WEBVTT - Addiction: A Chronic Condition - Lab 112 0:00:00.560 --> 0:00:04.120 Everything I see ads, even just people talking to me, 0:00:04.240 --> 0:00:08.639 everything saying you need more right right right, from social 0:00:08.680 --> 0:00:13.000 media to working to consumption, whether it's buying or partaking. 0:00:13.039 --> 0:00:17.520 It feels like there's just no balance between things. Yeah, 0:00:17.600 --> 0:00:20.239 and when we stopped and looked, we realized there was 0:00:20.280 --> 0:00:23.640 a term that was being thrown around a lot without 0:00:24.160 --> 0:00:27.479 knowing about it, and that's addiction. Yeah. People are like, oh, 0:00:27.520 --> 0:00:29.400 I'm addicted to this new game. I'm addicted to the 0:00:29.400 --> 0:00:33.920 Pumpkins spice latte, to work to expresso Martiniz. But what 0:00:34.280 --> 0:00:39.000 is addiction really? I'm TT and I'm Zachiah, and this 0:00:39.280 --> 0:00:46.680 is Dope Labs. Welcome to Dope Labs, a weekly podcast 0:00:46.680 --> 0:00:49.760 that mixes hardcore science with pop culture and a healthy 0:00:49.800 --> 0:00:57.560 dose of friendship. Now, in this episode, we're going to 0:00:57.760 --> 0:01:01.000 talk about substance use and what's happening in the brain 0:01:01.520 --> 0:01:05.360 and the psychological, social, and cultural environments that nurture this 0:01:05.440 --> 0:01:08.880 type of chronic brain disorder and its symptoms. This episode 0:01:08.920 --> 0:01:11.880 is for informational and educational purposes only, and it is 0:01:11.920 --> 0:01:15.160 not intended to be medical advice. And so now that 0:01:15.200 --> 0:01:17.880 we have that out the way, let's dive into it. TT, 0:01:18.440 --> 0:01:22.720 what are our questions. Well, I think for me understanding 0:01:22.760 --> 0:01:27.720 what addiction is so like the term addiction because like 0:01:27.800 --> 0:01:30.640 we were saying, everybody's throwing it around. I want to 0:01:30.680 --> 0:01:34.959 know what addiction really is. Yeah, and like where's the line, 0:01:35.000 --> 0:01:36.880 Like where is it that you're I like something a 0:01:36.920 --> 0:01:39.520 lot and I want more of it versus I'm addicted. 0:01:39.800 --> 0:01:43.560 And if there is a line, what's happening in our 0:01:43.640 --> 0:01:48.160 brains that crosses that, you know? And it's interesting because 0:01:48.200 --> 0:01:51.480 we see the casual use of the word addiction, but 0:01:51.640 --> 0:01:57.760 also we see like the villainization of addiction to different 0:01:57.800 --> 0:01:59.520 types of things as well, Like there seems to be 0:01:59.520 --> 0:02:02.480 like a higher even in addiction. Right, there's like these 0:02:02.600 --> 0:02:06.080 respectability politics that are in play where it's like some things, 0:02:06.080 --> 0:02:09.600 it's like, okay, addicted to television is fine, but addiction 0:02:09.720 --> 0:02:10.960 to this other thing is awful. 0:02:11.240 --> 0:02:11.520 Yeah. 0:02:11.560 --> 0:02:14.440 Oh, addiction to TikTok is bad, but addiction to Instagram 0:02:14.520 --> 0:02:17.800 is okay. I don't know how some of these things 0:02:18.080 --> 0:02:23.200 work socially, and so I'm curious about the history of 0:02:23.280 --> 0:02:26.760 addiction a little bit. And we haven't even touched on drugs, right, right, 0:02:27.000 --> 0:02:28.440 I feel like there are so many questions I don't 0:02:28.440 --> 0:02:30.960 even know where to start, right, so we should probably 0:02:31.000 --> 0:02:33.560 bring in our expert. This is a perfect time because 0:02:33.560 --> 0:02:35.600 the questions are just going to keep pouring out. 0:02:36.040 --> 0:02:39.880 We need answers. 0:02:41.800 --> 0:02:44.119 Today we're talking to doctor Zinga Harrison. 0:02:44.200 --> 0:02:47.239 Oh doctor and Zena Harrison. I'm a physician. 