Rev Left Radio - Never Enough: The Neuroscience and Experience of Addiction

Episode Date: May 28, 2021

Dr. Judith Grisel, former addict and current behavioral neuroscientist, joins Breht to discuss her life experiences and her fascinating book "Never Enough: The Neuroscience and Experience of Addiction". We discuss how addiction works at the level of the brain and how it feels at the level of experience. We also discuss multiple substances specifically, including marijuana, alcohol, caffeine, MDMA, and more. At the end, we talk about policy approaches to addiction, how America gets it wrong, how we should approach it societally, and then Judy offers some tips for how to prevent addiction and some hope for those who are struggling with it. Learn more about Judy here: https://www.bucknell.edu/meet-bucknell/bucknell-stories/faculty-stories/judith-grisel-psychology Find her book here: https://www.audible.com/pd/Never-Enough-Audiobook/1984841076 The Men's Health article mentioned in the episode: https://www.menshealth.com/health/a26146242/marijuana-weed-addiction-recovery-brain-science/   ----- Support Rev Left Radio: https://www.patreon.com/RevLeftRadio or make a one time donation: PayPal.me/revleft LEARN MORE ABOUT REV LEFT RADIO: www.revolutionaryleftradio.com

Hello everybody and welcome back to Revolutionary Left Radio. On today's episode, we have on the behavioral neuroscientist Judy Grissel to talk about her experiences as an addict early on in her life, as well as her book, Never Enough, The Neuroscience and Experience of Addiction. She was a former addict, got clean, went on to get a PhD, in neuroscience, studying addiction, and how it works at the level of the brain. And so weaving those two things together, the scientific knowledge as well as the experience

of addiction creates a really fascinating read in her book, Never Enough, which you can find anywhere books are sold. And particularly, I listen to it on Audible, where she herself reads her own book, and I always love that. So if you're more of a listening person, you can check out The Never Enough on Audible. But yeah, you know, we touch on a lot of issues and these are issues that are very meaningful in people's lives. They cut very deeply because almost everybody that's listening to this right now knows somebody if they themselves have not suffered from it who suffer from addiction of some sort or another. It's a hugely common thing in the modern world.

And so there are elements of any discussion that, you know, people will maybe bristle against. or totally agree with or find illuminating, et cetera. So just listen to this with an open mind, and I think you'll definitely get something out of it. I know I got a lot out of reading the book and out of this subsequent conversation with Judy. And as always, as we make very clear throughout, you know, nothing that we say as far as how certain substances are addictive

implies that we support the criminalization of any of these substances. Clearly, the carceral approach to addiction has been a disgusting failure. and we talk about that in closing of this conversation. And so, you know, none of this is to say that we want to criminalize any of these substances. In fact, it's almost always better to educate, to decriminalize. So it's not engaged with the carcceral state to provide resources for people who are addicted to get out without having to deal with the injustice system in the United States. And the sort of just the resources that come with helping people who have mental health issues more broadly.

And then everything that we say in this conversation is said to equip the listener with more understanding of how addiction operates, you know, experientially, as well as neurochemically, neuroscientifically, so that you all have more information and can be safe. You know, I know that I have used hundreds and substances hundreds and hundreds of times, almost everything you can imagine, from meth to cocaine to psychedelics, to pills, to everything in between. experimented with myself and I often did it in a reckless uninformed way in some instances very dangerously so an almost overdose on morphine as a teenager overdoing stuff like ecstasy as a team that facilitated my going into in-house hospital treatment for for clinical depression and on down the line just lots of reckless things that teenagers do particularly when they're under-informed so We offer this episode with the idea in mind that you can have healthy relationships to substances. And in fact, if you do have a certain healthy relationship with a certain substance,

it can actually make life a little better. It could add a little spice and flavor and variety to life. And there's nothing wrong with that, specifically when it comes to stuff like psychedelics, which I've talked about many times, if used responsibly and in an informed way, can often be life-enhancing in profound ways. My experience with psychedelics was one of the things that got me on a path of spirituality and meditation more broadly. So we just want to equip the listener with as much information as possible so that you can make more informed decisions in your life and hopefully can prevent within yourself and those close to you who you have influence on engagement with substances turning into addiction.

Because it's always a story of tragedy and despair when addiction wraps its fingers around your throat. So without further ado, this is a wonderful conversation with a very engaging, compassionate, and informed person, Judy Grissel, and I'm really excited to share this with you. My name is Judy Griselle, and I'm a professor of neuroscience at Bucknell University in central Pennsylvania. I'm also in long-term recovery from drug addiction. Yeah, welcome to the show, Judy. It's honestly an honor and a pleasure to have you on. As I've talked about off-air, this book that you wrote, Never Enough, The Neuroscience and Experience of Addiction is a book I really loved.

It was something I came across at a very crucial time in my life, and it's helped me a lot, and it's helped reorient my understanding and deepen my understanding of addiction. And, you know, people listening statistically have somebody in their family or friend group that has addicted in some way to some substance. So this is an ever-time, topic and one that almost everybody can relate to on some level. We'll get into the neuroscience of addiction here in a bit, but I think a better way to maybe start this conversation is kind of just

like tell us about your story of addiction, how it happened, what substances you were addicted to, and just kind of set the table for the rest of our discussion through your own personal experience. Sure. I'm kind of on a whim, maybe, but also I guess in a way I was set up for it because drugs were everywhere as they are now when I was growing up. I decided to drink, I was going to say a bit of alcohol, but maybe a large bit of alcohol, about a half a gallon of wine when I was just about 13. I think I might have still been a few days shy of 13. And that really changed my whole life. I think about it sometimes because I felt like I was fairly normal, maybe a little anxious and a little insecure, but probably a pretty typical

12-year-old from suburbia, America. And I drank that alcohol and was kind of off to the races. And I spent about 10 years taking as much of every single drug I could get my hand on, some of them. I didn't even know what they were. I just was. right from the start, pretty out of control. I loved the feeling that alcohol gave me and I loved even more the feeling that marijuana gave me. I liked cocaine a lot and amphetamine. I liked pills. So I ended up spending as much time as I could wasted and as a result of that and it was like fun for a few years and there was so some fun moments. But it, it got kind of hairy toward the end. I was homeless. I was living in South Florida at the time

that I hit bottom. This was in the late 1980s and I was injecting drugs using dirty needles. I didn't contract HIV, but I did get hepatitis C. I was kicked out of several schools beginning in 10th grade and two colleges. And I think most importantly, I, I, I loathed myself. I couldn't stop using, and it felt like drugs were the solution to my problems, but I also was self-destructing kind of from the inside out. So I ended up going to treatment, which, as I said, was a while ago, and I had no idea what treatment was. But I found myself in treatment right about the time of my 23rd birthday. Yeah, and I think that that trajectory is very common to anybody who's engaged heavily with various substances, where at first, you know, using of a substance is a really effective way to escape feelings of anxiety or incompleteness, low self-worth, go down the line, whatever it may be.

But then there becomes a point when, you know, the drugs stop doing what they initially did, the life around you starts falling apart. you're stuck in this doom loop where the drugs themselves make you feel shitty, and then you take the drug to escape that feeling, but then the hole just gets dug deeper, and it's, you know, self-loathing is one of the many negative products of that doom loop. What was that feeling, though? Because you talk about a little bit in your book when you first drank that half gallon of wine, you talk about, like, just like this sense of, you know, inhibition, lifted, and euphoria.

