Chapter 1: What are the key motivations behind quitting substances?
If someone says, I want to quit smoking, a good clinician will say, why would you want to do that? Just say, so tell me, what do you want to get out of this? Because it's work. I mean, I'm happy to work with you, but what is it? What are your motives? And sort of helping them build up in their own mind, because again, this is about them, not you. What do you get?
And that's what the therapist does. The other thing that's really important is that like any other, anytime you're making a behavior change, hang out with other people who are trying to make the same change. You want to start jogging? Join a jogging group. You want to stop drinking? I would suggest go check into an AA meeting or one of the other fellowships we have.
Having other people on the same journey is good for us. I mean, everything shows that no matter what you're doing, I'm losing weight, I'm exercising, I'm more whatever, I'm quitting smoking, because it gives you two things. It gives you support, but it also gives you some accountability. Say, hey, you were going jogging on Tuesday, you weren't there, what's up?
Are you going to be part of this group or not? And that is helpful for people.
Welcome to the Huberman Lab Podcast, where we discuss science and science-based tools for everyday life.
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Chapter 2: How does social support impact addiction recovery?
I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. My guest today is Dr. Keith Humphreys. Dr. Keith Humphreys is a professor of psychiatry and behavioral sciences at Stanford School of Medicine, and he is one of the world's foremost experts on addictive substances and behaviors and how to overcome addictions of all kinds.
He is also an expert on how science, commercial marketing, lobbying and the legal system interact to create what are called addiction for profit businesses. The alcohol, food and opioid industries come to mind as just a few examples of these. And he's an expert on how all of that shapes things like legal policy.
Today, we discuss all the major addictions to give you the most up to date information on alcohol, cannabis, opioids, gambling and much more. Dr. Humphries gives us the unbiased facts, and more importantly, he explains how to think about the health risks of any substance or behavior in a logical way.
For instance, while it may be true that a certain amount of alcohol could afford you some heart health benefits, we hear this, then we hear it's not true, it goes back and forth, he explains that any heart benefits that exist from alcohol are greatly offset by the increased cancer and other risks of alcohol.
And with respect to cannabis, he explains who may be okay to use it, but who should absolutely not. We also discussed the most effective ways to get over any addiction. That includes alcohol, pornography, stimulants, and much more. As you'll soon see, Dr. Keith Humphries is no ordinary scientist or psychologist or addiction expert.
He has the big picture on addiction and what it means to try and navigate life nowadays in an ocean of addiction for profit marketing and confusing health information. I assure you that today he doesn't tell you what to think or what to do about various substances and addictive behaviors, but rather how to think about them, and in doing so, how to avoid and overcome essentially any addiction.
It's a powerful conversation that I'm certain will help millions of people make better decisions. Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is, however, part of my desire and effort to bring zero cost to consumer information about science and science-related tools to the general public.
In keeping with that theme, today's episode does include sponsors. And now for my discussion with Dr. Keith Humphreys. Dr. Keith Humphreys, welcome. Good to meet you, Andrew. Addiction is a big topic, but I think for a lot of people, it gets slotted into one small drawer. But if we were to compare to say mental illness, many, many things, depression, manic bipolar, OCD and on and on.
How do you parse this thing that we call addiction in thinking about how best to possibly treat addiction, especially when it comes to trying to treat addiction in mass at the level of policy, which we'll also talk about today? Put simply, how do you frame addiction and how should people think about it?
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Chapter 3: What is the definition of addiction and its implications?
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If you'd like to try David, you can go to davidprotein.com slash Huberman. Again, that's davidprotein.com slash Huberman. Today's episode is also brought to us by BetterHelp. BetterHelp offers professional therapy with a licensed therapist carried out entirely online. I've been doing therapy for many years now, and I can tell you that it's a lot like physical workouts.
There are days when I want to do it and there are days when I don't want to do it. But every time I finish a therapy session, I come away feeling much better and knowing that the time was very well spent. Typically, when I finish a therapy session, I come away with at least one valuable insight or perspective on something that I'm working through.
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Chapter 4: How do genetics influence addiction susceptibility?
It should just be a non-issue, you know, of what do you want and if you say I want sparkling water, I just give you a glass of sparkling water and don't say why haven't you, why aren't you. drinking this intoxicating beverage, you know, you shouldn't need to explain it to me.
