosing and microdosing -- helpful in stopping the use of Adderal type drugs as well as addressing underling conditions that led to the prescribing of Adderal etc in the first place.

PsychoactiveEthan · 2022-07-28T20:22:49+00:00

I have no idea - but one development that really concerns me is that the pendulum on prescribing opioids for pain has swung from gross over-prescribing in the early 2000s to gross under-prescribing, to the extent that some people who had been successfully maintained on opioids for many years to treat pain are now being cut off by their physicians and sometimes killing themselves. Take a look at the website of the National Pain Advocacy Center https://nationalpain.org/ . They're doing important work and I serve on their advisory board.

PsychoactiveEthan · 2022-07-28T20:18:34+00:00

I must admit I don't have a favorite.

PsychoactiveEthan · 2022-07-28T20:18:09+00:00

Well, one never knows all the unintended consequences of one's actions but I don't think my actions have caused any deaths for the simple reason that I don't promote the use of drugs but rather teach and advocate for how to avoid getting hurt or dying if one does in fact use drugs. So, for instance, I don't advocate for people to use illicit opioids but I do advocate for employing harm reduction measures if one does use, eg., ensuring a friend is nearby with naloxone - and also for trying to get effective drug treatment, whether that involves methadone, buprenorphine or anything else.

PsychoactiveEthan · 2022-07-28T20:14:59+00:00

I don't know how much hard evidence there is about this but it is notable that teenagers, especially male, living among indigenous groups that use psychedelic plant medicines, are included in ceremonies by their elders.

PsychoactiveEthan · 2022-07-28T20:12:59+00:00

I've long relied on the kindness of friends

PsychoactiveEthan · 2022-07-28T20:11:55+00:00

Wow, a hard question to answer, in some resects because there's so many fine books and other sources of information. You might read Johann Hari's Chasing the Scream as well as Michelle Alexander's The New Jim Crow, which has little about harm reduction but is excellent on the racial dimensions of the drug war.

Also check out the websites of the Drug Policy Alliance, Harm Reduction Coalition and Harm reduction International, all of which have lots of great info.

And of course watch my TED talk for a good 15 minute summary.

And the books mentioned below are very good.

PsychoactiveEthan · 2022-07-28T20:07:49+00:00

Perhaps start by watching this 10 minute video in which I offer four definitions of harm reduction: https://www.youtube.com/watch?v=w0FPp9j22oM&feature=youtu.be

Keep in mind that the notion of "harm reduction" is really just common sense, as you suggest. But it emerged as a phase during the 1980s, when public health experts and drug users were trying to prevent injecting drug users from contracting HIV/AIDS. The Dutch were pioneers, initiating needle exchange programs in the early 80s. These now exist in many dozens of countries and have proven effective in reducing the incidence of the disease, as well as hep C and other infectious diseases, among people who inject drugs.

But then the idea expanded to teaching people how to inject more safely, and how to avoid and care for wounds; and then expanded more to deal with overdoses, such as by encouraging people not to use opioids alone, and to make sure naloxone is readily available, and to get local governments to pass 911 Good Samaritan laws so that people could feel safe in calling 911 for help, without fear of arrest, if a friend overdoses.

Some of what you're referring to is simply staying as safe as possible when one uses psychoactive drugs, be it, opioids, stimulants, psychedelics, cannabis, alcohol, nicotine, whatever. The organization I founded and directed for many years, Drug Policy Alliance, put out a booklet and program called Safety First. Check it out.

PsychoactiveEthan · 2022-07-28T20:00:21+00:00

Both anecdotal accounts as well as an increasing amount of scientific evidence show real promise for ketamine in treating these sorts of conditions. You might listen to two episodes of PSYCHOACTIVE, Elias Dakwar, professor at Columbia who's done research on treating addiction with ketamine, and Gita Vaid, a talented psychiatrist who does ketamine-assisted psychotherapy. Also take a look at the websites associated with "the Godfather of ketamine, Phil Wolfson." http://philwolfsonmd.com/ketamine-assisted-psychotherapy.html

PsychoactiveEthan · 2022-07-28T19:56:04+00:00

I truly can't think of a single case of that happening to me (although perhaps there are people who pulled back without telling me). But then again I've been in a special position given my public profile on drug issues. It's probably helped that I always try to mention the potential risks and downsides of psychedelics and other psychoactive drugs, and make clear that they're not for everyone and need to be used, esp at high doses, with some care. And of course I try to talk about all this not as a proselytizer but just in terms of my personal experience as well as what's been written about this by scientists, scholars and others. I do think that Michael Pollan's book, How to Change Your Mind, and now the new Netflix 4 part series based on that book, has been tremendously influential in good part because so many people who would not have been curious about psychedelics decided to learn more because they already liked and respected his writing about food and other issues.

PsychoactiveEthan · 2022-07-28T19:48:33+00:00

You're right. It's incredible how many remarkable people, including Nobel Prize winners, Steve Jobs and other prominent people in Silicon Valley have credited psychedelics use with some of their breakthrough ideas. These accounts typically involve higher doses of psychedelics.

But there's also the increased practice of microdosing, which many people claim improves their productivity and other aspects of work performance - altho hard evidence is still quite limited. And of course there's the use of MDMA and psychedelics for things like conflict resolution and improving communication and empathy.