Do you want to talk a little bit about that first, encounter with with drugs? Yeah, I think it's also fairly common, as you described, that people like me have an almost transcendent spiritual experience. I really had a sense of wholeness that came directly from the wine, you know, so it filled my physical belly, but it also seemed to fill my spiritual belly, I guess. And I felt, like I was okay and the world was okay and things that you know I'm sort of describing it was funny because until I had the drink I didn't know I was missing so much but once I had it I felt like I had the key to living and I saw many years later a sign on the back of a bar that I loved which was

alcohol makes you feel like you're supposed to feel when you're not drinking alcohol and that's exactly what it was for me. So suddenly, everything that had been not quite well was perfectly right. And so it just seemed, I remember thinking, and this is, you know, I was like in seventh or eighth grade, and I remember thinking, this is how adults get through life. Because to me, it looked like impossible. There was so much, you know, so many things that didn't seem right to this 13-year-old, you know, full of my wisdom, but suddenly I thought, oh, those aren't that bad. It'll be fine. You know, so it was really, it was two things, I guess. There was definitely euphoria and kind of a sense of bliss, but also escaping, as you say, the lack that, you know,

was kind of a core part of who I thought I was. Yeah, I relate to that very, very heavily. I got very into a smorgas board of drugs in my late teens. Eventually, I ended up in a clinical hospital for depression in-house for a while, and it was after quite a bit of heavy drug use. But I do remember the first time, and I think we'll talk about MDMA a little later in this convo, but the first time I tried MDMA, and it wasn't a bunk pill, I experienced those same feelings that you talk about. this euphoria and importantly, or what sticks out to me is this complete and total erasure of all the insecurities that a human being has, but particularly that those tender teenage years when you don't know who you are yet, and you're comparing yourself to everybody else, and you have deep-seated insecurities that you can't address yourself, you know, to have those lifted

completely, even for a short period of time, you can see how somebody would get hooked on any substance that did that, especially at that time. Absolutely. So that's a, that's a harrowing story. And of course, I encourage people to read the book where you go into even more detail about your story. But how did you ultimately get clean? And more than that, go on to become a behavioral neuroscientist who studies addiction. Sure. Well, as I said, I got to treatment and I thought I was going to a spa, but I was more like in a hospital. And not only that, but the staff were, you know, in their impression that if I wanted to live, then I needed to be abstinent. And you, I would have rather, you know, chewed off my own arms, I think, than been abstinent. Because I did, those were sort of my only coping tools for drugs and really basically my only friends and companions.

So I was, I was pretty much like we said, you know, hollowed out. It seemed to me that the only good thing about my life was drugs. I got sort of, I was so confused. I ended up in a treatment center in the middle of, you know, probably 2,000 miles from home and I didn't have a car anyway. So I, they said you need to be clean. And I thought that that was, first of all, a very raw deal because that wasn't what I was planning. I was planning to sort of just fix my life up a little. But I thought, you know, if they say I have a disease, then diseases, I think by definition, can be cured. Therefore, I'm just going to cure it so that I can use. And I remember distinctly this lasted many, many years, in fact, that I thought, well, if I can just, you know, drop a little acid on Easter or something, then maybe, you know, it won't be that bad. So I had a definite manipulative desire to figure out my own way. I was notorious for, you know, don't tell me what to do. And so this seemed much too bleak, either die, which I was convinced eventually that was

where I was headed, or be clean and sober, I thought there's got to be, you know, a backdoor somewhere. So even though I'd been kicked out of three schools and I had no redeeming qualities probably, I did have the perseverance and persistence and determination of every good drug addict. And so I figured, you know, I'm just going to plow through this until I figure out what's wrong with me, fix that thing, and then I'll be able to use without self-destructing. So I took me seven years to get my undergraduate degree, seven years in grad school to get a Ph.D. And then I did a three-year postdoc in genetics. And somewhere along the line, you know, I was staying sober.

I was taking advice at the same time. But I had this kind of, I was in a way I had told myself, I'm going to try to do what they say for some reason, you know, a certain amount of time. that's how long it's going to take me to fix it. And then I'll be able to go back and use. And so it was really selfish motivations and kind of the kind of really dog-like attributes of most drug addicts that motivated me to become a neuroscientist and to study addiction. And I was obviously not only, you know, crazy but very naive. It turned out that addiction is a tremendously complicated problem having to do with our biology, which I was focused on, as well as our developmental experiences and our social and cultural context. So, you know, somewhere along there, I realized, well, I'm not

getting anywhere. And that's why I ended up writing the book because I thought, well, at least I can explain what we do know, even though we haven't really been able to cure it. Right. How long did your, did cravings for various substances last after you went completely clean? Yeah. So I hate to be so doom and gloom. I, I liked all drugs that I tried, but I really loved marijuana. My craving for marijuana was for 14 years. I'm also a huge fan of live music. And in those days, I was, you know, follow some jam bands around. And I really couldn't go to listen to music, especially indoor concerts, because I would just be overcome with craving. So for marijuana, it was definitely the hardest, but even alcohol, which I sort of drank

like juice. I, I craved it for over a year every day. And then that eventually lifted. And it's mostly lifted. So when you, you know, when I talk about it now, it's not as if it never crosses my mind to have, you know, a margarita or smoke a bowl or something. It does, but the craving is not one that leads to a big physiological response and, you know, an all-consuming compulsion to pick up. So that has been kind of a long haul. And I think it's due to the fact that I really did love them. You know, it's this terrible irony that the people who don't really love drugs can use them all they want.

And they just don't do it right, as I would say. But people like me who would give up everything for it really can't afford that luxury. So mostly, I would say, 99.8% of the time and days, I don't even think about it. And my life is really full. And I recognize the costs. But once in a while, there's still a kind of errant thought that suggests, hey, what about this? Yeah. Yeah, really interesting.

And I guess, you know, I speak for everybody when I say I'm so happy that you've, found a way to get clean and went on to make something so interesting that can turn around and help other people who are struggling with addiction through the book itself and through your work more broadly. How widespread, you know, is addiction? Because I think, you know, it's really staggering. You've covered a little bit in your book just how widespread addiction of some form or another is. And I was hoping you could touch on that. And then maybe if you wanted to talk a little bit more about what you wanted to accomplish with the book, Never Enough. Absolutely. So it's, it is staggeringly common. More than one in five people are substance use

disordered. So it's, you know, 22% of the adult population has an addiction. And what's amazing to me about that is that at the very same time, the incidence is so high. And, you know, it's, the consequences are so devastating. I'll get to that in a second. We are promoting all kinds of drug use. So I guess my point is that if it was something really rare and a few of us just had this terrible liability, I could kind of see, you know, the kind of global denial. But as you mentioned when we started this conversation, so everybody knows somebody who's either dying from or or has died from or is really suffering from a substance use disorder. And so it's very pervasive.

In our, your age group, so between 15 and 34, it's the leading cause of death. Any kind of addiction, I'm just talking about pharmacological substances. I'm not talking about addictions to our phone or to food. this is a really probably even more pervasive and devastating addiction. So we kind of are a society and a culture. I think the whole world is really trying to escape or manipulate reality to such an extent that disordered behavior develops. And so this is something that the book is really about.

Why is it the case that the solution becomes the problem? So I wrote the book because I was, you know, one of the things about me is that I, if I have a target, I'm almost, and maybe I am obnoxious. So I'm, I'm extremely goal oriented. And I had this target of solving addiction. And, you know, for that reason, I, and I was really occupied with it in kind of the same way I would be occupied with. you know, scoring a bag of something other days. So I spent years, you know, just toiling away and it was very compelling and consuming. But one day I looked up from my desk, you know, two decades in or something, and realized, wow, we are not getting anywhere. And when I say not getting anywhere, I mean that the chances of somebody dying from a substance use disorder are higher today than they have ever been, despite my long hours of research and many people much smarter than me

doing the same thing. So we've not made a dent in the problem. The problem is getting worse. And so this, you know, hit me in a wave of despair. And I guess I, reached for a way to to have an impact that was positive. And I thought, even though we don't fully understand it and we can't cure it, there is so much that we know that would benefit people. And I'm a teacher, so I teach right now at Bucknell University, but I taught at other schools and students would say some of them that this was helpful to understand. you know, because they didn't know and there's so much misinformation out there. So as an educator, I guess it seemed natural to try to explain what we do know in these

scientific journals piling up, you know, overflowing out of library windows practically and to try to distill that into a sort of core set of information that would help people make better choices. So that was the goal. Yeah, and I would say you certainly succeeded in my opinion. And I think the fact that you have all this personal experience with it, it adds a level of gravitas and authenticity to this otherwise very scientific exploration of addiction that I think makes it speak even more strongly to people who are actually going through it. Because, you know, people can study something and know a lot about it but never have the experience of it.