0:02:47.440 --> 0:02:50.760 My specialties are psychiatry and addiction medicine. I have been 0:02:50.800 --> 0:02:55.359 practicing both for over the last twenty years. I'm co 0:02:55.440 --> 0:02:59.880 founder and chief medical officer of Eleanor Health, where we 0:03:00.000 --> 0:03:04.800 we care for people with addiction and a longitude a 0:03:04.840 --> 0:03:08.560 model and then also author of the book An Addiction, 0:03:09.240 --> 0:03:13.440 Six mind changing Conversations that Could Save a Life. The 0:03:13.520 --> 0:03:16.920 big issue I'm trying to tackle is just how scary 0:03:16.960 --> 0:03:20.600 it's been to talk about addiction, because the things we 0:03:20.680 --> 0:03:22.120 don't talk about kill us. 0:03:22.600 --> 0:03:26.839 I am a person who doesn't mind uncomfortable conversations, right, 0:03:26.880 --> 0:03:31.600 and that's the conversation I think is very taboo and 0:03:31.760 --> 0:03:35.840 makes people uncomfortable, which is interesting because the stats tell 0:03:35.920 --> 0:03:39.760 us that almost one in six people over twelve are 0:03:39.840 --> 0:03:43.040 diagnosis having a substance use disorder. I want to set 0:03:43.080 --> 0:03:46.480 the stage when we say addiction, and I really want 0:03:46.520 --> 0:03:49.720 people to understand what addiction is and what it isn't. 0:03:49.520 --> 0:03:51.040 I love the stat that you dropped. 0:03:51.080 --> 0:03:54.000 One in six people is diagnosed with a substance use disorder, 0:03:54.360 --> 0:03:57.440 So I would say substance use disorder is the medical 0:03:57.520 --> 0:04:01.800 diagnosis of a subset of the addictions, meaning the addiction 0:04:02.000 --> 0:04:04.320 is to a substance kind of a partner. 0:04:04.360 --> 0:04:06.600 Statistic to that is forty six. 0:04:06.440 --> 0:04:09.120 Percent of Americans, so one and two if you let 0:04:09.160 --> 0:04:15.000 me round up to fifty percent report themselves or someone 0:04:15.080 --> 0:04:18.160 close to them has struggled with the substance. 0:04:18.400 --> 0:04:19.920 So that's one out of two. 0:04:20.040 --> 0:04:24.720 So broad definition, you can think of addiction as continuing 0:04:24.760 --> 0:04:31.240 to engage in a behavior despite negative consequences, outweighing positive 0:04:31.279 --> 0:04:37.040 consequences or positive benefits, and so if you that's that's 0:04:37.120 --> 0:04:42.160 kind of like the broad definition. The official definition, which 0:04:42.200 --> 0:04:46.120 is given to us by ASAM American Society of Addiction Medicine, 0:04:47.200 --> 0:04:53.200 defines addiction as a brain disorder that leads to compulsive 0:04:53.279 --> 0:04:58.920 behavior that can be drugs, alcohol, which is a drug, vaping, 0:04:59.080 --> 0:05:03.800 which is a drug, smoking which is a drug, sex, gambling, shopping, 0:05:03.880 --> 0:05:09.040 social media, all of these different behaviors that run through 0:05:09.080 --> 0:05:14.720 the same neuro biological pathway. But so a brain disorder 0:05:14.880 --> 0:05:23.760 that leads to compulsive behavior that has negative physical, mental, social, 0:05:24.480 --> 0:05:30.120 and emotional consequences. So that's kind of like, what's super 0:05:30.160 --> 0:05:38.039 important about that medical definition is if I asked Yusekiah. 0:05:38.040 --> 0:05:40.640 Stroke is a disorder of what organ in your body? 0:05:41.440 --> 0:05:41.719 Brain? 0:05:42.600 --> 0:05:45.360 Asthma is a disorder of what organ in your body. 0:05:45.600 --> 0:05:47.640 I know the answer to this because I have asthma 0:05:47.680 --> 0:05:48.720 and that's the lungs. 0:05:49.000 --> 0:05:52.640 But you say, addiction is a disorder of what organ 0:05:52.680 --> 0:05:55.360 in the body, and people don't even think of it 0:05:55.800 --> 0:05:58.960 as a disorder of an organ in the body. 0:05:59.080 --> 0:06:00.040 The answer to that is. 0:06:00.160 --> 0:06:04.360 Brain addiction sounds like a cousin or maybe even a 0:06:04.400 --> 0:06:09.599 sibling to obsessive compulsive disorder. Yes, So that was the 0:06:09.640 --> 0:06:13.320 first thing that I thought, And the second is how 0:06:13.920 --> 0:06:17.160 easy it is to miss things because of what part 0:06:17.200 --> 0:06:18.880 of them we choose to look at. So if you 0:06:19.000 --> 0:06:23.880 focus on the choice or what the thing is that's abused, 0:06:23.960 --> 0:06:27.320 maybe you may say, oh, well, addiction to alcohol is 0:06:27.360 --> 0:06:30.359 not the same as addiction to drugs or addiction to gambling, 0:06:30.680 --> 0:06:33.000 or somebody who gambles a lot and puts themselves in 0:06:33.040 --> 0:06:35.480 a precarious situation is not the same as someone who 0:06:35.680 --> 0:06:38.200 does drugs and it's like, well, if you look at 0:06:38.240 --> 0:06:41.159 the pathway, that's very different than if you just look 0:06:41.160 --> 0:06:43.640 at the I don't even know what the term is 0:06:43.680 --> 0:06:45.360 for it, the choice I don't need. 0:06:46.640 --> 0:06:51.120 Yeah, the symptoms, the symptoms, And so I think to 0:06:51.200 --> 0:06:53.520 kind of to just use a medical term love that 0:06:53.600 --> 0:06:56.040 you said as a sibling or a cousin of OCD. 0:06:56.360 --> 0:06:57.360 Absolutely right. 0:06:57.480 --> 0:07:03.880 So OCD uses all of the same neurotransmitters as addiction. 0:07:04.320 --> 0:07:05.760 Ah okay. 0:07:05.880 --> 0:07:09.159 And so if you think of obsessions medically, obsessions, we 0:07:09.240 --> 0:07:12.640 define them as thoughts, intrusive thoughts that keep coming back. 0:07:13.120 --> 0:07:15.920 Compulsions are the behaviors. 0:07:15.560 --> 0:07:19.679 That people do to decrease the impact of those thoughts 0:07:19.760 --> 0:07:22.560 on them. And so if you think about addiction, you 0:07:22.560 --> 0:07:27.560 could think about the obsession as being the craving. Although 0:07:28.240 --> 0:07:32.520 cravings are not just cognitive, they're not just thoughts. Cravings 0:07:32.520 --> 0:07:35.120 are actually a whole brain and body experience. But you 0:07:35.120 --> 0:07:40.679 could think of cravings as the thought and using a substance, sex, drug, 0:07:40.800 --> 0:07:45.640 social media, shopping, whatever, as the behavior that relieves the 0:07:45.760 --> 0:07:53.360 distress from those intrusive thoughts. So nailed it, like a plus, Yeah, 0:07:53.600 --> 0:07:56.800 that was amazing. So the second part of what you say, 0:07:56.840 --> 0:07:59.640 which is like what we decide to focus on, and 0:07:59.680 --> 0:08:02.440 I said symptoms. So what I really want people to 0:08:02.600 --> 0:08:08.560 understand is addiction is a chronic condition that. 0:08:08.720 --> 0:08:10.280 Starts in the brain. 0:08:10.680 --> 0:08:16.040 Yes, anything that starts in the brain affects your entire 0:08:16.120 --> 0:08:21.280 body physically. Our brain is responsible for our thoughts, so 0:08:21.320 --> 0:08:26.080 it affects your thinking. Our brain is responsible for our emotions, 0:08:26.320 --> 0:08:30.440 so it affects your emotions. Our brains are responsible for 0:08:30.600 --> 0:08:35.400 our decisions, so it affects your behavior. Our brain is 0:08:35.480 --> 0:08:40.200 responsible for our impulse control, so it affects your impulse 0:08:40.240 --> 0:08:46.160 control and our thoughts. Feelings, decisions, and impulse control are 0:08:46.200 --> 0:08:50.200 how we interact with the world, and so anything that 0:08:50.240 --> 0:08:52.240 starts with the brain is going to impact the way 0:08:52.280 --> 0:08:54.800 we interact with the world. And what you're saying is 0:08:54.840 --> 0:08:58.120 when you look at addiction, just starting with the way 0:08:58.160 --> 0:09:01.240 a person interacts with the world, you think they're a 0:09:01.280 --> 0:09:06.360 bad person, they don't have good judgment, they are morally bankrupt, 0:09:06.800 --> 0:09:11.720 when in reality, it's a series of neurobiological things that 0:09:11.760 --> 0:09:16.319 are happening in the brain that turn into what we experience. 