Speaker 1: I'm Baryton Day Thurston and this is Spit and I
Speaker 1: Heart Radio podcast with twenty three and me. This is
Speaker 1: the podcast that explores how DNA is changing our lives
Speaker 1: and the world around us. So what does it take
Speaker 1: to overcome addiction? America is sick. Americans are dying, Towns
Speaker 1: are being destroyed, economies are crippled all by addiction, and
Speaker 1: the numbers are devastating. On two people a day die
Speaker 1: of drug overdoses, and they're killing more people than car
Speaker 1: crashes and gun homicides combined. Prescription opioids and heroin are
Speaker 1: the prime contributors to these stats. Once hooked on prescription painkillers,
Speaker 1: many people turned to heroin, which is often cut with
Speaker 1: more lethal drugs because it's cheaper and easier than getting
Speaker 1: another refill. Heroin used in the US has more than
Speaker 1: doubled and heroin deaths have more than quadrupled in just
Speaker 1: the past decade. These statistics are beyond alarming, and they're
Speaker 1: leaving us wondering what is it going to take to
Speaker 1: beat this addiction epidemic. In part one of this episode,
Speaker 1: I sit down with two people who are actively using
Speaker 1: their experience, their influence, and their voices to help answer
Speaker 1: that question. Nikki six founding member and Bassis of the
Speaker 1: world renowned rock band Motley Crew and six AM three
Speaker 1: time New York Times bestselling author, public speaker, philanthropist, photographer,
Speaker 1: and addiction recovery advocate. There was a whole inside me
Speaker 1: that wasn't my fault, but later we've become my responsibility.
Speaker 1: And Dr A. D. Jaffee, a world renowned mental health expert,
Speaker 1: lecturer at u c L, A addiction specialist and author
Speaker 1: of the Abstinence myth. Genetically, there are actually a few
Speaker 1: dozen markers that are important when it comes to us
Speaker 1: understanding whether somebody is more or less likely to become
Speaker 1: an addict. After my conversation with Nikki and A. D.
Speaker 1: I was left wondering is there a way to identify
Speaker 1: addictive or impulsive behaviors earlier before people succumb to a actions.
Speaker 1: Listening to part two of this episode, where doctors Abraham
Speaker 1: Palmer and Sandra Sanchez Roger of the University of California,
Speaker 1: San Diego School of Medicines Department of Psychiatry share their
Speaker 1: latest research. They discovered a genetic signature that correlates a
Speaker 1: person's ability to delay gratification with reduced chances of addictive behavior,
Speaker 1: meaning those that place more value on instant gratification over
Speaker 1: delayed gratification are more likely to experience addictive behaviors. Not
Speaker 1: everybody's felt the same deck of cards. Not everybody goes
Speaker 1: into these situations with the same strengths and weaknesses. Some
Speaker 1: people are very vulnerable to these substances which are prevalent
Speaker 1: in our society, and that shouldn't be seen as a
Speaker 1: personal weakness, that shouldn't be seen as something that they
Speaker 1: are blamed for. This is going to be interesting, this
Speaker 1: is going to be fun, and this is going to
Speaker 1: be very real. Let's begin with Nikki and a d.
Speaker 1: You both have some shared experiences. You both landed in
Speaker 1: some beautiful places. Nikki, I want to start in the
Speaker 1: beginning with you. What was your childhood and family life
Speaker 1: like and how can you anchor that story of your
Speaker 1: own addiction into those experiences. I was born in San Jose, California.
Speaker 1: My father was the first in our family to be
Speaker 1: born in America. His parents, my grandparents, were immigrants from Italy.
Speaker 1: My mom met my dad she was eighteen. He was
Speaker 1: about forty two years old. I was two years old
Speaker 1: when of my sister, Lisa was born with Down syndrome.
Speaker 1: They were told to not take her from the hospital,
Speaker 1: that she wouldn't live six days, much less six weeks
Speaker 1: or six months. My dad was very passionate about bringing
Speaker 1: her home, and they couldn't take care of her. It
Speaker 1: was nineteen sixty they didn't have the ability, and they
Speaker 1: didn't have the finances. My dad was like a construction
Speaker 1: worker and my mom was a stay at home mom,
Speaker 1: so that my sister went to a home and I
Speaker 1: was told that. I was very upset about that. I
Speaker 1: was very excited I was gonna have a sister. I
Speaker 1: was very upset as my first kind of thing I
Speaker 1: can connect to what what might be an abandonment for me.
Speaker 1: My dad left right after that, so I was about three,
Speaker 1: and then my mom left right after that, and I
Speaker 1: went to my grandparents, and I didn't know that I
Speaker 1: had been basically abandoned until I hit, you know, maybe
Speaker 1: my teens. I started to have a lot of anger
Speaker 1: towards my mom and my dad and everybody else has
Speaker 1: a mom and a dad, even if they were divorced.
Speaker 1: I'm living in Idaho with my grandparents, are traveling every
Speaker 1: six months. I become a very shy kid because I
Speaker 1: was always the new kid in school. I didn't have
Speaker 1: any roots. I didn't know who my family was, and
Speaker 1: I didn't know until I was a little bit older.
Speaker 1: I actually didn't even know who I was. And the
Speaker 1: one thing that I had was music. I go back
Speaker 1: in time and I remember that was the thing. I
Speaker 1: think music actually saved my life. I think without music,
Speaker 1: I might have ended my life early through either drugs, alcohol,
Speaker 1: or some other other ways. So I always look at
Speaker 1: music as like the thing that saved my life. That's
Speaker 1: a that's a deep story, and it's kind of actually amazing.
Speaker 1: So many parallels, but you hear and I can see
Speaker 1: all the work you've done by this moment to recognize
Speaker 1: all those old patterns, right, because it's really interesting how
Speaker 1: different and yet how similar our stories are. My family
Speaker 1: stayed together all the way through. My dad died of
Speaker 1: cancer about ten years ago, still married to my mom,
Speaker 1: but a lot of tumultuous elements of their relationship. They
Speaker 1: almost separated multiple times, you know, place being thrown in
Speaker 1: the house and yelling and shouting and a very emotionally
Speaker 1: withdrawn family. We moved to the States and we moved around,
Speaker 1: and I was the new kid in school and I
Speaker 1: was an immigrant, and I needed ways to fit in
Speaker 1: and so which I can totally relate to you at
Speaker 1: around the same age and well, I mean for me,
Speaker 1: it was fourteen, so maybe a little bit later than
Speaker 1: than the moving around started for you. And I was
Speaker 1: always really socially anxious until the first time somebody handed
Speaker 1: me a bottle of vodka at a sleepaway camp and
Speaker 1: knew drinking was bad, but the only reason I drank
Speaker 1: it at first was because I wasn't gonna be the
Speaker 1: weird kid to say no. And I had a few
Speaker 1: SIPs and I remember it burning down my throat, just
Speaker 1: being disgusting. But I'm not gonna be the one throwing
Speaker 1: up this stuff either, because all the kids are gonna
Speaker 1: make fun of me. And then fifteen minutes later it
Speaker 1: hit and I was good, Like for the first time
Speaker 1: it as long as I can remember, I didn't care
Speaker 1: what other people thought of me. I didn't feel awkward.
Speaker 1: I could talk to girls, all these things that I
Speaker 1: wanted to figure out, but like you said, I didn't.
Speaker 1: I didn't have a word for it. I didn't have
Speaker 1: a name for it. I didn't recognize this was going on,
Speaker 1: and now I found a solution. And I immediately after
Speaker 1: that sleepaway camp, I was drinking every weekend at fourteen,
Speaker 1: and it gave me a group of people with whom
Speaker 1: when I drank, at least, because I still didn't feel
Speaker 1: like I belonged if I wasn't drinking, but when I drank,
Speaker 1: I felt okay. And then we came around the same way.
Speaker 1: Everything came the same way, because as long as I
Speaker 1: could belong, everything supposedly in my head would be okay.
Speaker 1: But then that took me down some pretty dangerous routes.
Speaker 1: You know, within five to ten years. It developed quickly
Speaker 1: because the first drive, the first impetus, was just to
Speaker 1: be all right and to just belong. And it sounds
Speaker 1: like that's really really similar. I'm sure everybody listening to
Speaker 1: totally understand why you would have that coming from that
Speaker 1: background was the same for me. My earliest memory was
Speaker 1: we I think we were living in Lake Tahoe and
Speaker 1: there were these kids on the playground and one kid
Speaker 1: had a little envelope and he had some seeds, which
Speaker 1: then I know, like a gardener that was he was,
Speaker 1: actually there were sunflower seeds he said it was you know,
Speaker 1: it was pot and I was like, I don't really
Speaker 1: even know what that is. I mean that I was
Speaker 1: very young, I found out and I fit in, and
Speaker 1: all of a sudden, I wasn't the new kid in school.
Speaker 1: So it's the same thing. There was a whole inside
Speaker 1: me that wasn't my fault, but later we become my responsibility.
Speaker 1: There's always that thread back to either a single experience.
Speaker 1: For some people experience of severe trauma in a moment,
Speaker 1: but typically it's not one experience. It's almost an entire
Speaker 1: existence that is centered on not fitting in, feeling less
Speaker 1: than being outwardly mocked. One of my clients today it
Speaker 1: was telling her mom just regularly called or miss Piggy, like,
Speaker 1: I don't know how you develop without having struggles and
Speaker 1: ideas about what's going on with your weight. When that's
Speaker 1: the way that people are supposed to love you and
Speaker 1: support you, relate to you. As humans, we want to
Speaker 1: feel comfortable. We we need for that to happen, and
Speaker 1: we're supposed to get it from our socialization. And if
Speaker 1: I'm not going to get it from the group of
Speaker 1: people that I was born into, I'm gonna find it
Speaker 1: somewhere else. We're going to talk about the biological piece
Speaker 1: of this a lot here today as well. But some
Speaker 1: people I'm one of those people. I don't know if
Speaker 1: you are, but um, I have a proclivity to be
Speaker 1: experimental and try stuff out, be a little bit more
Speaker 1: maybe um inquisitive, inquisitive, impulsive, some of these other things
Speaker 1: that some of the people I was born around, and
Speaker 1: so when these things would show up, I was pretty
Speaker 1: quick to jump on them and not really do a
Speaker 1: lot of forethought and sit around and go, well, I've
Speaker 1: heard this is bad. These kids want me to fit in.
Speaker 1: What do I do? I just I jump on it.
Speaker 1: It's also hard when the people that are saying it's
Speaker 1: bad are actually not treating you good. So now you
Speaker 1: have some guy that's got a thing of something, and
Speaker 1: even though you don't really know him, it's like, oh,
Speaker 1: he's he's cool. Those guys are always cool to me,
Speaker 1: Like the guy that had the weed, the guy that
Speaker 1: you know they had a secret party and someone's I
Speaker 1: was like, wow, that's so much cooler than my existence.
Speaker 1: My existence is my mom ignored me, my dad ignored me.
