In his new book, Drug Use for Grown-Ups, Carl L Hart, a professor of neuroscience and psychology at Columbia University, puts forward a provocative argument: drug use is not a problem. Hart himself is a regular heroin user, and has been one for five years. He is also an eminent academic, writer, husband, father and respectable citizen. He functions just fine, thank you very much, and is certainly not addicted to heroin. In fact, he insists his life is improved by using it.
I was surprised to learn from Hart’s book that less than one third of heroin users can be considered addicts, and less than one in ten of those prescribed opioids for pain will become addicted. I was amazed to discover that the evidence showing the supposedly inevitably damaging effect illegal drugs have on the human body is not all that solid. It is apparently possible to take a lot of Class A drugs and be perfectly fine.
Hart argues that it is the criminalisation of drugs, rather than the drugs themselves, that causes problems. Overdoses, for instance, are typically a consequence either of ill-advised mixing of drugs (taking opioids with alcohol, say) or of chemical adulteration. If a safe, pure, legal product were made available, with clear labelling and guidance for users, Hart suggests that many lives could be saved.
He writes with great feeling about the destructive consequences of the war on drugs, particularly for black Americans, and his case is convincing, made more so by his personal account of drug use. Hart makes a libertarian argument for allowing “grown-ups” – that is, by his definition, sane and responsible adults – to make their own decisions, without state interference. To this end he puts a healthy, handsome face to heroin use.
Hart’s public persona reminds me a little of that of Aella, a successful creator on the porn platform OnlyFans who makes a cogent libertarian argument for the destigmatisation and full decriminalisation of the sex industry. Aella’s current involvement in the industry is as good as it gets: she has no physical contact with buyers, is not pimped, enjoys a flexible work schedule and earns lots of money. She has also managed to carve out a very particular niche within the OnlyFans market, specialising in softcore content combined with political commentary.
Most OnlyFans creators have no hope of achieving Aella’s level of success, and not only because of the wildly unequal way in which income is distributed on the site – as I wrote in these pages last year, if OnlyFans were a country, it would be the most economically unequal country in the world.
An additional problem for aspiring Aellas is that the number of sex buyers who are interested in her particular style of “product” is small. In reality, pictures of languorous women posing nude are not where the money is at. Rather, a friend of mine who has been involved in porn and cam work for many years reports that the market pushes women towards outcompeting each other by offering increasingly degrading and unpleasant sex acts. Some of the requests she has received from buyers are truly nauseating – and this in a part of the sex industry that is a long way from brothel or street-based prostitution, in which the risk of violence and disease is much greater.
There is a good faith debate to be had about which legal model is best suited to reducing this suffering, just as there is a good faith debate to be had about drugs policy. It could well be true that, as Hart and Aella suggest, the full decriminalisation of both industries would be the best approach. It could also be true that partial decriminalisation would be better: criminalising only sex buyers and drug dealers, for instance, while decriminalising the other party in the exchange. This is an empirical question that can only be answered through rigorous investigation.
I’d suggest we look neither to Hart nor to Aella when considering this question, or at least not to their personal experiences. This is because not only are both figures in particularly advantageous positions economically, they also seem to have other qualities that set them apart from the average person. Aella describes herself as unusual, someone capable of “high decoupling” when it comes to sex, which means she seems to be unaffected by the kind of distress that many other OnlyFans creators experience. I don’t doubt that Aella personally does well by the sex industry, but she has very little in common with the women at the most wretched end of it. She is a particularly glamorous and charismatic outlier.
In a similar way, Hart is – to put it mildly – an atypical heroin user. Not only is he unusually clever and accomplished, he also appears to have a remarkable degree of impulse control and is not, for whatever reason, vulnerable to addiction. His experience is a very long way from that of the clutch of rough sleepers who are usually found near my local Tube station, who have the kind of characteristically hoarse voices that result from crack cocaine burns to the larynx.
Perhaps these particular users would not have passed Hart’s “grown-up” test, in that they may not have been “autonomous, responsible, well-functioning, healthy adults” when they started using. But many of us are likely to fail this test at some time. In fact, I doubt anyone is ever really “autonomous”, given the necessary interdependence of human beings. The law is a blunt instrument, since it must apply equally to the imperfect “non-grown-ups” as to the exceptional “grown-ups”, with occasionally messy results. But, then, if a person has to jump a very high bar to benefit from a policy, perhaps it is the policy that’s at fault, not the person.
This article appears in the 24 Mar 2021 issue of the New Statesman, Spring special