0:09:16.720 --> 0:09:19.480 The brain is our experience of the world. Brain, it 0:09:19.559 --> 0:09:22.160 is it constructs all We just did an episode with 0:09:22.200 --> 0:09:26.040 a neuroscientist. She's a PhD student at PEN and she 0:09:26.160 --> 0:09:28.640 talked to us about pain, and she talked to us 0:09:28.720 --> 0:09:32.760 about like natural opioid release and the expectation of relief. 0:09:32.840 --> 0:09:36.240 And immediately it made me think about if you have 0:09:36.320 --> 0:09:38.920 these intrusive thoughts and then you have this compulsive behavior, 0:09:39.160 --> 0:09:42.439 and that's probably reinforced by another neural network that says 0:09:42.520 --> 0:09:46.080 you can expect relief, you can expect this thing, and 0:09:46.120 --> 0:09:49.960 so you're reinforcing some of these pathways in the brain. Okay, 0:09:50.000 --> 0:09:53.040 so let's talk about brain circuitry really quick. Okay, so 0:09:53.120 --> 0:09:55.719 this is a chronic brain disorder. But for people who 0:09:55.760 --> 0:09:59.199 are saying, okay, you keep saying brain disorder, what does 0:09:59.240 --> 0:10:03.839 that mean? What's happening? Can you talk more about reward 0:10:04.440 --> 0:10:07.400 and learning and impulse systems so that we can help 0:10:07.400 --> 0:10:10.920 people understand why this isn't something that you just snap 0:10:11.000 --> 0:10:13.120 your fingers and are done with it. 0:10:13.440 --> 0:10:15.400 So, okay, I want you to think about your brain. 0:10:15.440 --> 0:10:17.400 We're going to break it down into a number of 0:10:17.480 --> 0:10:21.200 different parts. The first breakdown we're going to do is 0:10:21.720 --> 0:10:24.800 your deep brain. So the deep brain is the part 0:10:24.840 --> 0:10:27.960 of the brain that we share with all animals. That's 0:10:27.960 --> 0:10:33.360 where our instincts are. That's where our impulses generate. That's 0:10:33.440 --> 0:10:38.679 where our motivation for survival is. That's the dopamine pathway. 0:10:39.200 --> 0:10:42.600 That's where our like breathing and heart rate and all 0:10:42.640 --> 0:10:46.440 of this is controlled. Okay, okay, deep brain on top 0:10:46.480 --> 0:10:48.960 of your deep brain. When humans think about the brain, 0:10:49.200 --> 0:10:52.160 you think about that little picture that we see pointed 0:10:52.240 --> 0:10:54.120 to the side that looks like a fist with all 0:10:54.160 --> 0:10:57.160 of the folds in it, right right, that's your what 0:10:57.200 --> 0:11:02.120 we call cerebral cortex. So your cortex is the part 0:11:02.160 --> 0:11:05.880 of the brain and humans that has really developed hugely, 0:11:06.000 --> 0:11:08.240 and that's where our higher order thinking is. 0:11:08.320 --> 0:11:11.240 So that's where our impulse control is. 0:11:11.720 --> 0:11:15.600 That's where what we call our executive decision making, so 0:11:15.800 --> 0:11:18.920 like taking in information, deciding. 0:11:18.400 --> 0:11:21.360 What it means, and then choosing to do something about it. 0:11:21.720 --> 0:11:24.280 And then that command center sends back down through the 0:11:24.320 --> 0:11:26.040 deep brain to the body to tell. 0:11:25.880 --> 0:11:26.839 It everything to do. 0:11:27.400 --> 0:11:30.400 And so I tell people, I want you to think 0:11:30.440 --> 0:11:34.240 about three parts of the brain as it relates to addiction. 0:11:35.120 --> 0:11:37.880 First is in the deep brain. It's called the ventral 0:11:37.920 --> 0:11:43.600 tegmental area VTA. From the nerds out there, Okay, the 0:11:43.720 --> 0:11:48.719 VTA has a neuron in it and any external stimulus. 0:11:48.880 --> 0:11:52.840 So something outside of your body in the world triggers 0:11:53.240 --> 0:11:57.480 a dopamine signal, okay, that sends forward to another part 0:11:57.559 --> 0:12:01.520 that is still in your deep brain, your nucleus cucumbents. 