Change Your Brain Every Day - Hijacked Brains: The Science of Addiction and How to Heal

Episode Date: June 22, 2026

On this episode of Change Your Brain Every Day, host Dr. Daniel Amen sits down with renowned addiction expert Mark Gold for a powerful, eye-opening conversation about addiction—and why it has far more to do with brain health than character or willpower.   Together, they explore how addiction physically changes the brain, why some people are more vulnerable than others, and how substances and behaviors hijack the brain's reward system. Dr. Amen and Dr. Gold break down the latest science behind effective, brain-based treatments and share practical strategies for healing, recovery, and long-term resilience.   Whether you're struggling with addiction yourself, supporting a loved one, or simply want to understand the brain better, this episode offers hope, clarity, and actionable insights that can truly change lives.

60,000 people a day have surgery in the United States safely with opioid drugs, but hundreds of people die every day of an overdose. When we say a drug is safe or dangerous, it's nuanced. Dr. Mark Gold is a pioneering addiction expert and researcher. Dr. Amen and Mark discuss the problem with addiction. Dr. Ames and substances in America. One would think since Prozac came out in 1988, depression would go down. It's skyrocketed.

The particular drugs have changed. but the net result is we have more and more people with substance use disorders. For the average person listening, based on your work over five decades, what are some of the important things you would want them to know about it? Well, I'd say, every day you are making your brain better or you are making it worse. Stay with us to learn how you can change your brain for the better every day. Hi, this is Dr. Daniel Eamon. I am so thrilled to talk about our brand new course, Brain Thrive, for preschoolers through grade one.

In this course, we're going to teach kids to love their brain, to know that it's amazing, to know that it controls everything they do and everything they are, is if they learn to love and care for their brains, everything in their life will be better. Welcome back to the Change Your Brain Everyday Podcast. I am so excited about this episode. I met Dr. Mark Gold 45 years ago just after finishing my residency in psychiatry at the Walter Reed Army Medical Center. Even then, he was changing how medicine understood a day.

Over five decades, Dr. Gold helped move addiction from moral judgment to brain science, pioneering work on opiate withdrawal, clonidine, altrexone, cocaine, dopamine depletion, food addiction, tobacco, marijuana, and polysubstance abuse. Called the father of medication-assisted treatments for addiction, he's authored more than a third. thousand peer-reviewed publications help build the McKnight Brain Institute and shaped addiction, treatment prevention, and public health worldwide. So Mark, welcome to Change Your Brain Everyday podcast. Thank you very much. It's great to be with you too. It's great to have five decades of work in the field and to know you for almost the whole time. and to watch you and your work explode as well. Well, you know what I'm just so curious about is what are some of the big lessons you have learned that you didn't know when you went into the field.

What are some things that come to mind? Probably the biggest lesson. And so I'm freestyling here. is I started out as a pleasure researcher. Like, I thought I would study the brain's pleasure system, and that would be my career. And really, my first faculty appointment was in neuroscience, and I thought of myself as a pleasure researcher. Well, how do you study pleasure? You could ask people about it, but I'm in neuroscience, so you can't ask animals about it.

So one way that we could study it was by giving drugs. And so then it turns out that I'm in a laboratory at Yale, and the head of the laboratory is doing a big funded research project on the so-called noreidinergic hypothesis for depression, meaning that high neuropinephrine is mania and low is depression. and he was ahead of the lab. The second guy in the lab is using the exact same animal model, and he's studying panic attacks,

meaning high noropreneprin is panic, and low is calm. And I'm sitting there as kind of the youngest person and the least bias and saying, this just doesn't make any sense to me. Because when I look at the stimulated animal, that looks to me like opioid withdrawal. And I then became an opioid expert and a drug expert,

but at a core, I'm a pleasure expert. And I think drugs and pleasure is the untold story. People take drugs in search of pleasure and acquire an hedonia, the inability to experience pleasure. So over the 50 years, I've really been, thinking about drugs and food and sex and everything in terms of the brain's own pleasure system and how if you don't take care of it, like you would say, you lose the full range of control and emotion related to pleasure.

