How to Overcome Addiction to Substances or Behaviors | Dr. Keith Humphreys

如何克服对物质或行为的成瘾？基思·汉弗莱斯博士

2026-01-12 | 官方页面 YouTube 官方音频

Keith Humphreys: Someone says, "I want to quit smoking," a good clinician will say, "Why would you want to do that?" Just say, "So tell me, what do you want to get out of this?

Because it's work.

因为这是工作。

I mean, I'm happy to work with you, but what is it?

What are your motives?" And sort of, helping them build up, in their own mind, because again, this is about them, not you, what do you get?

你的动机是什么？”某种程度上，帮助他们在自己的思想中建立起来，因为这又是关于他们的，而不是你，你会得到什么？

And that's what the therapist does.

这就是治疗师所做的。

The other thing that's really important is that like any other...

Anytime you're making a behavior change, hang out with other people who are trying to make the same change.

You want to start jogging?

你想开始慢跑吗？

Join a jogging group.

加入慢跑小组。

Keith Humphreys: You want to stop drinking?

基思·汉弗莱斯：你想戒酒吗？

I would suggest, go check into an AA meeting or one of the other fellowships we have.

我建议，去参加 AA 会议或我们拥有的其他奖学金之一。

Having other people on the same journey is good for us.

I mean, everything shows that no matter what you're doing, "I'm losing weight.

I'm exercising, or whatever.

我正在锻炼身体，或者其他什么。

I'm quitting smoking." Because it gives you two things.

我要戒烟了。”因为它给了你两件事。

It gives you support, but it also gives you some accountability.

It's like, "Hey, you were going jogging, and on Tuesday, you weren't there.

What's up?

怎么了？

Are you going to be part of this group or not?" And that is helpful for people.

你是否愿意加入这个团体？”这对人们很有帮助。

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

Andrew Huberman：欢迎来到 Huberman 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。

My guest today is Dr. Keith Humphreys.

今天我的客人是基思·汉弗莱斯博士。

Dr. Keith Humphreys is a professor of psychiatry and behavioral sciences at Stanford School of Medicine, and he is one of the world's foremost experts on addictive substances and behaviors, and how to overcome addictions of all kinds.

基思·汉弗莱斯博士是斯坦福大学医学院精神病学和行为科学教授，也是世界上成瘾物质和行为以及如何克服各种成瘾方面最重要的专家之一。

Andrew Huberman: He is also an expert on how science, commercial marketing, lobbying, and the legal system interact to create what are called addiction-for-profit businesses.

安德鲁·胡伯曼（Andrew Huberman）：他也是科学、商业营销、游说和法律体系如何相互作用以创建所谓的成瘾营利企业的专家。

The alcohol, food, and opioid industries come to mind as just a few examples of these, and he's an expert on how all of that shapes things like legal policy.

酒精、食品和阿片类药物行业只是其中的几个例子，他是所有这些行业如何影响法律政策等方面的专家。

Today, we discuss all the major addictions to give you the most up-to-date information on alcohol, cannabis, opioids, gambling, and much more.

今天，我们讨论所有主要的成瘾行为，为您提供有关酒精、大麻、阿片类药物、赌博等的最新信息。

Andrew Huberman: Dr. Humphreys gives us the unbiased facts and, more importantly, he explains how to think about the health risks of any substance or behavior in a logical way.

For instance, while it may be true that a certain amount of alcohol could afford you some heart health benefits, we hear this, then we hear it's not true, it goes back and forth.

例如，虽然一定量的酒精确实可以给你的心脏健康带来一些好处，但我们听到这个，然后我们听到这不是真的，这样反复。

He explains that any heart benefits that exist from alcohol are greatly offset by the increased cancer and other risks of alcohol.

他解释说，酒精对心脏的任何好处都会被酒精增加的癌症和其他风险所抵消。

Andrew Huberman: And with respect to cannabis, he explains who may be okay to use it, but who should absolutely not.

安德鲁·休伯曼：关于大麻，他解释了谁可以使用它，但谁绝对不应该使用它。

We also discuss the most effective ways to get over any addiction.

我们还讨论了戒除毒瘾的最有效方法。

That includes alcohol, pornography, stimulants, and much more.

其中包括酒精、色情内容、兴奋剂等等。

As you'll soon see, Dr. Keith Humphreys is no ordinary scientist, or psychologist, or addiction expert.

He has the big picture on addiction, and what it means to try and navigate life nowadays in an ocean of addiction-for-profit marketing and confusing health information.

他对成瘾有全面的了解，以及在当今成瘾营利营销和令人困惑的健康信息的海洋中尝试和驾驭生活意味着什么。

Andrew Huberman: I assure you that today, he doesn't tell you what to think or what to do about various substances and addictive behaviors, but rather how to think about them, and in doing so, how to avoid and overcome, essentially, any addiction.

It's a powerful conversation that I'm certain will help millions of people make better decisions.

这是一次强有力的对话，我确信它将帮助数百万人做出更好的决策。

Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.

在开始之前，我想强调一下，这个播客与我在斯坦福大学的教学和研究角色是分开的。

It is, however, part of my desire and effort to bring zero-cost-to-consumer information about science and science-related tools to the general public.

然而，我的愿望和努力的一部分是将有关科学和科学相关工具的零成本消费者信息带给公众。

Andrew Huberman: In keeping with that theme, today's episode does include sponsors.

And now, for my discussion with Dr. Keith Humphreys.

现在，我与基思·汉弗莱斯博士进行了讨论。

Andrew Huberman: Dr. Keith Humphreys, welcome.

安德鲁·胡伯曼：基思·汉弗莱斯博士，欢迎。

Keith Humphreys: Good to meet you, Andrew.

基思·汉弗莱斯：很高兴认识你，安德鲁。

Andrew Huberman: Addiction is a big topic, but I think for a lot of people it gets slotted into one small drawer.

安德鲁·胡伯曼：成瘾是一个很大的话题，但我认为对于很多人来说，它被放在一个小抽屉里。

But if we were to compare it to, say, mental illness, many, many things, depression, manic bipolar, OCD, and on and on.

但如果我们将其与精神疾病、抑郁症、躁狂躁郁症、强迫症等等进行比较。

Andrew Huberman: How do you parse this thing that we call addiction in thinking about how best to possibly treat addiction, especially when it comes to trying to treat addiction en masse at the level of policy, which we'll also talk about today?

安德鲁·胡伯曼（Andrew Huberman）：在思考如何最好地治疗成瘾时，您如何解析我们所说的成瘾问题，特别是当涉及到在政策层面上集体治疗成瘾时，我们今天也将讨论这一点？

So, put simply, how do you frame addiction?

那么，简单地说，你如何看待成瘾？

And how should people think about it?

人们应该如何思考？

Keith Humphreys: Yeah, it's hard because it's a word, unlike, say...

Maybe it's a little like schizophrenia, where people say, "Oh, you know, he's a schizophrenic person," what they actually mean is, he's a person with different moods and that sort of thing.

Addiction is even more like that.

成瘾更是如此。

It's in common parlance.

People say, "I'm addicted to a TV show," or "I'm addicted to my phone," or that sort of thing.

But it's not just stuff you do a lot, which we sometimes colloquially call addiction.

但这不仅仅是我们经常做的事情，我们有时通俗地称之为上瘾。

Keith Humphreys: It's the persistence of doing something that is harmful.

Keith Humphreys：这是指坚持做有害的事情。

So, like the classic animal study is, James Olds' study with rats done in the '50s, showing that you could give a rat the opportunity to give itself brain stimulation, which they enjoy.

And that they would continue to do that even as they were starving to death next to a pile of food pellets, or run out of water while they were next to water.

Keith Humphreys: That is what it was.

基思·汉弗莱斯：就是这样。

It's not doing the things over and over, or even being compulsive about things.

It's doing them to the point of destruction when you would normally, you know, any other behavior, you would think, well, you would just stop doing that.

But people don't, and that's the sine qua non of addiction.

Andrew Huberman: I've tried to create a definition for addiction, which is that it's a progressive narrowing of the things that bring one pleasure, that it doesn't happen all at once.

Like, someone doesn't take heroin once and then stop doing everything else.

就像，有人不会吸食海洛因一次，然后就不再做其他事情。

It tends to be progressive.

它往往是进步的。

I suppose it could be overnight.

我想这可能是一夜之间。

But is that true?

但这是真的吗？

I'm happy to revise the definition.

我很高兴修改定义。

Keith Humphreys: Yeah, no, that is true.

基思·汉弗莱斯：是的，不，确实如此。

So you see, the other types of rewards, particularly natural rewards, start to fall away from the person's life.

所以你看，其他类型的奖励，特别是自然奖励，开始从人们的生活中消失。

So, I'll sacrifice my relationship with my parents, or my spouse, or my friends.

所以，我会牺牲与父母、配偶或朋友的关系。

I will stop going to work, which would normally generate the things I need to eat, or I'll give up my housing for the sake of this substance.

我将停止工作，这通常会产生我需要吃的东西，或者我会为了这种物质而放弃我的住房。

Keith Humphreys: And then, you become not only more physically dependent on it, but essentially, you're psychologically dependent on it, because it's the one thing left that is still rewarding.

Everything else has been stripped away, and that makes it easier to understand why people would still hang on to it in that situation when it feels like, "Look, it's the only time I feel good is that moment when I take that hit."

Andrew Huberman: These days, there are a lot of industries that are an addiction for money, basically, industries.

Andrew Huberman：如今，有很多行业都对金钱上瘾，基本上是行业。

Keith Humphreys: Yeah.

Andrew Huberman: And we're going to talk about all of them.

Andrew Huberman：我们将讨论所有这些。

Keith Humphreys: Yeah.

Andrew Huberman: Nicotine, alcohol, cannabis, social media, all of these.

Andrew Huberman：尼古丁、酒精、大麻、社交媒体，所有这些。

But for the time being, do you think that there is truly something to the, quote unquote, "genetic bias" for becoming an addict, and is it very substance or behavior-specific?

Let's start with maybe alcohol, for example.

例如，让我们从酒精开始。

Keith Humphreys: Yeah.

Keith Humphreys: Yeah, that's a great question.

基思·汉弗莱斯：是的，这是一个很好的问题。

So, let me start by just getting rid of one myth, where we say people are born addicted.

因此，首先让我破除一个误区，即人们生来就上瘾。

You'll sometimes read, you know, if Mom was addicted to fentanyl, then the baby is born addicted.

有时你会读到，如果妈妈对芬太尼上瘾，那么婴儿生来就上瘾。

That is not possible, because a fetus has no association between their behavior and the exposure to the drug.

这是不可能的，因为胎儿的行为与药物暴露之间没有关联。

So, they can be physically dependent, meaning they'll go through withdrawal upon birth, but they're not addicted.

因此，他们可能会产生身体依赖性，这意味着他们在出生时就会经历戒断，但他们不会上瘾。

Keith Humphreys: But you can have risk from birth in your genes.

Keith Humphreys：但是你的基因可能从出生起就存在风险。

And those shared estimates of how much of that is shared, it's actually quite a bit.

那些共享的估计有多少是共享的，实际上是相当多的。

We look at studies where kids were adopted out of families with parents who were addicted to alcohol, a much higher likelihood of developing an alcohol problem, even if they were raised by teetotalers, for example.

我们研究了一些研究，这些孩子是从父母酗酒的家庭中领养的，即使他们是由禁酒者抚养长大的，他们出现酒精问题的可能性也更高。

Keith Humphreys: How big is that?

基思·汉弗莱斯：那有多大？

It varies across studies.

不同研究的情况有所不同。

It varies across substances, but it's large.

它因物质而异，但很大。

It might be, like, 0.3, 0.4, 0.5, for most of them.

对于大多数人来说，它可能是 0.3、0.4、0.5。

And you can imagine that the same genes, some might be specific, and some might be more general.

你可以想象相同的基因，有些可能是特定的，有些可能是更普遍的。

So, here's an example of a specific one.

所以，这是一个具体的例子。

If you are born into a group like the Han Chinese are, and you lack the enzyme or don't have much of a particular enzyme that is used to metabolize alcohol, it is just a less enjoyable experience to drink.

如果你出生在像汉族这样的群体，并且你缺乏这种酶或没有太多用于代谢酒精的特定酶，那么喝酒的体验就不那么愉快了。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: You can't break it down to acetaldehyde and acetic acid and all that sort of thing.

But that wouldn't lower your risk for anything else, but at least be specific for alcohol.

但这不会降低您患其他任何疾病的风险，但至少是针对酒精的。

But other genes for things like impulsivity, that would put you at risk across substances.

但其他基因如冲动，会让你面临跨物质的风险。

Being sensation-seeking, you're going to try more drugs.

That means it's more likely that you're going to get exposed to one.

这意味着您更有可能接触到一种病毒。

Keith Humphreys: Another thing we see happening, which is really fascinating and poorly understood, I, of course, know, doing what I do, lots of people are in recovery.

基思·汉弗莱斯：我们看到发生的另一件事确实令人着迷，但人们却知之甚少，当然，我知道，通过我所做的事情，很多人都在康复中。

And I've known people and had people in my studies who have been, say, clean and sober in their sense for 20 years, and then, all of a sudden, they develop a very strong sexual compulsion, or they gain 30 pounds because they're just eating and eating and eating.

