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Good evening.

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I want to talk to you
about your drug use.

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Well, not just yours.

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Yours, mine, everyone's.

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It's an awkward subject
in the United States

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where we have very specific ideas

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about drugs,

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but we need to talk about it

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because our thinking about drugs

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is completely disconnected 
from our behavior.

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It's disconnected from our drug use.

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Let's do a thought experiment:

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Close your eyes and imagine a drug user.

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OK, I want you to hold that image.

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We'll come back to it.

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So let's start at the beginning.

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For over 40 years the United States
has waged a devastating drug war.

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In that same period of time

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we've experienced an unprecedented boom

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in the pharmaceutical industry.

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The result of these two trends

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is that on the one hand
we've incarcerated millions of drug users

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while becoming the most medicated people

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in American history.

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How did we get to this conflicted place

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about drug use?

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And is it where we want to be?

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Let's say, for the sake of conversation,

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"No, it's not where we want to be."

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The thing is, we can change our behavior
and our approach to drugs

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if we all change our thinking about drugs
and the desire to use them.

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Let me define what I mean by drugs

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because I'm sure by now
your mind is just skittering around.

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When I say drugs,
I mean psychoactive drugs.

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These are substances
that affect our thinking,

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our affect, and our behavior.

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They include amphetamines, cocaine,

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hallucinogens, marijuana,

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opiates, alcohol, caffeine,

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nicotine, and psychotherapeutic drugs

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like antidepressants and stimulants.

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We rarely think about these drugs
as an entire category.

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Instead, we tend to split them
into two different kinds of drugs.

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We think of good drugs and bad drugs,

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or we think of illegal drugs
and legal drugs.

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Cultural historian, Nancy Campbell,
says that we tend to think of them

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as problem-solving drugs

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and problem-causing drugs.

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You know what I mean.

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(Laughter)

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These are socially created
attitudes and categories.

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They don't tell us very much
about the effects of these drugs,

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but they tell us a great deal
about what we think about drugs.

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So what are good drugs and bad drugs?

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Well, let's start with our stories
about good drugs.

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We tell ourselves the good drugs
are problem-solving drugs,

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medically necessary
or harmlessly pleasant.

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(Laughter)

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They're readily available in two ways:

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we either get access, openly available,

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the caffeine you had this morning
or the beer you have at dinner,

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or we have to seek them
through a prescription,

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a physician's consent.

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Ask your doctor, we do a lot.

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It's common.

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It turns out that even just
a tiny subset of good drugs,

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the American Psychological Association


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says that of the psychotherapeutic drugs,

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use has risen 22% in the last decade.

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That means that one out of five of you

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are on at least one
of these substances right now.

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Or across the country, 51 million people.

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Another 7 million use them
without the consent of a physician.

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Consider another good drug: alcohol.

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A hundred years ago
it was a contested substance.

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Now, cultural attitudes have changed

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and we look back
on that period of alcohol prohibition

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as a misguided attempt

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to control the desire
of millions of Americans to drink.

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In fact, we celebrate the use of alcohol.

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We serve it at our social functions,

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we give it as gifts to family
and complete strangers,

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and we expect it to be
at most of our meals.

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In other words,
alcohol is a psychoactive drug

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whose use has become normative
for most Americans.

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It's a good drug.

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Bad drugs...

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Well, the stories we tell ourselves
about bad drugs

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are that they are problem causing.

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They are criminal, dangerous, addictive.

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They're not for medical use.

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In fact, we use them to avoid reality
or to escape responsibility.

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They are a one-way ticket
to self-destruction.

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Our media is full of the horror stories

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of the users of bad drugs.

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Do you remember the frying egg? (Chuckles)

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Well since then, we've had crack babies,

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meth tweakers, coke heads, junkies.

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Their ravaged faces have been plastered

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all over public service announcements

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in Hollywood and television programs

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for decades.

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We know what happens
to people who use bad drugs.

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Or do we?

105
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When I talk about drugs and desire,
people make two assumptions:

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they assume I'm talking about
illicit substances

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and they assume
that if you desire a substance

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you can't control
your use of that substance.

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For the majority of users
of psychoactive substances

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in the United States,

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it turns out that is wrong.

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The National Institute of Health

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does an annual survey
of alcohol and drug use.

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And in that survey,
for just illicit drug users,

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they note that 22.5 million users

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use regularly,

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and of them,

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an average of 18% are addicted
to whatever substances they're using,

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because it's a whole category
of illicit substances.

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I say 18.5% is an average
because it ranges from 10% to 30%

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depending on the exact drug.

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Of the 131 million users of alcohol,

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11% become addicted.

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Hmm...

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Addiction is a real issue

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and many Americans struggle with it.

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It is also a serious social concern

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because of all psychoactive drugs
15 to 30% of users become addicted.

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The exception is nicotine:

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80% of nicotine users become addicted.

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But I think it's important
to realize two things.

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The first is:

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when I talk about this subject
people often react right about now,

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and the reason is that you probably know
somebody who struggles with addiction.

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I do,

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and I have compassion for that suffering.