So you can actually throw yourself to death? And that's a lesson. So one lesson as a person is if you have a good idea, you should pursue it. Obviously, my supervisors at that time thought it was a bad idea. And even the chairman of psychiatry when they met with me, and I bet you have similar stories, said I was committing career suicide going into addiction because everybody knew that people who had addictions were sociopaths and pathological to such an extreme that they could not

possibly be helped or treated. And did you even put you way back in 75 when I was in the Yale emergency room? We were not allowed to admit people with alcohol or substance abuse problems to Yale New Haven Hospital. It was considered a problem that couldn't get out of the emergency room unless someone had terminal hepatitis or some kind of medical complication. So we learn to treat people in emergency room and take them to AA meetings or church basements or church-sponsored residential treatment centers. So I'd say my first lesson is persistence. Next, of course, is resilience because you fail all the time in research. You know, the greatest baseball hitter of all time fails six times out of ten.

And I fail continuously and get up and try to figure out what I could do better. And each of my projects that you mentioned, the big projects, had critical moments where I was failing, could have failed, rescued it, got a lot of heat. You know, just imagine this. This is a, since we're just talking. I mean, one of my projects was secondhand smoke. And in your state, you know, I got to work on Rob Reiner initiative on secondhand smoke, did research related to secondhand smoke related to the flight attendants, who all were getting cancers and smoke-related diseases.

And my work showed pretty clearly that secondhand smoke was firsthand smoke, but without your consent. Like we could put animals in the chamber with tobacco smoke. They get addicted. We could produce withdrawal, all kinds of things. Then we went on to show virtually the same thing with cannabis. That secondhand cannabis smoke changed the brain. That brain change, you could produce withdrawal with cannabinoid antagonists.

And then I wanted to study opioids. So where could you study opioid smoking? You got a five-year grant to go to Afghanistan. And Mrs. Clinton funded it with the State Department, and we showed why it was that the children of opioid smoking, opium smoking fathers couldn't learn. They couldn't learn because the father was smoking. Secondhand smoke got the wife who was next to the person in the hut. It got in the breast milk. It got in the walls.

It got on the floor. and the baby that had the least amount of tissue had the highest amount of opioids in its body. But, of course, the child wasn't using opioids. So that's been an issue. You think about it. Think about watching TV and them raiding a mess house. And they then close up that one apartment. But everybody in all the other apartments has been getting.

meth through the walls. And they has met, the people show up and has met gear, but the neighbors of these people were exposed all along. I made a bad joke recently at a talk. And, you know, half of the time it goes, I'm not a comedian. So I said, like, they do radon testing. But honestly, they should look for tobacco, cannabis,

and other drugs on the wall. and sofa and in the carpets just to protect the people who are coming in next. Wow. That must have been so interesting in Afghanistan. We got breast milk, we got air, we got floor samples, and it just brought home. You can't teach a child when they're on drugs. You could try, but it would be better to get them in an environment where they had no drugs, and their brain was able to work at full capacity and develop and then try to teach them.

But all this, this has been bothering me as well on some of the harm reduction. You know, I ran a methadone program in 75. I'm all about harm reduction. But to think that. Smoking is the total answer to harm reduction is a mistake, especially indoors, again, because of second and third-hand exposure and polysubstance use. Some of the ideas that we have, we mean well, like sending tutors and teachers to help the children after. Afghanistan through the U.N. and our federal government state department. But first things first, you know, give him a drug-free environment to grow up in. So it's clearly a generational issue.