And it's like the underlying diathesis, whatever it is, has found a new phenotypic expression, because it was never actually resolved.

就像潜在的素质，无论它是什么，已经找到了一种新的表型表达，因为它从未真正得到解决。

What was resolved was the particular set of behaviors that went with the addictions they had when they got into recovery.

解决的是他们在康复过程中与成瘾相关的一系列特定行为。

Andrew Huberman: When it comes to alcohol, I've heard it's said that there's a subset of people with, I guess nowadays, they call it alcohol use disorder.

Can we just call it alcoholism today?

今天我们可以称之为酗酒吗？

Keith Humphreys: Sure.

Andrew Huberman: Okay.

安德鲁·休伯曼：好的。

Sometimes people will lash back at me if I refer to someone as an alcoholic, but I have enough friends who are alcoholics, that joke is only on them, by the way, who are recovered, so I can make the joke, because of their impressive recovery stories, and they all just say, "Just call it what it is," which is alcoholism.

There's just so much splitting of names now.

现在名字分裂太多了。

I don't want to put you in the position of saying something that's going to offend anyone, whereas I can do that.

Keith Humphreys: No, it's just worth getting into.

So, use disorder is a much broader spectrum thing.

So, if you diagnose someone with alcohol use disorder, it can be mild, moderate, or severe, and the people at the mild end, everyone at AA would laugh at, you know?

所以，如果你诊断出某人患有酒精使用障碍，它可以是轻度、中度或重度，而轻度的人，AA 的每个人都会嘲笑，你知道吗？

This is a person who occasionally drinks too much, has some harm, but basically, life is still put together.

And people in AA would be like, "You've got to be kidding me.

That's your problem?" It's only when you get up to the severe end, where we see the things that looks like addiction.

So, they aren't actually the same thing, addiction and use disorder.

所以，成瘾和使用障碍实际上并不是同一件事。

Use disorder is broader.

Andrew Huberman: Mm.

安德鲁·休伯曼：嗯。

Keith Humphreys: And it was there to sort of move alcohol like other health behaviors that you might start addressing, particularly in primary care.

So, just like we would like doctors to intervene when someone is 15 pounds overweight and has moderately high blood pressure, so that they don't, later, develop a more serious problem, that was the idea.

所以，就像我们希望医生在某人超重 15 磅并且患有中度高血压时进行干预，这样他们以后就不会出现更严重的问题，这就是我们的想法。

Keith Humphreys: Well, let's have a lower-severity problem that a doctor might, while the person still has a fair amount of control, advise you, "Hey, if you could just cut back a bit now, you could avoid a lot of suffering later." That's where that came from.

基思·汉弗莱斯：好吧，让我们来看看一个不太严重的问题，当这个人仍然有相当程度的控制力时，医生可能会建议你，“嘿，如果你现在能减少一点，你以后就可以避免很多痛苦。”这就是它的来源。

But I'm comfortable talking about addiction.

但我很乐意谈论成瘾。

It's a good word.

这是一个好词。

It's scientifically meaningful.

这是有科学意义的。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And it's something the public understands.

Keith Humphreys：这是公众能够理解的事情。

Andrew Huberman: Yeah, and if you go to an AA meeting, they go around the room saying, "I'm so and so, and I'm an alcoholic." They don't say, "I'm so and so, and I have alcohol use disorder."

安德鲁·休伯曼：是的，如果你去参加 AA 会议，他们会在房间里走来走去说：“我是某某，而且我是个酒鬼。”他们不会说：“我是某某，我患有酒精使用障碍。”

Keith Humphreys: Oh, that's right.

基思·汉弗莱斯：哦，没错。

Absolutely.

绝对地。

Yeah, yeah.

是啊是啊。

Andrew Huberman: So, many people who are in recovery define, at some level of their identity, not their total identity as an alcoholic.

Keith Humphreys: Right.

Andrew Huberman: It's actually an important part of the 12-step recovery process, which we'll talk about.

In any case, not to split hairs here, but I'm grateful that you're willing to embrace that nomenclature, and thanks for clarifying that, why it was split, because sometimes these clinical and naming things are split, because of, quote unquote, "sensitivities" we don't want to offend, et cetera, and we don't want to offend.

无论如何，不要在这里吹毛求疵，但我很感激你愿意接受这个命名法，并感谢你澄清为什么它被分开，因为有时这些临床和命名的东西是分开的，因为，引用不引用，“敏感性”，我们不想冒犯，等等，我们不想冒犯。

Okay, so alcohol.

Andrew Huberman: I've heard it's said that there's a subset of people, somewhere around 8% to 10%, for whom they drink alcohol, and they experience it very differently.

Andrew Huberman：我听说有一小部分人，大约 8% 到 10%，他们喝酒，但他们的饮酒体验却非常不同。

They experience it more as a, for lack of a better term, kind of a dopaminergic, an energizing experience.

And this could relate to tolerance, but they have a very different experience, subjectively, of alcohol than most everybody else, who can build up tolerance.

Andrew Huberman: Anyone can build up tolerance.

Andrew Huberman：任何人都可以建立宽容。

And then it takes longer to get into the sedative effects, the depressive effects of alcohol.

But I've heard it's said that this 8% to 10% are particularly susceptible to becoming alcoholics because they drink and they feel spectacularly good, and they can keep drinking in a way that many other people either pass out, black out, crash their car, end up in jail, or dead.

And so, in some sense, this 8 to 10% may be at greater risk than everyone else.

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

So, Marc Schuckit, who's a superb psychiatrist who's based in Southern California for most of his career, did some wonderful studies of male children of alcoholic fathers.

因此，马克·舒基特（Marc Schuckit）是一位出色的精神病学家，他的大部分职业生涯都在南加州工作，他对酗酒父亲的男孩进行了一些精彩的研究。

And one of the things he showed is that when given alcohol, their body sway is less at a level you can't even perceive, but he could measure that with a...

他展示的一件事是，当饮酒时，他们的身体摇摆会减少到你甚至无法察觉的水平，但他可以用……来测量这一点。

Andrew Huberman: Body sway?

安德鲁·休伯曼：身体摇摆？

Keith Humphreys: Yeah, like how much they move.

Keith Humphreys：是的，就像他们移动的程度一样。

How hard the alcohol hits them.

酒精对他们的打击有多大。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And they had fewer hangovers the next day.

Keith Humphreys：第二天他们的宿醉症状减少了。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And then, you might think, "Well, that's great.

It doesn't hit you that hard, but you can drink a lot." And like, no, that's the problem because someone else would get the signal of like, "Whoa, I'm feeling kind of dizzy here.

It doesn't hit you that hard, but you can drink a lot."就像，不，这就是问题所在，因为其他人会得到这样的信号：“哇，我在这里感到有点头晕。

I must have had too much to drink," or the next morning, they get up and go, "Oh, God, I'm never doing that again." They don't get that signal.

我一定是喝太多了，”或者第二天早上，他们起床说，“哦，上帝，我再也不会这样做了。”他们收不到那个信号。

It's less punishing, more rewarding.

惩罚更少，奖励更多。

Keith Humphreys: And you see that across drugs.

Keith Humphreys：你可以在毒品中看到这一点。

And this is almost surely genetic; how much people like different drugs, you know, varies enormously.

这几乎可以肯定是遗传的。你知道，人们对不同药物的喜爱程度差异很大。

I'll be personal about this.

我将就此事谈谈个人看法。

So, I had an injury.

I broke my ulna, and I had to take Vicodin for the pain afterwards.

我的尺骨骨折了，之后我不得不服用维柯丁止痛。

I find taking opioids so unpleasant.

我发现服用阿片类药物非常不愉快。

Keith Humphreys: I feel bound up, miserable, groggy, that I just took one and said, "Pain is better than this." I have worked with people clinically who say, "The first time I had an opioid, it was like a hole in my chest that had been there my whole life filled up for the very first time." That has everything to do with genes.

基思·汉弗莱斯（Keith Humphreys）：我感到被束缚、痛苦、昏昏沉沉，我只是拿了一颗并说：“疼痛比这更好。”我曾与临床医生一起工作过，他们说：“我第一次服用阿片类药物时，它就像我胸口上的一个洞，我一生都在那里，第一次被填满。”这与基因有很大关系。

There's no learning history there, right?

那里没有学习历史，对吗？

Keith Humphreys: But there's something...

基思·汉弗莱斯：但是有件事......

I'm just wired differently for that particular drug than people who get in trouble with it are.

我只是对这种药物的反应与那些因该药物而陷入困境的人不同。

And these don't necessarily go in groups, so someone can hate opioids, but love cannabis or love alcohol.

这些不一定成群出现，所以有人可能讨厌阿片类药物，但喜欢大麻或喜欢酒精。

And that, of course, is going to change their risk.

当然，这会改变他们的风险。

How could it not?

怎么可能不呢？

Andrew Huberman: This is such an important point, and I didn't realize that it extended to things outside of alcohol.

安德鲁·休伯曼：这是非常重要的一点，我没有意识到它延伸到酒精以外的事物。

Because oftentimes, when a discussion starts to surface about addiction and whether or not zero is better than any, whether or not things can be done in moderation, I think this is actually a big unspoken point of friction, because some people really can drink five or six drinks, and then the next day, they're at work hammering away, and they're going to say, "Listen, my life's going great."

因为很多时候，当讨论开始浮出水面时，关于成瘾问题，以及零是否比任何更好，事情是否可以适度完成，我认为这实际上是一个很大的不言而喻的摩擦点，因为有些人真的可以喝五六杯酒，然后第二天，他们在工作中苦苦挣扎，他们会说，“听着，我的生活进展顺利。”

Keith Humphreys: Oh, yeah.

基思·汉弗莱斯：哦，是的。

Keith Humphreys: Yup.

Andrew Huberman: And liver markers are still within range.

Andrew Huberman：肝脏标记物仍在范围内。

Eventually, they'll decline; they'll get worse.

最终，他们会拒绝； they'll get worse.

But the conversation becomes very difficult to have because it sounds like it's highly individual how people will react.

但这种对话变得非常困难，因为听起来人们的反应是非常个人化的。

And there are the behavioral impacts.

还有行为影响。

Like, for instance, I've heard the statistic that one of the greatest risks for becoming an alcoholic is if your first drink is before the age of 14.

举例来说，我听说过一项统计数据，成为酗酒者的最大风险之一是如果你第一次喝酒是在 14 岁之前。

Andrew Huberman: So, I find that some people will have their first drink, like you said, and it's like a magic elixir for their physiology, and there are very few things that can get somebody like that to stop drinking except the risk of losing everything, and sometimes even then.

安德鲁·休伯曼：所以，我发现有些人会第一次喝酒，就像你说的那样，这就像他们生理上的灵丹妙药，很少有什么事情可以让这样的人戒酒，除了失去一切的风险，有时甚至是失去一切的风险。

Keith Humphreys: Mm-hmm.

Keith Humphreys: Sometimes even then.

Keith Humphreys：有时甚至是这样。

Yeah.

是的。

Andrew Huberman: And so, maybe alcohol is the best template for talking about this, because it's socially acceptable in most places for adults anyway.

安德鲁·休伯曼：所以，也许酒精是谈论这个问题的最佳模板，因为无论如何，酒精在大多数地方对于成年人来说都是社会可接受的。

Keith Humphreys: It's legal, it's marketed.

Keith Humphreys：这是合法的，而且是市场化的。

Yeah.

是的。

Andrew Huberman: It's legal, it's marketed, and yet, how does one know whether or not they have a predisposition?

Andrew Huberman：它是合法的，它是市场化的，但是，人们如何知道自己是否有这种倾向？

Because those people might want to avoid using something, because our colleague Anna Lembke has said that, you can't get addicted to something that you've never done or taken.

因为那些人可能想避免使用某些东西，因为我们的同事安娜·伦布克（Anna Lembke）说过，你不能对你从未做过或从未服用过的东西上瘾。

Keith Humphreys: Yeah.

Yes.

是的。

Keith Humphreys: That is the most helpful advice, you know?

Keith Humphreys：这是最有帮助的建议，你知道吗？

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: So, I can never tell you if, in this game of "Russian Roulette," the bullet will not be in your chamber for sure.

基思·汉弗莱斯：所以，我永远无法告诉你，在这场“俄罗斯轮盘赌”游戏中，子弹是否肯定不会进入你的房间。

I can say, like, you're less likely for this, more likely for that, but the only way to determine that a substance will not damage your life is to never use it in the first place.

我可以说，你不太可能这样做，更有可能那样做，但确定某种物质不会损害你的生活的唯一方法就是从一开始就不要使用它。

There's always going to be some risk.

总会有一些风险。

There's been a lot of work on kind of genotyping to try to figure out, could I tell people what their genetic risk is for alcohol?

已经有很多关于基因分型的工作试图弄清楚，我可以告诉人们他们的酒精遗传风险是什么吗？

Keith Humphreys: And nothing is as good as just saying, "Your parents alcoholic?

