AMA #9: Kratom Risks, Does Infrared Sauna Work & Journaling Benefits

Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.

欢迎来到休伯曼实验室播客，我们在这里讨论科学和基于科学的日常生活工具。

I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.

我是安德鲁·胡伯曼，斯坦福大学医学院神经生物学和眼科教授。

Today is an Ask Me Anything episode, or AMA.

今天是“有问必答”节目（AMA）。

This is part of our premium subscriber channel.

这是我们的高级订户频道的一部分。

Our premium subscriber channel was started in order to provide support for the standard Huberman Lab podcast, which comes out every Monday and is available at zero cost to everybody on all standard feeds, YouTube, Apple, Spotify, and elsewhere.

我们的高级订户频道的启动是为了为标准 Huberman Lab 播客提供支持，该播客每周一发布，每个人都可以在所有标准源、YouTube、Apple、Spotify 和其他地方以零成本观看。

We also started the premium channel as a way to generate support for exciting research being done at Stanford and elsewhere, research on human beings that leads to important discoveries that assist mental health, physical health, and performance.

我们还启动了付费频道，为斯坦福大学和其他地方正在进行的令人兴奋的研究提供支持，这些研究对人类进行了有助于心理健康、身体健康和表现的重要发现。

I'm also pleased to inform you that for every dollar the Huberman Lab premium channel generates for research studies, the Tiny Foundation has agreed to match that amount, so now we are able to double the total amount of funding given to studies of mental health, physical health, and human performance.

我还很高兴地通知您，Huberman Lab 高级频道为研究工作产生的每一美元，Tiny 基金会都同意匹配这一金额，因此现在我们能够将用于心理健康、身体健康和人类表现研究的资金总额增加一倍。

If you'd like to subscribe to the Huberman Lab podcast premium channel, please go to hubermanlab.com/premium.

如果您想订阅 Huberman Lab 播客付费频道，请访问 hubermanlab.com/premium。

It is $10 a month to subscribe, or you can pay $100 all at once to get an entire 12-month subscription for a year.

订阅费用为每月 10 美元，或者您可以一次性支付 100 美元以获得一年的完整 12 个月订阅。

We also have a lifetime subscription model that is a one-time payment, and again, you can find that option at hubermanlab.com/premium.

我们还有一次性付款的终身订阅模式，您也可以在 hubermanlab.com/premium 找到该选项。

For those of you that are already subscribers to the premium channel, please go to hubermanlab.com/premium and download the premium subscription feed.

对于那些已经是高级频道订阅者的人，请访问 hubermanlab.com/premium 并下载高级订阅源。

And for those of you that are not Huberman Lab podcast premium subscribers, you can still hear the first 20 minutes of today's episode and determine whether or not becoming a premium subscriber is for you.

对于那些不是 Huberman Lab 播客高级订阅者的人来说，您仍然可以收听今天节目的前 20 分钟，并确定是否适合成为高级订阅者。

So without further ado, let's get to answering your questions.

因此，事不宜迟，让我们开始回答您的问题。

The first question is about kratom, and the question is, what are the short and long-term effects of taking kratom?

第一个问题是关于卡痛叶的，问题是，服用卡痛叶的短期和长期影响是什么？

For those of you that haven't heard of kratom, kratom is a substance that comes from a tree that grows naturally in Indonesia.

对于那些没有听说过卡痛叶的人来说，卡痛叶是一种来自印度尼西亚自然生长的树的物质。

The tree itself is called Mitragyna speciosa, and it's been known for hundreds of years or more, we don't really know how long, but at least for a couple of hundred years, that when people chew the leaves of this tree, they experience a mild stimulant effect.

这种树本身被称为 Mitragyna spiosa，人们已经知道它有数百年或更长时间了，我们真的不知道有多久，但至少有几百年了，当人们咀嚼这棵树的叶子时，他们会感受到轻微的兴奋作用。

And there's also a process of extraction whereby you can take the leaves and get high concentrations of kratom that nowadays is packaged into various supplements, most often consumed in capsule form, although sometimes it's sold in raw powder form.

还有一个提取过程，您可以通过叶子获得高浓度的卡痛叶，如今卡痛叶被包装成各种补充剂，最常以胶囊形式食用，尽管有时以生粉形式出售。

Here's the key thing to understand about kratom.

这是了解卡痛叶的关键点。

Indeed, at low dosages, kratom has a mild stimulant effect.

事实上，在低剂量下，卡痛叶具有轻微的兴奋作用。

However, at higher dosages, it has what's called an analgesic effect, that is, a painkilling effect, and it acts as a sedative.

然而，在较高剂量下，它具有所谓的镇痛作用，即止痛作用，并且具有镇静剂的作用。

And kratom itself acts as an opioid in the body.

卡痛叶本身在体内起到阿片类药物的作用。

This is what's making kratom a very controversial topic these days.

这就是卡痛叶如今成为一个非常有争议的话题的原因。

In particular, because most people have heard of the so-called opioid crisis.

特别是，因为大多数人都听说过所谓的阿片类药物危机。

The opioid crisis has been a term coined to largely center around issues that have taken place in the United States, although these issues definitely extend beyond the borders of the United States.

阿片类药物危机是一个主要围绕美国发生的问题而创造的术语，尽管这些问题肯定超出了美国的边界。

But the opioid crisis is essentially the overconsumption and widespread addiction to opioids.

但阿片类药物危机本质上是阿片类药物的过度消费和普遍成瘾。

Opioids include things like morphine, oxycodone, also called OxyContin, and there are other opioids similar to those compounds, all of which have the general effect of being painkillers and sedatives, and in some people, again, some people, eliciting a sense of euphoria, in particular at low to moderate dosages.

