Dr. Keith Humphreys

He started experimenting with people addicted to cocaine, saying, well, you're coming into treatment, how about tomorrow we'll do a urinalysis when you come in, and if it's a negative urinalysis, the first day we'll give you two bucks, and the day after we'll give you four bucks, the day after we'll give you eight bucks, the day after we'll give you 16 bucks.

And he found out people stopped.

You know, they wanted those rewards.

And that's managing a contingency.

You can use that to change stimulant users' behavior.

Also for other things, you know, like, you know, well, if you come in, there's some kind of reward or you –

if you fill out a job application, there's some kind of reward.

That is the only thing that really looks good for Stimulate Use Disorder.

And it's fine as a behavioral technology and I'm glad to say it's been expanded a lot.

You can do it under, you know, it's covered by insurance now in most places, but it's just disappointing to me

that if you took Keith 2025 back to late 80s and like talk to the same people I was meeting coming to treatment, they say, wow, what new things happen for people like me over the next, you know, in the 40 years, man, for the future, I'd say, I'm sorry, basically nothing.

And that is really disappointing.

Those are tough calls for parents.

There are kids whose lives are transformed positively by brittle, who cannot sit still, cannot do their homework, and it is transformative.

they are at the same time I would say over-prescribed.

It may be an example of a drug that sometimes is both under-prescribed and over-prescribed.

There's probably people who could benefit from not getting them.

And there's a lot of people who are getting them that...

I think there's just less tolerance for some variations in how all our brains work in medicalizing everything and I noticed that a lot, which makes parents anxious, you know, your kid has this thing and all that, as opposed to...

Well, he is kind of an active kid or he doesn't pay that much attention but he doesn't have an illness that needs to be medicated.