And they might be a fountain of knowledge on that subject, but there's something added when they can talk about their personal experiences with it and weave that into the scientific knowledge. So props to you for doing that. And even, like, as you were saying, how widespread it is, you know, almost one and four people, a quarter of human adults struggle with some form of addiction. And at times, you know, if my little life circle is any indication, I would even say that might be hitting a little low on the numbers at times, particularly after something like COVID pandemic, a year in which people's mental health, addictive behaviors on down the line,

all got exacerbated and made worse. We don't even fully know how that's affected addiction and substance abuse, et cetera. And I think as the smoke sort of clears, we'll find some jarring numbers on the other side of that tunnel. You know, you're exactly right. And they're coming through now, you know, in the big increase in overdoses. And, um, Yeah, increased depression and anxiety, which are kind of the wheels for addiction in a way. Yeah, so I think it is really been a hard time. But even aside from COVID, the rates have been going up and up and up. So there's more access to high potency substances, more stress, which is a factor in all of these disorders we're talking about.

so therefore more desire to escape. Yeah, absolutely. It's, it is, you know, kind of the epidemic before the, or the pandemic before the pandemic, I guess, the first pandemic. Maybe there's others too, but certainly it's as lethal and as widespread as anything else we've dealt with. Yeah, without a doubt. And at the last section of this conversation, we'll talk about some of the policies and errors that society makes in confronting addiction because I think you're alluding to this and this is a point I like to make very often the social conditions in which people exist can exacerbate these problems enormously and when you live in a very precarious economic political situation you have climate change barreling down on all ideas of your future then you go through

a pandemic I don't think social conditions can be separated from the despair people feel but again, we'll get into that at the end because I want to move now into addiction itself and the neuroscience of addiction. And so to start this section off, broadly speaking, at the level of the brain, you know, what is happening when someone develops an addiction to a substance? And at the level of the brain, what's happening during withdrawal from that substance? Sure. Addiction and withdrawal both represent the brain's capacity to adapt. And another way we could think of adaptation is learning. So this is just a fundamental attribute of how the brain works. It's really probably its best quality is its ability to adapt to our experiences. And addictive drugs are,

by definition, at a neural cellular level, really potent experiences. And the reason that the brain adapts to cause addiction. And I could probably say that addiction is three things. Craving for the drug, tolerance to especially the rewarding or pleasurable effects of the drug and withdraw when you take the drug away. And we'll unpack that a little bit. But these drugs at first, any any addictive drug at first is rewarding, which means that people experience something like what you and I did, you know, aha, this is wonderful. This is a great feeling. It helps me escape pain or escape boredom or escape exhaustion or whatever it is. But because it's an unnatural stimulus, it's not that we're escaping poor pain or boredom by, you know, doing art.

or something, or building a house, we're doing it with a substance, that the impact is not in the normal physiological realm. So the brain perceives this as something really potent and focused, which is not something that we evolved really, you know, it's like falling in love is focused and potent, but it's part of our long history. of evolution, you know, cocaine is not or opiates or not. So what the brain does is it, it recognizes this, oh, wow. And immediately, upon the first use, it begins to adapt by compensating for the drug. And the reason it compensates is because, and this is sort of the core of the book, Brett, so I'm glad we're talking about it, but the brain wants to maintain

homeostasis or an internal state of stability. And the reason it needs to do that is because if things are really chaotic and you're say really, really up and really, really down, you know, at random periods because you're taking drugs, it would be hard to know for the brain when something important happens. So I think I give an example maybe in the book of, let's say, every Tuesday, kind of like a Soma Holiday in Raven New World, if you read that. But, you know, we have to get, we all get to get wasted. So we just agree as a culture, let's all just check out on Tuesdays. If something really important happened, your child got sick or, you know, a tsunami was coming or even something really good happened,

like you meet somebody who you might fall in love with or something, you wouldn't be able to. to tell because you'd be kind of jacked up on the drug. So your brain prepares for that by counteracting the effect of every single mind-altering experience, including drugs. And it produces the exact opposite effect. So if you, say, drink alcohol to feel euphoria and to relax, the brain promotes or creates a sense of dysphoria and anxiety so that when the alcohol comes, you kind of show up even, you know, like you haven't really changed. And that's tolerance. And because you're tolerant, then you, because the brain is adapted, when the drug goes away, now you're left just with the dysphoria and the anxiety.

that's called withdrawal, and in fact, withdrawal is always the exact opposite of the acute effects of the drug. Always. It's just, you know, you don't even, if you're in my psychopharmacology class, you don't have to study withdrawal. You just have to know the acute effects, and then you're just right down the opposite. And then, of course, because you're in a state of withdrawal, when you're not using, you have craving, because how do you alleviate that aversive state? You just, get more drug. And the more you take a drug, the more potent it is, the more it baths the brain, the better the brain adapts. And drugs are powerful, but the brain is really, really powerful, too. And so the kind of bottom line of this is that there's no free lunch.

Yeah. Yeah, absolutely. And that was one of the parts of the book that I found incredibly fascinating and that dovetailed perfectly with my experience because people will, let's say, with something like marijuana. You use marijuana to fall sleep every night. Your brain becomes accustomed to it. You take away marijuana. What happens? You can't sleep at night. You have insomnia. Or in my case, you know, I'd never had health care because I grew up sort of lower class, working class, and never could afford it. So through my 20s, when I had like depression, I didn't have any other means of effectively treating it. So I used marijuana to make myself feel happier. And then when that marijuana is taken away, what happens? Well, I feel super depressed for a while. And, you know,

I have family members who use alcohol to cover up their anxiety and their trauma. And at moments when alcohol is not available, like one of them just went to the hospital recently and was basically forced to go through withdrawal with delirium tremens and everything, anxiety comes up and the trauma that's trying to be suppressed, childhood abuse, whatnot, that all came up. So I really found that very interesting. And this anticipatory effect that you talk about where I think you give the example of, you know, if you go every Friday to the bar to drink with your friends and then one Friday you're sick

or, you know, whatever the plans fall through, there's like this anticipatory pre-compensation that the brain does, getting ready to take in high levels of alcohol. And then when you don't fulfill that expectation, there's a little disorientation. Can you talk about that really quickly? Yeah, absolutely. I was thinking about your depression, too. And, uh, That's a perfect example because it turns out we now know that the more you smoke marijuana, the more likely you are to be depressed. So it's really counterproductive because people are using to self-medicate depression and anxiety and it's creating more depression and anxiety, just like alcoholics used to mitigate their anxiety and they become anxious and insomniacs, you know, opiate users. are trying to escape pain and eventually they're suffering more and more. So back to your real question.

The brain is not only good at adapting to the chemical while it's there, but it's so genius that it adapts when the chemical is about to come. And so my only, I guess, dependence these days is caffeine. And I'm dependent on caffeine because I don't wake up without, caffeine. When I get out of bed, my brain knows that the first thing she's going to do is go grind the beans. And I have a really fast coffee maker. So I like it, of course, fast and strong. So it comes out, you know, in 40 seconds. And so I'm really almost incoherent until I have that first cup of coffee. So I don't wake up because my brain knows I'm about.

to get a stimulant. So I'm very lethargic. And when I get the coffee, I just feel right. I just normal. Right. And this is a consequence. It's the same for every drug. And in fact, regular users, this is like the terrible news. Regular users are using not to get high, but to avoid feeling bad. Yeah. Yeah. That's the perverse conclusion of the addictive loop. And certainly with coffee, I'm the exact same way. That first time you drink coffee, you're like, oh, my God, this is amazing. I can, I'm quicker, my memory's better, my attention spans better. But then over time, it becomes very clear that you're just actually using coffee to get to normal.