The trust piece is super interesting, so is the vulnerability piece. A couple of thoughts about this and they're just editorial thoughts, so forgive me, but one is for years I thought how crazy it was, I would go to these meetings with doctors and scientists ostensibly we're working on issues related to health and everyone would just get trashed at the bar.
And I wasn't into that and I wasn't judgmental. I actually kind of liked it because by the third day of the meeting, I'm cranking and they're all just... I can tell they're all just bleary and they're also aging much faster than I am. They would get the tenured look as we would call it. Or as I would call it, like you see them in five years, I'm like, what happened to you? You aged 15 years.
And these people tended to drink a lot, both at meetings and outside meetings. Alcohol was paid for often by the meeting fees. I'm not trying to point a finger here. And then a lot of the stuff that happened at meetings that turned out cost people jobs was always alcohol related. In the instance of the man and woman on a date drinking or a group of people at work drinking together,
In Japan, it sounded like it was men getting drunk with other men. In my mental picture of the male-female dynamic in drinking, I'm going to simplify this. If she drinks, it makes her vulnerable. If he drinks, it makes him more stupid and impulsive. And so in the world where she's drinking and he's not, you gave the example that perhaps
you know, he would take advantage of her if he's encouraging it. Certainly there's that picture in his mind. He also can get her home safely. If he's drinking, he can't get her home safely and he might say or do something really dumb. So I feel like no matter how the math is arranged, it always ends up, drinking ends up being kind of a bad idea.
I mean, not trying to be judgmental here, because I don't judge what people do. Do as you wish, but know what you're doing is my philosophy. But I just don't see a world where drinking with your coworkers or drinking on a date with somebody that you don't know very well, male or female, right? for either of them, it's just like a lack of safety all around.
It just seems like a bad idea. As women move into more professions that may have changed that norm of, you know, everybody goes out and gets drunk because the consequences aren't the same and, you know, I know a lot of, you know, professional women, I don't want to do that, you know. You know, I don't want to be around the boss when he's drunk, you know.
And so let's have a Christmas lunch together at work instead of, you know, drinks afterwards. So I definitely see that. I think in the dating, now, of course, I haven't, thankfully had to worry about dating for 40 years. But what I think most people would say is just the anxiety, you know, is intense for some people and alcohol is anxiolytic, right?
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Chapter 5: What are the signs of addiction to substances like nicotine and cannabis?
I think a lot of people who use it are mistaking the treatment of withdrawal for a drug benefit. Can you elaborate? Yeah, sure. So, let's say you smoke, when you sleep, obviously you're not smoking and the nicotine blood level goes down and you wake up feel jittery and jangly and all that and you have your first cigarette and it feels great.
Chapter 6: How can withdrawal symptoms affect perception of substance benefits?
But that doesn't mean, wow, cigarettes are really good for you, you smoke and you feel really good. What you're doing is just the withdrawal that makes you agitated and angry and annoying goes away and you attribute that to the use of the nicotine.
But it could just be you are dependent on this drug and what you actually need to do is persist through the days where you will feel cognitively sludgy and maybe a little bit keyed up and all that, but then once you go through the withdrawal, you won't need it to get to that point. It happens with cannabis a lot too. A lot of people say, I can't sleep without it.
Chapter 7: What is the role of motivation in overcoming addiction?
One sign of cannabis withdrawal is sleeplessness. So are you sure that you've got like a sleep disorder that you're treating and not that you basically just are trapped in a cycle of withdrawal and medicating withdrawal. Opioids too is another example. People think my pain is coming back and it's like my injury. Well, it could be, but it could also be you're dependent on opioids.
What's your advice to those people to ride it out? There are treatments that can make withdrawal easier from different types of drugs. But yeah, I mean, if you can get past that point, you could be free of using it at all.
Chapter 8: How does personal experience influence views on addiction treatment?
And wouldn't that be nice to do? It's definitely worth running the experiment.
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I'm very curious as to whether or not the field of addiction treatment has started to parse early, middle stage, and kind of late stage addiction, or whether or not it's all just considered addiction. Like, for instance, a number of people now are suspecting that they might be addicted to social media or their phone or texting or something, something electronic.
They are suspecting that they might be too dependent on... food. They might be addicted to X, Y, and Z. And I think that represents the great success of you and your colleagues and people like Anna Lemke and people being public advocates about what addiction is and isn't.
But to me, it seems like independent of the substance or the behavior, if somebody is early in the experience of feeling like they're weighed down by something and it's hurting them in some subtle way, very different than somebody who's like raising a hand, hopefully, or thinking
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