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Can brain science save addiction policy? | Keith Humphreys

From Our Neurons to Yours

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If addiction is a disease of the brain, what does that mean for how we treat people—and how we write policy? In this wide-ranging conversation, Stanford addiction expert and policy advisor Keith Humphreys returns to the show to walk us through what neuroscience has taught us about substance use disorders and how that science intersects with law, public health, and politics.

From the biology of craving to the limits of autonomy, we explore the tension between compassion and accountability, and what truly effective treatment and prevention might look like.

Episode Highlights

  • Why addiction isn’t just a moral failure—and how brain science explains drug-seeking behavior
  • The biological pathways affected by opioids, alcohol, and stimulants—and why some drugs are harder to treat
  • What makes some people more vulnerable to addiction than others
  • Why effective addiction policy must account for impaired decision-making
  • How policy can—and can’t—respond to the science
  • The promise and limitations of brain stimulation, psychedelics, and medications like naloxone
  • Why prevention—especially for teens—is key to long-term change
  • What a more human, effective, and science-based future could look like

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Chapters

1. Intro: Addiction and the Brain (00:00:00)

2. Meet Keith Humphreys (00:01:05)

3. What Is Addiction, Really? (00:02:22)

4. Illness vs Accountability (00:05:05)

5. How Drugs Affect the Brain (00:06:22)

6. Genetics, Risk, and Subjective Experience (00:08:31)

7. Recovery and the Gray Zone (00:11:05)

8. Policy That Matches the Science (00:13:30)

9. Autonomy and Paternalism in Policy (00:15:45)

10. What Science Can—and Can’t—Fix in Policy (00:17:59)

11. How Pictures Changed Minds (00:20:48)

12. What West Coast Drug Policy Got Wrong (00:22:34)

13. A Health System That Treats Addiction Like Cancer (00:24:58)

14. Recovery-Oriented Housing and Harm Reduction (00:29:35)

15. Naloxone Saves Lives—But It's Not Enough (00:31:01)

16. The California CARE Court Model (00:33:07)

17. The Big Ideas: What Science Needs Next (00:36:53)

18. Financing the Future of Care (00:38:49)

19. The Current Political Threats to Addiction Care (00:41:45)

20. A Vision for 20 Years From Now (00:43:10)

59 episodes

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