基思·汉弗莱斯：没有什么比直接说“你的父母酗酒吗？”更好的了。

Yeah, I don't know." And if they were, that's the most useful bit of information.

Yeah, I don't know."如果是的话，那就是最有用的信息了。

Or, "Does the problem of drinking run in your family?" That kind of, as crude a question as it is, that's more useful than anything we have from SNPs or anything like that.

或者，“你家里有酗酒的问题吗？”这种问题虽然很粗略，但比我们从 SNP 或类似的东西中得到的任何东西都更有用。

Andrew Huberman: Does it cross sex?

安德鲁·休伯曼：它是否跨性别？

So, if a daughter has a father who's an alcoholic, does it cross sex as readily as it goes from, say, father to son or mother to daughter?

那么，如果一个女儿的父亲是个酒鬼，那么她的跨性别是否会像从父亲到儿子或从母亲到女儿一样容易呢？

Keith Humphreys: No. I mean, there is still risk there for sure, but the father-to-son link is the strongest one you see in genetic studies.

基思·汉弗莱斯：不。我的意思是，这肯定仍然存在风险，但父子之间的联系是你在基因研究中看到的最强烈的联系。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: Now, of course, in a sense, it's hard, right, because men drink more than women do, I mean, in our culture anyway.

基思·汉弗莱斯：当然，从某种意义上说，这很难，对吧，因为无论如何，在我们的文化中，男性比女性喝酒更多。

And they drink to excess more than women do anyway, whether they've got an alcohol problem or not.

无论如何，他们比女性饮酒过量，无论她们是否有酗酒问题。

So, if you think this is some sort of unfolding process, right, then men carrying risk would be more likely to have that risk realized through the behavior than a woman would, where there's still a fair amount of women who don't drink or drink, I mean, hardly any.

所以，如果你认为这是某种展开的过程，对吧，那么承担风险的男性比女性更有可能通过这种行为认识到风险，而女性中仍然有相当多的女性不喝酒或喝酒，我的意思是，几乎没有。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: So, it's sort of like the thing, if you had all the genetic loading for cocaine in 1800, it didn't matter.

Keith Humphreys：所以，这有点像，如果你在 1800 年拥有可卡因的所有基因负载，那并不重要。

There was no cocaine.

没有可卡因。

If you had all the genetic loading for alcohol and you've never drank, then it's really irrelevant.

如果你有酒精的全部基因负荷并且你从未喝酒，那么这真的无关紧要。

Andrew Huberman: I'd like to take a quick break and acknowledge one of our sponsors, David.

Andrew Huberman：我想稍微休息一下，并向我们的赞助商之一 David 表示感谢。

David makes a protein bar unlike any other.

大卫制作的蛋白质棒与众不同。

It has 28 grams of protein, only 150 calories, and zero grams of sugar.

它含有 28 克蛋白质，仅 150 卡路里，零克糖。

That's right, 28 grams of protein, and 75% of its calories come from protein.

没错，28克蛋白质，它的热量75%来自于蛋白质。

That's 50% higher than the next closest protein bar.

这比第二接近的蛋白质棒高出 50%。

These bars from David also taste amazing.

大卫的这些酒吧味道也很棒。

Right now, my favorite flavor is the new cinnamon roll flavor, but I also like the chocolate chip cookie dough flavor, and I also like the salted peanut butter flavor.

现在，我最喜欢的口味是新的肉桂卷口味，但我也喜欢巧克力饼干面团口味，我也喜欢咸花生酱口味。

Basically, I like all the flavors.

基本上所有的口味我都喜欢。

They're all delicious.

它们都很好吃。

Andrew Huberman: Also, big news, David bars are now back in stock.

安德鲁·休伯曼：另外，大新闻是，大卫金条现在又重新有货了。

They were sold out for several months because they are that popular, but they are now back in stock.

由于它们太受欢迎，它们被抢购一空几个月，但现在又有货了。

By eating a David bar, I'm able to get 28 grams of protein in the calories of a snack, which makes it very easy for me to meet my protein goals of one gram of protein per pound of body weight per day, and to do so without eating excess calories.

通过吃大卫棒，我可以在一份零食的卡路里中获得 28 克蛋白质，这使我很容易实现每天每磅体重 1 克蛋白质的蛋白质目标，并且无需摄入过多卡路里。

Andrew Huberman: I generally eat a David bar most afternoons, and I always keep them with me when I'm away from home or traveling, because they're incredibly convenient to get enough protein.

Andrew Huberman：大多数下午我通常都会吃大卫棒，当我出门在外或旅行时，我总是随身携带它们，因为它们非常方便地获取足够的蛋白质。

As I mentioned, they're incredibly delicious, and given that 28 grams of protein, they're pretty filling for just 150 calories, so they're great between meals as well.

正如我所提到的，它们非常美味，而且含有 28 克蛋白质，仅需 150 卡路里热量就可以产生饱腹感，因此在两餐之间也非常适合。

If you'd like to try David, you can go to davidprotein.com/huberman.

如果您想尝试 David，可以访问 david Protein.com/huberman。

Again, that's davidprotein.com/huberman.

同样，这是 david Protein.com/huberman。

Andrew Huberman: Today's episode is also brought to us by BetterHelp.

Andrew Huberman：今天的节目也是由 BetterHelp 为我们带来的。

BetterHelp offers professional therapy with a licensed therapist carried out entirely online.

BetterHelp 提供由持证治疗师完全在线进行的专业治疗。

I've been doing therapy for many years now, and I can tell you that it's a lot like physical workouts.

我从事治疗已经很多年了，我可以告诉你，这很像体育锻炼。

There are days when I want to do it, and there are days when I don't want to do it.

有想做的日子，也有不想做的日子。

But every time I finish a therapy session, I come away feeling much better and knowing that the time was very well spent.

但每次我完成治疗后，我都会感觉好多了，并且知道这段时间花得很值。

Andrew Huberman: Typically, when I finish a therapy session, I come away with at least one valuable insight or perspective on something that I'm working through, whether that's with work, relationships, or my personal life, or just simply my relationship to myself.

安德鲁·休伯曼：通常，当我完成一次治疗时，我会对我正在经历的事情至少产生一种有价值的见解或观点，无论是工作、人际关系还是我的个人生活，或者只是我与自己的关系。

There's just so much benefit that comes through effective therapy.

有效的治疗可以带来很多好处。

And with BetterHelp, they make it very easy to find an expert therapist who can provide you with the benefits that come from effective therapy.

通过 BetterHelp，您可以轻松找到专业治疗师，为您提供有效治疗带来的益处。

Andrew Huberman: With over 30,000 therapists, BetterHelp is one of the world's largest online therapy platforms, having served over five million people globally.

Andrew Huberman：BetterHelp 拥有超过 30,000 名治疗师，是世界上最大的在线治疗平台之一，已为全球超过 500 万人提供服务。

And it works, with an average rating of 4.9 out of 5 for a live session, based on over 1.7 million client reviews.

它确实有效，基于超过 170 万个客户评论，现场会议的平均评分为 4.9 分（满分 5 分）。

Also, because BetterHelp is done entirely online, it's extremely time-efficient.

此外，由于 BetterHelp 完全在线完成，因此非常省时。

There's no driving to a therapist's office, looking for parking, et cetera.

无需开车去治疗师办公室、寻找停车位等。

If you'd like to try BetterHelp, you can go to betterhelp.com/huberman to get 10% off your first month.

如果您想尝试 BetterHelp，可以访问 betterhelp.com/huberman，第一个月可享受 10% 的折扣。

Again, that's betterhelp.com/huberman.

再说一次，这是 betterhelp.com/huberman。

Andrew Huberman: Women are drinking more or less now?

Andrew Huberman：现在女性饮酒量增加了还是减少了？

Keith Humphreys: Women, unfortunately, in the late '90s, early 'aughts, the alcohol industry figured out that women had more money, but they weren't drinking the way men were.

Keith Humphreys：不幸的是，女性在 90 年代末、20 世纪 90 年代初，酒精行业发现女性有更多的钱，但她们并没有像男性那样喝酒。

So, they engaged in a long-term campaign to try to increase women's drinking.

因此，他们开展了一项长期运动，试图增加女性的饮酒量。

So, things like mommy wine juice, and those mommy wine chats online and all that, that was really engineered by them.

所以，像妈咪酒汁、妈咪酒在线聊天之类的东西，都是他们设计的。

Keith Humphreys: Even some of the ones that look organic online were engineered by the industry, and it worked.

Keith Humphreys：即使是一些在网上看起来有机的东西也是由行业设计的，而且它确实有效。

Women's drinking went up a lot, and the damage per drink is more for women for most things than it is for men, partly due to body size, but also partly, probably, due to some hormonal things.

女性饮酒量大幅增加，在大多数情况下，每次饮酒对女性造成的损害比男性更大，部分原因是体型，但也可能部分是由于某些荷尔蒙因素。

And so, it's been an exploitation, as I see it, of women.

因此，在我看来，这是对女性的剥削。

Keith Humphreys: And I notice a lot of young women now, like undergraduates I talk to, re-evaluating that, like looking at their mom's experience, and saying, "I don't think I want to do that." And I'm really encouraged by that.

基思·汉弗莱斯：我注意到现在有很多年轻女性，比如我交谈过的本科生，正在重新评估这一点，比如看看她们妈妈的经历，然后说，“我认为我不想这样做。”我对此感到非常鼓舞。

Not that I want to control the decisions we make, but I don't want them making them just because the industry slickly marketed to them, because the industry's sole interest is always going to be to generate profit, and you do that with addiction because, you know, something like what, 10% of our country drinks about half the alcohol.

并不是说我想控制我们做出的决定，而是我不希望他们仅仅因为这个行业巧妙地向他们推销而做出这些决定，因为这个行业的唯一利益永远是产生利润，而你这样做是上瘾的，因为，你知道，我们国家 10% 的人喝了大约一半的酒精。

So yeah, you're shocked, yeah.

所以是的，你很震惊，是的。

Andrew Huberman: 10% of the country drinks half the alcohol?

Andrew Huberman：全国 10% 的人喝了一半的酒？

Keith Humphreys: 10% of the country drinks half the alcohol.

Keith Humphreys：全国 10% 的人喝了一半的酒。

Right.

正确的。

United States.

美国。

So, if you're running the industry, you want that group to be as big as possible.

所以，如果你经营这个行业，你希望这个群体尽可能大。

You do not make money off people who have half a bottle of wine on special occasions.

你不会从在特殊场合喝半瓶酒的人那里赚钱。

You make your money on the people who drink the equivalent of multiple bottles of wine every single day.

你可以从那些每天喝多瓶酒的人身上赚钱。

Fundamentally, these industries, the more addiction there is, the better off they do financially.

从根本上来说，这些行业的成瘾程度越高，他们的经济状况就越好。

Andrew Huberman: Wow, there's a lot there.

Andrew Huberman：哇，有很多东西。

The statistics say that drinking is at an all-time low in the United States right now, at least the...

统计数据显示，目前美国的饮酒量处于历史最低水平，至少......

Keith Humphreys: Some statistics.

基思·汉弗莱斯：一些统计数据。

Yeah, yeah.

是啊是啊。

Andrew Huberman: Some statistics.

安德鲁·休伯曼：一些统计数据。

Keith Humphreys: Something seems to have changed, and this may have something to do with this new generation.

Keith Humphreys：似乎有些事情发生了变化，这可能与新一代有关。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: I mean, there's less risk behavior in lots of things over the last 10 years.

Keith Humphreys：我的意思是，过去十年来，很多事情上的风险行为都减少了。

So, cutting class, less chance of dropping out of high school, fewer unwanted pregnancies, all that stuff.

所以，逃课、高中辍学的机会减少、意外怀孕的次数减少等等。

That generation will probably be a drier generation than their parents were.

那一代人可能会比他们的父辈更加干燥。

Andrew Huberman: Is cannabis use higher in that group?

Andrew Huberman：该群体的大麻使用率更高吗？

Everyone likes to just default to, "Well, cannabis is up, so alcohol is down," implying that you have to do something, that people have to be using some sort of mind-altering substance.

每个人都喜欢默认，“嗯，大麻上升了，所以酒精下降了”，这意味着你必须做点什么，人们必须使用某种改变思想的物质。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

With the legalization of cannabis, we certainly have seen a lot more use and a lot stronger products, but youth use really has only changed pretty slightly.

随着大麻的合法化，我们当然看到了更多的使用和更强大的产品，但青少年的使用实际上只发生了很小的变化。

Andrew Huberman: Mm.

安德鲁·休伯曼：嗯。

Keith Humphreys: So, the growth has really been among adults, including adults who probably stopped at some point, and have now gone back in later life to using cannabis.

基思·汉弗莱斯：所以，这种增长确实发生在成年人中，包括那些可能在某个时候停止使用大麻、现在又重新开始使用大麻的成年人。

Andrew Huberman: We'll get back to cannabis, but I want to parse the alcohol stats a bit more, also as it relates to women.

安德鲁·胡伯曼：我们将回到大麻，但我想更多地解析酒精统计数据，因为它与女性有关。

Maybe we can just either put to rest or not, this argument, that some amount of alcohol, typically it's red wine, is couched this way, is more beneficial for you than not drinking at all.