0:12:01.880 --> 0:12:06.959 The nucleus cucumbents then packages that dopamine signal and sends 0:12:07.000 --> 0:12:10.160 it forward to your CEO of your brain and body, 0:12:10.200 --> 0:12:14.760 which is your prefernal cortex. Your CEO of your brain 0:12:14.840 --> 0:12:17.960 and body says, this is what the outside world is 0:12:18.000 --> 0:12:21.439 telling me, and then it takes information from your inside 0:12:21.480 --> 0:12:25.120 world and it decides what does that. 0:12:25.120 --> 0:12:27.920 Mean and what we are going to do about it. 0:12:28.320 --> 0:12:30.760 So what I just described to you is the three 0:12:31.920 --> 0:12:36.040 neuron or nerves that make up your dopamine pathway. Our 0:12:36.120 --> 0:12:41.520 dopamine pathway evolutionarily speaking, keeps us alive. 0:12:41.920 --> 0:12:42.319 Okay. 0:12:43.000 --> 0:12:46.559 So anything that generates a dopamine signal, your brain interprets 0:12:46.600 --> 0:12:53.079 as I need this to survive. The natural things that 0:12:54.040 --> 0:12:57.559 make a dopamine signal, our food need it to survive. 0:12:57.679 --> 0:13:03.960 M water, needed to survive mm hm, sex, needed for 0:13:04.040 --> 0:13:05.720 the species to survive mm hm. 0:13:06.160 --> 0:13:10.160 Because yes, to keep us humans, all species. 0:13:09.800 --> 0:13:11.080 The population. 0:13:12.440 --> 0:13:15.480 Right, the population alive, Yes, yes, yes, but there's another 0:13:15.480 --> 0:13:18.480 component of sex that's pleasure and connection. But we'll get 0:13:18.520 --> 0:13:20.240 back to the survival part. 0:13:20.440 --> 0:13:22.920 What else do we need nurturing? 0:13:23.600 --> 0:13:25.920 Because what happens the little human baby, what happens the 0:13:25.920 --> 0:13:27.480 little animal babies with no nurturing? 0:13:27.480 --> 0:13:28.600 They buy right, you're. 0:13:28.440 --> 0:13:28.920 Out of here. 0:13:29.160 --> 0:13:33.960 Those are the four natural determinants of dopamine. Here's what's crazy. 0:13:34.440 --> 0:13:36.640 You look at the drugs we have that people get 0:13:36.679 --> 0:13:38.720 addicted to. You look at the behaviors we have that 0:13:38.720 --> 0:13:41.040 people get addicted to. I'll talk about drugs right now. 0:13:42.120 --> 0:13:44.199 You can think of a dopamine signal from food as 0:13:44.200 --> 0:13:45.680 a light bulb starving. 0:13:47.320 --> 0:13:50.520 The ventral teg mental area says we need to eat. Pain. 0:13:50.840 --> 0:13:51.320 Light bulb. 0:13:51.640 --> 0:13:54.840 You see some food. The nuclear cucumbents is like, that's food. 0:13:55.200 --> 0:13:59.600 They package that information inside that make your stomach growl. Right, 0:14:00.080 --> 0:14:04.040 you feel hungry outside, you smell something. Your brain takes 0:14:04.080 --> 0:14:07.120 all that information. It says, I need to make a 0:14:07.160 --> 0:14:10.840 plan to eat so that we can stay alive. Yeah, 0:14:11.000 --> 0:14:13.400 that's the brightness of a light bulb pain. It's a 0:14:13.440 --> 0:14:17.920 great idea. Meth amphetamine. The size of that dopamine signal 0:14:18.160 --> 0:14:19.320 is ten to the ninth. 0:14:19.680 --> 0:14:22.480 Okay, so ten to the ninth. Ten to the sixth 0:14:22.560 --> 0:14:26.080 is a million times, and so ten to the ninth 0:14:26.320 --> 0:14:29.720 is a billion And so that means that your brain 0:14:30.120 --> 0:14:36.280 interprets dopamine signals way more than anything else. 0:14:36.440 --> 0:14:43.040 And your brain interprets a bigger dopamine signal as more important. 0:14:43.640 --> 0:14:44.120 Period. 0:14:44.600 --> 0:14:50.680 Yeah, So when people quote choose meth amphetamine over their family, 0:14:51.080 --> 0:14:54.080 it's because the myth amthetamine dopamine signal is ten to 0:14:54.120 --> 0:14:56.440 the ninth, the nurturing signal. 0:14:56.560 --> 0:14:59.680 One billion times one million times. 0:15:00.160 --> 0:15:03.080 Magnify it. And so the message that is sent forward 0:15:03.160 --> 0:15:09.080 with urgency to your CEO is we need this to survive, 0:15:09.320 --> 0:15:12.160 make a plan to never go without it. And as 0:15:12.280 --> 0:15:16.600 addiction kindles, like think about a fire, right, we go 0:15:16.680 --> 0:15:18.760 from that first ember, it gets. 0:15:18.560 --> 0:15:20.400 Bigger and bigger, and bigger and bigger. 