So I fell in love with psychiatry. My first wife tried to kill herself. And I took her to see a wonderful psychiatrist. And I came to realize if he helped her, it wouldn't just help her. that it would help me. And ultimately it would help our children and even our grandchildren because they'd be shaped by someone who is happier and more stable. And I've loved it for so long. But she grew up in a pretty violent alcoholic home. And that's when I learned about adult children of alcoholics

and the generational impact that alcohol and other drugs can have. So the work you're doing impacts generations of people. Thanks. You know, I'm still at it. Even just yesterday, I put out, you know, I write once a week for psychology today. I put out an article and I'm saying to myself, and you'll instantly know this is the case, of your work in your centers.

We don't know how many times people have overdosed. We don't know how many times they've been rescued with naloxone. We don't know how many times people with substance use disorders and alcohol have been in fights and arguments and lost consciousness and accidents. And so the literature on this is so confused. Think about just the choice of words. somebody is under the influence of opioids, they call them nodding or on the nod, as if they're sleeping. But if you actually look at the brain in sleep and their brain, they're not sleeping.

And people might say, well, what is it? And so I wrote, I compared, is it like being an anesthesia? No, because in anesthesia, you're hooked up. They give you the least dose possible. They monitor your respirations. They give you oxygen. They have naloxone right there. If they ever, God forbid, would make a mistake.

No, it's not like anesthesia. And the numbers were like astounding. Who knows what the real numbers are? But the estimates are about 60,000 people a day have surgery in the United States safely. with opioid drugs given to them and without any consequence. But hundreds of people die every day of an overdose. So no, drug taking is not like sleep, even though Morpheus is the god of sleep. It just looks like sleep, but it's not restorative like sleep.

it's destructive. And actually in this nodding, in this overdose scenario, drugs cause anoxic, hypoxic changes to the cells that are the most oxygen-sensitive, cells that we use for memory, emotional control, and so forth. So my assumption is that many of our patients with severe suffering, substance use disorders have had sequential loss of function that they maybe should be in a neuro rehab program. We have no way to know.

What a great idea. That's a don't ask. What a great idea. If you use substances, they damage your brain. If they damage your brain, they damage everything in your life. But if you stop and put them on a rehabilitation program, their brain can be better. Yeah.

That sums up our work. And, you know, since I was on your podcast and you brought up the idea of anoxia after an overdose, that I actually have a patient who took too much of an opiate, went into a cardiac crisis, became anoxic. and I have her big fat brain before that happened, and I have her much smaller toxic andoxic brain afterwards. And when I started looking in 1991 is when I ordered my first spec scan, I was a director of a dual diagnosis unit, a psychiatric hospital unit that deals with drug addicts.

All their brains look terrible. And so I would show them to all my teenage patients. I'm like, this is a healthy brain. This is a brain on drugs. Which brain do you want? And it was very powerful. Yeah, well, I was on that committee. And I have a picture of Herb Kleber, Chuck O'Brien,

the other guys that were on this, this is your brain on drugs committee. And it was the question, could a bunch of addiction experts, all of whom are probably deceased by now, except for maybe Bob DuPont and David Smith and I, come up with an ad to help people not use drugs? And the advertising people do this all the time. We couldn't think of anything. Like we came up with an ad that people are using cocaine. and in the background, you hear their pulse going faster and faster and faster and then having some untoward circumstance, like a stroke or a heart attack.

And I can't remember who said at the time. I go, no one will even show this at it. But this is your brain on drugs, captured a moment and was supported by some evidence because, as you know, in the old days, cocaine overdoses were not only hypertensive crises, but very, very high body temperature. And we take people in the emergency room and literally pack them in ice to help try to protect their brain from hypothermia-related brain injury, which was where the frying came from the frying pan.

Like that was the notion. It was cocaine, hypothermia, high temperatures would damage your brain. Yeah, no, it was brilliant.

David Smith and I were friends. We wrote a book together called Unchained Your Brain, Breaking the Addictions that steal your life. Yeah, I love David.

Let's, because most of people listening are not medical people, let's talk about some practical things that you have learned. And you have a newsletter that I read. It comes out on a regular basis.