But you know what, Brett, there was another study that came out this week. So coffee, I'll just say, is not bad for you. One of the other criteria for addiction besides craving tolerance and independence or withdrawal is that it has to, to hurt your life and, you know, has to have negative consequences. And as far as we know, unless you're pregnant or trying to get pregnant, caffeine has no negative consequences and several positive ones. So it definitely helps get things done, but it also protects against Parkinson's disease and maybe other kinds of dementia. It is not bad for your circulatory system or, you know, it helps you burn more calories when you're exercising. So,

Keep it up. Yeah, absolutely. Yeah. And in the case also, we're going to talk about marijuana here in a second. And just to be incredibly clear, we're talking about compulsive, probably daily use. You talk about using marijuana infrequently and intermittently, you know, you're not likely to experience any of these symptoms, this withdrawal, this addictive behavior, et cetera. So keep that in mind when we're discussing these substances. If you just have a beer once in a while with family, we're not talking about you.

We're talking about the neuroscientific definition of addiction. And another thing I wanted to touch on really quick, before we move on, is the ritual element of addiction? Because in my personal, you know, addictions and the people around me that I see addicted to various substances, it's almost like the ritual itself is just as important as the taking of the substance. You know, like when you're going out to get marijuana, you're driving. There's a sense of excitement when you meet up with the guy and you get the bag and you open it up and you smell it and then you take it home and then you grind it up. And it really is this ritualistic behavior that is in some perverse way grounding um and then you i started

realizing at the end of my compulsive use of marijuana it was like i actually started getting more out of that ritualistic seeking process then i got from the the substance itself after i actually inhaled um i just kind of felt like okay maybe it was like a unilateral or like a sideways shift in my perception it wasn't like an explosion of euphoria didn't like elevate me like it used to in the old days. But it was actually that ritualistic behavior surrounding the intake of the substance itself that gave me a lot of pleasure. Sure. Yeah. Well, you said a lot there. And one of the things I guess that you alluded to at the beginning was that how some people are fine socially using. So they can take drugs once in a while and just enjoy them. And that is because the brain

doesn't really adapt until it's a regular routine. So that's why I said earlier, you know, if you don't really want to, you can do it all you want because you don't really want to. But also it is true, and we now understand this, I don't think I got to say much about this in the book, but it's definitely the case that if you're young, as you learn everything better when you're young, you also learn addiction better. So if you're 30 years old and you pick up marijuana habit, it's much less likely to result in any kind of disordered use than it is if you're 13, just for the same reason that you could

also learn French better at 13 than you could at 30. So there's certainly that. But the other part of what you're talking about is that the brain anticipates the drug coming. And this also becomes part of its big response. And one of the crazy things about, so all addictive drugs, this is not a crazy thing, sorry, all addictive drugs activate a core pathway for pleasure and excitement and kind of news or novelty in the brain. But after a regular use, the cues around the addictive drugs activate that pathway, and the drug doesn't even do it anymore. So you're right, it becomes sort of a wider and wider scope, and in that

way, it also consumes your life, because now, you know, it's not enough just to have the drink or two drinks, but it really has to be part of this big sort of ritual. I guess. And the brain is, and part of the reason we find that pleasurable is because it's associated with this anticipatory exposure, you know, the pharmacological effects of the drug are coming. And I think it, it's, you know, you said that if you, when you got the drug, you weren't, you know, it wasn't really that great of a big deal. But if you don't get it, then, then it becomes a big deal in the opposite direction. right so it does create a deep dysphoria that's kind of hidden in there because it's not that you're

agnostic about the drug it's just that it's not really producing this profound change anymore in the positive way yeah fascinating fascinating stuff and uh when i stopped um compulsively using marijuana and went through this protracted sort of withdrawal period i replaced the ritual that came with marijuana with herbal tea so it would be like that was sort of a grounding thing when I felt these cravings specifically at night when I would previously use, I would put that energy into, like, you know, getting the tea out, boiling the water, et cetera, and I found that very helpful so for whatever that's worth. But let's go ahead and I want to sort of dive a little bit deeper into marijuana specifically, as you do wonderfully and powerfully in your book, there's this idea

out there that marijuana is somehow not addictive, that people do not go through withdrawal when they quit. It's sort of like this one substance is different from all the others. And in fact, when I did an episode recently sort of talking about the depression and anxiety that I struggled with after quitting, you know, a couple of people, not many, but a few people sort of scoffed at the idea that it had anything to do at all with marijuana and that, you know, perhaps their experience was completely different, et cetera. So what is the sort of truth of the situation regarding marijuana? And maybe you could even, you know, punch it up a little bit with your personal experience of quitting marijuana. Sure. And I have to be careful because I hate to sound, you know,

like a self-righteous ex-smoker or something. And it's definitely not that I want to begrudge people from enjoying it. Because I do, I think that, you know, it's in some ways a really lovely drug. And as I said, I absolutely, I felt like I was made for smoking marijuana or smoking marijuana made me definitely right. But the data suggests that it is absolutely. addictive as other drugs, maybe in general, about a fifth or a little more than a fifth of people who are regular smokers develop a cannabis use disorder, and that's characterized by anxiety,

depression, sleep problems, and sometimes gastrointestinal problems when you're not smoking. So the big indication of whether or not you have a problem is, when you don't do it, do you feel just fine? Because before you started using, you felt pretty fine before you started. But eventually, without getting the drug, you feel less than well. And so that happened for me, and that happened for you, and that happens for a significant number of people. And I think part of the reason there's so much confusion around it,

It's a complicated issue, but there's many things. One of them is that we have, unfortunately, the poster children of addictive drugs are both legal. So nicotine and alcohol are legal and hugely damaging. Alcohol is a neurotoxin and a cellular toxin in general. It causes tons of death, lots of suffering. Nicotine's horrible. I was just reading this morning how, you know, the whole COVID year, a lot of people who would have tried quitting didn't have the support to do so. And now we're going to watch the repercussions of that unfold in, you know, terrible, torturous deaths. But anyway, so these drugs are legal. So it makes sense in a way to look at other drugs in light of that. and THC is not as addictive as nicotine, and it's not as toxic as alcohol.

However, especially if you use it regularly, the withdrawal state, which is the brain's adaption to the drug, is going to be the exact opposite of the effects it produces. And so for me, it was anxiolytic, it was, so reduced anxiety, society. It made the world bright and sunny and interesting. It made a living kind of not only more bearable, but definitely more worthwhile. It was just like a way to sort of sprinkle fairy dust on my kind of otherwise tedious life. But because my brain was, you know, for TDM, I guess, as a result, I got so that, and this, the cause of this is that the proteins in the brain that respond to THC, which are called receptors, there are neurotransmitter

receptors, they deplete in regular smokers because the brain doesn't want to be turned on by THC all the time, so it does what it can to compensate, gets rid of these receptors. And in my case, and maybe in yours, without being stoned, life was really kind of bleak and uninspired and frustrating and unfriendly. So I, you know, I was in a bind because without the drug, things were no good at all. Like I couldn't bear to be around my family or going to work or, you know, dealing with, any kind of frustration. And with it, you know, it was okay, but, you know, there's only, you know, sort of, it's not a really good reason to keep using because I'm just trying to

feel normal. So, and there were, there were costs of that. So we, we know there's a kind of this use disorder. Oh, I was going to say that I'm sure people have noticed, but it took about, what, 20 minutes between, uh, the situation. where people who had a large amount of marijuana were seen as criminals and were locked up to the state now where people who have a large amount of marijuana are seen as investors and are making money. So I feel like there is a bit of a capitalist agenda at foot. And so in that agenda it really makes sense now that frankly a bunch of white guys are making loads of money on it we might as well just push it you know there's only so much you can drink we've sort of

saturated that market around the world because people eventually pass out or die so now we have a new market to exploit and that is you know how medical marijuana is benefiting everybody and the evidence for medical effects of THC is zero. Zilch. There's not a single whit of data to support that THC is helping anybody long term. Because even if it reduces anxiety, temporarily the long-term consequence is that your brain produces anxiety so that you kind of come out even and then without the drug, you're anxious. So, and I'll just finish that little thought up.