Speaker 1: Kind of a thing I think about and curious what
Speaker 1: you think about this, Do they know? Like I don't
Speaker 1: think my mom I knew what she was doing. I don't.
Speaker 1: I don't don't know the pressure my dad had being
Speaker 1: thirty years older than my mom in like the sixties,
Speaker 1: and he left and was my mom crazy? I've heard
Speaker 1: she was. I never really knew her. There's a child
Speaker 1: with down syndrome, there's financial he just he left. Did
Speaker 1: my mom know? Did they know? Shipping me off? And
Speaker 1: and even even it's like almost maybe not fair that
Speaker 1: I say shipping me off like I was like a
Speaker 1: bottle of water. Maybe they just didn't have any other tools,
Speaker 1: and maybe they thought they were saving you. Maybe what
Speaker 1: you've both done a beautiful job of establishing is the
Speaker 1: whole that addiction tries to fill a sense of lack
Speaker 1: of community, of loneliness, of abandonment, of belonging that you
Speaker 1: might not get from the people around you. So, Dr Jaffie,
Speaker 1: how do we scientifically understand what addiction actually is? So
Speaker 1: I want to be really clear from the outset. Well,
Speaker 1: a lot of people listening might think that this is
Speaker 1: a completely agreed upon idea. It's not. And there's a
Speaker 1: lot of debate among scientists in the industry in general
Speaker 1: about what addiction is. And everybody's heard the addiction disease
Speaker 1: model for that's one of the predominant models in the
Speaker 1: United States, for instance. Addiction absolutely has both biological and
Speaker 1: environmental and psychological components. Everybody will acknowledge that the question
Speaker 1: and I talked about this lot. There's a whole chapter
Speaker 1: in the Absent Smith literally dedicated to this part. Is
Speaker 1: for about a hundred years now, we've been fighting about
Speaker 1: who rules that kingdom, right, like is it more biology
Speaker 1: or more psychology or is all the environment. I think
Speaker 1: that's a somewhat uniquely American thing that we kind of
Speaker 1: want to know who one out, like who beats who
Speaker 1: beat who? Did biology beat psychology? And I think the
Speaker 1: reason I like this conversation he is I don't think
Speaker 1: there's really a winner. I think it becomes individually determined
Speaker 1: by each person's experience. So addiction is literally in a
Speaker 1: clinical sense and name we have given. We don't use
Speaker 1: it in the clinical terms anymore. Alcohol use disorder for instances,
Speaker 1: the name for what alcoholism is. An alcohol use disorder
Speaker 1: can have a you know, a low level, of moderate level,
Speaker 1: or severe level, and what it is is a collection
Speaker 1: of symptoms. It's a set of things that show up together,
Speaker 1: Drinking more than you want to, more frequently than you
Speaker 1: want to, not being able to stop with yourself when
Speaker 1: you say that you would um having consequences social, relational,
Speaker 1: employment based consequences of health that a mass, and that
Speaker 1: you still cannot correct your behavior based on right. And
Speaker 1: so the idea of an addiction is engaging in the
Speaker 1: behavior or substitutes of some sort that is negatively impacting
Speaker 1: your life in a multitude of ways, normally actually includes
Speaker 1: cravings within it, somewhere where even when you're not using,
Speaker 1: you are looking for and wanting the thing, and that
Speaker 1: it shows up for a long enough period of time
Speaker 1: with consequences to a mass, and the correction doesn't end
Speaker 1: up resulting. That's really as broad of a definition as
Speaker 1: you can have for addiction. And I include four criteria
Speaker 1: in the books of spiritual, Psychological, environmental, and biological. And
Speaker 1: for me, spiritual is anything that connect you to something big, right,
Speaker 1: Like my purpose now is to help other people struggling
Speaker 1: with this. That's a big enough spiritual thing for me,
Speaker 1: the helping of other humans. From the biological point of view,
Speaker 1: I think this is a really important thing to talk about,
Speaker 1: because there's no doubt that biology plays a part. I mean,
Speaker 1: I know for you, Nikki, a big part of your
Speaker 1: story was heroin. That's you talk about, but it was
Speaker 1: the other stuff too, you know, you talk get my
Speaker 1: hands on yeah, right, But you say something about heroin
Speaker 1: that I used to say about meth which was I
Speaker 1: used everything until I found that, and when I found that,
Speaker 1: I was good. I did. I stopped drinking when I
Speaker 1: found that. Heroin one for you and meth one. You
Speaker 1: were doing music, you had another job. I became a
Speaker 1: drug dealer. And I've read your story and it's it's fascinating.
Speaker 1: Everything in my life was drugs. Yeah, but everything you
Speaker 1: were headed on one way, and that just took your
Speaker 1: knees out from underneath you. Do you feel that there
Speaker 1: is an invisible line. Let's just use alcohol as a
Speaker 1: young example. The guy gives you some vodka. You feel
Speaker 1: like you fit in. You're getting some girls, like thinking
Speaker 1: your kids. You you got a new bicycle, going to
Speaker 1: some parties. You're drinking more. You throw up a couple
Speaker 1: of times. You throw up. You know on your new bicycle.
Speaker 1: There's signs that should keep going in one day I
Speaker 1: crossed the line. Do you remember when that was? Kind
Speaker 1: of don't And I've always wanted to ask somebody else,
Speaker 1: So I think this is there's an invisible line. I don't.
Speaker 1: I don't think there really is. And from a biological
Speaker 1: stamp when things absolutely happen right, neither National Student on
Speaker 1: Drug Addiction, in one of their papers a while back,
Speaker 1: that's about twelve fifteen years ago, talked about essentially has
Speaker 1: switched being thrown, which is a question you're asking biologically
Speaker 1: in the brain. The thing is, we've never found that switch.
Speaker 1: And it's not only that we've never found it, but
Speaker 1: the story typically for people progresses along a continuum. Right,
Speaker 1: things continue to get worse, and that line is sometimes
Speaker 1: perceived in hindsight. So when you get to the end
Speaker 1: of the story, you can look back and say, well,
Speaker 1: that's when things change. Like Matthews, I had no problem
Speaker 1: admitting that I was addicted to meth. When I was
Speaker 1: addicted to it, I didn't call myself an addict because
Speaker 1: I didn't understand that people like for you to take
Speaker 1: on them, Yeah, like that wasn't a thing for you.
Speaker 1: I told all my friends, AM like, I'm addicted to
Speaker 1: I would wake up every day and just you use
Speaker 1: meth after I just fell asleep because it was no
Speaker 1: reason for me to do it other than the fact
Speaker 1: that it had now served this role in my life.
Speaker 1: So biologically, a whole slew of things happened for hairin
Speaker 1: for instance. Right, we know that one of the main
Speaker 1: reasons why after continued hair on you is people have
Speaker 1: a hard time stopping. Your body regulates so much to
Speaker 1: the influx of opioids that all these normal processes that
Speaker 1: were never a problem for you, like eating and digesting food,
Speaker 1: just feeling comfortable in your skin literally so you're not
Speaker 1: crawling with pain everywhere. All those things have now changed
Speaker 1: because of the biology of the drug. And when you
Speaker 1: take the drug away, you experienced severe pain diarrhea. Like
Speaker 1: these things happen to your body. Doesn't make it anymore, right, yeah,
Speaker 1: and you and so this pain reliever that your body
Speaker 1: used to make naturally for itself, your body has now
Speaker 1: disregulated how it works and it has changed. That is
Speaker 1: an absolutely biological fact of what happens to a heroin addict. Now,
Speaker 1: the fact that that happens, we used to think is
Speaker 1: the only reason why people got addicted to heroin because
Speaker 1: they couldn't stop the heroin use afterwards. But we know,
Speaker 1: and I'm wondering about your experience, and the same thing
Speaker 1: is at some point you kicked it. So at some
Speaker 1: point even that was not enough to keep you from
Speaker 1: the use. But what was the difference? To me, the
Speaker 1: difference becomes the psychological components, the environmental components, and the
Speaker 1: spiritual components. Something changed about those other ones that allowed
Speaker 1: you to push through the biological piece because the biological
Speaker 1: people never go away, it will always be there. What
Speaker 1: to me is interesting and why I wrote the book
Speaker 1: about the absence Smith is people pretend like recovery, like
Speaker 1: getting over addiction. We just kind of define. I hope
Speaker 1: that was good enough for you to find what addiction
Speaker 1: is it is. But I want to jump in with
Speaker 1: because you talk about sort of overcoming the biology, which
Speaker 1: for this show comes back to genetics and predetermination or
Speaker 1: predisposition or heredity or inheritance of a proclivity to have
Speaker 1: an addictive personality or any physiology. So where are genetics
Speaker 1: in the story of what addiction is? Sure? As an
Speaker 1: umbrella to all this, I want to make sure that
Speaker 1: we stay connected to the idea that while biology absolutely matters,
Speaker 1: there is no known period, point blank predetermined genetic makeup,
Speaker 1: specific combination of alleles and genes that creates an addict
Speaker 1: or an alcoholic that does not exist. When people talk
Speaker 1: about an alcoholic personality or an addictive personality, they're talking
Speaker 1: about the more complex thing that we were talking about before. Right, Genetically,
Speaker 1: there are actually a few dozen markers that are important
Speaker 1: when it comes to us understanding whether somebody is more
Speaker 1: or less likely to become an addict. But the thing
Speaker 1: is they run the gamut from how your liver processes
Speaker 1: the drugs. Right. So, for instance, we know that there's
Speaker 1: an alleal called l d H two two which has
Speaker 1: to do with a specific enzyme in your liver that
Speaker 1: helps break down one of the by products of alcohol aldehyde.
Speaker 1: If you can't break down aldehyde, then you know formaldehyde. Right,
Speaker 1: everybody knows the name of that chemical. Aldehyde is toxic
Speaker 1: to your body. And if you know anybody who drinks,
Speaker 1: this happens a lot in Asian populations, drinks a tiny
Speaker 1: amount and gets really flush and sweaty. Their body can't
Speaker 1: process alcohol. There's a chemical reason for that, and it's
Speaker 1: because an enzyme and your liver doesn't exist to break
Speaker 1: down this by product, which means that as soon as
Speaker 1: you start drinking, your body goes into a toxicity sort
Speaker 1: of state essentially, well not even just detecting it, just
Speaker 1: being flooded with aldehyde, and so you can't process the
Speaker 1: chemical appropriately. Those people don't drink a lot, so that
Speaker 1: has to do with the biological predetermination. Those crowds that
Speaker 1: literally have an allergic reaction literally when they drink it,
Speaker 1: which was the opposite of us. But that's a kind
Speaker 1: of a good thing. Yeah, well, so here's the interesting thing, right,
Speaker 1: This is what's interesting. Biologically, they're less likely to use alcohol,
Speaker 1: but that doesn't remove their ability to become addicted because
Speaker 1: they'll find something else to fill the gap. Biologically, we
Speaker 1: end up chasing, well, what is the thing that's impacting.