I think it comes out every week or twice a week. And so people can just Google Dr. Mark Gold newsletter. Or maybe you can send a link and we'll post it. But I'd love it because it's generally very practical. So for the average person listening, based on your work over five decades, what are some of the important things you would want them to know about it? Well, I'd say thank you for reading my psychology today blog. It's called Addiction Outlook. I write at least once a week, and I try to pick a subject.

That's of general interest, but poorly understood. So this week I did, what's an overdose? It's certainly not sleep. It could be a brain injury event. I reviewed the psychedelic initiative. One thing I'd like people to know, and like the best, people said to me, like, it's terrible about sports gambling and, you know, how addicting the modern forms of gambling are.

And I said, well, it all started with church bingo. And so I literally wrote about how in America we go from church bingo to state lotteries to digital betting, to mobile apps, to instant payouts. And we create the most addicting, most compelling forms from something that's pretty innocuous. And, you know, the same thing would apply to cannabis at Woodstock, where I was a medic. And we had 0.5% THC cannabis. And now people say they're getting no cannabis if they have 30 times out of it.

So again, when we say a drug is safe or dangerous, we have to, it's nuanced. And the same thing for fentanyl. Fentil is used all the time in surgery. But when it's used on the streets of L.A., it causes death and destruction. But again, it's because of other factors like dose, like polysubstance, like self-reveillance, like self-administration. Self-administration changes a lot. The same thing would apply to talking about psychedelic. And by the way, I had a great time talking with you. And this week's addiction outlook, Psychology Today blog, I did was after thinking about your own work and thinking that

people had brain changes after substance use episodes and addictions and to focus on the brain. So I was thinking all of the lost opportunities that we have in helping people by not knowing their whole CNS and unconscious, accidents, fights, overdoses, reversal, and not knowing. that history and mentioned it to a to a prominent cardiologist who said it was the most ridiculous thing he had ever heard because obviously cardiologists know how many times you've had heart attacks and it just outrageous that we don't pay any attention to the brain but when I go through these 150 articles by the way my work is free I think there's a lot of hope now. There are things that are going on that are beneficial and that will help us in the long run. But I often say you should curb your enthusiasm. Wait for the evidence. And maybe the best

example of this, Dan, is looking at what happened with the FDA and Molly or MDMA. You know, They proposed it for PTSD. There were phase two trials for PTSD that were positive. There's a phase three trial that's PTSD that's positive. And everybody said it's going to be approved instantly. And then the FDA looked at it. And I listed in one article like what happened with Molly, 10 things, everything was wrong.

Not only did they have instances where people complained of boundary disorders between the therapists taking advantage of the clients who felt this drug-induced closeness to the therapist. And so there was misbehavior. It was also what we call functional unblinding, meaning after the study, they asked the person if they knew whether they got the drug or placebo. and they answered, they got the drug. And they answered the therapist. Did they get the drug or placebo?

I know it's ridiculous. And they said, we got the drug. So how can you do a double blind study when neither party is blind? And the same problem is that. That's kind of what I see is my role. If you just look back, let the science guide you, and try to explain to people, the FDA isn't against drugs that have notoriety or have a past as a drug of abuse. They approved ketamine.

Like the DEA didn't object to ketamine with the REM's guarantee. They made it intranasal. However, we've decided that we would not always follow them. that. Some doctors give ketamine for home delivery. This is such an important discussion because everywhere I go, people go, what do you think of psilocybin? And I'm like, the street drugs of the 60s are making a comeback, right? They are. Marijuana, ketamine, solosybin. I'm concerned, but I also want to do that. I think if you can keep to that as the mantra, you'll do yourself and patients a great service.

Brain health isn't built in a day. It's built daily. Small, consistent habits make a big difference. That's why I focus on supporting my brain every day and why we created BrainMD. Go to BrainMD.com and use code podcast 20 for 20% off. I've written about psilocybin for a long time in my addiction outlet blog. And I have a mentee who did the pioneering study showing what psilocybin does in the brain. It was in nature. I mean, it was the front page of the New York Times. His name is Josh Siegel. And I reviewed that work and other work.

