How to Overcome Addiction to Substances or Behaviors | Dr. Keith Humphreys
Timestamps are as accurate as they can be but may be slightly off. We encourage you to listen to the full context.
Podcast Summary
In this episode, Dr. Andrew Huberman interviews Dr. Keith Humphreys, a professor of psychiatry and behavioral sciences at Stanford School of Medicine and one of the world's leading experts on addiction. They explore all major addictive substances and behaviors including alcohol, cannabis, opioids, gambling, stimulants, nicotine, and social media. (03:00) Dr. Humphreys provides evidence-based insights on how genetics and usage patterns shape addiction susceptibility, while discussing the most effective treatment approaches from 12-step programs to emerging therapies like psychedelics and GLP-1 agonists.
- Main themes include understanding addiction as progressive narrowing of pleasurable activities, the role of genetics versus environment, industry manipulation for profit, and multiple pathways to recovery including both clinical treatments and peer support programs.
Speakers
Dr. Keith Humphreys
Dr. Keith Humphreys is a professor of psychiatry and behavioral sciences at Stanford School of Medicine and one of the world's foremost experts on addictive substances and behaviors. He has extensive experience in addiction policy, having served in both Republican and Democratic administrations to improve addiction treatment legislation. Dr. Humphreys has also worked as a hospice counselor for ten years and is widely published in addiction research, particularly regarding the effectiveness of 12-step programs and evidence-based treatment approaches.
Dr. Andrew Huberman
Dr. Andrew Huberman is a professor of neurobiology and ophthalmology at Stanford School of Medicine. He hosts the Huberman Lab Podcast, where he discusses science and science-based tools for everyday life, bringing zero-cost consumer information about science to the general public.
Key Takeaways
Addiction is Progressive Narrowing of Pleasure
Dr. Humphreys defines addiction as "a progressive narrowing of the things that bring one pleasure." (05:00) Unlike simply doing something frequently, addiction involves continuing harmful behaviors even when they destroy other rewarding aspects of life. This happens gradually as natural rewards like relationships, work, and hobbies fall away, leaving only the addictive substance or behavior as a source of reward. Understanding this progressive nature helps explain why addicted individuals continue using despite obvious negative consequences - the substance has become their primary remaining source of pleasure and reward.
Genetic Risk Varies Significantly Across Individuals
Genetic predisposition to addiction can account for 30-50% of risk, with significant individual variation in how people respond to substances. (07:00) Dr. Humphreys shares research showing that children of alcoholic fathers have much higher addiction rates even when raised by non-drinking adoptive parents. Some people experience substances as highly rewarding from first use, while others find them unpleasant. The most practical predictor remains family history - asking "does problem drinking run in your family?" is more useful than genetic testing for assessing individual risk.
Industries Profit From Addiction
Addiction-for-profit industries deliberately target vulnerable populations and engineer products to maximize dependence. (25:00) Dr. Humphreys explains that about 10% of Americans consume half of all alcohol sold, making heavy users the primary profit center. The alcohol industry specifically targeted women in the late 1990s and early 2000s with campaigns like "mommy wine culture." Similarly, modern cannabis products average 20% THC compared to 3-5% in the 1980s, creating vastly different brain exposure levels that dramatically increase addiction risk.
12-Step Programs Have Strong Scientific Support
Contrary to dismissive attitudes in some medical circles, 12-step programs like Alcoholics Anonymous have robust research evidence supporting their effectiveness. (152:00) Dr. Humphreys co-authored a prestigious Cochrane Review showing AA achieves 50% higher abstinence rates compared to professional therapies like cognitive behavioral therapy. The programs work by providing immediate accessibility (meetings available daily), social support, accountability, and a practical action-oriented approach. With nearly 24 million Americans in recovery and meetings available in 195 countries, 12-step programs represent the most accessible addiction treatment available.
Multiple Pathways to Recovery Exist
Recovery happens through diverse routes, with most people never seeing professional addiction treatment. (183:00) Dr. Humphreys emphasizes that life changes, relationships, consequences, and personal motivation can all trigger recovery. Some people quit when they become parents, others through legal consequences, career opportunities, or simply reaching a personal breaking point. The key insight is that addiction affects tens of millions of people, creating numerous pathways out. Treatment should focus on building motivation by helping people identify their personal reasons for change, analyzing behavioral patterns and triggers, and connecting with others making similar changes.
Statistics & Facts
- About 10% of Americans consume approximately half of all alcohol sold in the United States, making heavy drinkers the primary profit center for the alcohol industry. (22:00) This statistic demonstrates how addiction-for-profit industries depend on problematic use patterns rather than moderate consumers.
- Modern cannabis averages about 20% THC content compared to 3-5% in the 1980s and 1990s, representing a 65-fold increase in brain exposure when combined with daily use patterns. (38:00) Dr. Humphreys notes this potency difference is equivalent to the gap between a coca leaf and cocaine.
- Approximately 24 million Americans are currently in recovery from addiction, though most people don't notice them because recovered individuals look like everyone else in society. (110:00) This large population demonstrates that recovery is achievable and relatively common, providing hope for those currently struggling.