Speaker 1: So so so some of this is about literally how your
Speaker 1: liver or your gut eliminates or processes the substance. So
Speaker 1: that's one thing, and we have a lot of different
Speaker 1: variants genetically. The next piece is then what happens once
Speaker 1: it's in your bloodstream in terms of what receptors is
Speaker 1: it able to connect to, what systems in your body?
Speaker 1: Does this chemical attached to there's a reason why the
Speaker 1: drugs we use, other drugs we use, right, TC attaches
Speaker 1: to all these molecules all over I mean not just
Speaker 1: your brain, your gut, all over your body their TC receptors,
Speaker 1: opioids the same thing. All over your body. There are
Speaker 1: molecules that attached to one another. And so the variance
Speaker 1: because we don't all have the exact same receptors, whether
Speaker 1: your receptor is more active or less active, will mean
Speaker 1: that when the drug enters your system, you'll have more
Speaker 1: of a reaction or less of reaction. Weirdly, people actually
Speaker 1: have the opposite notion of how this happens. People struggle
Speaker 1: with alcohol primarily have a reduced sensitivity to alcohol, not
Speaker 1: a heightened sensitivity to alcohol. What does that mean? That
Speaker 1: means that they drink more or in order to get
Speaker 1: the same effect than other people around them, So they
Speaker 1: become heavier drinkers from beginning. That starts setting up all
Speaker 1: those other biological processes. And there's some people that I've
Speaker 1: experienced in my life that would drink, you know, morning, noon,
Speaker 1: night pass out. You're like that guy's not getting out
Speaker 1: of bed for three days. He's going to be the
Speaker 1: worst hangover up at seven o'clock in the morning in
Speaker 1: the gym, goes to launch, has a drink and does
Speaker 1: it again. How does that happen? So tolerance is an
Speaker 1: amazing thing. When I drank, I get two day hangovers.
Speaker 1: In the end of my drinking career, I would it
Speaker 1: would like, you know, you move up in the chain.
Speaker 1: It's great. You know heroin use, right, if we just
Speaker 1: go to that when people start using heroin, a small
Speaker 1: amount delivers a huge bang and creates a massive effect.
Speaker 1: I mean, once you get out over the nausea part, right,
Speaker 1: you have to get over that. Once you get over that,
Speaker 1: then it gives you this really big hay off in
Speaker 1: terms of feeling euphoric and and settled in a way
Speaker 1: that people have never felt before. You start using more
Speaker 1: and you need more and more drug, right, that's kind
Speaker 1: of the standard. And not only that, but then sometimes
Speaker 1: you need just a little bit like do you ever
Speaker 1: have those times where I'm sure you did one you
Speaker 1: needed to use not a lot, like, not enough to
Speaker 1: get high, but enough to be able to function. Yeah,
Speaker 1: So it's like you find this middle ground. So that
Speaker 1: guy you're talking about, his body is so tolerant of
Speaker 1: alcohol that he actually needs it for all his systems
Speaker 1: to operate normally based on what the new normal is
Speaker 1: for his body. And here we're having a biological conversation
Speaker 1: about addiction, right. But the issue is, like we said before,
Speaker 1: if you have these five genes and you come from
Speaker 1: this cultural background, like your parents are from this country
Speaker 1: or this area of the world, and you were born
Speaker 1: this weight, you will become an alcoholic. That marker doesn't exist,
Speaker 1: especially because we now know so much more about genetics
Speaker 1: than we used to with the concept of epigenetics. So,
Speaker 1: for instance, let's say that you came with the most
Speaker 1: heavy weighted biological predetermination for addiction. Right, Let's say all
Speaker 1: the genes were lined up to give you the highest
Speaker 1: risk of becoming a drug addict. If you are born
Speaker 1: in a relatively stress free environment and are wealth fed
Speaker 1: and nourish and taken care of, there are protective epigenetic
Speaker 1: systems in your body there can manage and essentially control
Speaker 1: some of that negative impact of your blueprint. So in
Speaker 1: that case, it could be a social thing that could change,
Speaker 1: that could totally flip flip you on your head. You
Speaker 1: can trauma, you get beaten, you get raped, you could
Speaker 1: be predetermined and live in a you know, in Himalayas,
Speaker 1: and you know, meditate every day and have this beautiful,
Speaker 1: peaceful life and you go down into the city and
Speaker 1: something traumatic happens and it triggers a lot of stuff
Speaker 1: and then you have your first experience. Yeah, there's so
Speaker 1: much in that story actually, right, because here's what you're
Speaker 1: talking about're talking about a person who's predetermined, but living
Speaker 1: in an environment and the psychological state of being that
Speaker 1: doesn't push you towards addictive behavior. And there he's safe
Speaker 1: with all the biological predetermination. Safe And do they know,
Speaker 1: do they feel it, do they feel out of whack
Speaker 1: or it's just in it's in the genes. We're getting
Speaker 1: into really good stuff. Because the idea for me is
Speaker 1: your biology is what I call your machine. It absolutely
Speaker 1: determines who you are. I always equate this always two cars, right,
Speaker 1: like if you have driven multiple if you all if
Speaker 1: you drive different cars, then they act differently. They have
Speaker 1: a different personality to them, from torque to speed, to
Speaker 1: gas mileage, all that stuff. But it's not like a
Speaker 1: Ferrari feels awkward because it's got high low end torque.
Speaker 1: That's just that's the way it is right, whereas a
Speaker 1: prius is kind of steady across its power line and
Speaker 1: it's really efficient in terms of use of gasoline. So
Speaker 1: I call the biology the thing that presets your your system.
Speaker 1: What are you primed for? Like, if you're primed for inquisitiveness,
Speaker 1: since station seeking is kind of the way we talk
Speaker 1: about it, or impulsivity, that's actually not necessarily a bad thing.
Speaker 1: Long term, you're more likely to be entrepreneurial, You're more
Speaker 1: likely to try other things that people are afraid of
Speaker 1: that can be exciting and really successful. There's not a
Speaker 1: bad element to that. Once we get into negative behaviors
Speaker 1: like problematic drug use, et cetera, then you cross over.
Speaker 1: So we're in an age where even children are being
Speaker 1: encouraged pursue your passion. On our social media, the people
Speaker 1: who are winning and succeeding saying you gotta know your passion, man,
Speaker 1: you gotta pursue that thing you love. And Nikki, you
Speaker 1: have pursued your passion, you know, musically, creatively, photographically, and
Speaker 1: we have benefited from that passion, and and saying with you,
Speaker 1: Dr Jeff, you have this passion for helping other people.
Speaker 1: You've written books, you got podcasts. But where do you
Speaker 1: think about the line, the threshold between the positive impact
Speaker 1: of pursuing your passion versus the destructive impact of pursuing
Speaker 1: a passion for meth? But listen to the passion, right, Nikki?
Speaker 1: You talked about music was one of those two was
Speaker 1: I think drugs are addict The behaviors are just a tool,
Speaker 1: that's all they are. In the beginning, you found music
Speaker 1: and that was one of the things that allowed you
Speaker 1: to organize, control, be okay in the chaos that was
Speaker 1: your life early on. And I never thought of it
Speaker 1: quite like that. But I remember being with my mom
Speaker 1: living in Los Angeles driving in this car. I can
Speaker 1: still see the dashboard. I don't know where we were,
Speaker 1: but there was a park and there was a lake,
Speaker 1: because it could have been like Balboa Park or something.
Speaker 1: I love how connected you out of this moment? And
Speaker 1: I remember hearing Petulia Clark's song Downtown and the lyrics
Speaker 1: are really colorful and they tell this story about you
Speaker 1: know downtown and what you know sunshine, And I remember
Speaker 1: that moment like yesterday, and that was the moment I
Speaker 1: fell in love with music. And what you just said
Speaker 1: was interesting because it could have been at that moment
Speaker 1: that I was like, all this chaos is happening, but this, this, this,
Speaker 1: this brings me piece. So I don't think we can
Speaker 1: separate the two right Without the pain, do you had experienced,
Speaker 1: the music wouldn't have had that power. And for me,
Speaker 1: I can tell you with certainty, I was a punk
Speaker 1: growing up like a fourteen years old. There was no
Speaker 1: purpose to my life. The purpose came because I came
Speaker 1: through this drug use nightmare. Right that when I woke
Speaker 1: from I had a million dollar bail, seven fifty thousand
Speaker 1: dollar bail. My parents found out it was a drug dealer.
Speaker 1: When I was pretending I was a musician, like my
Speaker 1: life had devolved, it had imploded. And when I finally
Speaker 1: dug my way out of that three or four years later,
Speaker 1: and I ended up back in school by necessity because
Speaker 1: I could not get a job because I had nine
Speaker 1: felonies on my record. When that happened is when I
Speaker 1: went I now have my purpose. And if I didn't
Speaker 1: have that pain, I wouldn't have had the purpose. I
Speaker 1: don't think we can separate the two so much. I mean,
Speaker 1: if you listen to Gary v or any of the
Speaker 1: people really are pushing people towards purpose. It's the same thing, right,
Speaker 1: get you get driven into the ground, and out of
Speaker 1: that pain, you discover the thing that rescues you from it.
Speaker 1: The problem for me was that nobody along the way,
Speaker 1: this is what I try to do for people. Now,
Speaker 1: Nobody along the way paused and said, I see you
Speaker 1: in pain. Nobody along the way came and said what
Speaker 1: can I do to help relieve? That was that because
Speaker 1: of some of the people in your environment. In my environment,
Speaker 1: the first time I was introduced to heroin, I actually
Speaker 1: don't want to even say who it was because it's
Speaker 1: you know, they're actually not here anymore because of drugs.
Speaker 1: But there was other people. They said, hey, do you
Speaker 1: want to try some some junk And I said yeah,
Speaker 1: And I'll tell you why. I said yeah, because these
Speaker 1: guys that I thought were so cool, like Johnny Thunders
Speaker 1: and the New York Dolls and Keith Richards and all
Speaker 1: these guys that were shooting dope were so cool and
Speaker 1: that that was my goal. That was my goal, and
Speaker 1: I did it. And I literally wanted to become a junkie.
Speaker 1: That was I remember when I got clean, I was like,
Speaker 1: how sick? That was? Why did I not go, oh,
Speaker 1: I'll try it. I was like, not only will I
Speaker 1: try it, this is who I am. And because it
Speaker 1: gave me something, it gave me a connection to something
Speaker 1: that was My goal was to be, you know, a
Speaker 1: successful musician and outlaw rock and roller, to to live
Speaker 1: life the way I wanted to write the lyrics the
Speaker 1: way I want to write. I'm gonna tell my story.
Speaker 1: I'm going to live the bohemian life. And I died,
Speaker 1: as did the guys that were in that room. They're
Speaker 1: all dead. And you came back. I came back, and
Speaker 1: you've outlined the amount of work it took to do
Speaker 1: that right. So and it, but it gave me purpose.
Speaker 1: You know, last night I was laying downstairs with my wife.
Speaker 1: We were talking about doing the show, and I was
Speaker 1: very excited about it, and she said, you know, I
Speaker 1: believe that you were spared because this is your mission.