也许我们可以要么停止，要么停止这个论点，即一定量的酒精，通常是红酒，以这种方式表达，比完全不喝酒对你更有益。

Andrew Huberman: My read of the data, and we covered this in a long episode on alcohol a few years ago, was that zero is better than any, and that two per week, two drinks per week, and that's getting very specific about ounces for spirits versus two per week, it's sort of the upper limit for adult non-alcoholics that don't want to incur any additional health risk.

安德鲁·休伯曼：我读过的数据是，零比任何酒精都好，每周喝两杯，每周喝两杯，这对烈酒的盎司数和每周两杯的酒精含量非常具体，这对于不想承担任何额外健康风险的成年非酗酒者来说是上限。

The cancer risk is very clear.

癌症风险非常明确。

Andrew Huberman: The disruption to sleep, which probably cascades into other things, such as inflammation, et cetera.

Andrew Huberman：睡眠受到干扰，这可能会引发其他疾病，例如炎症等。

But is zero better than any?

但零比任何都好吗？

Is two safe for non-alcoholic adults?

对于不酗酒的成年人来说，两个安全吗？

Because every week, it seems I see a new article that says, "Zero is better than any." "No, wait.

因为我似乎每周都会看到一篇新文章说：“零比任何都好。” “不，等等。

It turns out there's some benefit from two drinks per week." And frankly, I'm not tired of it, but it's almost getting funny, the extent to which the traditional media, not to poke on them, but they just keep flip-flopping.

事实证明，每周喝两杯酒有一定的好处。”坦率地说，我并不厌倦它，但这几乎变得有趣了，传统媒体不去戳他们，但他们只是不断地反复无常。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: And then, the questions that always come up are, "Well, did the alcohol industry sort of encourage this study?" Because if we're honest, there's a lot of advertising of alcohol in traditional media outlets.

安德鲁·胡伯曼：然后，总是出现的问题是，“那么，酒精行业是否鼓励了这项研究？”因为老实说，传统媒体上有很多酒类广告。

Keith Humphreys: Oh, absolutely.

基思·汉弗莱斯：哦，当然。

So, a statement against interest, because I like red wine, I would love to believe it is healthy.

所以，反对利益的声明，因为我喜欢红酒，我很愿意相信它是健康的。

It's not.

它不是。

And the whole thing about red wine, per se, by the way, was, it never made any sense.

顺便说一句，关于红酒本身，它从来没有任何意义。

Why would there be a benefit to red wine that wasn't in other alcoholic beverages, right?

为什么红酒会有其他酒精饮料所没有的好处，对吧？

And it came from a 60 Minutes story, I think it was in the '90s.

它来自一个 60 分钟的故事，我想那是在 90 年代。

It was about why French people, why do Mediterraneans live so long?

这是关于为什么法国人、为什么地中海人那么长寿？

It's the red wine.

这是红酒。

And red wine sales exploded.

红酒销量呈爆炸式增长。

This is so great.

这太棒了。

Andrew Huberman: Resveratrol was an argument.

Andrew Huberman：白藜芦醇是一个争论。

Keith Humphreys: Yes, that's right.

基思·汉弗莱斯：是的，没错。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: There are such trace amounts that are just ludicrous, you know, in a grape skin.

Keith Humphreys：葡萄皮中含有如此微量的物质，你知道，这简直是可笑的。

And so, that was just spread, and it was just so great for the industry.

因此，这种想法就被传播开来，这对整个行业来说真是太棒了。

It's better for you than not drinking.

这对你来说比不喝酒更好。

And that's just not true.

但这不是真的。

They would look at studies and say, "Well, look, the non-drinking group have higher mortality than the low-drinking group." And they famously call it the J-shaped curve, sort of like that.

他们会查看研究并说：“嗯，看，不喝酒的人群比低度饮酒的人群死亡率更高。”他们将其称为“J 形曲线”，有点类似。

Keith Humphreys: The problem is, non-drinkers include people who are like in Alcoholics Anonymous.

基思·汉弗莱斯：问题是，不喝酒的人包括戒酒互诫协会中的人。

That's why they don't drink.

这就是他们不喝酒的原因。

They had a wretched experience with alcohol.

他们在酗酒方面有过一段悲惨的经历。

And so, they've had different kinds of damage to their bodies, maybe their health isn't as good, and they're not going to live as long.

所以，他们的身体受到了不同程度的伤害，也许他们的健康状况不太好，他们的寿命也不会那么长。

But it's not that they would be better off if they went back to drinking.

但这并不是说如果他们重新喝酒就会过得更好。

Things would go to hell, basically, for them.

对他们来说，事情基本上会变得一团糟。

And that just got marketed and spread, and it's not true.

这只是营销和传播，但事实并非如此。

There might be some cardiac benefit, okay?

可能对心脏有一些好处，好吗？

Keith Humphreys: But we don't get to live our lives as single organs.

Keith Humphreys：但是我们不能作为单个器官来生活。

We have a whole body.

我们有一个完整的身体。

You have to weigh that, if that is true, and it is wobbly, but if that's true, it's smaller than the cancer risk.

你必须权衡这一点，如果这是真的，它是不稳定的，但如果这是真的，它比癌症风险要小。

So, your net is you're not going to get any mortality gain or mortality reduction from drinking alcohol.

所以，你的净结果是你不会因为饮酒而增加或降低任何死亡率。

Keith Humphreys: If you have two drinks a week, and by a drink I mean like a 12-ounce beer, a one-ounce shot, or a glass of wine, a four-ounce glass of wine, you have a slightly higher risk, but it is very, very, very small, and it's not the kind of thing...

Keith Humphreys：如果你每周喝两杯酒，我所说的一杯酒是指喝一杯 12 盎司的啤酒、一杯一盎司的烈酒，或者一杯葡萄酒、一杯四盎司的葡萄酒，那么你的风险会稍高一些，但风险非常非常非常小，而且不是那种事情……

If I were giving health advice to the country, that would not be on my top 10 things to be really frightened about.

如果我要向国家提供健康建议，那么这不会成为我真正害怕的十大事情之一。

I think it's very small.

我认为它很小。

It's just not good for you.

这对你来说只是不好。

That's what science has overturned, the industry message that this will extend your life, and you'll be more healthy if you drink than if you don't.

这就是科学所推翻的，行业的信息是，喝酒会延长你的寿命，而且喝酒会比不喝酒更健康。

There's no way we can establish that as being true.

我们无法证明这是真的。

Andrew Huberman: You said it very clearly, but I'm going to just repeat it because I think it's super important for people to take note that the cardiac benefit is less than the cancer risk.

安德鲁·休伯曼：你说得很清楚，但我只想重复一遍，因为我认为人们注意到心脏益处小于癌症风险非常重要。

And I think that's a very important way to view these stats.

我认为这是查看这些统计数据的非常重要的方式。

The episode that we did about alcohol had a lot of different responses.

我们制作的关于酒精的剧集有很多不同的反应。

There's obviously a selection bias in the responses.

答案中显然存在选择偏差。

Many people gave up drinking, who I later learned wanted to quit drinking.

许多人戒酒了，我后来了解到他们也想戒酒。

They didn't like it.

他们不喜欢它。

Andrew Huberman: The downstream effects of the disruption to sleep from alcohol and so on are probably part of the effect.

Andrew Huberman：酒精等对睡眠造成的下游影响可能是其中的一部分。

It was very interesting as it relates to women, because many people, including some members of my family, really like their post-work glass of wine or want to drink to just kind of mark an end to the day and relax.

这对于女性来说非常有趣，因为很多人，包括我的一些家庭成员，都非常喜欢下班后喝一杯葡萄酒，或者想喝一杯来结束一天并放松一下。

Andrew Huberman: My observation was that many women who stopped drinking, either because of that discussion about alcohol or others that they had heard, did so when they learned that women have a particular risk of cancer as it relates to alcohol, meaning if the breast cancer risk and other hormone...

安德鲁·胡伯曼（Andrew Huberman）：我的观察是，许多女性戒酒，要么是因为有关酒精的讨论，要么是因为她们听到的其他内容，当她们得知女性患癌症的特定风险与酒精有关时，这意味着如果乳腺癌风险和其他激素……

Keith Humphreys: Ovarian cancer.

基思·汉弗莱斯：卵巢癌。

Andrew Huberman: And ovarian...

安德鲁·休伯曼：还有卵巢……

Hormone-related cancers, and so forth.

与激素相关的癌症等等。

Not always hormone-related.

并不总是与激素有关。

But the moment that the...

但就在那一刻...

It's probably best to avoid alcohol entirely; the conversation moved into women-specific health.

最好完全避免饮酒。话题转向了女性健康问题。

It had a very potent impact, which is interesting in its own, right?

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: And it speaks to what's perhaps required to override some of the marketing because, let's be fair, it's nice to relax with friends, and if people think relaxing with friends is easier to do over a glass of wine or two, then that's a great, not just marketing scheme, it's also somewhat true for them until there's counter evidence.

安德鲁·胡伯曼：这说明了可能需要什么来推翻某些营销，因为，公平地说，与朋友一起放松是件好事，如果人们认为喝一两杯酒与朋友一起放松更容易，那么这是一个很棒的，不仅仅是营销方案，对他们来说也是如此，直到有反证。

And so, what I'm really getting at here is, how is it that people should frame what they know to be risky versus the other benefits of alcohol that clearly exist?

所以，我真正想说的是，人们应该如何看待他们所知道的有风险的东西与酒精明显存在的其他好处之间的关系？

Andrew Huberman: Like, it helps people relax, it's social, they stress less, and so on and so forth.

Andrew Huberman：比如，它可以帮助人们放松，它具有社交性，可以减轻他们的压力，等等。

Keith Humphreys: Mm.

基思·汉弗莱斯：嗯。

Keith Humphreys: Mm.

基思·汉弗莱斯：嗯。

Keith Humphreys: As I mentioned, I'm someone who drinks wine, and I know that, on average, it's not healthy.

Keith Humphreys：正如我所提到的，我是一个喝酒的人，我知道，平均而言，这并不健康。

Why do I do that?

我为什么要这么做？

It's like, well, because it creates other things, particularly with exactly that situation, that getting together with friends is enjoyable, enriching.

Good food is enriching.

Good food and good wine tastes good.

好的食物和好酒的味道都很好。

Keith Humphreys: And I value those things, and there are many other decisions we make like that where we endure some risk because we care about something else.

Keith Humphreys：我很重视这些事情，我们还会做出许多其他类似的决定，因为我们关心其他事情，所以我们要承受一些风险。

It's dangerous for someone my age to hike up a mountainside, probably.

But if the view is spectacular, I say, "Oh, I'm going to accept that risk, and maybe I'm more prone to twist my ankle or something, but this is just really beautiful." That's okay.

But if the view is spectacular, I say, "Oh, I'm going to accept that risk, and maybe I'm more prone to twist my ankle or something, but this is just really beautiful."没关系。

Keith Humphreys: I think what the place we got in alcohol that was bad was needing an explanation to stop.

So, how often have you ever said to someone at a party or seen someone say at a party, "Why are you drinking?" I've never heard that, but I've certainly heard a million times, "Why aren't you drinking?"

Andrew Huberman: If you don't drink at parties or you refuse an offer of alcohol, people think there's something wrong with you.

Andrew Huberman：如果你在聚会上不喝酒或者拒绝喝酒，人们就会认为你有问题。

Keith Humphreys: Yeah, and you have to have an explanation, like, "Well, I got an exam tomorrow morning," or, "I've got a cold," or something.

基思·汉弗莱斯：是的，你必须有一个解释，比如，“嗯，我明天早上要考试”，或者“我感冒了”之类的。

It's like, you shouldn't need an explanation.

就像，你不需要解释。

But people do feel that social pressure, and so that's one way health information can work.

但人们确实感受到了社会压力，因此这是健康信息发挥作用的一种方式。

Why didn't the person just quit beforehand?

为什么这个人不提前退出？

Keith Humphreys: Because they may not have had an explanation that worked in their circle, and now you could say, "Well, I see those data on ovarian cancer, and I just decided to quit drinking." And health is a reason people still accept, I think, as legitimate for changing behavior.

You can make that because cancer is scary, and that may be why people quit.

Same thing happened when the first Surgeon General's smoking thing came out.

Keith Humphreys: Everybody smoked.

基思·汉弗莱斯：每个人都抽烟。

To sort of fit in at work, you had to smoke, and when that came out, there were a lot of people who just quit immediately.

They clearly were capable of quitting, wanted to quit, but they needed some expert to tell everybody, "Why are you not smoking anymore?

Why don't you carry cigarettes anymore?

你为什么不再带烟了？

I can't bum one off you anymore." It's like, "That's why."

我不能再欺负你了。”就像是“这就是原因”。

Andrew Huberman: Why do you think people who drink feel uncomfortable about people not drinking around them?

When people would ask me if I wanted to drink, and I'd say, "No," and they'd say, "Why?" They often say that.

When people would ask me if I wanted to drink, and I'd say, "No," and they'd say, "Why?"他们经常这么说。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: I would say the truth, which is, "I'll say anything that's on my mind without drinking."