0:15:20.760 --> 0:15:40.520 Your CEO becomes less and less able to refute that message. 0:15:41.240 --> 0:15:44.800 Now this, I am having a dopamine response here because 0:15:44.840 --> 0:15:48.440 I enjoy this type of stimulation. Okay, there's so much 0:15:48.880 --> 0:15:52.360 evolutionary biology, and there are so many things that our 0:15:52.400 --> 0:15:58.520 brain primes us for that are historical that no longer exists, right, 0:15:58.520 --> 0:16:01.200 and so I love the example to give us a 0:16:01.360 --> 0:16:05.920 range to understand magnitude between something really simple like hey, 0:16:06.000 --> 0:16:09.800 we need something to eat. You talked about vaping. Something 0:16:09.800 --> 0:16:15.160 that has incredible marketing for young people, fruity flavors. We 0:16:15.280 --> 0:16:20.600 see it all across social media. Packages beautiful packaging, cool yes, 0:16:21.200 --> 0:16:23.360 and so you know, so there's all of that going on. 0:16:23.520 --> 0:16:27.680 I think about marketing for food, and I'm also then 0:16:27.720 --> 0:16:30.280 thinking about what kind of signals do we see. I'm 0:16:30.360 --> 0:16:32.560 also thinking about social media. I don't know if you've 0:16:32.600 --> 0:16:36.560 seen it's on Netflix. It's a documentary. Oh unknown number. 0:16:37.160 --> 0:16:40.920 I thought that that was such a crazy documentary, like 0:16:41.600 --> 0:16:42.680 I could not believe it. 0:16:42.800 --> 0:16:46.400 Okay, no spoil or alerts for the listeners, but mind 0:16:47.280 --> 0:16:48.120 below now. 0:16:48.240 --> 0:16:50.120 And so I was thinking about what would make a 0:16:50.160 --> 0:16:52.280 person do this. I'm thinking about what we know about 0:16:52.280 --> 0:16:54.880 social media and the dopamine hits people get with the 0:16:54.920 --> 0:16:59.200 gamification of these different platforms. And I'm wondering because you know, 0:16:59.280 --> 0:17:01.400 you can't just override your biology. 0:17:01.840 --> 0:17:03.640 At least, I don't think you can write. 0:17:03.680 --> 0:17:06.200 And that's what I've learned from my friend, and so 0:17:06.480 --> 0:17:10.280 you would probably have to replace it with something else, right, Yeah, 0:17:10.680 --> 0:17:12.920 So when we think about things that are taking over 0:17:13.000 --> 0:17:16.680 our dopamine pathway, how do you get rid of them? 0:17:17.119 --> 0:17:19.720 You have to empower people with information. 0:17:19.920 --> 0:17:23.840 Right, So if we go back to our childhoods, just say. 0:17:23.720 --> 0:17:28.760 No baby, that black T shirt their yes, those good letters, 0:17:28.800 --> 0:17:30.920 it is etched into my memory. 0:17:31.000 --> 0:17:32.760 Okay, just say no. 0:17:32.880 --> 0:17:35.960 It doesn't work because it doesn't give people the information 0:17:36.200 --> 0:17:40.040 why they should say no, right, Like, empower people with 0:17:40.160 --> 0:17:44.280 information and then honor the choices that they make about it. So, 0:17:44.480 --> 0:17:48.359 for example, we can think about addiction. I describe to 0:17:48.400 --> 0:17:51.719 you the three neuron pathway. This is now like the 0:17:51.840 --> 0:17:59.160 three stages, right, One you have intoxication, Two you have withdrawal. 0:18:00.200 --> 0:18:01.800 Three you have craving. 0:18:02.480 --> 0:18:06.960 The combination of withdrawal and craving drive you back to 0:18:07.240 --> 0:18:11.320 use whatever. That behavior is intoxication. So when you think 0:18:11.359 --> 0:18:18.200 about social media actually brilliantly designed because your mind and 0:18:18.280 --> 0:18:21.720 your own business, and they trigger you with a notification, yeah, 0:18:22.000 --> 0:18:24.560 and then you know that notification is sitting there, and 0:18:24.760 --> 0:18:28.720 then you develop withdraw right, like those obsessive thoughts around 0:18:28.800 --> 0:18:30.800 what is that notification that. 0:18:30.800 --> 0:18:32.280 I didn't see? 0:18:32.480 --> 0:18:35.399 And then you go on social media and you scroll, scroll, scroll, 0:18:35.440 --> 0:18:38.440 and you get intoxicated because it is giving a dopamine 0:18:38.560 --> 0:18:42.159 and no, most likely through the connection pathway. Right, And 0:18:42.200 --> 0:18:45.160 so the way I think we help protect people against 0:18:45.200 --> 0:18:48.919 this is one not making it as if. 0:18:49.800 --> 0:18:54.360 Those people over there have addictive behaviors. 