Speaker 1: Your mission is not to be Keith Richards Jr. Yeah.
Speaker 1: I like rock and roll. I like it really loud
Speaker 1: and it's snotty. That's not my that's not my purpose.
Speaker 1: My only purpose. She wants to be a father, is
Speaker 1: to be an advocate for sobriety. It's to help. The
Speaker 1: next kid that comes up and someone says, hey, man,
Speaker 1: you want to try junk and he goes that guy
Speaker 1: Nikki six is pretty cool. He's still doing it. He's
Speaker 1: a photographer, he's an artist, he's still making music, musicals, movies,
Speaker 1: and he's sober. Maybe that is my purpose. I think
Speaker 1: that's one of the reasons for me why we have
Speaker 1: to speak out. For instance, I'll tell you flat because
Speaker 1: I want to be clear about this, I'm not fully sober.
Speaker 1: I kick drugs. That's been eighteen years since I use meth.
Speaker 1: I drink socially. Now. Part of the reason I talked
Speaker 1: about this is that purpose you just connected to is
Speaker 1: so important in my opinion, to find what every moment
Speaker 1: is about for you. Right. I don't know how you
Speaker 1: feel about this, but when I get one of those messages,
Speaker 1: whether it's Instagram or Facebook, from somebody who read the book,
Speaker 1: I saw my story, saw one of my talks, and
Speaker 1: they say, you find you finally spoke to me in
Speaker 1: a way that nobody had before. And I'm gonna whatever
Speaker 1: the next thing is they're about to do to change
Speaker 1: their life for the better. It's the biggest gift you
Speaker 1: because get it's it's amazing. What are the ways that
Speaker 1: you found your way back? And and how are we
Speaker 1: making mistakes and what we expect from people. I think
Speaker 1: people put a lot of weight on themselves. I know
Speaker 1: we put a lot of weight on people. You go
Speaker 1: called turkey, you do the specific program or doesn't count
Speaker 1: your weak because you've succumbed to this temptation repeatedly. I
Speaker 1: suspect all that is false and that there are other
Speaker 1: ways out. But you've both been through it. You're experts
Speaker 1: in different ways. What have you seen that works to
Speaker 1: bring people back from that? Can you talk? When I
Speaker 1: gave you the bracelet? You talked about this experience you
Speaker 1: had after a relapse. Do my just talking about that
Speaker 1: right now? Yeah? I've been sober nine almost nine years,
Speaker 1: maybe a little under that. I decided to try it on,
Speaker 1: but not just to try it on. I had a
Speaker 1: good excuse. I had a crazy relationship I was in.
Speaker 1: I was in a band that was crazy. I had
Speaker 1: drifted far enough away that I couldn't really remember what
Speaker 1: it was like to have my skin feel like sand paper.
Speaker 1: I feel like my guts were like hanging out of
Speaker 1: my mouth. As I was going through Heroin withdrawal. You know,
Speaker 1: when you're throwing up and you have diarrhea at the
Speaker 1: same time, there's only one toilet. It's not pretty. It's
Speaker 1: not a glamorous rock star living the life, designer clothes,
Speaker 1: driving a Ferrari. It's it's disgusting. It's the bottom and
Speaker 1: you literally do want to die. And I forgot, I'll
Speaker 1: be honest, I forgot for a second, and I had
Speaker 1: some good excuses in my alcoholic brain, and so I
Speaker 1: tried it on, tried a couple of beers, someone had
Speaker 1: a little bump, cheated on my wife. My whole life
Speaker 1: went in the toilet. And I literally put myself into
Speaker 1: rehab before I got like addicted again, before I had
Speaker 1: done any more damage. I had already done enough damage.
Speaker 1: And a short week or so, and I remember being
Speaker 1: in the desert at this rehab, and I kept waking
Speaker 1: up at four o'clock in the morning for some reason
Speaker 1: every morning, and I was like, Okay, I get it.
Speaker 1: You want to talk to me, So you weren't supposed
Speaker 1: to leave the room till six o'clock in the morning.
Speaker 1: And it was kind of weird for me because I
Speaker 1: was dorming with like eight other guys and they're like,
Speaker 1: I'm like, why am I? I went from a mansion
Speaker 1: to this rundown rehab and a desert with eight other
Speaker 1: guys in there. I just was like, So I went
Speaker 1: out and I went for a walk in the desert
Speaker 1: and as the sun was coming up, I hit my
Speaker 1: knees and I said, I will never use again if
Speaker 1: you can just help me see the way, and I will.
Speaker 1: I will help other people. I've had people say, yeah,
Speaker 1: that's a great story. It is a great story because
Speaker 1: it worked. I don't know if there was a spiritual intervention.
Speaker 1: I don't know what it was, but it was action
Speaker 1: right and determination and a program. And there's many people
Speaker 1: around me, so I had to make a choice. But
Speaker 1: to answer your question about the slip and about shame
Speaker 1: and about guilt and stigmas on the least six ammen.
Speaker 1: We wrote a song called maybe It's Time, and it
Speaker 1: is about that moment when you are like, you know,
Speaker 1: maybe it's time. You know, I put maybe It's time
Speaker 1: because you know it's gives a little. It should have
Speaker 1: literally been called it is time, but it didn't sing
Speaker 1: right uh and editing his album right now right here,
Speaker 1: but previous to that. I wrote a song called Accidents
Speaker 1: Can Happen, which was about falling off the wagon, and
Speaker 1: it's really just one day. It is a mistake, it's
Speaker 1: an accident, and accidents can happen, inspiring people that have
Speaker 1: fallen off the wagon to go again, go back at it.
Speaker 1: Sometimes we don't get it the first time. With diets,
Speaker 1: we don't get it the first time. If you have
Speaker 1: a sex addiction, we can't get it the first time.
Speaker 1: You're an overspend or you're living beyond your means, it
Speaker 1: takes us time. Who does it does get anything? But
Speaker 1: how horrible if you mess up and everybody points at
Speaker 1: you and says what's wrong with you? And you say,
Speaker 1: you're right, what is wrong with me? And you go
Speaker 1: back to your past that's what started in the first place,
Speaker 1: and exactly which is the problem. And so you were asking,
Speaker 1: I wanted to hear that story because I think it's
Speaker 1: so important a for people to hear that you can
Speaker 1: be okay. I mean, we can use whatever market you
Speaker 1: want for okay. And I think we should broaden that
Speaker 1: definition a little bit than just sobriety. You can be
Speaker 1: okay for nine years, screw up royally and come back Now,
Speaker 1: there are a couple of things that happened because, in
Speaker 1: my opinion, some of the misinformed focus we put on
Speaker 1: only how many days in the growth of sobriety do
Speaker 1: you have? Because we put so much focus on that
Speaker 1: thing and not on anything else, you go from having
Speaker 1: nine years to zero days, and in everybody's eyes, you've
Speaker 1: not become abject failure because yeah, you used to have
Speaker 1: two thousands some days, but now you're back at zero.
Speaker 1: So the person who came in last week and it's
Speaker 1: their first time getting any help is now better than
Speaker 1: you somehow based on this measurement. And as you just
Speaker 1: pointed out, it's really a bad thing. I've seen it.
Speaker 1: I've seen it up. And not only that, but you
Speaker 1: know when I hear the story that you tell you
Speaker 1: weren't back to zero in that moment you've checked yourself
Speaker 1: into treatment. First of all, that is not at all
Speaker 1: the same guy that had first been struggling. That's the
Speaker 1: number one. Secondly, when you were waking up at four
Speaker 1: o'clock in the morning, you weren't looking for self destructive
Speaker 1: anything anymore. You were trying to solve a problem. And
Speaker 1: I don't know, we talked you talked about a tiny bit,
Speaker 1: but it sounds like there were a lot of problems
Speaker 1: that were amassing, and because you were sober, it felt
Speaker 1: like what a lot of people feel like as well.
Speaker 1: I'm sober, so everything must be good. But I'm in
Speaker 1: the wrong relationship. I'm in the wrong this, I'm in
Speaker 1: the wrong that I'm took on a job I shouldn't take.
Speaker 1: Life starts sucking because we're not measuring success by any
Speaker 1: other means other than the sobriety. And now you don't
Speaker 1: have a buffer. Yeah, there's no so in buffer. So
Speaker 1: as soon as you find that buffer again, those problems
Speaker 1: are still there. I had not dealt with my mom.
Speaker 1: I had not dealt with my dad. I had not
Speaker 1: dealt with the traveling and the moving and feeling where.
Speaker 1: I remember when I was in Idaho and I was
Speaker 1: like growing my hair along and I was in and
Speaker 1: I remember these kids started, you know, calling me, calling
Speaker 1: me gay, and I remember that I was so young.
Speaker 1: I never heard the word, and I was like what
Speaker 1: I had literally went to the library and looked it up. Later,
Speaker 1: my mom asked me if I was a transvestite. I
Speaker 1: went to scho what is that? Because I had purple
Speaker 1: fingernail polished. I was emulating David Bowie. I was like
Speaker 1: writing me I was an artist. But those like things
Speaker 1: like as I got older, like I never I wasn't gay.
Speaker 1: If I was, I would have embraced it. But it
Speaker 1: was like lots of messaging, abandonment, travel, who are you?
Speaker 1: Why do you look like different? You're different? And then
Speaker 1: and then I was sober, but a lot of that
Speaker 1: was still in my universe. So so my whole point
Speaker 1: about recovery is we have to really broaden how we
Speaker 1: measure success. One of the tools that I give everybody
Speaker 1: I work with is this wheel of life I changed
Speaker 1: a little bit. There's one you can find online and
Speaker 1: if anybody goes to by the way to ignited dot com,
Speaker 1: you can download a free one just right now, and
Speaker 1: it's got ten areas of life. Do an assessment. Figure
Speaker 1: out how you're doing, how are your family relationships, how's
Speaker 1: your personal growth, how's your financial situation, what's your living
Speaker 1: environment like, how's your purpose? How are you contributing to society.
Speaker 1: There's all these different areas, and I gotta tell you,
Speaker 1: you can have thirty seven years sober and had gotten
Speaker 1: sober the day after you dragged the first time, and
Speaker 1: if you're scoring zero and all these other areas of life,
Speaker 1: I can tell you one thing, you're miserable and sobriety
Speaker 1: has nothing. And some people call that dry like a
Speaker 1: dry drunk dry drunk. I don't even know if that's
Speaker 1: you know, it's at least an a term. People use
Speaker 1: it in the rooms a lot. Because if you broaden
Speaker 1: this definition, what I think will end up happening for
Speaker 1: us over time is we can take somebody in your situation,
Speaker 1: for instance, who has fallen off the wagon, like used again,
Speaker 1: and say, well, we we saw this because all the
Speaker 1: scores and everything else in your life were going down.
Speaker 1: You used to be really happy in all these areas,
Speaker 1: and you get less less happy if you are assessing that,
Speaker 1: at some point somebody would go, what's going on with this?
