Dr. Keith Humphreys

And it feels like to the marriage person, like this is just not the person I married in the first place, that's why we don't match, not because I picked the wrong person, but that person changed.

Yeah, well, that is fundamental to the understanding of the disorder, that is a change in the brain.

And you can call it disease, you can call it disorder, I often think of it as deeply maladaptive learning.

I'm like that rat who really, really believes the most important next thing for me to do is to consume this powder, and when I'm ignoring all the things that I'm evolved to do instead,

So it's definitely true, you see these changes and you can observe them in the brain and it's amazing you can even predict things that the person can't even report on.

So we did some work, myself, Claudia Padula, Brian Knudson, Kelly McNiven up at the VA in Menlo Park,

people who were in a residential program addicted to methamphetamine, all of them off methamphetamine while they're in the residential thing, and then imaging them and showing them cues of meth-associated things like the pipe or the powder and all that, and asking them, how much do you like that?

What do you feel towards that?

Well, independent of that, there's also nucleus accumbens activation that you can see.

And that predicted who relapsed.

not what they said, but what there was going on in their brain.

They didn't even necessarily know it.

I crave this.

I like this.

I want this.

And it helps explain why addicted people sometimes get unfair rap in terms of, well, they lie about what their desires are.

I really, really want to stop using

Well, you know, I would assume if they're in a residential program for 28 days, they do in fact want to stop using, but they don't have complete insight to what's going on on the inside of the brain like anyone else is.

So that person, those two people would both say, I really, really want to do this.

And one goes out and relapses and the other doesn't.