阿片类药物包括吗啡、羟考酮（也称为奥施康定）等，还有其他与这些化合物类似的阿片类药物，所有这些药物都具有止痛药和镇静剂的一般作用，对某些人来说，同样是对某些人来说，会引起欣快感，特别是在低至中等剂量时。

However, people quickly develop a tolerance to those drugs and need to consume more and more of them in order to get the effect that they initially got from a lower dosage.

然而，人们很快就会对这些药物产生耐受性，并且需要消耗越来越多的药物才能获得最初通过较低剂量获得的效果。

And they are not just highly habit-forming, they are highly addictive.

它们不仅很容易让人上瘾，而且很容易上瘾。

And we can distinguish between habit-forming and addictive by simply saying that addictive means people will continue to take something or do something despite negative consequences.

我们可以区分习惯形成和成瘾，简单地说，成瘾意味着人们会继续采取某事或做某事，尽管有负面后果。

There are other relevant definitions of addiction as well.

成瘾还有其他相关的定义。

I define addiction more broadly as the progressive narrowing of the things that give you pleasure.

我将成瘾更广泛地定义为逐渐缩小给你带来快乐的事物。

And indeed, when people get addicted to opioids, it is a very bad picture.

事实上，当人们对阿片类药物上瘾时，情况会非常糟糕。

It often hampers many, many areas of their lives, and seriously so.

它常常妨碍他们生活的许多方面，而且情况严重。

So the opioid crisis refers to the overprescription of opioid drugs.

所以阿片类药物危机是指阿片类药物的过度处方。

That's sort of what it's generally taken to mean, but it also includes accessing opioids such as morphine, oxycodone, et cetera, through gray market sources, through black market sources, and on and on.

这就是它通常的含义，但它还包括通过灰色市场来源、黑市来源等等获取吗啡、羟考酮等阿片类药物。

And of course, the acquisition of the drugs is just one piece.

当然，药品的收购只是其中的一部分。

It's also the overconsumption of those drugs, and of course, the addiction to those drugs, which has proved to be so pernicious.

这也是这些药物的过度消费，当然还有对这些药物的成瘾，这已被证明是非常有害的。

So what does this have to do with kratom?

那么这和卡痛叶有什么关系呢？

Kratom is also an opioid, and we'll talk about how it differs in its opioid properties from the drugs I just talked about, because it is different from morphine and hydrocodone, but it also has some similar properties as well.

卡痛也是一种阿片类药物，我们将讨论它的阿片类药物特性与我刚才谈到的药物有何不同，因为它与吗啡和氢可酮不同，但它也有一些相似的特性。

But the deal with kratom is that a good number of people out there have managed to wean themselves off opioids such as morphine and hydrocodone through the use of kratom.

但卡痛叶的问题在于，很多人已经通过使用卡痛叶成功戒掉了吗啡和氢可酮等阿片类药物。

And that has been used as justification for keeping kratom on the market and keeping it legal.

这已被用作让卡痛叶留在市场上并保持其合法性的理由。

However, and this is a very important however, kratom itself has also proved to be not only habit-forming, but addictive, especially when taken at dosages that exceed that lower dose that just generally creates a bit of stimulant, a little bit of euphoric effect.

然而，这一点非常重要，卡痛叶本身也被证明不仅会形成习惯，而且会让人上瘾，特别是当服用剂量超过通常只会产生一点兴奋剂、一点欣快效应的较低剂量时。

When people start taking higher dosages of kratom, it is very clear that it does become addictive and itself is very hard to come off of, so much so that people experience so-called kratom withdrawal.

当人们开始服用更高剂量的卡痛叶时，很明显它确实会让人上瘾，而且很难戒掉，以至于人们会经历所谓的卡痛叶戒断。

Now, the reason I mention that kratom has been used by a good number of people to wean themselves off of the more potent forms of prescription opioids is that when I solicited for questions about kratom on social media, it was a very binary response.

现在，我之所以提到卡痛叶已被很多人用来戒掉更有效的处方阿片类药物，是因为当我在社交媒体上征求有关卡痛叶的问题时，这是一个非常二元的回答。

In fact, there was one camp, a very rabid camp, that said, "Kratom is terrible.

事实上，有一个阵营，一个非常狂热的阵营，他们说：“卡托姆太可怕了。

I took this stuff.

我拿了这个东西。

I got addicted.

我上瘾了。

It was extremely hard to come off of." There were additional comments in there, such as, "I know somebody who literally had to go to rehab because of kratom, who developed a bunch of other addictions because of kratom." Essentially, many, many responses of people who had only bad experiences with kratom, meaning they liked it enough at first that they continued to take it, and it became addictive for them or somebody that they know.

这是非常难以摆脱的。”那里还有其他评论，例如，“我知道有人因为卡痛叶而不得不去戒毒所，他因为卡痛叶而产生了一系列其他成瘾。”从本质上讲，许多人对卡痛叶有过不好的经历，这意味着他们一开始就很喜欢它，所以他们继续服用它，并且它对他们或他们认识的人来说变得上瘾。

However, there was another camp that was equally vocal, which kept saying, no, if one really adheres to the lower dosages of kratom, kratom itself can be a useful tool for getting off other opioids.

然而，还有另一个阵营同样直言不讳，他们一直说，不，如果一个人真的坚持较低剂量的卡痛叶，卡痛叶本身可以成为摆脱其他阿片类药物的有用工具。

And there were even a few bona fide medical professionals, medical doctors that is, and I happen to know them and their reputations as quite good, who chimed in and sort of reconciled the two camps by saying, indeed, if one can avoid taking kratom at all, you should.