Speaker 1: Like the relationship score is going from an eight two
Speaker 1: years ago to a three. You can't be married with
Speaker 1: a three score in your relationship. That's not happy, right,
Speaker 1: And that's the goal. And you came from that background,
Speaker 1: so you know what impact that has on somebody growing
Speaker 1: up in a household or living around that kind of relationship.
Speaker 1: And so if we don't pay attention. And here's where
Speaker 1: I think biology is an important base, right, like the car.
Speaker 1: It's the thing that you build the restaurant, because it's
Speaker 1: your machine that you build a psychology in the environment on.
Speaker 1: But if you don't understand what you built on top
Speaker 1: of that base, you're leaving everything up the chance, right
Speaker 1: for those who are trying to solve this epic sized
Speaker 1: problem that we have political leaders, business leaders, loved ones, children, doctors. When,
Speaker 1: in your experience, should we be doing more or less
Speaker 1: of to get us closer to that better place? Well,
Speaker 1: I mean there's so many answers to that. To be
Speaker 1: honest with you, I'm so happy that the conversation is
Speaker 1: being echoed around the world all over the place. You
Speaker 1: can't pick up the news, you can't turn on the
Speaker 1: news on your phone. It's there. It's this is an
Speaker 1: epidemic and it's like you did the numbers in the beginning.
Speaker 1: We know what the numbers are. They're devastating. There's a
Speaker 1: lot of answers to that, and some of the stuff
Speaker 1: that you're talking about is important for people to hear.
Speaker 1: There is recovery programs, but there's stuff that I feel
Speaker 1: that people don't talk about and before we get into
Speaker 1: what is the big answer, you know, is is it
Speaker 1: a government issue? Is that you know, is it better regulations?
Speaker 1: Yes to all this stuff in my opinion, But I
Speaker 1: think there's other stuff that people that are looking to
Speaker 1: get sober could be looking at as well, and that
Speaker 1: is setting themselves up for success. I believe that acupuncture
Speaker 1: is something and cut pressure is something that can really
Speaker 1: help addicts get off drugs. One tool, only one tool.
Speaker 1: I'm noticing a lot of evidence for that, especially about opiates.
Speaker 1: A lot of evidence abound acupuncture in particular for opiated
Speaker 1: And I do acupuncture, and it's really interesting being a
Speaker 1: recovered heroin addic and alcoholic and everything else addict acupuncture
Speaker 1: opens up these pathways for me that I wish I
Speaker 1: felt when I was a little boy. And now I'm
Speaker 1: on herbs from the acupunctures, and I've been doing transcendental
Speaker 1: meditation for about ten years. That is another thing. So
Speaker 1: sometimes I think it's like, for example, if you're going
Speaker 1: to get surgery on your shoulder, and I'm only referencing
Speaker 1: that because I just had rotator cuff surgery. I went
Speaker 1: to a specialized chiropractor. He did a lot of work
Speaker 1: with magnets. So we did a lot of stretching, a
Speaker 1: lot of working aligning my body. Acupuncture, I focused on diet,
Speaker 1: I focused on re physical therapy. So when I went
Speaker 1: and got it, I was as good as I was
Speaker 1: going to get to get it. You know, it's confusing
Speaker 1: because you have people that are like so bad, You're like, hey,
Speaker 1: before you go to rehab, let's do all these things
Speaker 1: to make the possibility of your recovery better. It's a
Speaker 1: bit of a weird concept, but I think it's something
Speaker 1: I would like to see in the conversation. First of all,
Speaker 1: I love these I love the Eastern tools, and more
Speaker 1: and more of those things are being incorporated into more
Speaker 1: traditional recovery like meditation and mindfulness is now a part
Speaker 1: of pretty much every recovery program you would hear about.
Speaker 1: And if it's not and you're checking some out, do
Speaker 1: not go there, right because one of the things that
Speaker 1: the meditation and mindfulness allow you to do is develop
Speaker 1: awareness around some of these issues that you have been
Speaker 1: running away from for decades and you don't even know
Speaker 1: you need to address them until you look inside for
Speaker 1: a little bit. But you asked, kind of how do
Speaker 1: we start solving this problem. Yeah, these kinds of conversations,
Speaker 1: first of all, are the the way we start solving
Speaker 1: the product. We're fixing it right now. I love it. Well,
Speaker 1: here's the problem, and I talked about this in my
Speaker 1: tech talk. I talk about the labels that we have
Speaker 1: on and I get your you've been in a recovery
Speaker 1: for a long time and you've readjusted what being an
Speaker 1: addict means in your head because you've shifted it. But
Speaker 1: for a lot of people, i'd say the vast majority
Speaker 1: of people who live in the world, addict is a
Speaker 1: really negative label. And what it means that you're a
Speaker 1: loser who's unmotivated, weak willed, maybe even stupid. Are you
Speaker 1: once for a bad person? You're not trustworthy? Not you lie? Yeah,
Speaker 1: and so addict has that label on top of it.
Speaker 1: What ends up happening unless we completely as a society
Speaker 1: change the meaning of the word addict. What happens is
Speaker 1: when you tell somebody that they're an addict, they will
Speaker 1: do everything they can to run away from that. And
Speaker 1: that is the reason why, in my opinion, based on
Speaker 1: the research I did when I was doing research, people
Speaker 1: with addiction problems don't go get help. Why Because as
Speaker 1: we stand in the current system of care, the first
Speaker 1: thing you have to do. I experienced this in the
Speaker 1: first forty five minutes and rehab. The first thing you
Speaker 1: have to be able to do is to identify as
Speaker 1: an addict. And we also all know that addicts have
Speaker 1: to quit forever. That's the other thing. The forever word
Speaker 1: is very fearful. It's tough, and I'm just trying to
Speaker 1: get through this day. Sometimes. It's the reason I wrote
Speaker 1: this book called The Absent and Smith is there are
Speaker 1: people who are in danger, and what I mean by
Speaker 1: that is like their substances can kill them in the
Speaker 1: next because the way they're doing things. Sometimes for those people,
Speaker 1: we do need to separate them and save them by
Speaker 1: isolating them so they can't get their drugs. For everybody else,
Speaker 1: which is the majority of people who have problems with
Speaker 1: drugs and alcohol and behaviors, that quitting forever and having
Speaker 1: to label myself an addict to get the help are
Speaker 1: really big barriers. And what I'm really hoping we can
Speaker 1: start changing is let's explain to people that there are
Speaker 1: things you can do to make yourself better, even if
Speaker 1: you're not ready to do any of that other stuff.
Speaker 1: You can start using smaller tools to make your life better,
Speaker 1: to stop running away and ace. You know you talked
Speaker 1: about shoulder surgery. If you do more massage to your shoulder,
Speaker 1: then it will damage itself less than the long term
Speaker 1: if you would have done it. So we can get
Speaker 1: into some preventative work and things like that around getting
Speaker 1: people to take better care of themselves. In general, I
Speaker 1: think not enough people like Nicky come out and talk
Speaker 1: about I used to be like this, but now I
Speaker 1: do these other things and I'm better for it, and
Speaker 1: I have different role models, so that we can shift
Speaker 1: the overall conversation of what an addict is, first of all,
Speaker 1: but more importantly, in my opinion, what it means to
Speaker 1: be struggling with addiction. Because most of the news stories
Speaker 1: we hear are about people who die from overdose, parents
Speaker 1: who got arrested because they neglected their kids and don't
Speaker 1: care about them, or rock stars or celebrities who screwed up,
Speaker 1: drove into a poll, got arrested, killed themselves. The vast
Speaker 1: majority of the stories we hear are negative stories about addiction.
Speaker 1: There are not enough of these stories to say, you
Speaker 1: know what, I've been there I made it out to
Speaker 1: the other side, and here's here are the tools that
Speaker 1: I use so that people who are stuck you can
Speaker 1: start looking up to somebody like Nikki and say, if
Speaker 1: he can do what I can do it. I feel
Speaker 1: that if we have a big picture, we would like
Speaker 1: to be part of the voices that steer whatever current
Speaker 1: administration we have towards better laws, better regulations. We would
Speaker 1: like to see that happen. That is a big ass
Speaker 1: tug boat to turn that thing around. But during that time,
Speaker 1: and without getting into politics, some of these conversations you're saying,
Speaker 1: and if they could be tangible. So when I mentioned
Speaker 1: meditation to people, a lot of people just gloss over
Speaker 1: and they go, Wow, Nikki is going to be sitting
Speaker 1: on a hill going on. It's not what's happening. I
Speaker 1: am daily trying to become a better man. I am
Speaker 1: every day looking at yesterday's behavior. I'll journ at night
Speaker 1: and I'll be like, this is what happened, and hey,
Speaker 1: I kind of blew it. I sent an email and
Speaker 1: I could have just been a little bit kinder, and
Speaker 1: then I will try to implement that into my next day.
Speaker 1: All these little tiny steps, if we could get that
Speaker 1: messaging out there somehow to addicts, whether it's through recovery,
Speaker 1: through messages, through books like that you've written, through podcasts,
Speaker 1: and getting people with the louder voices celebrities to talk
Speaker 1: about it in a way that gives addicts hope. For me,
Speaker 1: it was your junkie, you gotta go to rehab or
Speaker 1: you're gonna die, And yes, thank god, but that's not
Speaker 1: everybody's story. Everybody's story is not that some people stories
Speaker 1: about marijuana. Some people's stories about that they were beat
Speaker 1: as a kid and that they need sleeping pills to
Speaker 1: deal with uh, you know, night's stress. I mean it
Speaker 1: goes on. How do we get people to be feel
Speaker 1: healthy so that this is something that they want to embrace,
Speaker 1: it's not something that they're being beat up over, something
Speaker 1: to run toward rather than something to run away from. Absolutely,
Speaker 1: what's the one thing you'd say to somebody who's listening
Speaker 1: that's also suffering from addiction. The one thing is that
Speaker 1: there's a way out of this. I don't care how
Speaker 1: far down you've gotten. I don't care how many relationships
Speaker 1: you've destroyed, arrest, you've had, struggles, you've been through a
Speaker 1: little I've seen it all, Nikki, You've seen it all.
Speaker 1: It doesn't matter how hopeless you feel in this moment.
Speaker 1: There's a way out of this. When you're in the
Speaker 1: throes of whatever it is that you're addicted to, you
Speaker 1: don't think you can get out, and most of the
Speaker 1: messaging coming to you is what's wrong with you. So
Speaker 1: it's really hard when you're in a hole and you
Speaker 1: have people throwing dirt on top of you, you know,
Speaker 1: and so you're like, well, I think I'll just stay
Speaker 1: in the hole and do what they want me to do.
Speaker 1: And I'm here to say that, you know, you could
Speaker 1: get out of that hole. You don't have to be
Speaker 1: engaged with the people that are in your life that
Speaker 1: are either enabling you or whatever they're doing to you.
Speaker 1: I had a kind of an eye opening moment probably
Speaker 1: about fifteen years ago. I was in therapy and I
Speaker 1: kept talking about these issues with my mom the therapists.