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: "You don't want me to drink, because then I'll tell you everything that's on my mind."

安德鲁·休伯曼：“你不想让我喝酒，因为那样我就会告诉你我想到的一切。”

Keith Humphreys: Oh, that's good.

基思·汉弗莱斯：哦，那很好。

Andrew Huberman: It's true.

安德鲁·休伯曼：确实如此。

I mean, I will tell people what I'm thinking.

我的意思是，我会告诉人们我的想法。

I don't need to loosen up.

我不需要放松

I'm pretty relaxed in social settings.

我在社交场合非常放松。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: I don't have much social anxiety, but I realize some people might have trouble with social anxiety.

安德鲁·休伯曼：我没有太多社交焦虑，但我意识到有些人可能有社交焦虑。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Yeah.

是的。

I spent a little time in Japan when I was a young man, and there's this culture of going out after work, like the salary man going to work, and someone getting really, really drunk, and everyone's drinking, and you're vulnerable with each other.

It's like a trust exercise, like that falling backwards thing, except it is that we're all drunk.

这就像一种信任练习，就像向后摔倒一样，只不过我们都喝醉了。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And if someone weren't doing it, it's like, "Why are you not undergoing any...

基思·汉弗莱斯：如果有人不这样做，就像是，“为什么你不经历任何......

So we're all going to be vulnerable, and you're not?"

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: "Are you going to exploit us in some way?

基思·汉弗莱斯：“你会以某种方式剥削我们吗？

Or I'm going to say, 'I think I hate the boss,' and then you're going to repeat that at work, because you're the one person sober enough to remember I said that?" I think that is a real thing that people have anxiety about.

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: Or I can imagine, say, what if a man and woman are on a date, and the guy keeps giving drinks to the woman and doesn't drink himself?

What is the natural thing to think?

自然的想法是什么？

"Are you trying to get me drunk?

“你是想把我灌醉吗？

Are you going to take advantage of me because you're going to be with it, and I'm not, because I'm going to be drunk?"

你会利用我，因为你会和它在一起，而我不会，因为我会喝醉吗？”

Keith Humphreys: So those kinds of fears may be in the soup.

基思·汉弗莱斯：所以这些恐惧可能就在汤里。

Maybe that's rational at some level, but I don't think that should drive our sort of routine social interaction with our friends.

也许这在某种程度上是合理的，但我认为这不应该推动我们与朋友的日常社交互动。

It should just be a non-issue of, "What do you want?"

这不应该是一个“你想要什么？”的问题。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And if he goes, "I want sparkling water," I just give you a glass of sparkling water, and don't say, "Why aren't you drinking this intoxicating beverage?" You shouldn't need to explain it to me.

Keith Humphreys: And if he goes, "I want sparkling water," I just give you a glass of sparkling water, and don't say, "Why aren't you drinking this intoxicating beverage?"你不需要向我解释。

Andrew Huberman: The trust piece is super interesting, so is the vulnerability piece.

A couple of thoughts about this, and they're just editorial thoughts, so forgive me.

对此有一些想法，它们只是编辑的想法，所以请原谅我。

But one is for years, I thought how crazy it was, I would go to these meetings with doctors and scientists who ostensibly were working on issues related to health, and everyone would just get trashed at the bar.

And I wasn't into that, and I wasn't judgmental.

我不喜欢这个，我也不评判。

I actually kind of liked it, because by the third day of the meeting, I'm cranking, and I can tell they're all just bleary, and they're also aging much faster than I am.

They would get "the tenured look" as we would call it, or as I would call it.

他们将获得我们所说的“终身外观”，或者我所说的。

Keith Humphreys: Uh-huh.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: And you see them in five years, I'm like, "What happened to you?

安德鲁·休伯曼：五年后你会看到他们，我会想，“你怎么了？

You aged 15 years." And these people tended to drink a lot, both at meetings and outside meetings.

你已经15岁了。”这些人往往会喝很多酒，无论是在会议上还是在会议外。

Alcohol was paid for, often, by the meeting fees.

酒水费用通常是通过会议费用来支付的。

I'm not trying to point a finger here.

我并不是想在这里指责。

And then a lot of the stuff that happened at meetings that turned out cost people jobs was always alcohol related.

会议上发生的很多导致人们失业的事情总是与酒精有关。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: In the instance of the man and woman on a date drinking or a group of people at work drinking together, in Japan, it sounded like it was men getting drunk with other men.

Keith Humphreys: It's men, yes.

Keith Humphreys：是的，是男人。

Andrew Huberman: In my mental picture of the male-female dynamic in drinking, I'm going to simplify this: if she drinks, it makes her vulnerable.

If he drinks, it makes him more stupid and impulsive.

如果他喝酒，就会让他变得更加愚蠢和冲动。

Keith Humphreys: Mm-hmm.

Andrew Huberman: And so, in the world where she's drinking, and he's not, you gave the example that perhaps he would take advantage of her.

安德鲁·休伯曼：所以，在她喝酒而他不喝酒的世界里，你举的例子也许他会利用她。

If he's encouraging it, certainly there's that picture in one's mind.

如果他鼓励这样做，人们的脑海中肯定会浮现出这样的画面。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: He also can get her home safely.

安德鲁·休伯曼：他也可以让她安全回家。

If he's drinking, he can't get her home safely, and he might say or do something really dumb.

如果他喝了酒，他就无法让她安全回家，他可能会说或做一些非常愚蠢的事情。

So I feel like no matter how the math is arranged, drinking ends up being kind of a bad idea.

所以我觉得无论数学如何安排，喝酒最终都是一个坏主意。

I mean, not trying to be judgmental here, because I don't judge what people do.

我的意思是，我不想在这里做出评判，因为我不会评判人们的行为。

Do as you wish, but know what you're doing is my philosophy.

做你想做的事，但知道你在做什么是我的哲学。

But I just don't see a world where drinking with your coworkers or drinking on a date with somebody that you don't know very well, male or female, right?

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: For either of them, it's just like a lack of safety all around.

安德鲁·休伯曼：对于他们中的任何一个人来说，这就像周围缺乏安全感。

It just seems like a bad idea.

这似乎是一个坏主意。

Keith Humphreys: As women move into more professions, that may have changed that norm of everybody goes out and gets drunk, because the consequences aren't the same.

And I know a lot of professional women friends that say, "I don't want to do that."

我知道很多职业女性朋友都会说：“我不想那样做。”

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: "I don't want to be around the boss when he's drunk.

基思·汉弗莱斯：“我不想在老板喝醉的时候和他在一起。

And so let's have a Christmas lunch together at work instead of drinks afterwards." So I definitely see that.

因此，让我们在工作时一起吃圣诞午餐，而不是之后喝酒。”所以我确实看到了这一点。

I think in the dating, now of course, I haven't thankfully had to worry about dating for 40 years, but what I think most people would say is just the anxiety is intense for some people, and alcohol is anxiolytic, right?

Keith Humphreys: And so it's probably that that people are sort of feeling.

Keith Humphreys：所以人们可能有这样的感觉。

They're too nervous.

他们太紧张了。

And whether they should or they shouldn't, that's just, I think, probably in the soup, one of those benefits people care about.

我认为，无论他们应该还是不应该，这可能只是人们关心的好处之一。

And there are people, it has to be said, who are more socially engaging when they've had a drink than when they haven't, because they're kind of wound-up people.

不得不说，有些人喝了酒后比没喝过酒时更愿意参与社交活动，因为他们是那种情绪激动的人。

When they relax, some other stuff comes out, and they may seem more appealing.

当他们放松时，一些其他的东西就会出现，它们可能看起来更有吸引力。

Andrew Huberman: It's interesting.

安德鲁·休伯曼：这很有趣。

We could dissect it a number of ways, but I think that's enough contour for people to be able to think about whether or not they have a genetic predisposition, understand that zero is better than any.

我们可以通过多种方式对其进行剖析，但我认为这足以让人们思考他们是否有遗传倾向，了解零比任何都好。

If we hear about some cardiac benefit, to weigh that against the cancer risk and not just take it as an independent piece of information, and then to think about vulnerabilities of other people's actions and vulnerabilities of one's own actions and words if drinking.

如果我们听说某些对心脏有益的信息，请权衡其与癌症风险，而不仅仅是将其视为独立的信息，然后考虑其他人行为的脆弱性以及饮酒时自己行为和言语的脆弱性。

And then people can make an informed decision.

然后人们就可以做出明智的决定。

That's kind of how I feel about it.

这就是我的感受。

Keith Humphreys: A good summary.

基思·汉弗莱斯：很好的总结。

Andrew Huberman: Again, do as you wish, but know what you're doing is the purpose here.

Andrew Huberman：再说一遍，按照你的意愿去做，但要知道你正在做的事情才是目的。

Let's talk about cannabis a bit, because eventually I'd like to weave back to how industries impact use and abuse.

让我们稍微谈谈大麻，因为最终我想回到工业如何影响使用和滥用。

Cannabis, when I was growing up, was illegal.

在我成长的过程中，大麻是非法的。

You'd go to jail for it.

你会因此入狱。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: People still smoked pot.

安德鲁·休伯曼：人们仍然吸大麻。

It happened.

它发生了。

The idea was that it was much less potent.

我们的想法是它的效力要小得多。

We can talk about that.

我们可以谈谈这个。

But now it's a whole industry.

但现在它是一个完整的行业。

Keith Humphreys: Yes.

基思·汉弗莱斯：是的。

Andrew Huberman: And the edible industry has contributed to this greatly, because it bypasses the blowing of smoke, the smell, and a number of other things.

安德鲁·胡伯曼：食品工业对此做出了巨大贡献，因为它绕过了烟雾、气味和许多其他东西。

So, what are your thoughts about cannabis as something that can be used, quote-unquote, "recreationally," "medicinally," and its potential for abuse?

那么，您对大麻作为一种可以“娱乐”、“药用”及其滥用潜力的东西有何看法？

And then let's talk about how those things have been amplified or reduced by the fact that it's essentially legal or decriminalized.

然后我们来谈谈这些事情是如何因其本质上合法或非刑事化而被放大或减少的。

So, what are your thoughts on cannabis?

那么，您对大麻有何看法？

Keith Humphreys: Yeah, so whenever I talk about it, I make a distinction between sort of old and new cannabis.

Keith Humphreys：是的，所以每当我谈论它时，我都会区分新旧大麻。

So, if you go back to the '80s and '90s, when, as you mentioned, it was illegal everywhere, the THC content, that's the principal intoxicant, would be 3%, 4%, 5%, something like that on average.

所以，如果你回到 80 年代和 90 年代，正如你提到的，当时在任何地方都是非法的，THC 含量（主要的麻醉剂）平均为 3%、4%、5%，类似的水平。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And now studies of legal sales show the average product is about 20%.

Keith Humphreys：现在合法销售的研究表明，平均产品的税率约为 20%。

So that's dramatically stronger.

所以这要强得多。

The other point is how people use it is different, perhaps related to that high potency.

另一点是人们使用它的方式不同，也许与它的高效力有关。

Jonathan Caulkins pulled together a lot of really interesting data that got a lot of play, and it showed that about 40, I think it's 42% of people who use cannabis use it every day or almost every day.

乔纳森·考尔金斯 (Jonathan Caulkins) 收集了许多非常有趣的数据，这些数据得到了广泛关注，它表明大约 40，我认为使用大麻的人中有 42% 每天或几乎每天都使用大麻。

That is also different.

这也是不同的。

Keith Humphreys: If you go back in the past, the more modal user might have been once or twice a week.

Keith Humphreys：如果你回到过去，更模态的用户可能每周使用一两次。

So you put those things together, so you take somebody, what was like an '80s pot smoker.

所以你把这些东西放在一起，然后你就找了一个像 80 年代的烟民一样的人。

"Well, on weekends I'd smoke a joint at 5%." But now if it means every day I'm consuming 20%, you quickly realize their brain exposure is dramatically higher, about 65 times higher between the modes of those two experiences.

“嗯，周末我会抽 5% 的大麻烟。”但现在，如果这意味着我每天消耗 20%，你很快就会意识到他们的大脑暴露程度要高得多，在这两种体验模式之间大约高出 65 倍。

Keith Humphreys: So what does 65 times mean?

Keith Humphreys：那么 65 次是什么意思？

Well, it coincidentally is also the potency difference between a coca leaf and cocaine.

巧合的是，这也是古柯叶和可卡因之间的效力差异。

That is 65 times two.

也就是 65 乘以 2。

So it's a big difference.

所以这是一个很大的区别。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And as you know, dose makes the poison.

Keith Humphreys：如您所知，剂量决定毒药。

So, it is just a really different drug than what was back there.

所以，它与以前的药物完全不同。

And this is very hard to get across to parents, because their view is like, "Ah, I smoked weed.

这很难让父母理解，因为他们的观点是，“啊，我吸大麻。

Who cares if my 15-year-old is using it?" But that's kind of like saying you drank low alcohol beer and you're not concerned that your 15-year-old is guzzling vodka.

谁在乎我 15 岁的孩子是否在使用它？”但这有点像说你喝了低度啤酒，而你并不担心你 15 岁的孩子正在狂饮伏特加。

That's kind of the difference.