甚至还有一些真正的医疗专业人士，即医生，我碰巧认识他们，而且他们的声誉相当好，他们插话并调和了两个阵营，他们说，事实上，如果有人能完全避免服用卡痛叶，你就应该这样做。

There is no reason to take this thing thinking that it's, quote-unquote, "good for you." You would be wise to avoid taking it because there is a high probability if you take it at a given dosage or at a dosage that is going to get your brain and body into a state of euphoria, analgesia, and that sort of classic opioid effect, that it's going to become habit-forming or addicting for you.

没有理由认为这件事“对你有好处”。你最好避免服用它，因为如果你以给定的剂量服用它，或者以会让你的大脑和身体进入欣快感、镇痛和那种经典的阿片类药物作用的状态，那么它很可能会让你上瘾或上瘾。

That said, these same medical professionals acknowledged that a fair number of people that they knew managed to get off of the more potent forms of opioids, such as morphine, oxycodone, and so forth, using kratom, and they said, well, if it's a choice between being addicted to morphine and hydrocodone versus taking kratom and addicted to those substances, and kratom somehow allowed them to taper off of those substances, that they would look more favorably upon kratom if and only if they would also commit to progressively lowering their dose of kratom and eventually coming off of kratom.

也就是说，这些医疗专业人士承认，他们认识的相当多的人使用卡痛叶成功戒掉了更有效的阿片类药物，如吗啡、羟考酮等，他们说，好吧，如果要在吗啡和氢可酮上瘾与服用卡痛叶并对这些物质上瘾之间进行选择，并且卡痛叶以某种方式允许他们逐渐减少这些物质，那么他们会更喜欢卡痛叶，如果并且只有当他们也承诺逐步降低卡痛叶剂量并最终停止使用卡痛叶时。

So the general takeaway from all of that is if you can avoid taking kratom, meaning if you haven't taken it already, don't.

因此，所有这些的一般要点是，如果您可以避免服用卡痛叶，这意味着如果您还没有服用过，就不要服用。

And that reminds me of a very important point, which a guest on the Huberman Lab podcast, Dr. Robert Malenka, who's a MD and PhD, he's my colleague at Stanford School of Medicine.

这让我想起了一个非常重要的观点，即休伯曼实验室播客的嘉宾罗伯特·马伦卡博士，他是医学博士和博士，也是我在斯坦福大学医学院的同事。

He's a world expert on the mechanisms underlying addiction and dopamine and drug reinforcement, among many other things.

他是成瘾、多巴胺和药物强化机制等方面的世界专家。

What he said on the podcast is absolutely true, which is that it is impossible to get addicted to a substance that you've never consumed.

他在播客上所说的绝对正确，那就是你不可能对从未食用过的物质上瘾。

That might seem obvious, but think about that one again.

这似乎是显而易见的，但请再想一想。

It is impossible to get addicted to a substance that you've never consumed.

你不可能对从未食用过的物质上瘾。

So I think the safest statement to make is if you have not tried kratom, you would be wise to avoid it because you stand a chance to become addicted to it.

因此，我认为最安全的说法是，如果您还没有尝试过卡痛叶，那么您最好避免使用它，因为您有机会对它上瘾。

If, however, you are somebody that's addicted to other forms of opioids, you absolutely should talk to your physician about that and how to get off of those opioids.

然而，如果您对其他形式的阿片类药物上瘾，您绝对应该与您的医生讨论这一问题以及如何戒掉这些阿片类药物。

But there is evidence that some people have used kratom to successfully wean themselves off the more potent forms of opioids that I talked about, namely morphine and hydrocodone, as well as a few others.

但有证据表明，有些人已经使用卡痛叶成功戒掉了我谈到的更有效的阿片类药物，即吗啡和氢可酮，以及其他一些药物。

Now, if you're somebody who already takes kratom, you need to be very thoughtful about the dosage that you take, and you also need to be thoughtful about the fact that people differ dramatically in their response to opioids.

现在，如果您已经服用卡痛叶，您需要非常仔细地考虑您服用的剂量，并且您还需要考虑到人们对阿片类药物的反应存在巨大差异这一事实。

This is oh-so-important, and people do not talk about this enough.

这非常重要，但人们对此的讨论还不够。

We hear, for instance, that, oh, if people are taking anywhere from one to five grams, maybe one to six grams of kratom per day, that's keeping it in the dosage range for which people don't generally tend to get addicted.

例如，我们听说，哦，如果人们每天服用一到五克，也许一到六克卡痛叶，那就将其保持在人们通常不会上瘾的剂量范围内。

You'll hear things like that.

你会听到类似的事情。

And by the way, when I say one to five or one to six grams per day, I'm not talking about the individual compounds that are present in kratom.

顺便说一句，当我说每天一到五克或一到六克时，我并不是在谈论卡痛叶中存在的单个化合物。

There are a couple of different plant alkaloids I'll talk about in a moment that are present in kratom, and these have different effects on the opioid system.

我稍后将讨论卡痛叶中存在的几种不同的植物生物碱，它们对阿片类药物系统有不同的影响。

So nowadays, some of the companies that sell kratom, and by the way, this is sold over the counter as a supplement.

所以现在，一些销售卡痛叶的公司，顺便说一句，这是作为补充品在柜台上出售的。

It does not require a prescription to purchase, at least at this point in time in the United States.

购买它不需要处方，至少目前在美国是这样。

Some of these products will have a higher concentration of one or the other alkaloids within them, such that you can't really compare one gram of one brand of kratom to one gram of another brand of kratom because they can have wildly different levels of these different alkaloids, and these different alkaloids have wildly different impact on different aspects of your brain and body biology.

其中一些产品中的一种或另一种生物碱浓度较高，因此您无法真正将一种品牌的卡痛叶的一克与另一种品牌的卡痛叶的一克进行比较，因为它们可能含有不同水平的不同生物碱，并且这些不同的生物碱对您的大脑和身体生物学的不同方面有截然不同的影响。

In particular, how much they tend to impact the so-called endogenous opioid system.