0:18:55.040 --> 0:18:59.879 All of us have some addictive behavior of some sort 0:19:00.080 --> 0:19:03.679 because we are all wired with the dopamine pathway. So 0:19:03.800 --> 0:19:08.360 my addictive behavior may be food, My addictive behavior may 0:19:08.400 --> 0:19:14.000 be shopping, My addictive behavior may be alcohol. My addictive 0:19:14.040 --> 0:19:17.080 behavior for some people may be exercise. 0:19:17.720 --> 0:19:20.680 Right, whatever, work. 0:19:20.840 --> 0:19:24.280 Let's not forget work, because I actually, I actually say 0:19:24.280 --> 0:19:25.200 it all the time. 0:19:24.960 --> 0:19:27.320 To people like I use work like a drug. 0:19:27.920 --> 0:19:31.600 I love work when I'm not working, I have withdrawal, 0:19:33.000 --> 0:19:35.800 I have cravings for work when I'm not working. When 0:19:35.840 --> 0:19:40.520 I am working, I binge yes. I work to my detriment. 0:19:40.840 --> 0:19:44.320 I work to negative consequences. I get lots of positive 0:19:44.359 --> 0:19:49.280 feedback for this, and it makes my addiction loop worse. Right, So, 0:19:49.440 --> 0:19:54.080 like all of us have something that is addicted to us, 0:19:54.160 --> 0:19:57.000 because that's just the neurobiology of have we built. So 0:19:57.040 --> 0:19:59.960 if we can accept that, that gives us compassion for 0:20:00.160 --> 0:20:03.080 the person whose addiction happens to be alcohol, for whose 0:20:03.080 --> 0:20:06.199 addiction happens to be opioid, for whose addiction happens to 0:20:06.240 --> 0:20:11.040 be cocaine, and then we empower yourself with the prefernal 0:20:11.040 --> 0:20:16.520 cortex can be trained to top down control that deep brain. 0:20:17.560 --> 0:20:23.280 It requires a supportive environment, It requires community and belonging, 0:20:25.080 --> 0:20:29.920 It requires education and knowledge and empowerment. And so how 0:20:29.960 --> 0:20:33.920 do we address environments, how do we address cultures? 0:20:34.280 --> 0:20:36.440 How do we address psychological needs? 0:20:37.119 --> 0:20:40.000 All of that allows us to create an environment that 0:20:40.160 --> 0:20:42.480 a prefernal cortex can be trained. 0:20:43.960 --> 0:20:48.320 This is also blowing my mind a little bit. So 0:20:48.480 --> 0:20:52.159 I was reading something about the genetic risk and they 0:20:52.160 --> 0:20:54.919 put it at about forty to sixty percent. What do 0:20:54.960 --> 0:20:58.119 we know about genetic risks as it relates to addiction? 0:20:58.240 --> 0:21:00.920 Is there a hereditary component to it? What's the state 0:21:00.960 --> 0:21:01.800 of things right now? 0:21:02.119 --> 0:21:04.440 Yeah, it's a multi gene an environment interaction. 0:21:04.920 --> 0:21:08.880 I lay out this framework that says every chronic condition 0:21:09.040 --> 0:21:14.080 has biological inputs, psychological inputs, and environmental inputs. And the 0:21:14.200 --> 0:21:19.040 environment is both cultural environment and physical environment. And so 0:21:19.080 --> 0:21:21.040 if you look at all three of those, This is 0:21:21.040 --> 0:21:24.119 how the book is laid out into six sections. The 0:21:24.200 --> 0:21:29.679 first three sections are inherited, So inherited biological, that's your DNA, 0:21:30.440 --> 0:21:35.480 inherited psychological, your childhood, inherited environmental, the culture and physical 0:21:35.600 --> 0:21:36.679 environment you were raised in. 0:21:37.320 --> 0:21:38.520 When we look at. 0:21:38.440 --> 0:21:43.480 Inherited biological forty to sixty percent of your risk for 0:21:43.600 --> 0:21:47.080 developing an addiction of any sort is coded in your 0:21:47.160 --> 0:21:49.280 DNA the day you. 0:21:49.200 --> 0:21:52.719 Are born, forty to sixty percent. 