这就是区别。

Keith Humphreys: And it's just a bigger deal than it used to be.

Keith Humphreys：这比以前更重要。

Even when you take away the fact that you have an industry really pushing it, just the drug is stronger, more addictive.

即使你不考虑有一个行业在真正推动它这一事实，这种药物也会更强大、更容易上瘾。

Does it have any medical applications?

它有任何医学应用吗？

Almost surely.

几乎可以肯定。

The cannabinoid receptor system, evolutionarily, is one of the oldest in the history of Homo sapiens.

从进化的角度来看，大麻素受体系统是智人历史上最古老的系统之一。

It is both in the brain, but it's also in the body.

它既存在于大脑中，也存在于身体中。

There are clearly going to be some applications for pain.

显然会有一些针对疼痛的应用。

Keith Humphreys: Many people would say they spontaneously get relief.

Keith Humphreys：很多人会说他们自发地得到了缓解。

It's hard to tell always what that means because sometimes that's just relief from withdrawal.

很难说清楚这意味着什么，因为有时这只是戒断带来的解脱。

But probably some type of medical applications for pain will come out of this plant.

但这种植物可能会产生某种类型的止痛医学应用。

We do have some out of the CBD, which is the non-intoxicating part.

我们确实有一些来自 CBD 的部分，这是不致醉的部分。

There's a medication that is used in seizure disorders in kids.

有一种药物用于治疗儿童癫痫症。

So, there'll be some other things like that, for sure.

所以，肯定还会有其他类似的事情。

Keith Humphreys: It's easier to study this than it has ever been before.

Keith Humphreys：研究这个比以往任何时候都容易。

About 2020, Congress changed the way research works, so it's a lot simpler to do it.

2020 年左右，国会改变了研究的工作方式，因此研究变得更加简单。

So we'll figure those things out.

所以我们会解决这些问题。

But it is just a more dangerous drug than it was when I was a young person.

但这只是一种比我年轻时更危险的药物。

Andrew Huberman: Had a guest on the podcast who's a cannabis researcher, runs an animal lab, and we invited him on because I had released a solo episode about cannabis.

安德鲁·胡伯曼：播客上有一位嘉宾，他是一名大麻研究员，经营着一家动物实验室，我们邀请他参加，因为我发布了有关大麻的个人剧集。

We touched on some of the risks for psychosis in young men, and made some points about, frankly, concerns about cannabis because of the high THC content.

我们谈到了年轻男性患精神病的一些风险，并坦率地提出了一些关于大麻由于四氢大麻酚含量高而引起的担忧的观点。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: He was not happy with the things I said.

安德鲁·休伯曼：他对我说的话不满意。

He made that clear on social media.

他在社交媒体上明确表示了这一点。

So, by the way, this isn't the way to get invited on the podcast, but we invited him on.

顺便说一句，这不是获得播客邀请的方式，但我们邀请了他。

And I think we had a very fruitful discussion where he clarified a few things for me.

我认为我们进行了一次非常富有成果的讨论，他为我澄清了一些事情。

Keith Humphreys: Okay.

基思·汉弗莱斯：好的。

Andrew Huberman: And one of the things that he claims is that despite the higher THC content, that there's a distinct difference between smoked versus edible cannabis, whereby people who smoke cannabis, even the high THC cannabis, are very good at gauging the kind of level of high so that they don't go into paranoid modes.

Andrew Huberman：他声称的一件事是，尽管 THC 含量较高，但吸食大麻与食用大麻之间存在明显差异，吸食大麻的人，即使是高 THC 大麻，也非常善于衡量高 THC 水平，这样他们就不会进入偏执模式。

Andrew Huberman: They don't surpass the plane of high that would make them feel paranoid or put them into a psychotic episode.

安德鲁·休伯曼：他们没有超越让他们感到偏执或陷入精神病发作的高度。

But that people who take edibles, because it's harder to gauge where you're at, if you can just swallow an edible or even nibble on an edible, often surpass the level at which they would be comfortable, meaning at which there's a psychotic episode or there's paranoia.

但是那些吃食物的人，因为很难判断自己所处的位置，如果你可以吞下食物，甚至轻咬食物，通常会超过他们感到舒适的水平，这意味着出现精神病发作或偏执。

Andrew Huberman: So he was making this kind of soft argument for the fact that the elevated THC levels in cannabis are not such a problem because people are essentially taking less to offset the difference.

安德鲁·胡伯曼：所以他提出了这种温和的论点，因为大麻中的四氢大麻酚含量升高并不是一个问题，因为人们基本上用更少的剂量来抵消这种差异。

Keith Humphreys: Yeah, I think there's no evidence for that at all.

Keith Humphreys：是的，我认为根本没有证据证明这一点。

And people are surprisingly bad, even experienced pot smokers, at judging in lab studies of how strong different cannabis is.

令人惊讶的是，人们在实验室研究中判断不同大麻的强度有多差，即使是经验丰富的大麻吸食者也是如此。

I don't agree with that part, but I do agree we should think about the edibles differently because of the onset is different through the gut.

我不同意这一点，但我确实同意我们应该以不同的方式思考食物，因为通过肠道的发病方式是不同的。

So when you smoke anything, you get that, that goes very efficiently to the brain.

所以当你吸任何东西时，你就会明白，它会非常有效地进入大脑。

But when you eat something, it takes a while to have its effect.

但是当你吃东西的时候，需要一段时间才能看到效果。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And so, particularly when these products came out, and a lot of people were new to them, they would bite down on one piece of the whatever, the bar, the cookie, or whatever.

Keith Humphreys：所以，特别是当这些产品问世时，很多人对它们都是新的，他们会咬下一块任何东西，比如巧克力棒、饼干或其他什么东西。

Five minutes later, I feel the same.

五分钟后，我也有同样的感觉。

Take another bite, still feel the same.

再咬一口，感觉还是一样。

And then just eat the whole thing, and then it would all hit them like a train.

然后把整个东西吃掉，然后它就会像火车一样撞到他们。

And that does happen.

这确实发生了。

Keith Humphreys: The other thing that is true is that a lot of these products are not well-made or they're not up to the standards you would have for a cookie.

Keith Humphreys：另一件事是事实是，这些产品中有很多制作不好，或者达不到饼干的标准。

You would never open up a bag of chocolate chip cookies in the United States and find all the chocolate chips at one end and just dough in the rest, but that does happen with cannabis products in legal markets.

在美国，你永远不会打开一袋巧克力片饼干，发现一端是所有巧克力片，另一端只是面团，但合法市场上的大麻产品确实会发生这种情况。

And so, if you just bite on the wrong part, you're getting the whole enchilada, so to speak, because it's not evenly blended through.

所以，如果你咬错了部分，你就会得到整个辣酱玉米饼馅，可以这么说，因为它没有均匀地混合在一起。

And there are some people who've gotten into trouble on that as well.

有些人也因此陷入了麻烦。

Andrew Huberman: Interesting.

安德鲁·休伯曼：有趣。

What about the psychosis risk?

精神病风险怎么样？

Keith Humphreys: Yeah, so I was very skeptical of this literature for years.

Keith Humphreys：是的，多年来我一直对这些文献持怀疑态度。

Not to say that the science was bad, but just it seemed to me there'd be lots of ways to explain it.

并不是说科学不好，只是在我看来有很多方法可以解释它。

And I'm a lot less skeptical now, candidly, because in the old studies, they would be those who were men who had used cannabis in teen years, and then they would have higher rates of psychotic disorders in adulthood.

坦率地说，我现在不再那么怀疑了，因为在以前的研究中，他们是那些在青少年时期吸过大麻的男性，然后他们在成年后患精神病的几率会更高。

These were studies based on Swedish registries because everybody has to register for the military.

这些是基于瑞典登记的研究，因为每个人都必须登记参军。

Keith Humphreys: And they would track people, and it's quite amazing data.

Keith Humphreys：他们会跟踪人们，这是非常惊人的数据。

It is a whole national data.

这是整个国家的数据。

That's good.

那挺好的。

But there are lots of reasons that could come about.

但可能出现的原因有很多。

Could be a common factor between those two things.

可能是这两件事之间的共同因素。

But the evidence has gotten stronger as the drug has gotten stronger.

但随着药物的效果越来越强，证据也越来越强。

And again, we've got to realize people are using it much more intensely.

再次，我们必须意识到人们对它的使用更加频繁。

Keith Humphreys: So if this effect is there, it's much more plausible that it would be from a much stronger drug used every day, could generate higher rates of psychosis.

Keith Humphreys：因此，如果存在这种效应，那么更有可能的是，它来自每天使用的更强效药物，可能会产生更高的精神病发生率。

It's hard to test this because it's a rare, thankfully, condition.

测试这一点很困难，因为谢天谢地，这是一种罕见的情况。

But I think there is probably something there, I am sad to say.

但我很遗憾地说，我认为可能有一些东西。

I wish there weren't, but there probably is something there.

我希望没有，但那里可能有东西。

Keith Humphreys: I would not use cannabis if I had any first-degree relatives with any schizophrenia, schizoid personality, anything, bipolar disorder.

Keith Humphreys：如果我有任何一级亲属患有任何精神分裂症、分裂样人格、任何双向情感障碍，我就不会使用大麻。

I would not personally recommend that for anybody.

我个人不会向任何人推荐这个。

I think that's probably quite risky.

我认为这可能是相当危险的。

Andrew Huberman: And what about the cardiac risk and other health risks?

安德鲁·休伯曼：那么心脏病风险和其他健康风险呢？

I've heard recently that there's a direct risk of cannabis, even if it's not smoked or vaped, on cardiac health.

我最近听说大麻对心脏健康有直接风险，即使它不是吸食或吸电子烟的。

Keith Humphreys: I'm not sure of that, of non-smoked cannabis in the heart.

Keith Humphreys：我不确定心里是否有非吸食大麻。

I mean, I haven't looked at that literature, so I don't know the answer to that.

我的意思是，我没有看过那些文献，所以我不知道答案。

I realize there's one point I should touch on that you also raised earlier about first drinking, which is everything is different when the brain is plastic, and our brains are most highly plastic when we're young.

我意识到有一点我应该谈谈你之前也提到过关于第一次喝酒的问题，那就是当大脑具有可塑性时，一切都会不同，而我们年轻时的大脑可塑性最高。

Keith Humphreys: And so, a lot of these effects, the worst things are going to be because people start when they're in teen or late single digit.

Keith Humphreys：因此，很多影响，最糟糕的事情将是因为人们在青少年或晚期个位数时就开始了。

That's where addictions overwhelmingly start, and that is where, if there is a psychotic risk, it's almost surely then during that period of brain development before people get their first psychotic break, which tends to be around 18, 19, 20, 21.

这就是成瘾绝大多数开始的地方，如果存在精神病风险，几乎肯定是在大脑发育的那个时期，人们第一次精神病发作之前，通常是在 18、19、20、21 岁左右。

I'd worry about it less, for anything, initiating a substance when you're 50 is far less likely to end you up with an addiction or some other terrible thing than when you're young.

我不太担心这个问题，无论如何，在你 50 岁时开始使用某种物质，比年轻时更不可能导致你上瘾或发生其他可怕的事情。

Andrew Huberman: I'm sure everyone knows at least one person or has heard of one person who's very productive in their life, healthy family, job, et cetera, high energy, who uses cannabis.

Andrew Huberman：我确信每个人都至少认识一个人或听说过一个人，他在生活中非常富有成效，家庭健康，工作等等，精力充沛，他使用大麻。

In my observation, they are the rare exception.

根据我的观察，他们是罕见的例外。

And there are a lot of examples of people who use cannabis who don't really go anywhere in life.

有很多使用大麻的人在生活中并没有真正去任何地方的例子。

Andrew Huberman: They don't go through the normal developmental progression of finding a job that can sustain them, right?

安德鲁·休伯曼：他们没有经历寻找可以维持他们生活的工作的正常发展过程，对吧？

Of organizing their life, their relationship life, their professional life, and clearly, there are other aspects to life, but those are key ones, right?

组织他们的生活，他们的人际关系生活，他们的职业生活，显然，生活还有其他方面，但这些都是关键的，对吧？

And what are the data on high THC or just frequency of cannabis use as it relates to life progression?

高 THC 或大麻使用频率与生命进程相关的数据是什么？

"Failure to launch," we call it now, for typically it's guys, young men that fail to launch.

我们现在称之为“发射失败”，因为通常是男人、年轻人发射失败。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: And I want to be clear, not for political reasons, but I want to be clear, when I say fail to launch, I don't mean that every kid has to go to college and be a varsity athlete or any of this, but just moving out of one's home eventually, getting a regular job, keeping the job, hopefully having healthy relationships of various kinds, and being self-sustaining.

安德鲁·休伯曼：我想澄清，不是出于政治原因，但我想澄清的是，当我说失败时，我并不是说每个孩子都必须上大学并成为大学运动员或任何这样的人，而是最终要搬出家，找到一份固定的工作，保住这份工作，希望拥有各种健康的人际关系，并能够自给自足。

That's what I'm talking about.