特别是它们对所谓的内源性阿片类药物系统的影响程度。

Okay, so when we talk about dosages, we have to keep this in the back of our mind, and we have to keep in the back of our mind that there does seem to be a subgroup of people.

好吧，所以当我们谈论剂量时，我们必须牢记这一点，而且我们必须牢记似乎确实有一小群人。

We don't know how big this subgroup of people is, but we know it's not everyone.

我们不知道这个群体有多大，但我们知道这并不是所有人。

But it's somewhere between 10% and 40% of people seem to respond to opioids in a particularly potent way.

但大约 10% 到 40% 的人似乎对阿片类药物有特别有效的反应。

They really like them.

他们真的很喜欢他们。

And perhaps not surprisingly, people outside of that category don't tend to like opioids.

也许并不奇怪，该类别之外的人往往不喜欢阿片类药物。

I can certainly say that I am somebody who, when I've been prescribed things like Vicodin or any other opioid post-surgery for pain, I hate taking those drugs.

我可以肯定地说，当我在手术后服用维柯丁或任何其他阿片类药物来缓解疼痛时，我讨厌服用这些药物。

I absolutely hate it.

我绝对讨厌它。

I'd rather deal with the pain.

我宁愿去面对痛苦。

They make me nauseous.

它们让我感到恶心。

They make me feel terrible.

他们让我感觉很糟糕。

That said, I know people who love opioids.

也就是说，我认识喜欢阿片类药物的人。

It's like a natural fit for their chemistry in the sense that it tends to evoke more euphoria.

这就像他们的化学反应的天然契合，因为它往往会唤起更多的欣快感。

They just immediately like the feeling.

他们只是立即喜欢这种感觉。

Some of you may remember the episode of the Huberman Lab podcast that I did about alcohol, and there too, I discussed the fact that about 8% to 10% of people who consume alcohol get an increased dopamine response to alcohol that's not observed in other people.

你们中的一些人可能还记得我在 Huberman Lab 播客中关于酒精的一集，在那里，我也讨论了这样一个事实：大约 8% 到 10% 的饮酒者对酒精的多巴胺反应增加，而其他人则没有观察到这一点。

And that particular subgroup of people is very, very at risk for developing alcohol use disorder, sometimes called alcoholism, because they can drink in a way and they experience a high from drinking in a way that other people simply do not experience.

这个特定的人群非常非常有可能患上酒精使用障碍，有时称为酒精中毒，因为他们可以以某种方式饮酒，并且他们会以其他人根本不会经历的方式从饮酒中体验到快感。

Now, like everybody else, if they consume too much alcohol, they get drunk.

现在，像其他人一样，如果他们喝太多酒，他们就会喝醉。

So it's not about the drunk effect, it's about the dopamine and other sorts of chemicals that are released in those people in response to alcohol that other people just don't seem to experience at the same level of potency.

因此，这与醉酒效应无关，而是与这些人因酒精反应而释放的多巴胺和其他种类的化学物质有关，而其他人似乎没有经历过相同水平的效力。

So again, with things like kratom and the other opioids, there's a category of people, and it's a much larger category of people.

再说一次，对于像卡痛叶和其他阿片类药物这样的东西，有一类人，而且是一个更大的人类。

Again, 10% to 40%.

再次强调 10% 到 40%。

We don't know exactly how many because the studies are not really completed, and there aren't enough of those studies yet, unfortunately.

我们不知道到底有多少，因为研究尚未真正完成，而且不幸的是，这些研究还不够。

But when those people take an opioid Wow, oh wow, do they like it.

但是当那些人服用阿片类药物时，哇，哇，他们喜欢吗？

And those people in particular are very much at risk for developing an addiction to opioids.

这些人尤其容易对阿片类药物成瘾。

And so those people especially should never, ever go near kratom if they haven't, or if they are already taking kratom, these are the people that are constantly ratcheting up their dose.

因此，这些人尤其不应该接近卡痛叶，如果他们还没有这样做，或者如果他们已经服用卡痛叶，这些人就会不断增加剂量。

These are the people that tell you, "No, I'm not addicted," but if you were to say, "Hey, all right.

这些人会告诉你，“不，我没有上瘾”，但如果你说，“嘿，好吧。

Well, then let's do an experiment where you don't take kratom for a week." Those are going to be the people that are suddenly going to get anxious about the mere idea of that.

好吧，那么我们来做一个实验，一周不服用卡痛叶。”这些人会突然因为这个想法而感到焦虑。

I've also talked about this in reference to cannabis when I did an episode about cannabis.

当我制作一集有关大麻的节目时，我也谈到过大麻。

Again, I'm not putting a blanket statement out there about cannabis as being good or bad.

再说一遍，我并不是对大麻的好或坏做出一揽子声明。

On that episode, I talked about the fact that cannabis does indeed have various therapeutic uses, but that there are a good number of people who rely on cannabis for anxiety control and other ways of modulating their brain chemistry and bodily chemistry such that if you were to say, "Hey, are you addicted to cannabis?" They'd say, "No, I don't have to smoke cannabis.

在那一集里，我谈到了大麻确实有各种治疗用途的事实，但是有很多人依靠大麻来控制焦虑和其他调节大脑化学和身体化学的方法，这样如果你说，“嘿，你对大麻上瘾了吗？”他们会说：“不，我不必吸大麻。

I don't have to take my edibles." But if you were to push them a little bit and say, "All right, well then, let's do an experiment where you don't consume any cannabis in any form for 10 days." They don't like the idea of that experiment at all.