Speaker 1: It's like those things that burn into your brain. I
Speaker 1: can still see the sun shining through the window and
Speaker 1: there was like dust like in the you know, in
Speaker 1: the light, you know that. And I kept talking about
Speaker 1: my mom and my mom this, and my mom said this,
Speaker 1: and my mom was putting me down about this, and
Speaker 1: I'm like a grown man with like a family, and
Speaker 1: I'm still struggling with this mom thing. And the therapist said, hey, Nikki,
Speaker 1: you don't have to love your mother. She abandoned you,
Speaker 1: and that set me free. So if there's anything I
Speaker 1: can say to people, is just because people are your
Speaker 1: you know, biological family, they may not be the best
Speaker 1: source for you to find recovery doesn't mean you can't
Speaker 1: love him. I still love my mom, you know, right
Speaker 1: up until she passed away. But I didn't let her
Speaker 1: have the power over me to keep making me feel bad,
Speaker 1: which I don't know could have maybe led to something
Speaker 1: might have manifested itself in anger depression. So that's one thing,
Speaker 1: you know, I'd like to say to people. Let me
Speaker 1: ask you both, what are you working on that you
Speaker 1: want people to know about? Right now? We have just
Speaker 1: wrapped up filming and editing of the Netflix movie about
Speaker 1: Motley Crue called The Dirt. So that's a very different
Speaker 1: project than the Heroin Diaries musical, which is going to
Speaker 1: open next year. A lot of people have asked me
Speaker 1: Heroin Diaries musical. The point of it is that you
Speaker 1: can use art to spread messages. I've been doing it
Speaker 1: in songwriting, whether I want to rile people up or
Speaker 1: I want to get people to think. It's been happening forever.
Speaker 1: It happens with all versions of art, paintings throughout history
Speaker 1: and self expression. So we've put together a fantastic musical
Speaker 1: and it's just beautiful. You're gonna see your pain and
Speaker 1: struggle and addiction and recovery and better and messaging on
Speaker 1: top of that and some of the stuff we've talked about.
Speaker 1: So that's that's what I'm working on right now, and
Speaker 1: it's been a real passion project. It helped a lot
Speaker 1: that a lot of people thought it was a weird idea,
Speaker 1: So there's still that little side inside of me and
Speaker 1: I'm sure it's society. Oh you're gonna tell me no, Okay,
Speaker 1: here we go. Yeah, I love it. So, you know Ignited,
Speaker 1: which is the company I started just to help people
Speaker 1: with across any area. I've struggled with sex addiction issues
Speaker 1: as well, and so my wife and I do a
Speaker 1: lot of work with couples around that. You know, some
Speaker 1: of the same personality traits that led to me using
Speaker 1: drugs and meth and all those things earlier on in
Speaker 1: life are still there, and I need to learn how
Speaker 1: to live with my machine, just like everybody else that
Speaker 1: I talked to. So ignited with not spelled. I g
Speaker 1: n t D is the big project that I'm taking
Speaker 1: on that involves podcasts, It involves writing this book, and
Speaker 1: involves doing a workshops with my wife, and it involves
Speaker 1: an addiction course. You know, one of the things that
Speaker 1: I'm trying to do for people is make rehab not
Speaker 1: the thing they have to do to get help. Shame
Speaker 1: is such a huge component of this. We need to
Speaker 1: lower the shame hurdles to get help and make it easy,
Speaker 1: not easier easy, for people to get help. I joked that, like,
Speaker 1: the barrier should be so low that you could fall
Speaker 1: into recovery right literally, because you shouldn't have to want
Speaker 1: to quit. You're you're almost doing like pre recovery. It's recovery.
Speaker 1: Recovery will split it. And so on that note, I
Speaker 1: will have us run toward the end of this conversation.
Speaker 1: Thank you both very much. I want to say in
Speaker 1: conclusion that the idea of these contributing elements, even what
Speaker 1: addiction is, has been really valuable. That the biology the
Speaker 1: machine is but one of at least four components, the psychology,
Speaker 1: the environment, the spirituality, and that sense of purpose that
Speaker 1: trying to fit in to be cool is something we
Speaker 1: can redefine. Your hell cool, Nikki, You and you redefine that,
Speaker 1: I think for a lot of our our listeners, and
Speaker 1: that we can be better, and that we need more
Speaker 1: tools to be able to do that. All of our
Speaker 1: lives are worth living, every single life is worth saving,
Speaker 1: and every single person suffering from an addiction has the
Speaker 1: ability to beat it. Some use different tools than others
Speaker 1: in that journey, but none of us is ever too
Speaker 1: broken or too scarred. We wouldn't be here. We would
Speaker 1: not be here, So thank you both for being here.
Speaker 1: This has been beautiful. After my conversation with Nikki and
Speaker 1: a D, I was left with two burning questions I
Speaker 1: had to explore. First, what's a trusted resource I can
Speaker 1: send people to for more information on prevention, treatment and help. Second,
Speaker 1: how can we better understand predisposition to addiction to better
Speaker 1: identify behaviors and patterns before they turn into addictions. My
Speaker 1: first stop was the Surgeon General's Office, which turned me
Speaker 1: on to the National Opioid Action Coalition visit no AC
Speaker 1: at n o a C dot org to learn more
Speaker 1: about the facts and stats and to get connected to
Speaker 1: help and treatments. If you or someone you love is
Speaker 1: battling opioid misuse, there are resources to help you be
Speaker 1: the one to break down the stigma and get treatment assistance.
Speaker 1: Visit n o AC dot org to learn more. My
Speaker 1: next call was too doctors Abraham Palmer and Sandra Sanchez
Speaker 1: Roger from the University of California, San Diego School of Medicines,
Speaker 1: Department of Psychiatry. They are trailblazing new research that just
Speaker 1: discovered a genetic signature for delayed discounting. What does that
Speaker 1: mean and why is it important? Let's have them explain.
Speaker 1: Thank you both for jumping on the line to continue
Speaker 1: our discussion about addiction, about health and and about the
Speaker 1: science of addiction. The place I want to start is
Speaker 1: what do we know about addictive behavior as far as
Speaker 1: is it something we're born with? Is there a predisposition
Speaker 1: to it? Where are we without understanding right now? We're
Speaker 1: all born with different brands, and our brands are different
Speaker 1: at birth because of the genotype that we have, because
Speaker 1: of genetics, because of what we got from our parents,
Speaker 1: and also because of important things that happen while our
Speaker 1: brain is developing, which could be trauma or infection in
Speaker 1: the mother, could be exposure to drugs by the mother.
Speaker 1: And so we go into this with different decks of cards.
Speaker 1: And one of the things that is different as a
Speaker 1: result of that is the risk that each person has
Speaker 1: to develop drug addiction. Some of us are unlikely to,
Speaker 1: some of us are very likely to. That's a fundamental
Speaker 1: thing for understanding why we would look at the genetics
Speaker 1: of drug abuse is that we're trying to dissect some
Speaker 1: of the risk factors for drug abuse, particularly those genetic ones.
Speaker 1: I guess that we can answer that question with another question,
Speaker 1: which is um, whether we can explain the predisposition or
Speaker 1: addiction with genetics um. But to answer this question then
Speaker 1: I have to give a little bit tour as to
Speaker 1: what do we mean by addiction really? And I would
Speaker 1: like us to vision a spiral right now, and we
Speaker 1: may all starts, or some people may be predisposed. For example,
Speaker 1: with personality traits of sensation seeking, you may be more
Speaker 1: likely to try and new things, especially if you're another lesson.
Speaker 1: You said sensation seeking, So that is foolishly sliding down
Speaker 1: a snow covered hill on a piece of wood for example, correct,
Speaker 1: jump off a bridge connected to a bungee cable, biking downstairs. Yeah.
Speaker 1: So um, these people may then transition to high UM
Speaker 1: drug intake or high alcohol consumption UM. But then maybe
Speaker 1: after a while, for example ADO lessons leading to adulthood,
Speaker 1: they may stop drinking highly and they may just drink
Speaker 1: socially for example. But a minor proportion of people will
Speaker 1: transition to more compulsive drug intake, which may lead to
Speaker 1: the dependence and relapse. So we're talking about a spiral
Speaker 1: of addiction that is really hard to break if you
Speaker 1: don't get good treatment, and so different genetic factors may
Speaker 1: contribute at different stages of this addiction spirals. So for example, UM,
Speaker 1: it may influence your decision to take the drug. It
Speaker 1: may influence how sensitive you are to the effects of
Speaker 1: the drug, the severity of the withdrawal symptoms, how quickly
Speaker 1: you develop tolerance, or even your inability to quit. So
Speaker 1: there are multiple elements genetic elements that may be influencing.
Speaker 1: But what we know is that the proportion of how
Speaker 1: much genetics explain is not a hundred percent. Biology is
Speaker 1: not deterministic, so there is a high component of the environment.
Speaker 1: So we may be born with a predisposition, but the
Speaker 1: environment plays a big role, right, And that's the theme
Speaker 1: that we keep finding in these discussions that, as you
Speaker 1: so eloquently put in, biology is not destiny in some ways,
Speaker 1: but it does contribute to where we end up. I
Speaker 1: understand that you've partnered with twenty three and me taken
Speaker 1: advantage of people's opt in ability to to join in research,
Speaker 1: and you've discovered some things both about addictive behavior in
Speaker 1: general and dependence in particular. Can you walk me through
Speaker 1: what your study was and some of what it has shown. Sure, So,
Speaker 1: as Sandra said, one of the things that we've emphasized
Speaker 1: in our research is to try to decompose something complicated
Speaker 1: like addiction into smaller factors where we could study the
Speaker 1: genetics of those factors, and where we know or expect
Speaker 1: that understanding the genetics of those factors would improve our
Speaker 1: understanding of the genetics of drug abuse as a as
Speaker 1: a disorder. So I want to start with the marshmallow tests. Yes,
Speaker 1: I love marshmallows. Many of your listeners love marshmallows. Many
Speaker 1: of your listeners smelled marshmallows. Who doesn't want to start
Speaker 1: with marshmallows. I gotta camp fire in my mind right now. Yes,
Speaker 1: that's right, And it was just Halloween, so that we're
Speaker 1: writing the middle of the candy holidays right now. So, uh,
Speaker 1: you could offer a child marshmallow, and you could tell
Speaker 1: them that if they wait five minutes, they could have
Speaker 1: two marshmallows instead of the one marshmallow. And if we
Speaker 1: can put ourselves back into our childhood or imagine our
Speaker 1: own kids, it's easy to envision that that would be
Speaker 1: a real struggle. That the kid would understand that it
Speaker 1: would be better to have too than one, but they'd
Speaker 1: love to have that one marshmallow now. And in fact,
Speaker 1: if you look at the kids offered this test, some
Speaker 1: of them will take the marshmallow, some of them will
Speaker 1: wait for the marshmallow. And that ability to delay gratification,
Speaker 1: or that tendency to make impulsive decisions that have negative
Speaker 1: long term consequences, that's a thing that we're very interested
Speaker 1: in studying, and in particular in studying the genetics of
Speaker 1: not because we don't believe that lots of life experiences
Speaker 1: shape those kinds of decisions, but because we believe that
Speaker 1: some of the variability and how people respond to situations
Speaker 1: like that is genetic, and so we call that delay discounting.