这就是我要说的。

Keith Humphreys: Yeah, absolutely true.

基思·汉弗莱斯：是的，绝对正确。

I mean, for example, I did Ezra Klein's show.

我的意思是，例如，我参加了埃兹拉·克莱因 (Ezra Klein) 的演出。

He's obviously a very successful guy, and he mentioned that he sometimes uses cannabis edibles.

他显然是一个非常成功的人，他提到他有时会使用大麻食品。

Andrew Huberman: He has that look.

安德鲁·休伯曼：他就是那样的样子。

No, I'm just kidding.

不，我只是开玩笑。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: Sorry, Ezra.

安德鲁·休伯曼：抱歉，以斯拉。

Just teasing.

只是逗弄而已。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

There are very, very, very successful people who use cannabis, for sure.

当然，有非常、非常、非常成功的人使用大麻。

Overall, though, I mean, I'll steal a phrase from Jonathan Caulkins.

不过，总的来说，我的意思是，我会借鉴乔纳森·考尔金斯的一句话。

It's like, we have performance enhancement drugs.

就像，我们有性能增强药物。

It's kind of a performance-degrading drug.

这是一种降低表现的药物。

So it's not fentanyl.

所以它不是芬太尼。

Your odds of your death being directly traced to it are extraordinarily low.

你的死亡直接归因于它的可能性非常低。

Keith Humphreys: But it does, with regular use, undermine certain things that you need to succeed in the modern world, like short-term memory and concentration, and being able to keep track of details.

Keith Humphreys：但如果经常使用，它确实会破坏你在现代世界取得成功所需的某些东西，比如短期记忆和注意力，以及跟踪细节的能力。

And for some people also, it undermines their sort of motivation to do much of anything.

对于某些人来说，这也削弱了他们做任何事情的动力。

I mean, the couch lock is a real thing.

我的意思是，沙发锁是真的。

Keith Humphreys: I know families in Palo Alto, where I'm from, a very achievey place, who had a straight-A son doing everything, starring on a sports team, whatever, who, six months later, was just smoking cannabis all day and had no interest in the team he used to star on and the math he used to be great on.

基思·汉弗莱斯：我认识帕洛阿尔托的一些家庭，我来自那里，一个非常有成就的地方，他们有一个全优儿子，做所有事情，在一支运动队中担任主角，等等，六个月后，他只是整天吸大麻，对他曾经担任主角的球队和他曾经擅长的数学不感兴趣。

And that's pretty frightening.

这非常可怕。

Keith Humphreys: And all those things are not conducive to succeeding, again, in a modern world.

Keith Humphreys：所有这些事情都无助于在现代世界中取得成功。

If maybe back in an agrarian society, it didn't matter because everything was on muscle power, right?

如果回到农业社会，这并不重要，因为一切都依赖于体力，对吧？

But to succeed in this society, you have to be able to do those things.

但要想在这个社会取得成功，你必须能够做到这些事情。

And you are in competition.

而且你处于竞争之中。

If you want a job computer coding, you're in competition not just with the smartest kids in your neighborhood.

如果你想要一份计算机编码的工作，你面临的竞争不仅仅是你邻居中最聪明的孩子。

You're in competition with the smartest kids who are in Mumbai and in Tokyo.

您正在与孟买和东京最聪明的孩子竞争。

Keith Humphreys: And if you can't focus, or you're just slower, and you can't remember things, or you have trouble making sure you keep track of time, that is going to put you at a disadvantage.

Keith Humphreys：如果你无法集中注意力，或者你的速度变慢，并且你记不住事情，或者你无法确保自己掌握时间，那么这将使你处于不利地位。

And you can end up at that stereotype of living in mom's basement.

你最终可能会陷入住在妈妈地下室的刻板印象。

That, unfortunately, is true of a chunk of people who are heavy users of cannabis.

不幸的是，对于大量吸食大麻的人来说，情况确实如此。

Andrew Huberman: Yeah, I worry a lot about examples of so-and-so is very high achieving, and they use cannabis.

安德鲁·胡伯曼：是的，我很担心某某的成就非常高，而且他们使用大麻。

I had a friend growing up who desperately wanted to be a professional golf player, and he would cite all these professional golf players who were heavy drinkers.

我有一个成长过程中的朋友，他非常想成为一名职业高尔夫球手，他会列举所有这些酗酒的职业高尔夫球手。

He ended up just being good at the heavy drinking part, sadly.

遗憾的是，他最终只是擅长酗酒。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: I think he turned his life around at some point.

安德鲁·休伯曼：我认为他在某个时候改变了他的生活。

But these examples of people who can use very addictive substances and are open about that and are very high-achieving, I think, there's a real detriment to that messaging.

但我认为，这些例子表明人们可以使用非常容易上瘾的物质，并且对此持开放态度，并且取得了很高的成就，这对这种信息传递确实有害。

Now, of course, you don't want people to cloak their reality, but it's complicated.

当然，现在你不希望人们掩盖他们的现实，但这很复杂。

Keith Humphreys: Yeah, and it also has policy risks too.

Keith Humphreys：是的，而且也存在政策风险。

I mean, when you make up the rules, your laws and regulations, to think, "Well, I'm accomplished.

我的意思是，当你制定规则、法律和法规时，你会想：“好吧，我已经完成了。

I'm able to use this, so that must mean it's pretty safe." It's like that just doesn't follow logically.

我能够使用这个，所以这一定意味着它非常安全。”这似乎不符合逻辑。

The fact that you occasionally take a snort of cocaine or whatever, and you're still a state senator.

事实上，你偶尔会吸一点可卡因或其他什么东西，但你仍然是州参议员。

That doesn't prove that that would be safe for everyone.

这并不能证明这对每个人来说都是安全的。

Keith Humphreys: And we know people have different levels of risk.

Keith Humphreys：我们知道人们面临不同程度的风险。

They have different social capital.

他们有不同的社会资本。

They have different incentives in their lives.

他们的生活中有不同的动机。

And you can't overgeneralize from sort of a lucky life or a costed life.

你不能过度概括幸运的生活或付出代价的生活。

Sometimes you can do more of that than you can when there are not many nets sort of between the person and the ground.

有时，当人和地面之间没有太多的网时，你可以做更多的事情。

Andrew Huberman: By now, I'm sure that many of you have heard me say that I've been taking AG1 for more than a decade, and indeed, that's true.

Andrew Huberman：到目前为止，我相信你们很多人都听我说过我服用 AG1 已有十多年了，事实上，这是真的。

The reason I started taking AG1 way back in 2012, and the reason why I still continue to take it every single day, is because AG1 is, to my knowledge, the highest quality and most comprehensive of the foundational nutritional supplements on the market.

我早在 2012 年就开始服用 AG1，并且至今仍然每天服用，因为据我所知，AG1 是市场上质量最高、最全面的基础营养补充剂。

Andrew Huberman: What that means is that it contains not just vitamins and minerals, but also probiotics, prebiotics, and adaptogens to cover any gaps that you might have in your diet while also providing support for a demanding life.

Andrew Huberman：这意味着它不仅含有维生素和矿物质，还含有益生菌、益生元和适应原，可以弥补您饮食中可能存在的任何空白，同时也为高要求的生活提供支持。

Given the probiotics and prebiotics in AG1, it also helps support a healthy gut microbiome.

鉴于 AG1 中的益生菌和益生元，它还有助于支持健康的肠道微生物组。

The gut microbiome consists of trillions of little microorganisms that line your digestive tract and impact things such as your immune status, your metabolic health, your hormone health, and much more.

肠道微生物组由数万亿个小微生物组成，它们排列在您的消化道中，并影响您的免疫状态、代谢健康、激素健康等。

Andrew Huberman: Taking AG1 consistently helps my digestion, keeps my immune system strong, and it ensures that my mood and mental focus are always at their best.

Andrew Huberman：持续服用 AG1 有助于我的消化，保持我的免疫系统强大，并确保我的情绪和精神焦点始终处于最佳状态。

AG1 is now available in three new flavors: berry, citrus, and tropical.

AG1 现已推出三种新口味：浆果味、柑橘味和热带味。

And while I've always loved the AG1 original flavor, especially with a bit of lemon juice added, I'm really enjoying the new berry flavor in particular.

虽然我一直很喜欢 AG1 原味，尤其是添加了一点柠檬汁，但我真的特别喜欢新的浆果味。

It tastes great, but then again, I do love all the flavors.

味道很棒，但话又说回来，我确实喜欢所有的口味。

Andrew Huberman: If you'd like to try AG1 and try these new flavors, you can go to drinkag1.com/huberman to claim a special offer.

Andrew Huberman：如果您想尝试 AG1 并尝试这些新口味，您可以访问 Drinkag1.com/huberman 申请特别优惠。

Right now, AG1 is giving away six free sample packs of AGZ, which is AG1's new sleep formula, which, by the way, is fantastic.

现在，AG1 正在免费赠送六包 AGZ 样品包，这是 AG1 的新睡眠配方，顺便说一句，非常棒。

It's the only sleep supplement I take.

这是我唯一服用的睡眠补充剂。

It eliminates the need for all these pills, and my sleep has never been better.

它消除了对所有这些药物的需要，而且我的睡眠从未如此好过。

The special offer gives you six free samples of that AGZ, as well as three AG1 travel packs and a bottle of vitamin D3+K2 with your first subscription.

特别优惠为您提供 6 个 AGZ 的免费样品，以及 3 个 AG1 旅行包和一瓶维生素 D3+K2。

Just go to drinkag1.com/huberman to get started.

只需访问 Drinkag1.com/huberman 即可开始。

Andrew Huberman: I heard a wonderful talk that you participated in with one of the members of the Kennedy family.

安德鲁·休伯曼：我听到了您与肯尼迪家族的一位成员一起参加的一场精彩的演讲。

It wasn't Robert.

那不是罗伯特。

Keith Humphreys: Patrick?

基思·汉弗莱斯：帕特里克？

Andrew Huberman: Patrick Kennedy, excuse me, who's been very open about his own recovery.

安德鲁·休伯曼：帕特里克·肯尼迪，对不起，他对自己的康复情况非常开放。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: So many gems in that talk.

Andrew Huberman：那次演讲中有很多精彩内容。

We'll put a link to it, and we'll touch on some of those things again, but it's such an important conversation.

我们将放置一个链接，我们将再次讨论其中的一些内容，但这是一次非常重要的对话。

And it came up in that discussion that many industries are industries of addiction, alcohol, cannabis, gambling.

在那次讨论中，许多行业都是毒瘾、酒精、大麻、赌博的行业。

Nowadays, I was thinking about what you guys were talking about, and nowadays it's very difficult to look at any industry and not see it that way at some level.

如今，我正在思考你们在谈论的内容，现在很难在某种程度上不以这种方式看待任何行业。

Keith Humphreys: They talk about it themselves that way.

Keith Humphreys：他们自己就是这样谈论的。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: If you get together with app developers, they'll say, "How do we make this more addictive?" And it is good for business.

Keith Humphreys：如果你与应用程序开发人员聚在一起，他们会说，“我们如何让这个更容易上瘾？”这对商业有好处。

There is no customer like an addicted customer.

没有什么顾客比得上瘾的顾客了。

So, of course, that's going to be appealing if you're trying to sell something.

所以，当然，如果你想卖东西，这会很有吸引力。

Andrew Huberman: I guess the question is, healthy addictions or adaptive addictions, or things that fall outside the progressive narrowing of the things that bring you pleasure.

安德鲁·休伯曼：我想问题是，健康的成瘾或适应性成瘾，或者是那些不属于逐渐缩小给你带来快乐的事物范围的东西。

Because a kid getting, quote-unquote, "addicted" to a learning app, that carries over into a number of things, one hopes, in school or even social media.

因为一个孩子对学习应用程序“上瘾”了，人们希望这会影响到学校甚至社交媒体的很多事情。

Keith Humphreys: Oh, yeah.

基思·汉弗莱斯：哦，是的。

Yeah.

是的。

Andrew Huberman: I've learned a lot from YouTube videos.

Andrew Huberman：我从 YouTube 视频中学到了很多东西。

Heck, I even watched that YouTube video of you and Patrick on YouTube.

哎呀，我什至在 YouTube 上看过你和帕特里克的 YouTube 视频。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: So, there's this double-edged blade piece.

Andrew Huberman：所以，这是一个双刃刀片。

But when it comes to alcohol and cannabis, what you told us earlier, getting women to drink more by making it seem like an important part of being a woman in the United States, to drink, that sounds diabolical.

但是，当谈到酒精和大麻时，您之前告诉我们的，让女性喝更多的酒，让饮酒看起来像是美国女性的重要组成部分，这听起来很邪恶。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Yeah.

是的。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: Convincing people that cannabis is going to make them more creative, and it's not as bad as alcohol, that to me is very diabolical.

Andrew Huberman：让人们相信大麻会让他们更有创造力，而且它不像酒精那么糟糕，这对我来说是非常邪恶的。

And I worry about this, "Well, it's not as bad as alcohol," argument because, I mean, shooting yourself in the head is way worse than stabbing yourself in the head.