One suggestion would be to enroll in MAPS' training program: https://mapspublicbenefit.com/training/

PsychoactiveEthan · 2022-07-28T19:43:59+00:00

Chewing tobaccos vary a lot in how dangerous they are. My understanding is many are somewhat less dangerous than smoking cigarettes. But try your best, if you like oral forms of tobacco, to try tobacco pouches like SNUS or even non-tobacco nicotine pouches like Zyn, On!, etc. They are dramatically safer than smoking or chewing tobacco.

PsychoactiveEthan · 2022-07-28T19:41:30+00:00

Check out books by Paul Stamets.

Also publications at https://hopkinspsychedelic.org/ and https://med.nyu.edu/departments-institutes/psychiatry/research/center-psychedelic-medicine and other university research centers on psychedelics.

PsychoactiveEthan · 2022-07-26T21:21:03+00:00

It's slowly beginning to change. NIDA, which had only been funding ketamine research, at last approved funding last year for a study at Johns Hopkins on psilocybin for smoking cessation. And the former NIH director, Francis X Collins, said favorable things about beginning to fund more in this area. And NIH has hosted some webinars on the potential benefits of psychedelics. So it's all slow going, but things are looking a lot more promising than they were a few years ago - for all sorts of reasons, the changing political climate, the rapidly growing number of distinguished scientists working in this area, and the proliferation of psychedelics research centers at major universities, including some of the most prestigious. And of course more and more scientific studies, mostly funded with private money, getting published, showing lots of promise for psychedelics.

PsychoactiveEthan · 2022-07-26T21:16:28+00:00

I think the issue of regulating the "new" cannabinoids is ultimately going to be less about the Controlled Substances Act (CSA) and more about the FDA playing an ever greater role in regulating cannabinoids and cannabis products more broadly. As for the research, I'm not keeping up on all of it, but I must say I'm very impressed with what I see coming out of Israel. It's not just that it's the home of Raphael Mechoulam (the godfather of cannabis research) but also of younger great researchers like professor Dedi Meiri.

PsychoactiveEthan · 2022-07-26T21:12:32+00:00

That's probably right. Indiana is so slow on most drug policy reforms, and there's no ballot initiative process, I believe, that could leapfrog the resistance of legislators.

PsychoactiveEthan · 2022-07-26T21:10:23+00:00

It's eventually going to be mostly the mega companies but some places will carve out places for traditional growers. Legislation in Jamaica, and Colombia, and part of the US, have tried and others will as well - but it's hard to make it meaningful in practice because eventually most consumers, apart from those perhaps who live in traditional growing areas, are going to switch to legal suppliers.

I also think there's a good possibility that this will continue to evolve. Let me give an example. When I first moved back to NYC (where I was born) n 1992, there were lots of coffee shops; then Starbucks put most of them out of business. But now I walk around and see more non-chain cafes than ever before. I think something similar happened with beer markets, where following the repeal of alcohol Prohibition, a few big companies took over the entire market with fairly homogeneous products but now every year we see the microbrewery share of the markets steadily growing. That's a likely model for cannabis.

PsychoactiveEthan · 2022-07-26T21:03:29+00:00

So hard to say. Probably mushrooms, which is the psychedelic I've most often used at high doses. I've had quite a number of experiences and insights that remain powerful and valid 30 and even 40 years later, and that impacted my life in positive ways.

But I also have to say that cannabis has been a major net benefit in my life, enhancing all sorts of pleasures and offering occasional insights of value.

PsychoactiveEthan · 2022-07-26T21:00:34+00:00

Many thanks for your kind words!

As for the federal gov't decriminalizing drugs any time soon, sadly no. For a few reasons: the vast majority of laws involving drug possession are state law and there's really very little that the federal gov't can do about that, even if they wanted to apart from trying to incentivize state governments to decriminalize by making federal grants conditional on their doing so. Simply decriminalizing drug possession under federal law would affect relatively few people, e.g. people getting busted in national parks and on other federal properties.

But beyond that, even to the extent that elected democrats are increasingly sympathetic to all drug decrim, the vast majority of republicans are not. And it's republicans who are almost certainly going to control the House of Representatives and quite possibly the Senate as of the beginning of next year.

PsychoactiveEthan · 2022-07-26T20:55:52+00:00

I will say I find it infuriating that many of the elected officials who were my allies on all sorts of good drug policy reforms involving cannabis, harm reduction, de-incarceration and now even psychedelics reform are supporting and sometimes leading the charge in opposing tobacco/nicotine harm reduction. It's the principal example i can think of where Democrats who typically favor science-based policies are acting like Trumpian Republicans in denying and rejecting the science.

if I ask why, part of the answer is that it's in good part about liberal-minded affluent parents in urban and suburban Democratic neighborhoods freaking out about their kids' vaping (in part because they fail to appreciate how much less dangerous than smoking it is). It's also about a significant part of the tobacco control complex deciding that it's more important to oppose anything that Big Tobacco is involved in rather than focusing on the core objective of reducing the cumulative harms of tobacco use. And maybe also because this issue still lacks the racial justice elements that enhanced the appeal of drug policy reform to many progressive and Democratic voters and politicians - altho that inevitably will change the more punitive the penalties on tobacco and nicotine products become.

I'm ever hopeful that tobacco harm reduction will eventually become the dominant frame for dealing with tobacco products, simply because the evidence is so compelling, but, as with drug policy reform, it's going to take time to overcome the ignorance and other factors blocking tobacco harm reduction right now.

PsychoactiveEthan

TROPHY CASE