So I'll tell you one thing I'm very interested in. And I wrote about this recently. Could psilocybin treat cocaine use disorder or methamphetamine use disorder? And as you know, we don't really have any treatments for that, meaning no medication-assisted treatments. That isn't to say that rehabs haven't successfully treated people with all kinds of drug disorders and polysubstance disorders. for many, many decades.

But if you were to ask me beforehand, if I had a group of mostly unemployed, mostly African American, crack addicted people, and gave them any substance as a treatment, would anything help? Now, we developed this dopamine hypothesis, said that 1984, 85, said cocaine was addicting by virtue of its effects on dopamine, and that over time, cocaine used up more dopamine than the brain could make, so the person became anodonic and so forth. And so while that theory has proven to be very successful, it never led to a treatment.

all the treatments that were built around that failed. Every single treatment, I list them all with great humility in this psilocybin paper of mine. But here you have it. They give psilocybin to these people. I think it's in Alabama over a long period of time. And it turns out that both self-reported, of cocaine use. And cocaine use, as shown on urine tests, decreased tremendously and abstinence increased. So for the first time, and compared to placebo, there was hope. Now, other hope for

psychedelics would be that the mechanism by which they act is so different from typical psychiatric medications. Take the example of treatment-resistant depression. Like we give SSRIs or antidepressants, and it takes weeks, six weeks, let's say, for an effect. And then if it didn't work, we have to change the dose or change the medicine and so forth. But here for psychedelics, it's possible that we can give one dose and restructure things and have an effect. So I think there's great promise and also, as you point out, Harold, because a doctor who treats himself as a fool for a patient. The same thing would apply here. These are controlled trials.

So if you're in one of Josh Siegel's trial, he's going to do an extensive psychiatric evaluation beforehand to be certain that you're not going to get. a persistent hallucination disorder, or you're not going to get schizophrenia, or you're not going to think you can fly and jump out a window so that they would prescreen someone and give them the psychedelic treatment in a controlled environment with guides and with monitor, both of which are really important because if psychedelics could prevent all of depression and anxiety and all these problems, the people of the 60s, the people of Woodstock that I took care of in tents for bad trips and so forth, they would have had different lives than most of them had, but they didn't. But as a therapy, we might get something in a controlled setting that would be very helpful for us for really difficult patients with legit like failed at TMS, fail at psychotherapy, persistent depression.

And maybe there's a psychedelic approach for that, you know, the kind of towed approach. that Mike Tyson popularized. They have psilocybin being tried for treatment resistant depression. And it may be the first one to be approved. The trials have been going very well. They have a dose. They have a purified form. They have a procedure that maximizes safety and minimizes harm.

And they have a follow-up, like we do. for spravato. So I do see a way that that, that there would be a path for improved access, but to think that you're just going to buy it on the street or from a state supplier, there is even a study, Dan, where they looked at psilocybin mushrooms. I forget if it was Oregon or Washington or Colorado and tested them. It's, it's hard for somebody to get. a therapeutic dose, even if they could self-administer it safely, even if it was safe for them to take. So I think, again, if you remember the old axioms all the way from Hippocrates, a doctor who treats himself as a fool for a patient, let the experts evaluate and treat you and hope, I would hope we could find, protocols that the experts can follow that would help people who can't be helped right now.

So soldiers with traumatic brain injury. You know, we have Ibogaine trials going on for that. We have end of life. This is an interesting one for Scylla Seibon. And most people don't follow this literature. but the Johns Hopkins group that showed that psilocybin could reduce cigarette smoking. And that same group showed maybe 20 years ago that psilocybin reduced end-of-life crisis. And I don't know.