我不需要带我的食物。”但如果你稍微逼迫他们说：“好吧，那么，让我们做一个实验，让你在 10 天内不食用任何形式的大麻。”他们根本不喜欢那个实验的想法。

So much so that were they to run that experiment, they would experience a lot of the withdrawal symptoms associated with addiction.

以至于如果他们进行这个实验，他们会经历很多与成瘾相关的戒断症状。

So I can't in good faith say that kratom is safe for everybody, because it is simply not.

所以我不能真诚地说卡痛叶对每个人都是安全的，因为它根本就不是。

Now, is it safer than the other opioids, and if so, why?

现在，它比其他阿片类药物更安全吗？如果是，为什么？

Well, in order to address that, let's take a short glance at the pharmacology of kratom and how it works in terms of its neurochemistry in the body.

好吧，为了解决这个问题，让我们简要了解一下卡痛叶的药理学以及它在体内神经化学方面的作用。

And I'm going to keep this pretty brief, because in the future I'm going to do an extended episode all about opioids, and I will include kratom in that conversation.

我将保持简短，因为将来我将制作一个关于阿片类药物的扩展剧集，并且我将在该对话中包括卡痛叶。

But just to back up a little bit and discuss what opioids are, opioids are compounds that can activate the so-called endogenous opioid system.

但为了支持一点并讨论什么是阿片类药物，阿片类药物是可以激活所谓的内源性阿片类药物系统的化合物。

All of us have within our brain and body the capacity to release our own opioids.

我们所有人的大脑和身体都有释放自身阿片类药物的能力。

That's right, you have opioids within your body.

没错，你体内含有阿片类药物。

They are released from neurons, and they bind to so-called opioid receptors.

它们从神经元中释放出来，并与所谓的阿片受体结合。

Perhaps some of you have heard of the so-called runner's high.

也许你们中有些人听说过所谓的跑步者高潮。

The runner's high is a euphoric state.

跑步者的高潮是一种欣快的状态。

It's a fairly mild euphoric state in most cases, but it's a euphoric state induced by long-duration effort, AKA the runner's high.

在大多数情况下，这是一种相当温和的欣快状态，但这是由长时间的努力引起的欣快状态，又称跑步者的兴奋。

The runner's high is just a phrase used to explain that when we engage in long-duration, repetitive-action effort, the body starts releasing these endogenous opioids.

跑步者的兴奋感只是一个短语，用来解释当我们进行长时间的重复性运动时，身体开始释放这些内源性阿片类药物。

They bind to receptors, and they trigger things like analgesia, relief from pain.

它们与受体结合，引发镇痛、缓解疼痛等作用。

They trigger mild euphoria.

它们会引发轻微的欣快感。

They tend to change our perception of the outside world, make things look more beautiful, shiny.

它们往往会改变我们对外部世界的看法，让事物看起来更加美丽、闪亮。

They give things a little bit of a sheen.

它们赋予事物一点光泽。

What I just described is a mild version of what people experience when they take something like morphine.

我刚才描述的是人们服用吗啡等药物时所经历的温和版本。

When people take morphine, there's a more of a sedative effect, there's more of a euphoric effect, and there's more of a dreamlike effect, and again, it will depend on dosage.

当人们服用吗啡时，会有更多的镇静作用、更多的欣快作用、更多的梦幻效果，这又取决于剂量。

Kratom and morphine and hydrocodone all have the property of acting like the endogenous opioids, but at much higher potency.

卡痛、吗啡和氢可酮都具有与内源性阿片类药物类似的特性，但效力更高。

When you bring them into your system, they cross the blood-brain barrier, so they go into the brain, and they bind to a number of different opioid receptors.

当您将它们带入您的系统时，它们会穿过血脑屏障，进入大脑，并与许多不同的阿片受体结合。

There's the mu opioid receptor.

有μ阿片受体。

By the way, these names all follow Greek alphabet letters, so the mu opioid receptor, the kappa opioid receptor.

顺便说一句，这些名字都遵循希腊字母，所以 mu 阿片受体，kappa 阿片受体。

There are a bunch of different ones.

有很多不同的。

Kratom binds preferentially to the mu opioid receptor and somewhat to the kappa opioid receptor.

卡痛优先与 mu 阿片受体结合，并在一定程度上与 kappa 阿片受体结合。

There's a big misconception out there.

这里面有一个很大的误解。

A lot of people, especially people who are proponents of kratom, will say, "No, morphine and hydrocodone bind the mu opioid receptor, whereas kratom binds the kappa opioid receptor, so it's a different compound.

很多人，尤其是卡痛叶的支持者，会说：“不，吗啡和氢可酮结合 mu 阿片受体，而卡痛叶结合 kappa 阿片受体，所以它是一种不同的化合物。

Very, very different." Not true.

非常非常不同。”不正确。

Not true.

不正确。

Kratom, morphine, and hydrocodone all bind to the mu opioid receptor, and that's what's largely responsible for its opioid-like effects, especially when you get the dosage up to a level where you start getting the mild sedation, the analgesia, the pain relief.

卡痛、吗啡和氢可酮都与 mu 阿片受体结合，这在很大程度上导致了其类似阿片类药物的作用，尤其是当您将剂量提高到开始获得轻度镇静、镇痛和缓解疼痛的水平时。

And keep in mind, a lot of people are taking kratom because they want pain relief.

请记住，很多人服用卡痛叶是因为他们想要缓解疼痛。

And when that mu opioid receptor system is activated, it indirectly activates a lot of the reinforcement circuitry in the brain that relates to dopamine and serotonin.

当 mu 阿片受体系统被激活时，它会间接激活大脑中与多巴胺和血清素相关的许多强化回路。

This is another area that we'll go into in more depth in the future, but there's been a lot of controversy, people saying, "Oh, kratom doesn't trigger the dopamine system, therefore it's not addictive." But that is simply not true.

