Dr. Keith Humphreys

So it's rewarding and it is potentially addictive.

But, you know, so what would you see if someone were addicted?

Someone comes in and says, I'm drinking so much, I'm retching.

I'm having, you know, shooting stomach pains.

I can't sleep.

I said, are you going to stop?

And if, you know, I've actually never met... But perhaps there are some people who say, no, I can't seem to stop using it.

I was like, okay, that would be addictive.

But I've never met a true what I consider a coffee addict person because it's not that intense of a stimulant.

And, you know, the thing, you know, you can GI symptoms, things like that, that would be the main thing or jitteriness and sleeplessness.

But almost everybody who experiences those seems to quit.

So, or at least everyone I've met seems to quit.

More generally on stimulants, I have to say this is the biggest disappointment of my career in the addiction field.

I started my career in the late 80s and going into the Lower East Side of Detroit which was very rough, crack cocaine was everywhere.

And the treatment offering to people who were addicted to crack cocaine then in the late 80s is not very different from what it is today, almost four years later.

No pharmacotherapy at all, no evidence of anything that works in pharmacotherapy.

A lot of psychotherapies that don't really seem to work very well, you know, and groups and stuff like that, you know, which have sort of like very most modest effects, I'm talking about therapy groups, that's not a lot of development.

A lot of people have tried, I mean, they've tried all kinds of medications for stimulants and just not been able to succeed.

The only thing that seems to work

is contingency management, which are these things where you... Steve Higgins, I think, was the first person to do this, where he showed against the idea that people have no control on addiction, which is in fact rare, they have impaired control, but not no control.