I just think these the, you want me? to spend some time on the mechanism? Because the mechanism may explain why it's interesting for psychiatry, too, for psilocybin. You bet. And from what I understand, based on brain imaging studies, is it decreases default mode network activity, especially in the back, especially in the poster. I have a before and after Ibegain study, and it's exactly what it did. The problem is it also dropped their frontal lobes significantly.

It didn't make their brain look healthier, but clearly did that. And so for people listening, the default mode network is that part of your brain that sort of talks to you? It's the chatterbox. I often think of it. And often the critic in your head that tells you, what's wrong with you? And psilocybin decrease the activity there. Talk more about that, Mark. Well, I think that's important that you started with that because that's, I think, really important. And Josh Siegel's work kind of shows that. People talk about habit formation and addictions

especially. But the same applies to psychiatric illness. You're kind of stuck in a rut, doing the same thing, and it's not working out, but you're still doing the same thing. And so they talk about how the changes in the default network can improve flexibility. Now, this doesn't mean that you could do this without a guide. Maybe that's something we should be thinking about, training psychedelic therapists. That doesn't mean that you should be doing it at home on the weekend or in Jamaica. but it is important to note that when we talk about psilocybin, very little time is spent talking about serotonin, though it has a 5HT2A receptor activation. Most of it is about brain networks.

And I like this notion of brain networks. That's how TMS works, rather than thinking that TMS changes noraphenephyrine or dopamine or, serotonin acts on the network that's involved in this negative thinking, bad mood and so forth. So I think the things that are the most exciting about psychedelics are the fast response. The thing that's the most exciting about ketamine is it broke the rules about how fast a person could find relief. there are clinical trials right now to study psychedelics and others for ketamine in people who have suicidal thinking. Maybe they'll be giving it an emergency room rather than putting somebody in four-point restraints or sending them to a locked ward in a psychiatric hospital. All these things would be just great if we can develop the protocols and the doctors will follow them.

We don't, I mean, I personally like these RIMS protocols, like what makes bravado safe is the procedure. Like, you have to be in the office. You have to be monitored. You take the treatment, you're monitored. You leave the treatment room, but you stay around, you're monitored. And I suspect there'll be something like that. if psilocybin's approved for treatment-resistant depression, especially LSDs in phase three, I believe, right now, for impossible to treat anxiety disorders. You have, I don't know, the president's initiative on psychedelics moving for psychedelic drugs into the kind of rapid,

review process. So I just think there's a lot happening. So let's talk about ketamine. Lots of excitement when it first came out. I have 50 doctors that work with me. I think as a group, we're pretty underwhelmed by its long-term effectiveness. Yes, it can take someone who's suicidal and help avert the crisis. if you will, do you have a sense? You know, it's like when marijuana came out, it's like, oh, it has great mental health benefits. You did a review that went, not so much.

It's like, no, not so much. And, you know, one would think since Prozac came out in 1988, that depression would go down. Well, it skyrocketed since then. and since ketamine came out, I don't think the incidence of depression is going down. Yeah, well, so we should, you know, I mean, I spent a lot of time in my career on, like you, but I worked in laboratory models on food and what we eat and exercise. Like, you know, we have a high impact exercise model that prevents or reduce.

reduces drug use. You know, by the way, people forget in the old days, if you overfed an animal, drug self-administration would go down. And we studied alcohol as a bridge to sugar because of the sugar cane alcohol connection. So I do think our behavior, what we spend our day doing, is just maybe impossible to reverse with medications. But I would stick to the side of if you had a depression and you're a psychiatrist have to treat them, what's the algorithm?