Speaker 1: And the large for that term delay discounting is that
Speaker 1: the longer you have to wait for something, the less
Speaker 1: it's worth. Okay, so you discount something based on the
Speaker 1: delay or based on how long you have to wait
Speaker 1: for it. So maybe five dollars now to some people
Speaker 1: might be very similar to ten dollars a month from now. Okay,
Speaker 1: they want the five dollars even though it's less. They
Speaker 1: want it because it's sooner. And and so can I
Speaker 1: just interject here because I get the idea I want
Speaker 1: marshmallows now, not tomorrow, but perhaps because I don't have
Speaker 1: as much confidence that tomorrow will even happen. But it
Speaker 1: depends on my environment. And if I'm in a very
Speaker 1: stressful environment and unreliable, volatile environment, that discount is high.
Speaker 1: The future is worth a lot less. All I have
Speaker 1: is the present. It sounds like what you're saying is
Speaker 1: delay discounting is one of these factors that contributes to
Speaker 1: addiction A and that genetics contribute to how much we
Speaker 1: discount the future, like delay discounting is driven in part
Speaker 1: by genetics. Is that right? That's exactly right, and that's true.
Speaker 1: By the way, in humans you can also do delayed scounting,
Speaker 1: and like pigeons and and non human primates, rats and
Speaker 1: across the board, you see that there are genetic factors
Speaker 1: that predict that. Okay, so you looked into these genetics
Speaker 1: and and just trying to control or eliminate the idea
Speaker 1: of the environmental effect I live in a volatile environment.
Speaker 1: To morow is worthless. There's some genetic component. To what
Speaker 1: degree does genetics contribute to this delay discounting? Well, so
Speaker 1: it's a fraction, and you can estimate that fraction in
Speaker 1: different ways, including using twins studies or using studies like
Speaker 1: the ones we've done in twenty three and me that
Speaker 1: emphasize a lot of people who are only distantly related
Speaker 1: to one another. When you say twin studies, you mean
Speaker 1: studying actual twins, identical and non identical twins. So this
Speaker 1: is a classic study design. Identical twins are genetically identical.
Speaker 1: Non identical twins share about fift because their siblings, and
Speaker 1: so something is genetic. You expect the identical twins to
Speaker 1: be more similar to each other than the non identical twins,
Speaker 1: and you can actually do some relatively simple algebra to
Speaker 1: come up with estimates where you get essentially the percentage
Speaker 1: of the variability and a trait that's attributable to genetics
Speaker 1: from that kind of a study design. All right, So
Speaker 1: so keep taking me on this journey. You've explained kind
Speaker 1: of delayed discounting. What else can you share about the
Speaker 1: way the study was set up, in what you found out,
Speaker 1: I would like um to add something to this, because
Speaker 1: this is the uniqueness of our approach what we're trying
Speaker 1: to do, and this is why we can study the
Speaker 1: channel population, which is that we're studying a continuum. We're
Speaker 1: not studying black or white. Were studying a scale of gray,
Speaker 1: and we all carry certain risks, so we're all more
Speaker 1: or less impulsive, and so that's why we can carry
Speaker 1: out those studies in the general population, which can help
Speaker 1: us get a large sample size, which is much needed
Speaker 1: for genetic studies. We need not even hundreds, but thousands
Speaker 1: or hundreds of thousand participants to really find robust genetic findings.
Speaker 1: And I'd like to ask a follow up on that note,
Speaker 1: because we've read most of us about scientific studies before
Speaker 1: genetic studies, and you have to sign up, you have
Speaker 1: to go through a clinical process, you opt in heavily.
Speaker 1: Maybe you're a college student looking for some extra cash.
Speaker 1: What is the difference between that classic model of a
Speaker 1: study versus what you were able to do here. So, actually,
Speaker 1: when I first started studying delay discounting, we were doing
Speaker 1: it with that kind of college student model and paying
Speaker 1: college students to come into a lab and fill out
Speaker 1: questionnaires about a lot of things, including delay discounting, and
Speaker 1: then we would genotype those college students with their consent
Speaker 1: of course, and try to look at the relationship between
Speaker 1: Jeanes and behavior. And the trouble was that even really
Speaker 1: good people doing this kind of work, really very professional people,
Speaker 1: a high quality operation, the best we could do was
Speaker 1: a few hundred a year, okay, scheduling, it's cetera. And
Speaker 1: as you get into genetics, and as we've progressed in
Speaker 1: our understanding of genetics, it became clear that we didn't
Speaker 1: need a thousand, We needed ten thousand or a hundred
Speaker 1: thousand to really break this open. So this translates into
Speaker 1: twenty five years of research that sounds that starts to
Speaker 1: sound like a very bad idea, and so I became
Speaker 1: interested in working with twenty three and me and other
Speaker 1: groups that have large populations, populations that were already genotyped,
Speaker 1: which can be an expensive step otherwise, and who we
Speaker 1: could ask questions, including questions about delay discounting, questions about
Speaker 1: alcohol use, etcetera. Because that meant that we could go
Speaker 1: to a whole different scale, that we could get into
Speaker 1: the hundreds of thousands, tens of thousands, hundreds of thousands,
Speaker 1: the sample sizes that we really needed to address these traits.
Speaker 1: And we could do that because the people are already genotyped,
Speaker 1: because they're willing to participate in this kind of research,
Speaker 1: and because we can ask them these questions over the internet,
Speaker 1: so we don't have to do this scheduling bring them
Speaker 1: into a laboratory environment. And that's a paradigm that many
Speaker 1: gene deesists have started to use over the last few years,
Speaker 1: and it's really uh accelerated enormously the progress in the area.
Speaker 1: In fact, in less than four months, we collected information
Speaker 1: from twenty five thousand participants, So twenty five years in
Speaker 1: four months. Correct, that's uh my advantage. What are some
Speaker 1: of the big conclusions, then, let's let me get back
Speaker 1: on the road of the study in which you found
Speaker 1: out you're looking at delay discounting, etcetera. But what do
Speaker 1: we know now that we didn't know before? So, uh,
Speaker 1: we can't give people marshmallows over the internet, of course,
Speaker 1: And so we asked them questions about money, and I
Speaker 1: gave an example of that earlier five dollars now versus
Speaker 1: ten dollars in a month. And if you ask a
Speaker 1: battery of questions, and there's some standardized batteries that have
Speaker 1: been developed over decades, you could estimate which people are
Speaker 1: more future oriented and which people are less future which
Speaker 1: people have higher delay discounting, and which people have lower
Speaker 1: delayed discounting. And in particular, by using these questions, we
Speaker 1: were able to give everybody a score, kind of a
Speaker 1: single value. And then we could ask of lots and
Speaker 1: lots of sites where people are different, sites where they
Speaker 1: have genetic differences. We could ask whether or not that
Speaker 1: site accounted for any of the variability or the differences
Speaker 1: in the way people answered those questions the score that
Speaker 1: people got, and we were able to see that in fact,
Speaker 1: there was a lot of signal there there were a
Speaker 1: lot of sites that collectively could explain some of that variability,
Speaker 1: And there were some particular sites that were so strong
Speaker 1: in explaining that variability that we could be very confident
Speaker 1: that there was a real association. When you're using the
Speaker 1: words sites here repeatedly, you're referring to sites in the
Speaker 1: human genome. Is that correct? That's right, particular basis, particular
Speaker 1: letters in the DNA code, where some people have one
Speaker 1: letter and some people have another letter. Some people have
Speaker 1: one nucleotide to use a more technical term, and some
Speaker 1: people have an alternative nucleotide. So, in other words, was
Speaker 1: that the genetic risk was distributed across thousands of genetic
Speaker 1: variants across the genome, and each with a little effect,
Speaker 1: each contributed very little. It is the accumulation of all
Speaker 1: those variants. And I like to use the metaphor of
Speaker 1: going to Ikea and assembling a table, and it is
Speaker 1: all those screws, little ones that make the table a table.
Speaker 1: Each one has small contribution, but that all together create
Speaker 1: the table. Maybe a silly metaphor, but I think it's useful.
Speaker 1: I hope you're not buying tables with a million screws,
Speaker 1: but okay, so you have it. Sounds like a clearer
Speaker 1: picture of the genetic contribution too, you know, addictive behavior.
Speaker 1: Is that a fair sort of summary, that's right. And
Speaker 1: from that we can get a few things, And one
Speaker 1: of them is we can identify particular sites, as I
Speaker 1: said earlier, that we're very confident are really associated with
Speaker 1: the trade, and those sites are going to be in
Speaker 1: or near particular genes, and as biologists, we can then
Speaker 1: start to try to understand how is it that that
Speaker 1: gene is changing the way the brain works, is changing
Speaker 1: the way a person or an animal would would respond
Speaker 1: when posed with the choice between a smaller current reward
Speaker 1: or a larger future reward. We really want to understand
Speaker 1: as biologists exactly what's going on in the brain which
Speaker 1: sells talking, how, talking to who? And maybe even how
Speaker 1: can we intervene in that process in a way that
Speaker 1: might be useful or therapeutic. So that's one of the
Speaker 1: things that we're trying to get. The other thing we're
Speaker 1: trying to get is a kind of a genetic signature,
Speaker 1: or the ability to score people based on their genotype,
Speaker 1: to score them on how impulsive do we expect them
Speaker 1: to be, even for people who we haven't directly measured impulsivity,
Speaker 1: and and that allows us to look at other samples,
Speaker 1: say samples where somebody had done a genetic study of
Speaker 1: attention deficit disorder a d h D, and to ask
Speaker 1: whether or not this genetic signature of high impulsivity is
Speaker 1: associated with or was related to the genet signature for
Speaker 1: say risk of a d h D, or risk to
Speaker 1: become a smoker, or risk to fail to quit smoking
Speaker 1: once you've started. Those are some of the associations we
Speaker 1: actually did see using this data so that we could
Speaker 1: really demonstrate that the delay discounting high, high delay discounting,
Speaker 1: or low delay discounting is a risk factor for various
Speaker 1: things relevant to drug abuse and other psychiatric disorders. As
Speaker 1: you alluded to earlier, addiction has a significant impact on
Speaker 1: so many people. There's an economic impact, there's an emotional impact,
Speaker 1: there's a relationship impact, and there's also shame and stigma
Speaker 1: associated with living with these conditions and having these behaviors. Absolutely, so,
Speaker 1: how do you bridge that experience, that pain, and that
Speaker 1: cost with what you're starting to get clarity on with
Speaker 1: these new studies about the genetic factors that contribute to
Speaker 1: some of these behaviors. This is a great question because
Speaker 1: we are currently facing an opiated crisis, for instance in
Speaker 1: the US on many poul dyeing. As a result, UM,
Speaker 1: substant use disorders are underdiagnosed. Um. We're also facing in
Speaker 1: research that it is an area that is highly underfunded
Speaker 1: as well. So stigma plays a big role. There seems
Speaker 1: to be a negative label associated with substant use disorders.