这是我们将来会更深入研究的另一个领域，但存在很多争议，人们说，“哦，卡痛叶不会触发多巴胺系统，因此它不会上瘾。”但事实并非如此。

It indirectly activates the reinforcement circuitry that includes both dopamine and serotonin, but its primary effect is to hit this mu opioid receptor system that exists in a bunch of places in the brain, but mainly in the brain stem in a structure called the periaqueductal gray nucleus, which then provides pain relief.

它间接激活包括多巴胺和血清素的强化回路，但其主要作用是打击存在于大脑多个位置的 mu 阿片受体系统，但主要存在于脑干中称为导水管周围灰核的结构中，从而缓解疼痛。

It triggers a number of different shifts in cognition.

它引发了许多不同的认知转变。

It's what creates that mild euphoria, et cetera, et cetera.

这就是产生轻微欣快感的原因，等等。

Now, how can we be so confident that kratom is acting so similarly to hydrocodone and to morphine, albeit with lower potency?

现在，我们怎么能如此确信卡痛叶的作用与氢可酮和吗啡如此相似，尽管效力较低？

And the reason is, if you give people a drug that blocks the mu opioid receptor prior to them taking kratom, they don't experience any of the classic effects of taking kratom.

原因是，如果在服用卡痛叶之前给人们服用一种阻断 mu 阿片受体的药物，他们就不会经历服用卡痛叶的任何经典作用。

No euphoria, no analgesia, no sedation.

没有欣快感，没有镇痛，没有镇静。

Even at the low dosages, no mild stimulant effect.

即使在低剂量下，也没有轻微的兴奋作用。

So we really have to look at kratom as an opioid, okay?

所以我们真的必须将卡痛叶视为阿片类药物，好吗？

That's just the honest truth, and if you're somebody who doesn't like this message because you like kratom, I'm not telling you that you don't like kratom.

这只是诚实的事实，如果您因为喜欢卡痛而不喜欢此消息，我并不是在告诉您您不喜欢卡痛。

I'm telling you, you likely like kratom because it's an opioid.

我告诉你，你可能喜欢卡痛，因为它是一种阿片类药物。

So again, if you go online and you start asking questions about kratom, again, you're going to see these two camps.

所以，如果你上网并开始询问有关卡痛叶的问题，你会再次看到这两个营地。

You're going to see the, "Kratom is terrible.

你会看到“Kratom 太糟糕了。

It's addictive.

这很容易上瘾。

It's everything bad," camp, and then you're going to see the other camp out there, very vocal as well, talking about how kratom helped them avoid other things that are worse.

一切都很糟糕，”阵营，然后你会看到另一个阵营，也非常直言不讳地谈论卡痛叶如何帮助他们避免其他更糟糕的事情。

And this is an argument that frankly I don't think we want to lean on, right?

坦率地说，我认为我们不想依赖这个论点，对吗？

The idea that substance A is not as bad as substance B, and that making substance A unavailable is just going to send everyone running for substance B, that's a weak argument, frankly, right?

物质 A 不像物质 B 那样糟糕，并且让物质 A 不可用只会让每个人都去寻找物质 B，坦率地说，这是一个站不住脚的论点，对吗？

I heard this argument around cannabis, and by the way, I'm I think pretty balanced about cannabis.

我听到了关于大麻的争论，顺便说一句，我认为对大麻的看法相当平衡。

If you listen to the episode I did on cannabis, I think you'll agree that I believe that cannabis has its therapeutic applications.

如果您听过我关于大麻的节目，我想您会同意我相信大麻有其治疗用途。

I also believe that young people, especially young males with a predisposition to psychosis, should not be taking high-concentration THC cannabis, because the data tell us they are already at risk of psychosis and they are at a much greater risk of psychosis if they do.

我还认为，年轻人，尤其是容易患精神病的年轻男性，不应该服用高浓度 THC 大麻，因为数据告诉我们，他们已经面临精神病风险，而且如果这样做，他们患精神病的风险要大得多。

So I think I'm pretty balanced about the story on cannabis, but I often hear the argument, "Oh, cannabis isn't as bad as alcohol and therefore cannabis is good." That's simply not rational.

所以我认为我对大麻的故事相当平衡，但我经常听到这样的论点：“哦，大麻不像酒精那么糟糕，因此大麻是好的。”这根本不合理。

What we should be saying is whether or not it's cannabis or alcohol or kratom or any substance for that matter, what are the potential benefits?

我们应该说的是，无论它是大麻、酒精、卡痛叶还是任何与此相关的物质，潜在的好处是什么？

What are the potential risks?

潜在的风险有哪些？

And again, this is far too much than we can go into in this AMA, and we will go into in a future full-length episode of the "Huberman Lab" podcast.

再说一遍，这远远超出了我们在本次 AMA 中所能讨论的范围，我们将在未来的“Huberman Lab”播客的完整剧集中讨论。

But the other thing to really keep in mind is the lack of regulation over kratom supplements.

但真正要记住的另一件事是缺乏对卡痛补充剂的监管。

Now, as many of you know, I am a fan of many, not all, but many supplements in certain conditions.

现在，正如你们许多人所知，我是许多（不是全部）但在某些情况下的许多补充剂的粉丝。

I always say behaviors first, then nutrition, then, if and only if it's needed, rely on supplementation.

我总是说首先是行为，然后是营养，然后，当且仅当需要时，才依赖补充。

But supplementation is a big category.

但补充品是一个很大的类别。

But when we're talking about supplements that are opioid compounds, I start to get nervous because of the high abuse potential and the high addiction potential of opioids, and kratom is included in that category.