Now, for me, if I could forget about reimbursement, I would probably start with TMS. And the reason I would start with TMS is because the brain is the source of the problem. Circuitry is a source of the problem. And I'm not saying we're going to do diet and exercise in these, but of the biological treatments, I think TMS has been pushed down the output by pharmaceuticals, unfairly. And then I think, then the question is if a person fails, would you give them

ketamine? I think it's an interesting treatment. It works fast, as you said, a guy out in California, a good friend of mine at Stanford, Alan Shettsburgh, has been, has just shown, and his paper was just in the American Journal of Psychiatry last week or the week before, has shown that you could extend the effects of ketamine by adding buprenorphine to it. So it's an interesting proof of his, or at least support for his theory, that ketamine is working in part by its opioid-like effects. And so what he's done is shown that the ketamine effect that wears off, like we described, can be extended with Suboxone at low doses.

Then don't they get hooked on Suboxone or buprenorphine? When buphernorphine first came out as a treatment for opiates, I'm like, oh, this is so interesting. But then I couldn't get people off of it. And I always think, you know, I don't want to start you on something you can't stop. That's so interesting. It's a method. But anyway, look, so I think,

again, my research side is different than your clinical side. When they say ketamine to me, I'm saying like, wow, how does that work? Like we have all these theories in psychiatry and ketamine, well, we need a new theory to explain how it works. What's the mechanism for cancer? Well, you know, basically you have the main thing. It's definitely not, well, it's debated. That's the point. So Shatsberg says, no, no, you shouldn't consider ketamine just the way it's described in the literature. You should say it's really not just NMDA. It's an MDA. It's an MDA receptor receptor. blockade plus some sort of opioid augmentation.

And they first brought this to our attention by giving naltrexone to people who were treated with ketamine. But anyway, it's so my... And did that block the effect? Did that block the effect? Yeah, yeah, yeah. Oh, that's so interesting. It's a glutamate receptor system and MDA.

There's some depressions that respond to opiates. In fact, as a clinical person, someone who's, I had a treatment-resistant depression, went to the dentist because his wisdom teeth were taken out and put on Vicodin and his depression went away. Now, giving them opiates is not the, answer. No. I mean, that's the mechanism.

Yeah. And you look at the MDA mechanism. And you just reminded me of this with the dentist. Like, I'm

dangerous because I pay too much attention to everything. That's in science. But the nitrous. That's a. So ketamine

and nitrous worked the same way. And another thing worth keeping in mind is that Nitris is not a controlled substance by the DEA. And the guy who showed in a double-blind experiment with the dose of nitruses, that's an equal antidepressant,

is a guy named Chuck or Charles Conway. And he's been trying to get nitrous approved as an antidepressant, but it's so cheap. And it's not really patentable. It's not controlled. But I do think that might explain laughing gas. Oh, no, I have patience and did it to laughing gas. And so I'm like, oh, great. You know, it's just, it's such an interesting feel.

I mean, that's kind of like for your, the listeners and viewers and people that you work with, you couldn't, this is a great time with a lot of promise. You just don't want to see like a Matthew Perry event. You just, the guidelines are set for the specific reason of limiting harm. And the 60s showed a lot of. harm to all these drugs that were resurrecting for beneficial use. And we have to stay in the lane and we'll get the benefits without the pain for much of the benefit. What's a new that told me a long time ago, as the perception of dangerousness of a drug goes

down. Its use goes up. Because I'm a 22 year old daughter and she says dad, they're not drinking as much. They're using mushrooms. So they go to parties

and it's still asybin parties. Right? You're the one that told me that, I think. Well, I mean, I'll take credit for it. I used to say that in lectures because of how to

we get cocaine epidemics, keep recycling. And what it is is that we, like you and I, we learn the harms, and then over time we forget. And then it comes back. So, you know, cocaine's back and ketamine is back. And it, but yes, there's actual data that shows that perception of harm is directly related to use. I mean, people aren't using drugs at parties to commit suicide. And they, the trend following, I mean, you're trying to start a trend around brain health. That would be a trend worth following.

But the trend following about drugs has meant over my 50 years, the particular drugs have changed, but the net result is we have more and more people with substance use disorders. They're having to write the criteria now for ketamine use disorder and make it part of the DSM. There's a professional articles now on ketamine use disorders. You see them all over your doctor. Have been the one who got you hooked. Yes, yes.