Speaker 1: And UM. It is interesting because no one would tell you, oh,
Speaker 1: you can choose to have a heart attack, right, would
Speaker 1: be very silly to say to someone. But yet it
Speaker 1: seems that for substant use disorders, someone could say you
Speaker 1: could choose to not take drugs. Right. And I'd like
Speaker 1: to quote a sentence um that Nikki mentioned that he
Speaker 1: was trying to feel a hole, which wasn't his fault.
Speaker 1: So you could say that there is a predisposition, if
Speaker 1: you will, a genetic predisposition, but that it was his responsibility.
Speaker 1: And so what I'm trying to get to is that
Speaker 1: there is a predisposition um, and this is what our
Speaker 1: research knows. That there is a biological route to these conditions,
Speaker 1: but that the effect of the environment is very powerful.
Speaker 1: So to contradict another classic sentence of a junkie will
Speaker 1: always be a junkie. That's certainly not true, and we
Speaker 1: can do lots to change the environment and to develop
Speaker 1: better treatments. And this is what we're trying to do
Speaker 1: with research. We're trying to reduce the stigma, but showing
Speaker 1: that there is a biological contribution and that perhaps one
Speaker 1: day if we learn and know enough about the biology,
Speaker 1: we can develop better treatments. So with more science we
Speaker 1: have a better explanation, we will hopefully tend to blame
Speaker 1: people less, but also develop new ways out of addiction
Speaker 1: because of our new we site. Yeah, I mean, I
Speaker 1: think two people that are working in the area of
Speaker 1: the biology of addiction. The idea of blaming the patients
Speaker 1: is it's not something we even talk about anymore because
Speaker 1: nobody thinks that way in the medical community, in the
Speaker 1: research community. But I think you're exactly right that by
Speaker 1: doing this kind of research, we come up with really
Speaker 1: concrete examples that maybe some of your listeners and other
Speaker 1: people can relate to that demonstrate how not everybody's dealt
Speaker 1: the same deck of cards, how not everybody goes into
Speaker 1: these situations with the same strengths and weaknesses, and therefore
Speaker 1: some people are very vulnerable to these substances which are
Speaker 1: prevalent in our society. Uh, And that that shouldn't be
Speaker 1: seen as a personal weakness, that shouldn't be seen as
Speaker 1: something that they are blamed for. That should be seen
Speaker 1: in stead as as a vulnerability that they have that
Speaker 1: we all as a society need to help them to avoid. Ideally,
Speaker 1: and if if avoidance fails, then to deal with and
Speaker 1: recover from. As Sandra alluded to, one of the one
Speaker 1: of our hopes personally is that this biological understanding might
Speaker 1: lead to novel treatments, might need to new ways that
Speaker 1: we could intervene so that somebody who's trying to remain
Speaker 1: absent or is trying to decrease or completely stop drug
Speaker 1: use would be able to do that more easily because
Speaker 1: we would actually be able to say, look, we're going
Speaker 1: to do something that's going to change the biology of
Speaker 1: your brain in a positive way, in a way that
Speaker 1: makes these drugs less tempting or that interrupts this kind
Speaker 1: of compulsive tendency to seek and use the drugs. In fact,
Speaker 1: we should be treating mental illnesses in the same way
Speaker 1: that we're treating medical or physical conditions. Yeah. And and
Speaker 1: as you said, you know, no one chooses to have
Speaker 1: a heart attack, and I think that's just such a
Speaker 1: powerful metaphor. We don't choose to break our bones. You know,
Speaker 1: we have accidents, but to see these in a less
Speaker 1: judgmental scale and more of this is part of what
Speaker 1: it is to be a life form, and this is
Speaker 1: part of what it needs to be human can strip
Speaker 1: away some of the factors that inhibit us from from
Speaker 1: approaching each other with compassion and with actual answers, such
Speaker 1: as stigma. I agree. And also you could say that
Speaker 1: it's a mistake for somebody who to have taken the
Speaker 1: drugs in the first place, and it's a mistake for
Speaker 1: somebody to have allowed themselves to progress down a road
Speaker 1: towards a addiction. But we've all made mistakes, and indeed,
Speaker 1: the people having the heart attacks may not have kept
Speaker 1: up with the kind of diet and exercise advice that
Speaker 1: they've been given. People who have made mistakes don't necessarily
Speaker 1: need to be punished by our society for those mistakes.
Speaker 1: We should instead be looking at that and saying, here's
Speaker 1: a person seeking recovery, acknowledging that they've made mistakes and
Speaker 1: now they need help and now they need our help,
Speaker 1: and they need help of of you know, among others,
Speaker 1: the research community, and that's the way we approach these problems.
Speaker 1: Was reading your study and you use this phrase citizen
Speaker 1: scientists to kind of refer to the people who opted
Speaker 1: into this study, and you've just been talking about helping.
Speaker 1: So can you explain the concept of the citizen scientists
Speaker 1: and how folks listening now can be helpful to answering
Speaker 1: these questions better in order to treat one another better. Yeah, well,
Speaker 1: twenty three and me is one platform, not the only
Speaker 1: platform in which citizens scientists, that is, people that want
Speaker 1: to help with research can from their living room, from
Speaker 1: their bedroom, can get involved by answering questions that various
Speaker 1: researchers have decided are important to pose to them. And
Speaker 1: they are not compensated for this. They're doing this because
Speaker 1: they are interested in the research. They're interested in helping out,
Speaker 1: They're interested in making the fact that they've already been
Speaker 1: uh study genetically genotyped. They're interested in making that available
Speaker 1: and uh that is the critical thing that this study
Speaker 1: depends on. And indeed, other other studies that we've done
Speaker 1: that have involved cohorts, including but not limited to twenty
Speaker 1: three and me. All of them have to do with
Speaker 1: the UH. These public efforts that have reached out to
Speaker 1: people without compensation to participate in studies where they frankly
Speaker 1: ask a lot of questions, where they take time that
Speaker 1: they could have spent on anything, and they spend it
Speaker 1: trying to advance research. And we are extremely grateful, in fact,
Speaker 1: to all those people that donated their data for research
Speaker 1: on We're hoping in a way that um, this conversation
Speaker 1: today will inspire more people to participate in genetic studies
Speaker 1: in the future. We've been called in the past to
Speaker 1: donate blood, right to help with a blood drive, to
Speaker 1: donate food, and now donate spit, you know, donate donate
Speaker 1: some of your your genome to help scientists like you
Speaker 1: two and those you work with help us. So I
Speaker 1: I love that idea of the citizen scientists and that
Speaker 1: there are ways that all of us can help you
Speaker 1: help us. One of the hopes is that we can
Speaker 1: get a handle on the genetic risk for these disorders.
Speaker 1: Maybe because you'd want to make predictions for individual people
Speaker 1: you're particularly susceptible to these disorders, you should be particularly cautious.
Speaker 1: Although I want to say that right now, people already
Speaker 1: can work with family history. They already know what their
Speaker 1: family history is in most cases and exceptions being people
Speaker 1: who are adopted, for example, and that family history is
Speaker 1: presently more powerful than anything we can do with genetics.
Speaker 1: Maybe that will change one day as we get larger
Speaker 1: samples as is, but right now, people who know that
Speaker 1: their families struggled with alcohol and drug abuse should assume
Speaker 1: that they're higher than normal risk for alcohol and drug abuse,
Speaker 1: and they may want to make decisions to avoid uh
Speaker 1: using those drugs altogether, or be very careful about moderating.
Speaker 1: And then the other critical thing that all of the
Speaker 1: citizens science can bring to bear is, first of all,
Speaker 1: it can make it much less expensive to do this research,
Speaker 1: whereas it's very expensive to have clinicians diagnosed people with
Speaker 1: alcohol use disorder and to gina take those people, or
Speaker 1: to go out and to try to find people who
Speaker 1: have particular sometimes rare disorders. Alcoholism is common, but some
Speaker 1: genect disorders are rare. To find those people and then
Speaker 1: gena type them is expensive and slow. So one of
Speaker 1: the revolutions of this approach is that we can start
Speaker 1: to do things faster, better, and cheaper, and again we're
Speaker 1: thankful for all those participlintes, and we hope that more
Speaker 1: and more people will allow us to do genetic studies
Speaker 1: like the one that we did an all those are
Speaker 1: doing m in the future. Completely. I agree about the
Speaker 1: gratitude to the participants, us about our vision sort of
Speaker 1: for the future. And I was talking about a little
Speaker 1: bit about prevention because that's part of it, and then
Speaker 1: I want to also emphasize that we're really very interested
Speaker 1: in treatment and that if we can gain a better
Speaker 1: understanding of what it is about a brain that's changed
Speaker 1: in the addictive state, what is an addicted brain, then
Speaker 1: we'll have a better understanding of how we can normalize that.
Speaker 1: And in particular, the really problematic thing about addiction is
Speaker 1: that people have this increased lifetime risk to return to
Speaker 1: drug use to relapse. Those are the people that really
Speaker 1: need help, and those are the people that we would
Speaker 1: ideally like to be able to offer increasingly effective pharmacological
Speaker 1: treatments so that they would go to their doctor they'd say,
Speaker 1: this is the thing, this is the addiction. I'm trying
Speaker 1: to recover from this now, and we could give them
Speaker 1: something that would reduce the craving that would make it
Speaker 1: easier for them to stay away from that uh that
Speaker 1: very high risk of relapse. UH. And that's going to
Speaker 1: require understanding what addiction is, what is unique about the
Speaker 1: brain that makes it more or less susceptible for addiction,
Speaker 1: what changes about the brain in that state of addiction.
Speaker 1: And that's something that many, many people are working on. So,
Speaker 1: you know, I was just at a scientific conference that
Speaker 1: had literally thousands of people working on different aspects of
Speaker 1: this problem, so very active area of research. Genetics is
Speaker 1: just one component of that research, but it's one area
Speaker 1: that allows us to generate new leads to kind of
Speaker 1: identify do targets, new molecules, new genes, maybe new pathways
Speaker 1: in the brain that hadn't previously been studied or understood,
Speaker 1: and to bring in to focus their role in this problem. Okay,
Speaker 1: so you're awesome, both of you. Dr Abraham Palm or
Speaker 1: Dr Sandra Sanchez Roorgy, thank you so much for generating
Speaker 1: new leads, for sharing your investigation with us. You science
Speaker 1: detectives on what we can learn more or of through
Speaker 1: genetics about how to treat each other better and how
Speaker 1: to treat uh those suffering from and experiencing addictive use disorder, alcoholism,
Speaker 1: and associated constellations of symptoms. Thank you so much, all right,
Speaker 1: thank you for having us. I want to dig in
Speaker 1: more on today's topics and guests. Check our show notes
Speaker 1: and if you enjoyed the episode, share it with a friend,
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