但是，当我们谈论属于阿片类化合物的补充剂时，我开始感到紧张，因为阿片类药物具有很高的滥用潜力和很高的成瘾潜力，而卡痛叶就属于这一类。

A couple of other key notes about kratom.

关于卡痛叶的其他一些要点。

While death directly from kratom is fairly rare, it has happened.

虽然直接死于卡痛叶的情况相当罕见，但这种情况确实发生过。

Now, hydrocodone and morphine suppress respiration, actually suppress breathing by way of a mechanism that if you're a listener of the "Huberman Lab" podcast, you know about, which is the so-called physiological sigh.

现在，氢可酮和吗啡抑制呼吸，实际上是通过一种机制抑制呼吸，如果你是“休伯曼实验室”播客的听众，你就会知道，这就是所谓的生理叹息。

Many of you have heard me talk about the physiological sigh as something that you do voluntarily, the double inhale through the nose and then a long exhale in order to rapidly reduce your level of stress.

你们中的许多人都听我说过，生理叹息是你自愿做的事情，通过鼻子两次吸气，然后长长地呼气，以迅速降低你的压力水平。

As far as we know, that's the fastest way to deliberately lower your level of stress.

据我们所知，这是有意降低压力水平的最快方法。

But the physiological sigh was discovered in the 1930s as a spontaneous pattern of breathing that occurs involuntarily in sleep in order to reinflate the lungs and offload carbon dioxide and bring oxygen back into the system on the subsequent breath.

但生理叹息在 20 世纪 30 年代被发现是一种自发呼吸模式，在睡眠中不由自主地发生，目的是使肺部重新充气并排出二氧化碳，并在随后的呼吸中将氧气带回系统中。

When I interviewed Dr. Jack Feldman, who is a professor at University of California, Los Angeles, and really the pioneer of the modern neuroscience understanding of respiration, he talked about some studies in his laboratory that were exploring why people die when taking opioids.

当我采访杰克·费尔德曼博士时，他是加州大学洛杉矶分校的教授，也是现代神经科学对呼吸的理解的先驱，他谈到了他实验室中的一些研究，这些研究正在探索人们服用阿片类药物时为什么会死亡。

This is a major issue associated with the opioid crisis.

这是与阿片类药物危机相关的一个主要问题。

And what he mentioned was that the opioids bind to particular receptors in the brain stem locations that generate physiological sighs.

他提到的是，阿片类药物与脑干位置的特定受体结合，产生生理叹息。

So opioids, when taken as drugs, suppress physiological sighing and do so during sleep, and lack of adequate respiration, meaning people stop breathing during sleep, is one of the primary reasons why people die when they take opioids.

因此，当阿片类药物作为药物服用时，会在睡眠期间抑制生理性叹息，而缺乏足够的呼吸，意味着人们在睡眠期间停止呼吸，是人们服用阿片类药物时死亡的主要原因之一。

Now, kratom is not known to suppress respiration when taken at low to moderate dosages, but when combined with any other opioids, and certainly when combined with alcohol, it can suppress respiration.

目前，尚不清楚卡痛叶在低至中等剂量服用时会抑制呼吸，但当与任何其他阿片类药物结合使用时，当然与酒精结合使用时，它可以抑制呼吸。

And while the data on this are fairly scant, there is some evidence that kratom-induced death is caused by suppression of the respiration system.

虽然这方面的数据相当缺乏，但有一些证据表明卡痛叶引起的死亡是由呼吸系统抑制引起的。

So again, death due to taking kratom at the dosages that are recommended on most commercial packaging is fairly rare, although it has happened.

因此，尽管确实发生过，但因服用大多数商业包装上推荐剂量的卡痛叶而导致死亡的情况相当罕见。

It's unclear if it happened because it was taken in combination with other compounds.

目前还不清楚这种情况是否是因为它与其他化合物一起服用而发生的。

That seems likely.

这似乎是有可能的。

But we can't forget that a lot of people are taking kratom at much higher dosages, and in fact, progressively higher and higher dosages from these over-the-counter sources.

但我们不能忘记，很多人服用卡痛叶的剂量要高得多，事实上，这些非处方药的剂量越来越高。

And with increased dosage, there is, yes, an increased risk of respiratory failure.

随着剂量的增加，呼吸衰竭的风险也会增加。

So again, all of this points to the fact that kratom is simply not a benign substance.

再次强调，所有这些都表明卡痛叶根本不是一种良性物质。

So if we're going to be very honest, the addictive potential of kratom is real.

所以说实话，卡痛叶的成瘾潜力是真实存在的。

It is exacerbated for some people compared to others, but it is real.

与其他人相比，某些人的情况更为严重，但这是真实的。

Its very similarities to other more potent forms of opioids are what make it attractive for some people who are trying to come off those more potent form of opioids.

它与其他更有效形式的阿片类药物非常相似，这使得它对一些试图戒掉那些更有效形式的阿片类药物的人来说很有吸引力。

But the goal, of course, is to completely come off all opioids, and kratom itself can be a bit of a trap.

但当然，目标是完全戒除所有阿片类药物，而卡痛叶本身可能有点陷阱。

It can be a trap in the sense that people who have never taken other opioids can become addicted to kratom itself.

从某种意义上说，这可能是一个陷阱，从未服用过其他阿片类药物的人可能会对卡痛叶本身上瘾。

That is absolutely clear.

这是绝对清楚的。

That can happen.

这可能会发生。

It has happened in a great number of people.

这在很多人身上都发生过。

It's also clear that kratom can potentially be a trap.

很明显，卡痛叶可能是一个陷阱。

Notice I said potentially, because if people are trying to come off other more potent forms of opioids and then they use kratom to do that, and then they're ratcheting up their dosage of kratom such that they're now matching the endogenous response to kratom in a way that doesn't really distinguish from the effects that they were getting from morphine and hydrocodone, well, then they're just using a different form of morphine and hydrocodone.