Not only is there no evidence that it's beneficial, even though most people think it is, but there's good evidence that it causes cognitive impairment. That means it makes you stupider. It, um, do I sound judgmental? I do. Sorry. It also produces, uh, incidents of psychosis or it doesn't, it, it, uh, unmasks psychotic symptoms to precipitate a disorder called schizophrenia, which is hugely debilated.

and it's also correlated with increased incidence of depression. So psychosis or schizophrenia, cognitive impairment are unequivocally associated with smoking more. It changes brain development and it does not help at all. Depression, it probably makes it worse. Yeah. Yeah, and on those fronts, those specific ailments, I completely agree. I guess the counter sort of argument on that front would be with other things, maybe like insomnia, pain, there's some evidence in epilepsy, appetite provokers for people

with cancer who might not have appetites, et cetera. On those fronts, would you say that there is some evidence that marijuana, at least in some degree, could be helpful? So I'm talking about THC, you're talking about marijuana. Marijuana has many cannabinoids in it. The two most prevalent are Delta 9 tetrahydrogycannabinol and cannabodial. Cannabodial is clearly linked to improving certain types of epilepsy. And these types of epilepsy were before we discovered the benefits of cannabodial basically untreatable.

They're in children and there was nothing you could give the kids to help. And so what they had to do was have brain surgery and remove big chunks of their brain. So this is an absolute lifesaver cannabodial. THC has no benefit there. Cannabodial is clearly beneficial. The insomnia and the, you know, it's the same as all sleep aids. They work great in the beginning. And if you're older when you start using them, you might not adapt.

so well, which means you might not need to, you know, you might not get tolerant. You might not need to increase the dose. But eventually, people don't sleep as well with it, with THC. With pain, the studies are still going on, but there's no clear evidence of benefit in the long run. So this is really unfortunate, but pain is highly preserved. It's something necessary. for survival, and every single mechanism we've tried for pain, as we know from the opioid epidemic. And opioids are brilliant at treating pain, but they lead to addiction. Every single mechanism, the pain kind of breaks through. So we don't know about that yet. And I think one good argument is that we haven't done enough research on it, which I think is a great thing to do.

And we need to study the effects of THC, cannabodial, but marijuana, you know, it's a mixed bag. There's also Delta 8 THC, which is a new, another compound that might have different effects. So as far as the scientific consensus goes, there is no evidence of medical benefit. I see. Yeah, and I think that's really important, too, that marijuana is not synonymous with THC. THC is one compound among many, many compounds that are within. this thing that we call marijuana. And, of course, it's Schedule 1 drug status prevents a lot of the research that could help solve some of these unanswered questions or replicate some of these studies, et cetera.

Maybe that's going to be changing in the next couple of years, but for a long time, that was the case. And so you had very little good information on the topic. And when there's not a lot of good information, you know, the communities themselves will overstate claims, they'll, you know, they'll make absurd unverifiable claims. about, you know, marijuana can cure cancer and, you know, it's not addictive at all and all this other stuff. So in the vacuum created by ignorance, more ignorance flourishes. There is certainly that disgusting contradiction where in some cases, like white entrepreneurs,

but in some cases even like Republican politicians who, in their entire career, they've been for the carceral state, imprisoning people who are addicted to drugs, criminalizing marijuana, are now investing in the marijuana business as people who had their lives ruined by these carceral policies still sit within cages for using or selling the very thing that these people are now making millions of dollars off of. So that's, that's particularly grotesque in its own right. I do want to like touch really quickly before we move on on this idea that you hear a lot that marijuana is not physically addictive. It's, it's only psychologically addictive. Is this a meaningful dichotomy in your opinion or does it reflect some confusion on

on what we mean by addiction. Well, actually, it's kind of insightful, and it brings up an interesting point. When I started using cocaine in the early mid-80s, cocaine wasn't considered addictive. Believe it. And the reason is that there was no physical dependence. There was no physical withdrawal. And we were looking at cocaine compared to alcohol or opiates, where, you know, from a block away, you could tell if someone was withdrawing.

for alcohol, they might be having life-threatening seizures because the brain would be hyper-excited in exact opposition to the sedative effects or sedative effects of alcohol long-term. And with opiates, you could tell, because they were suffering, obviously, you know, they'd have diarrhea and runny eyes and noses, and they'd be really agitated. So again, you could really look at it. And we mistook dependence for physical dependence. But I think it was 1986 in the middle of the cocaine epidemic. People said, you know, wait a minute.

Just because we can't measure something on their body doesn't mean they're not suffering withdrawal or dependence. And so we characterized a cocaine dependence syndrome where people were anadonic, meaning they couldn't experienced pleasure. They were lethargic and, you know, they felt dysphoric, so hugely unhappy and discontent. And they decided this is, this qualifies. So now the definition of dependence is psychic dependence. You may or may not have physical dependence. All addictive drugs produce a psychic dependence. So for that reason, that's not an longer for what the last 35 years, a good measure of dependence or addiction. I see. So there is something, there is something to it. Very interesting. Let's go ahead and move

on. And, you know, I do want to touch on alcoholism really quick. You know, alcoholism may be the substance that most Americans are addicted to, if not most people. And I know I have several family members and friends who qualify as alcoholics. And of course, it's, you know, heartbreaking to see up close and personal. I actually have someone very close to me dying from liver and heart diseases brought on by decades of heavy alcoholism. What is happening at the level of the brain for someone who is addicted to alcohol? And maybe you can even touch on how alcohol is so normalized in our society and how that plays into addiction. Yeah, wow. So alcohol is, I think I call it a sledgehammer in the book. It is a pharmacological and social

physical sledgehammer. And it's such a part of our culture and from kind of the beginning of human culture that it's hard to extricate ourselves from the negative consequences and the, you know, it's sort of evolved along with us. But alcohol does many things to the brain. It's unique in that it's basically water. So it's such a simple small molecule that it, and it goes wherever water goes. So it basically spreads all throughout your body very simply and readily.

And it is tiny and it interacts in all kinds of ways. But it does probably four main things at the pharmacological level. So when I first drank, for instance, that half a gallon of wine I had in my friend's basement, it caused the release of dopamine in this pleasure pathway, which made me feel very euphoric. It also caused the synthesis and release of endorphin, and endorphin is a compound that our brain makes that's as potent as morphine, which is as potent as heroin. So I had like my own little opiate rush going on, which made me feel warm and, and cozy and content.

And it also speeds up the brain's main brakes, which are a neurotransmitter called GABA. And so there's more GABA, which makes you relaxed and sedated and not anxious. And then it slows down finally another neurotransmitter, which is the main kind of gas pedal, glutamate. So slowing down glutamate and speeding up GABA make you feel and act sedated.

So I was sedated, I was warm and content, and I was euphoric, perfect. With regular use, the brain produces the exact opposite effects. So dopamine levels plummet and stay down. The endorphin levels go down, and they're basically at a lower level. In people who regularly drink, they have less. of their own endogenous opioids. And glutamate levels go down. No, they go up because the acute levels was to put glutamate down.