0:21:53.280 --> 0:21:57.919 If we look at the forty to sixty percent inherited 0:21:58.240 --> 0:22:02.760 risk through your DNA for any addictive disorder, that. 0:22:02.760 --> 0:22:07.919 Is higher than high blood pressure. 0:22:07.920 --> 0:22:16.639 Ooh, that is higher genetic loading than asthma, that is 0:22:16.840 --> 0:22:22.680 higher genetic loading than type two diabetes. So whereas we 0:22:22.760 --> 0:22:26.439 look at addictions so more realistically, like you just chose 0:22:26.480 --> 0:22:31.679 to have addiction. It's really because it's hard to separate feelings, behaviors, 0:22:31.680 --> 0:22:34.360 and thoughts from like who you are as a person. 0:22:34.720 --> 0:22:37.600 Doctor Harrison, How do you even go about talking about 0:22:37.600 --> 0:22:41.280 something like this, Like how do you prepare your kids 0:22:41.280 --> 0:22:45.520 to understand this type of risk at like a biological 0:22:45.600 --> 0:22:48.720 level when it comes to the genetics of it all. 0:22:49.280 --> 0:22:56.040 I have a very robust family history of addiction of 0:22:56.080 --> 0:23:00.480 all sorts and mental health conditions from both sides. Maternal 0:23:00.520 --> 0:23:04.440 side is loaded, paternal side is loaded. What that allows 0:23:04.480 --> 0:23:10.520 me to do is practice generational prevention with my kids. Right, 0:23:10.600 --> 0:23:13.359 so from four years old, I start training my kids 0:23:13.359 --> 0:23:16.760 into the understanding of addiction as a chronic medical condition 0:23:16.920 --> 0:23:21.239 that deserves and requires compassion for the people who are 0:23:21.280 --> 0:23:24.080 suffering from it. And then as they get older, I 0:23:24.119 --> 0:23:27.480 can say, listen, this is what Mom gave you in 0:23:27.560 --> 0:23:31.680 your DNA. Risk for high cholesterol, risk for alcohol use disorder, 0:23:31.800 --> 0:23:39.359 risk for cocaine use disorder ADHD, resilience, high IQG. 0:23:38.960 --> 0:23:41.240 Like these are all the things that come in my DNA. 0:23:41.800 --> 0:23:43.160 But because you know. 0:23:44.920 --> 0:23:47.679 You are most likely on the sixty percent end of 0:23:47.760 --> 0:23:51.080 that spectrum based on our family history, like sixty percent 0:23:51.119 --> 0:23:54.200 of your risk for development an addiction you were born 0:23:54.240 --> 0:23:58.320 with courtesy of mom. Right, then, when you go to 0:23:58.359 --> 0:24:00.199 a party in high school and the kids are on 0:24:00.240 --> 0:24:01.879 a line of cocaine, they might be able to do 0:24:01.920 --> 0:24:04.360 a lot of cocaine and have fun. Right, they might 0:24:04.400 --> 0:24:06.639 be able to binge drink. Let me tell you what 0:24:06.720 --> 0:24:08.960 happens in our family. They might be able to hit 0:24:09.000 --> 0:24:11.320 the bong for marijuana. Let me tell you about this 0:24:11.400 --> 0:24:16.000 schizophrenia risk in your DNA. And then that empowers people 0:24:16.680 --> 0:24:19.639 to choose maybe differently. 0:24:19.880 --> 0:24:26.159 I love that because what it really highlights is this, huh, 0:24:26.800 --> 0:24:31.800 this lack of compassion that is actually artificially creating, because 0:24:32.200 --> 0:24:34.119 I think if we were to say, oh, this person 0:24:34.200 --> 0:24:37.240 has breast cancer and they inherited this from their family, 0:24:37.480 --> 0:24:40.080 we wouldn't say, well, why did they smoke cigarettes? If 0:24:40.119 --> 0:24:44.080 they knew that their mom or grandma had breast cancer. 0:24:44.160 --> 0:24:47.159 We wouldn't say why did they live in this neighborhood 0:24:47.160 --> 0:24:50.760 where they would be exposed to carcinogens or whatever. We 0:24:51.080 --> 0:24:55.679 wouldn't do those things. Yeah, we would not villainize people 0:24:55.880 --> 0:24:59.520 for working with the cards that they were dealt, you 0:24:59.600 --> 0:25:02.000