请注意，我说的是潜在的，因为如果人们试图摆脱其他更有效形式的阿片类药物，然后他们使用卡痛叶来做到这一点，然后他们逐渐增加卡痛叶的剂量，这样他们现在就以一种与卡痛叶的内源性反应相匹配的方式，这种方式并没有真正区分他们从吗啡和氢可酮获得的效果，那么他们只是在使用不同形式的吗啡和氢可酮。

And I'm sure that some of you are out there saying, "That is ridiculous.

我确信你们中的一些人会说：“这太荒谬了。

You cannot compare the effects of kratom to the effects of hydrocodone." But the potency is about one-sixth of hydrocodone, and there are people out there who are just increasing and increasing both the dosage and modifying the type of kratom that they're taking so that they're getting the kratom that has a particularly high concentration of one of the alkaloids that hits that mu opioid receptor hardest.

你无法将卡痛叶的效果与氢可酮的效果进行比较。”但其效力约为氢可酮的六分之一，有些人只是不断增加剂量并改变他们服用的卡痛叶类型，以便他们获得的卡痛叶含有特别高浓度的一种生物碱，对μ阿片受体最有效。

And in doing so, sure, they're not getting the pure hydrocodone effect, but they're getting really close.

当然，在这样做的过程中，他们并没有获得纯氢可酮的效果，但他们已经非常接近了。

So my advice would be, if you haven't touched kratom, don't touch it at all, ever.

所以我的建议是，如果你没有碰过卡痛叶，就永远不要碰它。

If you are taking kratom, you need to take note of what we just discussed.

如果您正在服用卡痛叶，则需要注意我们刚才讨论的内容。

Thank you for joining for the beginning of this "Ask Me Anything" episode.

感谢您参与本期“有问必答”剧集的开始。

To hear the full episode and to hear future episodes of these "Ask Me Anything" sessions, plus to receive transcripts of them and transcripts of the "Huberman Lab" podcast standard channel and premium tools not released anywhere else, please go to hubermanlab.com/premium.

要收听完整剧集以及这些“Ask Me Anything”会议的未来剧集，以及接收这些会议的文字记录以及“Huberman Lab”播客标准频道和其他地方未发布的高级工具的文字记录，请访问 hubermanlab.com/premium。

Just to remind you why we launched the Huberman Lab podcast premium channel, it's really twofold.

只是提醒您为什么我们推出 Huberman Lab 播客高级频道，它实际上是双重的。

First of all, it's to raise support for the standard Huberman Lab podcast channel, which of course will still be continued to be released every Monday in full length.

首先，是为了提高对标准Huberman Lab播客频道的支持，当然该频道仍然会继续每周一完整发布。

We are not going to change the format or anything about the standard Huberman Lab podcast.

我们不会更改标准 Huberman 实验室播客的格式或任何内容。

And to fund research, in particular research done on human beings, so not animal models, but on human beings, which I think we all agree is a species that we are most interested in.

并资助研究，特别是对人类进行的研究，所以不是动物模型，而是对人类进行的研究，我认为我们都同意这是我们最感兴趣的物种。

And we are going to specifically fund research that is aimed toward developing further protocols for mental health, physical health, and performance.

我们将专门资助旨在开发进一步的心理健康、身体健康和表现协议的研究。

And those protocols will be distributed through all channels, not just the premium channel, but through all channels, Huberman Lab podcast, and other media channels.

这些协议将通过所有渠道分发，不仅仅是付费频道，而是通过所有渠道、Huberman Lab 播客和其他媒体渠道。

So the idea here is to give you information to your burning questions in depth and allow you the opportunity to support the kind of research that provides those kinds of answers in the first place.

因此，这里的想法是为您提供深入的紧迫问题的信息，并让您有机会支持首先提供此类答案的研究。

Now, an especially exciting feature of the premium channel is that the Tiny Foundation has generously offered to do a dollar-for-dollar match on all funds raised for research through the premium channel.

现在，高级渠道的一个特别令人兴奋的特点是，Tiny 基金会慷慨地提出对通过高级渠道筹集的所有研究资金进行一美元对一美元的匹配。

So this is a terrific way that they're going to amplify whatever funds come in through the premium channel to further support research for science and science-related tools for mental health, physical health, and performance.

因此，这是一种很棒的方式，他们将扩大通过优质渠道获得的资金，以进一步支持心理健康、身体健康和表现方面的科学和科学相关工具的研究。

If you'd like to sign up for the Huberman Lab premium channel, again, there's a cost of $10 per month, or you can pay $100 up front for the entire year.

如果您想注册 Huberman Lab 高级频道，每月费用为 10 美元，或者您可以全年预付 100 美元。

That will give you access to all the AMAs.

这将使您能够访问所有 AMA。

You can ask questions and get answers to your questions, and you'll of course get answers to all the questions that other people ask as well.

您可以提出问题并获得问题的答案，当然您也会获得其他人提出的所有问题的答案。

There will also be some premium content, such as transcripts of the AMAs and various transcripts and protocols of Huberman Lab podcast episodes not found elsewhere.

还会有一些优质内容，例如 AMA 的文字记录以及其他地方找不到的 Huberman Lab 播客剧集的各种文字记录和协议。

And again, you'll be supporting research for mental health, physical health, and performance.

同样，您将支持心理健康、身体健康和表现方面的研究。

You can sign up for the premium channel by going to hubermanlab.com/premium.

您可以访问 hubermanlab.com/premium 注册高级频道。

Again, that's hubermanlab.com/premium.

再说一次，这是 hubermanlab.com/premium。

And as always, thank you for your interest in science.

一如既往，感谢您对科学的兴趣。