So now glutamate rises and GABA goes down. And so as a result of that, your brain is not so sedated by alcohol, but when you take it away, you can have seizures and die. so all of those things change and they begin changing the first time you drink you know in a way I think about this but the first time was the best time because my brain was the least adapted but in regular drinkers of course they don't feel those all the great effects they're just kind of keeping the tone you know keeping things even so it is in our society very normalized And partly again, because there's a lot of money to be made, even though it sort of makes itself, it's such a simple, you know, you have fermented fruit.

We can all make our own alcohol as probably everybody realizes. But it's just a moneymaker. And also, I think we do have a huge amount of stress provoking and anxiety provoking. awareness. And so there's many reasons to be stressed. I had a student in my office a couple days ago and I said, you know, yeah, if you're not anxious, you're probably crazy because there's certainly so much to be anxious about, which is kind of a perfect environment for alcohol to find a niche, you know, because it relieves anxiety at first. So if people can't sleep or feel worried, you know, alcohol will acutely at least make it better, although it exacerbates these things so that you then are

insomniac and anxious. So I think it's just the, and we should say, I think it's important, about 25 or 22 or 23% of the population have an alcohol use disorder, but many more people drink and they don't have an alcohol use disorder. So in a way, having a substance as part of our culture, you know, benefits more, I guess, than it harms, although there's kind of a narrowing of that gap so that it's harming more and more and benefiting fewer and fewer. But still, there are people who can drink, you know, for enjoyment and not for medicine. Yeah, absolutely. And even just outside of addiction, alcohol has many sort of deleterious social effects, you know, more likely to get into a car accident,

violent crime. Usually when there's violent crime, there's a over-representation of people who are drunk, domestic abuse, you can go down the line. So even if somebody is not addicted to alcohol, there are negative downstream effects, but as you also say, plenty of people, myself included. And I sort of maybe dodged a bullet familiarly on this front because while I'm surrounded by people who have alcohol disorders or substance abuse to alcohol, I myself have missed that particular one and I can engage with it normally and not have to drink on a nightly basis or anything like that. So plenty of people that I know can engage with it in that way and be completely fine. So always want to make those curious.

I should say, and I hate to be a Debbie Downer, but there's been recent studies, big, large, excellent studies that have shown unequivocally that there's no benefit to alcohol and it is harmful. So I said it was a toxin, a cellular toxin, and even one drink a week, if you can believe this, one drink a week, which doesn't seem like even worth it to me, but that has measurable consequences on your health and longevity. So you can see that one drink of week will reduce, will increase your risk of cancer, just a tiny bit, many cancers, and also reduce your life expectancy. So we used to think that people who were moderate drinkers had some benefits. And of course, this is definitely up the alley of the alcohol purveyors because they want to promote this idea, just like we now see with marijuana, that it's medicinal.

No evidence for that. It's only harmful. And if you really want to extend your lifespan and increase your well-being, this is in the Lancet, I think, about a year and a half ago or so the best amount of alcohol is zero. Wow. Which is kind of crazy. And this gets to this big question, you know, are we using drugs? I think we can ask this individually and as a culture to enhance.

our lives and our well-being, or is it diminishing it? And I think the challenge is that it's very hard to see when it flips. Yeah, absolutely. And I mean, I know from my own experience, when I don't drink, I sleep better. I feel better the next day. I mean, you go down the line, there's plenty of evidence just personally and anecdotally for that being true. But that is funny because I was maybe, you know, I'm not in the field, so I'm sort of lagging behind with the science that I know, and I was always sort of taking it for granted that, like, as you said, this idea that I've heard a million times in a million different ways, drinking too much alcohol is bad, but weirdly people that don't drink any alcohol also live shorter lives than people who

drink moderately or have one drink a day. And so I had kind of internalized that as truth. So these more recent studies coming out, obliterating that is very interesting. Yeah, you know what caused that? it's really interesting because it turns out that people who drink, you know, a couple drinks a week are moderate and moderation is good for your lifespan. If you're somebody who's moderate, you're also likely to exercise regularly, get a good diet, get good sleep, you know, be one of these boring people. No, I'm kidding. But, you know, be one of these like perfect people. And those people do live longer. So that's what caused it. It was a great example of correlation doesn't mean causation.

Super interesting. But now in the good studies where we look at the effects of very low amounts of drinking, we can pull it out. And this is in hundreds of thousands of subjects all around the world. So it's, you know, as we get more data, we get more knowledge and insight and understanding. Yeah. That's so interesting. Well, I guess I can't keep telling myself that my one glass of whiskey at the end of the week is actually benefiting me. Very interesting. Well, you know, Moving on, one part of your book that really stood out to me is your section on Molly or, you know, what is known as MDMA, it used to be called Ecstasy. I'm someone who has taken the drug, I mean, probably a dozen or two dozen times over my entire life, but, you know, they've all been well spaced out, never with a dangerous amount, et cetera. But after reading your book, I sort of like told my wife that, you know, I'd probably never do this one again.

Can you talk about just the specific dangers of this drug? And again, you know, if you're just somebody that's used it a couple times, no reason to panic or, you know, freak out. But I think equipping us with the knowledge of what's actually happening at the level of the brain when somebody does Molly should hopefully prevent people from from overdoing the drug. So can you talk a little bit about that? Absolutely. And it's very timely because it's in the news this week as data is coming out that this is an effective combined therapy with psychotherapy or cognitive behavioral therapy for PTSD. So people who have extreme PTSD have been shown to benefit more when MDMA is combined with psychotherapy and support.

So it's a great question. And I'm going to answer it first in a really general way. But it turns out that the drugs that are most harmful are those that don't mimic anything natural. Marijuana is not that bad for your brain. I don't think it's good for your life in many ways. but it doesn't harm the brain. Nicotine doesn't really harm the brain. Opioids, you could be an opiate addict for 100 years,

and your brain would look pretty good. But alcohol is not at all natural. MDMA is not at all natural. Amphetamines and methamphetamine, not natural. And those drugs tend to, I guess for good reason, the brain didn't really evolve to, to have those, and so they tend to be more harmful. With MDMA, there's clear evidence in many laboratory studies from places like Johns Hopkins and other good places that high dose or

regular use damages neurons that contain serotonin. And in some cases, they are so damaged that they can't communicate anymore so the neurons don't work anymore. And we can look at the acute effects of MDMA, we'll try to make you feel connected and loving and well in a kind of a social setting. And then look at, and that's due to the fact that serotonin levels are very high with an acute dose of MDMA. However, as always, the brain adapts by reducing seroton levels. And there's good evidence that people who take MDMA regularly have depression and also have, which is characterized in a way by a lack of connection,

a lack of empathy for ourselves and for other people, and kind of a lack of imagination. So I think that, you know, it is a dangerous drug. I tell my students and my own children that probably methamphetamine, MDMA, and alcohol are the most neurotoxic. And there's a lot of evidence to support that. Now, going back to the argument about, well, then why give it to people who have post-traumatic stress disorder? this is a good point there we don't have a good treatment for post-traumatic stress disorder the treatment we have basically the state of the art is a lot of talk therapy and frankly that's

expensive and time consuming and we always want a cheap quick solution so this may be beneficial so we always have to balance the benefits with the costs and I guess in lower doses and infrequently you know not as likely to cause the brain damage yeah and in the PTSD situations it's not like you need to be on a continuous course of MDMA it's like a it's an experience guided with the therapist etc to maybe access some of those difficult feelings and memories and traumas in a sort of context in which you're you more or less feel okay so it's just very interesting and again, it's that balancing act. But once in a blue moon, infrequent use, not overdoing it when you do do it,

you're not going to destroy your brain, but specifically repetitive, constant use is something I think that we should really make sure people are aware of and warn people against doing. I was on, you know, you go on Reddit, you can find almost anything. And there was one situation where you can go look it up to where this guy was saying that he was trying to microdose Molly. And so for like multiple. months in a row, he was taking a small amount of it every day. And thousands and thousands of comments

and people are just, you know, in various ways, some nice and some mean, just telling them, you got to stop. It's not healthy what you're doing. And in your book, you mentioned, I don't know if you want to talk about it really quickly, this person that you knew that was a DJ and that sort of overdid it and how that turned out. Yeah, I know a few people actually. I have more recent too, because a lot of the music I listen to, it's pretty popular at some of these concerts. But anyway, in this case, it was a student first, who was really brilliant, worked in my research lab, not the most focused, but a really interesting, talented student. And he became a DJ, and he started doing a lot of Molly. And he, you know, I kind of keep

touch every few years. And then he was a bartender. And I could see, actually, he came back to my lab. I don't know if I told this whole story in the book, but he did come back to my lab after he was a DJ. And he made a bunch of kind of boneheaded mistakes. He was very clearly less thoughtful. He was impulsive, I guess. And he would always be very sorry, but he was just like knee-jerk mistakes in a research lab. You know, it's not so great. But anyway, he ended up committing suicide. And I did talk with him, you know, probably 18 months or so before that.