It's crazy. Before we have to stop, I want to talk about pleasure. So we started, you started your career with pleasure. I think one of the things that gives me the most pleasure is seeing my patients do well. I just get joy out of that. What are some of the things that you've seen that you actually put into your own life that increase the pleasure centers in your brain. Married to the high school sweetheart, and we've been married for 55 years. So I have a partner.

We have just lots of shared experiences to recall and bring us joy. and we have children and grandchildren. Same for that. Individually, I used to run. When you first met me, I would have been a runner. And that gave me calm and peace and pleasure. And I liked being in nature. That was really, and it got me interested in studying exercise as a neurorestorative treatment.

I think I've used that throughout my life. So today I got up. I did a two-mile walk along the river, and I did the same thing before noon. And after we get off, I'll go to a grandson's birthday party, and I'll be a happy person from sunrise to sunset, I go to sleep at about the same time every day. I go wake up.

It's basically on a sun calendar. When the sun comes up, I get up, when it goes down, I start resting. And I did do sleep research early in my life, so I've taken sleep quite seriously my whole life as a result of that. I'm keenly aware that I don't have the same pleasure system that I had as a teenager, but also maybe that's good. So, I mean, I said to Nora Wolkoff one time, because she was imaging the dopamine cells as you age, and you need a substrate to have maximum drug experience.

So, of course, you have the most responsive dopamine. dopamine system when you're a teenager. And as you get older, it is less and less. So she had this graph that was like this. And I said, well, what's the end of it? She said, it was like 60 on her graph. And I said, like, I'm much older than 60. I still have pleasure.

So how do I have pleasure without these cells that you say are essential for pleasure? And so according to her, it was derivative, euphoric recall. It was like I have the, I understand the way my, I replay the old pleasure in my brain and there's a delay, but I definitely can still feel it. I have no idea whether that's true or not, but I have an intact pleasure system. I'm lucky about that. My mother was a Julia-R-trained pianist, and really up until a few months before she died, and she was almost 98. She played the piano in the morning.

She played the piano at lunch. She played the piano at night, and loved every day of it. I love that so much. So it's connection, it's good habits. it's exercise and likely doing meaningful work that makes a difference in the lives of other people. Mark, thank you so much for spending your time with us. I know the people who are watching, listening will appreciate you. How can people learn more about your work, get your newsletter, follow you?

So there's a free subscription bar on the Addiction Outlook. So they basically just go, Mark Gold, Addiction Outlook, Psychology Today, they'll take you to my homepage. There's literally 140 free articles on everything that you were interested in and things are not interested in. I'm working right now on an article on SSRIs and whether they're addicting. It's a people give me ideas. Dan gave me an idea, which I just developed.

My youngest daughter, who's a psychiatrist, often will give me ideas and say, you know, you should really do this. And actually, it was her idea. She's a psychiatrist at the University of Tennessee system. She said, Dad, nobody knows anything about your work. and you have all the people referring to it in science, but no one outside.

And why don't you do this? And I said, well, like, do what? I should have called you, Dan. But instead, she said, like, write this person at psychology today. So I wrote the editor. And she says, send me a sample. I mean it. So I said, like, I've written so many.

She said, it's different. Writing that people understand it is different. And you do a very good job. of that you write so that everybody can understand it. You write in a beautiful, accessible way. You're in a war for the health of your brain. Everywhere you go, someone's trying to shove bad food down your throat that will kill you early or give you an addictive gadget,

put terrible news in your head making you anxious. Hi, I'm Dr. Daniel Aman, founder of Aeman Clinics, and Amon University. My wife, Tanna and I created the Brain Warriors Way course. It's 26 hours of content where we walk you through specifically in detail

how to have a better brain and a better life. From the food you eat to the thoughts you think to the strategies that you can engage in every day. If you want to survive and thrive, you have to become a brain warrior. All right, my friend, we have to stop.

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