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On the other hand,
it's important to realize

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that if 15-30% of the users
of psychoactive drugs become addicted

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that means that 70-85% of the users don't.

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That means that 70-85% of users 
of psychoactive drugs

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are controlled users.

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It's almost hard to believe
because we never hear that.

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Instead, we tend to focus
on the people who are addicted,

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which is a very tiny subset
of a very tiny subset.

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But like a researcher
in chemical dependence said to me -

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his name is Robert Whitney -

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"It's like the flu,

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the virus is all around you
but not everybody gets it."

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So on the spectrum of people who abstain
and the people who are addicted

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are all the other users.

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And what are they using?

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Well,

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of the psychoactive drugs
that we could possibly use

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and the ones we hear
the most about are illicit drugs.

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Under 9% of the users
of all psychoactive drugs

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use those illegal drugs.

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Another 15.7% use
pharmaceuticals, non-medically,

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so recreational or repurposed
for other reasons.

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We'll talk about that in a minute.

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Another 20% use
pharmaceuticals as prescribed.

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And then there are the majority of users,

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over 50% who use alcohol
and over 68% who use nicotine.

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The thing to notice

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is the majority of these drugs
are socially approved.

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And in fact, the majority of the users
of these drugs, of all of them,

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use in a controlled fashion.

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So I have to ask,

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can millions of happy,
controlled drug users be wrong?

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(Laughter)

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We're all users.

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Whether you run seven miles
to feel energized or to shake your stress.

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Whether you smoke that bowl
before you go to a movie with your buddy.

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Whether you drink that bottle,
or bottles of wine with your family.

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Or you eat a handful of mushrooms
to go out on a hike.

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Or maybe you just have to have

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that first, second, and fifth cup
of coffee in the morning.

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We're all users

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and our practice reveals
how we want to live.

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I want to talk about one substance
and three sets of users

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to kind of illustrate
what I'm talking about.

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Psychostimulants have become
a much more prescribed drug

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over the last ten years.

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They're typically prescribed
for psychological disorders,

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or people who have something
like Attention Deficit Disorder.

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And so a lot of teenagers
and college students use these drugs.

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So do their friends

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because everyone has figured out
these are "performance enhancing" drugs.

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In other words,

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they help you focus 
for an extended period of time.

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If you go to the library
in a college campus

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within two minutes
you can have Ritalin or Adderall

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and can sit down to study
for your exams or write a paper.

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It's a common practice.

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Well, the first set of users
I want to talk about

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are elementary school children

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because the parents
of those teenagers and college students

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have figured out
they have an academic edge.

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In fact, they now call
those drugs "smart drugs."

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They're going to their pediatricians

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and asking for their middle school
and elementary school children

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to be put on these drugs.

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Not because they evidence
the symptoms of ADD

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but because they want
that performance enhancement.

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So, I wonder if these parents know

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that one of the most prescribed drugs
is an amphetamine.

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These same parents would be horrified

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if their children turn to methamphetamine.

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But as the parent of one
elementary school child

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who had a dramatic turnaround
after being put on this drug said,

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"Well, she was miserable,
so she wasn't doing her school work,

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and she was completely socially withdrawn.

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Now she's happy,

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she's excelling at her school work
and she's socially active.

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Why not?"

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Why not, indeed.

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The second group of users
I'll talk about

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are professional athletes.

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If college students figured this out

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you know that professional
athletes have figured out

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that performance enhancement
is a good thing.

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And some leagues have decided
to allow the use of this drug

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with the prescription of a doctor.

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Suddenly, across Major League Baseball,

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every other player has ADD.

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It's crazy.

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The thing is, who can blame them?

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If I had to play
over 180 games (Chuckling)

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over the year, that went on
for hours and hours

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and sometimes extra innings,

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I would want a stimulant too.

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(Laughter)

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The third group of users
are writers and thinkers.

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Historically, some of our most famous
philosophers and writers

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have openly used amphetamines
and have extolled their purpose.

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For the same reason
that the college kids,

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the high school kids,
the professional athletes,

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want to use them.

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They help refine focus,

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they help you focus
for extended periods of time.

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So, writers like W.H. Auden
or Graham Greene,

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or thinkers like Jean-Paul Sartre,
are famous for their amphetamine use.

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Lots of writers use them,
including this writer.

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When people come and tell me

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about the propaganda they've heard
about methamphetamine,

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people who have clearly
never tried the drug,

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I sometimes will say,

247
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"I wrote my dissertation in nine months

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with the occasional help
of methamphetamine.

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It was a really functional drug,
it worked for me."

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So here's my question:

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Does it matter, if I'm a controlled user

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does it matter if I use
to get my work done?

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If I use to feel good?

254
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Does it matter if you use
to avoid feeling bad?

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Or your friend uses to have
an introspective spiritual experience?

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Does it matter if we all use
because we want to be celebratory

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and feel intoxicated?

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Our practices reveal how we want to live.

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The majority of users are controlled users

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of all psychoactive substances.

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All of them.

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They are your teachers, your mentors,

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your friends, your neighbors.

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Cultural norms are learned.

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We create them

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and we can change them.

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I'll drink to that.

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(Applause)