And he was just despairing. He felt the opposite, again, of the kind of hip-connected global oceanic goodness feeling, he felt the exact opposite, which was isolated and alienated and despairing. And we know that chronic use of high-dose MDMA is associated with depression. Right. And that was very clear that he was using high amounts for a long period of time. That's what he told me. Yeah. Yeah. Very scary stuff. All right. So let's go ahead. One more question before we zoom into the conclusion of this section. I really appreciate you taking the time to have this. Oh, I'm happy to be here. It's great conversation.

Just want to make sure I was respectful of your time. But the one category of drugs in your book that seem to stand separate from the rest are psychedelics. You dedicate chapters to specific groups of substances and you have a chapter on psychedelics. We've done plenty of episodes on psychedelics, its relationship to mysticism and spirituality, et cetera. And one thing that comes up is that psychedelics are not only not addictive, but in some ways anti-addictive. When you take a big LSD trip or a big psilocybin mushroom trip, you're not excited to do it again the next day. And in fact, you know, you usually need weeks, months, sometimes years to integrate your experience if it was a profound one. So why are psychedelics not addictive like these other

substances? And maybe you can even touch on the promising benefits that they offer. Sure. They are drugs that do not activate that core reward pathway. So every addictive drug shares in common its ability to release dopamine in this so-called mesolimbic dopamine pathway. And when dopamine is active in that pathway, it's really pleasurable and in a kind of an exciting and titillating way almost. But psychedelics do not do that. And for that reason, non-human animals won't take them. They'll, you know, a rat won't self-administer psychedelics. and, but they will take every other drug, including MDMA, including THC, etc. So that's a big clue, first of all.

They don't produce pleasure. They alter experience and perception and in ways that are insightful. And they've been really marginalized, I think, because of political misunderstanding. And so they were put in a category with other addictive drugs, you know, because they were used by some of the same people, but without evidence for that. So pharmacologists for, I think, 40 years haven't thought they were addictive. And as far as the benefit goes, it's very exciting. It's, we're doing more research now and we're seeing good things. And this, so these are psilocybin, mescaline, DMT, or ayahuasca, which is the component of ayahuasca and LSD.

And they help people see themselves from a bigger perspective and maybe connect with something larger than themselves. And in so doing, they're less driven by their neurotic tendencies to escape. reality or alter reality. So, and, you know, there's crazy studies. Like one, one I think is really interesting. It's kind of an old one, but they looked at prisoners and the reasons for getting in prison, whether they were violent kind of crimes that hurt people or nonviolent crimes. And it turns out that all drug use is associated with more violent crimes, including the loving MDMA or THC, for example. But not psychedelics. Those were dislinked or so negatively correlated with those kinds of crimes and also with going back to prison after being let out. So I think there is

evidence that there's kind of an insight derived from these as tools, not as addictive of drugs, but as pharmacological tools to help people cope with, you know, existential questions. And I want to go back to the microdosing thing just for a second, because this is also popular with LSD. And there was just a recent study, and I'm pretty sure it'd be the same with MDMA, except you'd also be causing toxic effects, that it's basically a placebo effect. So, you know, there's probably getting less drug to the brain than you need to produce a pharmacological effect means that it's probably not having any benefit. Yeah. So very interesting.

I saw that too. I actually have, my best friend is a neuroscience, neuroscience postdoc at Washington University. And, you know, when we were teens together, we experimented with anything and everything, including many psychedelic trips together. and he sent me that actual that study because we have been talking about microdosing and it's becoming a popular thing and silicon valley people are always talking about how it improves creativity I experimented it with myself I didn't personally find any you know effects that I could discern from trying it out and then that new study comes out and kind of confirms that which is which is interesting and and you know we're thinking about and I know also like just thinking of the way that

drugs interact with the broader society, things like coffee, alcohol, stimulants, and even stuff like weed, they don't really sort of confront or are antithetical to the basic incentive structures and value systems of a broader capitalist society. You know, they can fit quite nicely within a capitalist society. And when the 60s counterculture came, it was sort of part and parcel with this explosion of psychedelics onto the scene in our society and it was very countercultural if you've ever done doses of psychedelics i mean the last thing that you are going to take seriously is that money is important you know all ideas of machismo and ego seem to seem utterly absurd this whole idea that you go to work and work at a job you hate five days a week um to make somebody

else money, why you barely scrap by, all of that kind of seems more and more absurd. And in fact, in the 60s, there's this huge, you know, either movement into spiritual practices or like communal living, sort of experimenting with ways to live and exist outside of the system itself. And so I think, especially in the 60s when so little was known about these drugs, that countercultural effect sort of had an effect on the rest of conservative elements of society saying, these are not drugs that we want to condone and let spread. Do you think that's more or less correct? I think that's exactly correct, right on. Great point. Yeah. And I just want to say one more thing. I've talked about this before, but I talk about being very into Buddhism and meditation since I was a teenager

and the whole thing that got me into spirituality and meditation was actually a very high dose of mushrooms. I took it at 16. I took two eighths or a quarter, seven grams with no experience, not knowing what to expect. And I had a disillusion of object, subject, dualism. So laying on my back, looking up at the sky, it felt orgasmic, ecstatic. The stars were raining down into me. I felt one with the entire cosmos. And although that was a brief little ecstatic moment and I was pulled out of it,

it opened up my mind like, wow, there's different states of consciousness. And obviously, Buddhism and meditation became a more sustainable way of perhaps achieving those states of consciousness so i think that's true people exactly i think it can be a tool that could be really useful for exactly what you're saying it's not in itself a goal or an end but i think it could be a means to recognizing truth absolutely all right so let's do men towards the treatment and the conclusion section of this conversation and you end your book with a really compassionate and informed analysis of the failures of our society to adequately meet the problem of addiction and you offer some ideas on how we can be better at doing so. I was hoping maybe you could

discuss these failures as well as your ideas for improving our response at a policy and societal level. Well, the failures are well recognized by all of us that many people are dying and suffering from their substance use disorders. So it's not as if, you know, there's, there's not been an impact. It's a tremendous impact. And I think that that is not due, as I suspected, to something wrong with the brains of these poor individuals who just can't, you know, manage to control their use. I think it is a much bigger problem than that. And one of the things I really increasingly appreciate is that the vast majority of addiction develops in adolescence who are either bored or in pain. And so it's adolescence because their brain is so plastic and there's plenty of mind-altering potent substances of round that are addictive.

And the boredom or in pain, I think, is. because these are catalysts for wanting to escape our situations. We know that adverse childhood experiences, which could be all kinds of things, most of us have had at least one, but many have had many more, things like your parents getting divorced or fighting in the home or having depression or substance use disorder themselves, those kinds of things lead to pain. in children who don't know a way to cope until they experience drugs. And then all of a sudden it looks like, wow, here's a good solution.

And so modeling and finding better, more efficacious and compassionate ways to help all people, but especially vulnerable adolescents cope with pain would be at the top of my list. another is this kind of on the opposite end kids are sort of designed so it's kind of baked into their neurobiology to take risks try new things be a little stupid and and not really worry about the consequences and that's for good reason because if they were like most 60 year olds then nothing would ever change. You know, we'd have all this, we'd just be conservative all the time. So kind of having both sets of people is perfect because young people push all of us forward in really important ways.

So they're made for that. And also they're made for this for their own selves because they would never leave home, you know, if they didn't have these tendencies to say, screw this. I want something else, you know, not this. So that is healthy and good, but there's nothing much for them to do, you know, and what do we offer those kids? A job, you know, a menial job that's boring or, you know, there's just not the kinds of things. Like, you know, I don't know, a thousand years ago, someone who's 14 would be probably setting off to homestead somewhere with their new family. but now, in which case those tendencies would be really great. Now you're 14, you should be quiet, stay in school, you know, be good. And those things are really run against the adolescent grain. So I think we need to look for better ways for kids to exploit those tendencies for adventure and risk and novelty that don't cause brain.

And I think we'd all be better off if we could do that. Absolutely. Yeah, and in the adolescent brain, it's fairly well known that the prefrontal cortex is still developing this ability to balance your current actions with this long-term consequences is not fully developed, and therefore you see, as you said, heightened risky behaviors. And I certainly participated in a whole slew of them as a teenager, including reckless drug use of many kinds. I'm happy to have made it out more or less okay.

But I have a daughter and a niece who are entering their teenage years, and, you know, I'm very open and honest about this stuff, and I'm specifically telling them, like, I don't expect you to never try anything, but, you know, here's the science says on your developing brain, here's why getting into using any substance on a regular basis is terrible for these crucial years of development, et cetera, and it's trying to equip them with the information so that, you know, not to expect the unacceptable from a teen, but to equip them with the information and to

give them somebody like me who's not going to scream and punish and be an authoritarian, but can guide and teach and inform and somebody they trust and can come talk to when these situations arrive, which many teens simply don't have. So I think that's important. And the other thing, too,

and I think that you would agree with this, is the carceral approach to addiction, where people are locked in cages for having substances and being addicted to substances and then the downstream effect where somebody might commit a crime to get money to pay for a substance. That is, you know, after decades and decades of trying the carceral approach, not made a dent in addiction or suffering of any sort. In fact, it's exacerbated the suffering by splitting up families in many instances, not giving

people the mental health care they need. So using those resources that we'd use to incarcerate people who are struggling with mental health and addiction issues, using those to, fund rehabilitation centers and a more medical, compassionate approach to these problems, I think could solve a whole slew of some of the issues that we see at this level. Would you agree with that? I completely agree. And in fact, the literature is now suggesting finally that contingency management, which is a way of rewarding people for positive change. So, you know, instead of punishing them for negative behaviors, rewarding them for positive behaviors, is very much more effective for people trying to be recovering.

And I guess going back to educating your niece and your daughter, I think in addition to education, we do want to try to find outlets for those tendencies that would not only benefit them, but benefit the rest of us. And it's not as if there's nothing worthwhile to do. but we have to make, make ways for those alternate choices. Yeah, absolutely. And the one point that I mentioned earlier,

I just would like to briefly touch on and maybe get your response, is this idea of social conditions, because I think in the modern era, you know, the problems of addiction and even mental health more broadly are hyper individualized and they're biologized. So it's like, you know, I'm depressed and anxious all the time. Well, that's because you have an imbalance. of neurochemistry and this pill will fix it, but there is no sort of systematic approach to

showing or to exploring how things like addiction, you know, diseases of despair and mental health issues like anxiety and depression are tied to really rotten social conditions in many cases, hyper atomization, loneliness epidemic, precarity of work, the uncertainty surrounding people's futures, the seeming non-responsiveness of political institutions to democratic and bottom-up energies that clearly want serious institutional change on a plethora of fronts. The social conditions, I think, are a huge component of this, and I think often gets overlooked when we're thinking about ways of treating these problems. Do you more or less agree with that? I wholeheartedly agree, and I probably came to it from the other end. So you seem to have gotten there from

you know, some top-down wisdom. But I came the hard way, which is that I believed in the neural model. I believed in the biomedical cause. And I have been banging my head against those data, you know, for 30 years, where it is now very obvious from the data itself that the cause is not within individuals. You know, it's almost like the brain is more the cart than the horse. And the horse is these large social, cultural, institutional setups. So I completely agree. And I think that it doesn't mean the brain's not involved,

and it doesn't mean it's not worth studying that. But it's all connected. and the brain is influenced by all of our experiences and all of our conditions. So I really agree that with a problem this big and this intractable, we need to have all kinds of strategies, including medical and social and educational interventions, and as much as we can get, probably from the humanity, and philosophy, but we need to recognize that this is a

disease, a set of diseases that is increasing in incidence robbing us of our well-being and lots of human capital, speaking of capital, and that, you know, it's going to take more than a molecular switch to fix it. Absolutely. Perfectly said. Last question here, do you have any advice for people who are struggling with addiction themselves or maybe have a close loved one who is struggling

with addiction. I know this is a very difficult question, and there's so many variables in individuals' lives, but do you have any broad advice for folks struggling? Sure. The biggest thing, I think, is that there is hope and that if a person is supported with all the means possible to abstain for a while, the brink. the brain will readapt and so that what, you know, for me at the beginning, everything seemed bleak and hopeless, but now I can say happily that there's a ton of joy and even thrill and

adventure in my life and it has nothing to do with substances. So I really feel like be kind to your brain and trust and support its ability to adjust and that there is lots of good things. There's lots of hard things too, but those are also good in a way. So I think give it time and support and ask for help. Yeah, incredibly well said. Having somebody close to you struggling is a little more difficult in that the genesis of their transformation or getting sober has to really come from within. And I've learned with dealing with many addicts in my life that this punitive, resent-filled,

why can't you be different approach doesn't work? And in fact, just pushes them into the corner of their own addiction even more. And so there's no easy solution when it comes to helping others. But I lead with the foot of compassion and understanding, letting my loved ones know that their worth to me is not dependent on whether they're clean or not, but that I care about their future and their health. And so I want to help whenever they're ready and whatever capacity I can to make them feel better when they're ready. And I think that's almost all you can do in that situation.

That's really well said too. I agree with everything you just said. Thank you, Judy, so much for coming on the show. Thank you so much for writing this wonderful book and for your work more broadly. It really made an impact on me. And hopefully through this conversation, we'll be able to impact many more people. Before I let you go, can you please let listeners know where they can find you and your book online? Sure. Thanks for having me. Well, I'm a professor at Bucknell, so you can write to me at Bucknell University, or you can find the book, Never Enough, the Neuroscience and Experience of Addiction anywhere. And in fact, the chapter on T-H-C that you referred to is freely available, I think, through men's health. So you could look up my last name, Griselle, G-R-I-S-E-L in men's health, and you could just read that chapter. And I also have TED Talks and other kinds of talks online, but I

I'm not a big social media user. So I think email would probably be the best. If you have any questions, I'd love to be in touch. Yeah, and good for you on the social media front. And yeah, it's funny because your men's health article is actually what made me find you and then eventually find your work because I was like Googling, like, quit marijuana, feel depressed and anxious and like just going through things, trying to find anything that could help.

And I came across that article and then it was attached to your book. I went and got the book. And I actually listened to the book on Audible, which you yourself read. And I always love when an author reads their own work. And it had an extra layer of intimacy in that sense. So that's also another option for people. I will link to as much of that, though, in the show notes so people can easily find your work right away just by looking at the show notes of this episode. And again, thank you so much, Judy, for coming on.

Really appreciate your work. And let's do it again sometime. Thank you.