我担心这个“嗯，它不像酒精那么糟糕”的争论，因为我的意思是，朝自己的头部开枪比刺伤自己的头部更糟糕。

Keith Humphreys: Well, alcohol also kills about 150,000 Americans a year.

Keith Humphreys：嗯，酒精每年也会杀死大约 150,000 名美国人。

So if that's our bar, we should have hand grenades in the drugstore.

所以如果那是我们的酒吧，我们的药店里应该有手榴弹。

That would kill tens of thousands, but not 150,000.

这将导致数万人死亡，但不会导致 15 万人死亡。

We should legalize drunk driving because that only kills 10,000 people.

我们应该将酒后驾驶合法化，因为醉酒驾驶只会导致一万人死亡。

I mean, that's just a crazy thing to set as the, "Well, as long as it kills less than 150,000 people a year, it sounds great to me." No, that doesn't make any sense.

我的意思是，这真是一件疯狂的事情，“好吧，只要它每年杀死的人少于 150,000 人，对我来说这听起来很棒。”不，这没有任何意义。

Keith Humphreys: I mean, I'll be clear, economically, I am a capitalist.

基思·汉弗莱斯：我的意思是，我要明确的是，在经济上，我是一个资本家。

I'm glad we have companies.

我很高兴我们有公司。

I love living in Silicon Valley.

我喜欢住在硅谷。

I love all the things people create there, and I think that is an important part for society to work, to have a private sector.

我喜欢人们在那里创造的所有东西，我认为这是社会运转、拥有私营部门的重要组成部分。

Keith Humphreys: And at the same time, you have to regulate addictive goods, temptation goods, very intelligently and tightly, because you can't count on the sort of rational consumer to protect themselves like you can when you're dealing with cabbage or lettuce, which nobody ever overdoses on.

基思·汉弗莱斯：与此同时，你必须非常明智和严格地监管令人上瘾的商品、诱惑性的商品，因为你不能指望理性的消费者像处理卷心菜或生菜时那样保护自己，因为没有人过量食用卷心菜或生菜。

But we do see people burning down their lives over all these drugs.

但我们确实看到人们因这些药物而失去生命。

Keith Humphreys: And for that reason, to protect those people, but also to protect the rest of us from the consequences of that, that's why you need things like advertising restrictions.

基思·汉弗莱斯：出于这个原因，为了保护这些人，同时也为了保护我们其他人免受其后果的影响，这就是为什么你需要诸如广告限制之类的东西。

That's why taxes to which people are...

这就是为什么人们要缴税...

Even heavy users respond to price.

即使是重度用户也会对价格做出反应。

That's a really important tool to regulate them.

这是监管它们的一个非常重要的工具。

I would do much more with cannabis, particularly just some of the promotion is so naked, and a lot of it is in places where kids are exposed, particularly.

我会用大麻做更多的事情，特别是一些促销活动是如此赤裸裸，而且很多都是在孩子们接触的地方，特别是。

Keith Humphreys: And this has just been a long-term fight.

基思·汉弗莱斯：这是一场长期的斗争。

We had it with the tobacco industry.

我们与烟草业有过这样的经历。

Almost any nasty thing you could say about the tobacco industry turned out to be true.

几乎所有关于烟草业的坏话都被证明是真的。

I mean, they did work to make it more addictive.

我的意思是，他们确实努力让它更容易上瘾。

They worked to defeat any type of health regulation.

他们努力打破任何类型的健康监管。

They were marketing to kids, all that stuff.

他们向孩子们推销诸如此类的东西。

So, those are the economic incentives.

所以，这些就是经济激励。

And so, you should not be naive if you work in this space about what the financial incentives are if you're making an addictive product.

因此，如果您在这个领域工作，那么您不应该天真地了解如果您正在制作令人上瘾的产品，那么经济激励是什么。

Keith Humphreys: More addiction is good for your bottom line.

Keith Humphreys：更多的成瘾对你的利润有好处。

So us on the other side have to say, "All right, we're going to put in laws and regulations so that that is harder to achieve." Never going to get rid of all of it, but you can make it a lot, lot harder.

所以我们另一边必须说，“好吧，我们将制定法律和法规，这样就更难实现。”永远不可能摆脱所有这些，但你可以让它变得非常非常困难。

Gambling is a great example.

赌博就是一个很好的例子。

I mean, I'm just amazed that we have just given up on any restrictions on gambling now.

我的意思是，我很惊讶我们现在刚刚放弃了对赌博的任何限制。

When I was a kid, Pete Rose was not allowed to go into the Hall of Fame because he had once placed a bet on his own team.

当我还是个孩子的时候，皮特·罗斯不被允许进入名人堂，因为他曾经在自己的球队上下过赌注。

Keith Humphreys: He wasn't even doing anything corrupt, but he bet on his own team would win.

Keith Humphreys：他甚至没有做任何腐败的事情，但他打赌自己的球队会赢。

He was kept out of the Hall of Fame.

他被排除在名人堂之外。

Now you can't watch a sporting event without having gambling ads shoved in your face.

现在，您无法在观看体育赛事时看到赌博广告。

That's an example of something that should just not be the case.

这是一个不应该出现这种情况的例子。

That is terrible for anyone who's trying to quit gambling.

这对于任何试图戒赌的人来说都是可怕的。

It's terrible.

太可怕了。

A lot of young men, particularly, but not just young men, are just ruining themselves economically over sports gambling, and we don't need this.

很多年轻人，特别是但不仅仅是年轻人，因为体育赌博而在经济上毁掉了自己，我们不需要这样。

We can do without it.

没有它我们也能做。

Andrew Huberman: The gambling thing's a real concern.

Andrew Huberman：赌博问题确实令人担忧。

We had a guest on this podcast who's a self-admitted gambling addict, and a friend of mine who treats gambling addicts said it's among the worst of the addictions because they live with the reality, it's true, that the next time really could change it all.

我们的播客中有一位嘉宾，他自认是一名赌博成瘾者，而我的一位治疗赌博成瘾者的朋友说，这是最严重的成瘾行为之一，因为他们生活在现实中，这是真的，下一次真的可以改变这一切。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: And he said, eventually, they get addicted to the shame of losing.

安德鲁·休伯曼：他说，最终，他们会沉迷于失败的耻辱。

Winning becomes a thing of the distant past.

胜利已成为遥远的过去。

I mean, this sounds crazy to the rest of us, but it's fascinating and disturbing.

我的意思是，这对我们其他人来说听起来很疯狂，但它既令人着迷又令人不安。

Keith Humphreys: It's fascinating.

基思·汉弗莱斯：这很有趣。

Andrew Huberman: And gambling addicts will say that every addiction is gambling.

安德鲁·休伯曼：赌博成瘾者会说每一种成瘾都是赌博。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: That's good.

基思·汉弗莱斯：那很好。

There's a tremendous book, "Addiction by Design," and I'm afraid I'm going to mispronounce the name of the person who wrote it.

有一本很棒的书，《设计上瘾》，我担心我会念错这本书的作者的名字。

I think it's Schüll, but I'm not sure, but I know the title, "Addiction by Design," about gambling, and she profiles people who play video poker, many of whom work in the casino.

我认为是舒尔，但我不确定，但我知道标题“设计上瘾”，是关于赌博的，她介绍了玩视频扑克的人，其中许多人在赌场工作。

They basically get paid, and then they go pay the casino back by giving it away.

他们基本上得到报酬，然后他们通过赠送钱来偿还赌场。

But some of them will take a toothpick and bend it and force the bet button down, and they won't even touch it.

但有些人会拿一根牙签，将其弯曲，然后用力按下投注按钮，但他们甚至不会碰它。

Keith Humphreys: They'll just sit there and watch in kind of a dissociative state as it just runs and runs and runs until their money is gone.

Keith Humphreys：他们会坐在那里，以一种游离的状态看着它一直跑啊跑啊，直到他们的钱花光为止。

It's really like zombification of this stuff.

这真的就像这些东西的僵尸化。

And that tech has been perfected to be addictive.

而且这项技术已经非常完善，让人上瘾。

I do go to Las Vegas once every couple years.

我每隔几年就会去一次拉斯维加斯。

Not for gambling, but I just enjoy the sort of pageantry, and the food and all that.

不是为了赌博，但我只是喜欢那种盛大的场面、食物等等。

It's very hard to see dealers at tables anymore because dealers don't give the perfect timing of reinforcement that machines can do.

很难再在牌桌上看到荷官了，因为荷官无法给出机器可以做到的完美强化时机。

Keith Humphreys: And you have to wait for your reward and all that kind of thing, and you wait till you find out, and there's a social component.

基思·汉弗莱斯：你必须等待你的奖励和所有类似的事情，直到你发现，这其中有一个社交成分。

Well, that all slows down the process, whereas a machine can give you exact timing between your press the button, and then you get your reward or your win or your loss.

好吧，这一切都会减慢整个过程，而机器可以为您提供按下按钮之间的准确时间，然后您获得奖励或获胜或失败。

And it can just go infinitely 24 hours a day, unlike a dealer, never gets tired.

而且它可以一天24小时无限运转，不像经销商，永远不会疲倦。

And so, all the casinos, like chopped up dealers' tables, and now you're just playing with a machine.

所以，所有的赌场，就像切碎的荷官桌子，现在你只是在玩机器。

Andrew Huberman: Incredible.

安德鲁·休伯曼：难以置信。

I don't want to spill off into too many anecdotes on my side, but I will share something that was shared by a previous guest on the podcast you may find interesting.

我不想透露太多我这边的轶事，但我会分享一些你可能会觉得有趣的播客上前一位嘉宾分享的东西。

Michael Easter is at a university out in Las Vegas, and he got access to one of these...

迈克尔·伊斯特 (Michael Easter) 在拉斯维加斯的一所大学就读，他获得了其中一个机会……

He wrote "The Comfort Crisis" about getting outdoors, getting away from things, and basically carrying a weight on your back and walking as a therapy of sorts.

他写的《舒适危机》是关于到户外、远离事物、基本上把负重和步行作为一种治疗。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Keith Humphreys: Uh-huh.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: An important one to do regularly.

Andrew Huberman：定期做的一项重要工作。

But he got access to one of these research casinos, and it turns out that slot machines used to be a small fraction of the income of casinos.

但他进入了其中一个研究赌场，结果发现老虎机曾经只占赌场收入的一小部分。

Keith Humphreys: That's right.

基思·汉弗莱斯：没错。

Andrew Huberman: Now, it's 80% or more.

Andrew Huberman：现在，已经达到 80% 或更多。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: And he said that that came about because a father who worked for the casino industry was at home watching his kids play video games, and he realized that the kids weren't playing to win.

安德鲁·胡伯曼：他说这是因为一位在赌场工作的父亲在家看着他的孩子们玩电子游戏，他意识到孩子们玩游戏并不是为了赢。

They were playing for the novelty of what was on the next screen.

他们正在为下一个屏幕上的新奇内容而玩。

And the kids didn't realize this, but it became clear to him.

孩子们没有意识到这一点，但他却很清楚。

So now, and I think this will help people.

所以现在，我认为这会对人们有所帮助。

This is why I'm taking the time to share this once again.

这就是为什么我花时间再次分享这一点。

Now, if you play a slot machine, you think you're trying to win.

现在，如果您玩老虎机，您会认为自己正在努力获胜。

Andrew Huberman: Hear the ching, ching, ching, ching, ching, and the bells go off, and you won.

安德鲁·休伯曼：听到“叮、叮、叮、叮、叮”的声音，铃声响起，你就赢了。

You think that's the dopamine reward.

你认为这就是多巴胺奖励。

But they've figured out that unlike the old rotor machines, where you have some cherries and bells and stuff, in the electronic landscape, you could have an infinite amount of novelty through novel combinations.

但他们发现，与旧的转子机器不同，在电子领域，你可以通过新颖的组合获得无限的新奇感。

So now, they figured out that people will play to win 50 cents on the dollar, so they lost 50 cents, right?

所以现在，他们发现人们会以 1 美元赢得 50 美分，所以他们损失了 50 美分，对吗？

Andrew Huberman: And they know that rationally, or they could know that rationally, but they'll continue to play until it's all gone, as long as you give them novelty.

安德鲁·休伯曼：他们理性地知道这一点，或者他们可以理性地知道这一点，但只要你给他们新奇的东西，他们就会继续玩，直到一切都消失。

So people aren't even really playing for the money anymore.

所以人们不再真正为了钱而玩游戏了。

They think they are.

他们认为他们是。

They're actually just being stimulated with enough novel combinations that their bank account gets drained.

事实上，他们只是受到了足够多的新奇组合的刺激，以至于他们的银行账户被耗尽。

The house takes it all.

房子承担了一切。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Yeah.

是的。

Andrew Huberman: When I heard that, it changed my view of gambling.

Andrew Huberman：当我听到这个消息时，它改变了我对赌博的看法。

Because I always thought it was about winning money and leaving.

因为我一直以为就是赢了钱就走。

It's actually more about playing, and it's more about the novelty that's introduced in each, quote-unquote, "hand or spin."

实际上，它更多的是关于游戏，更多的是关于每一个“手或旋转”中引入的新颖性。

Andrew Huberman: And I think knowing that carries over certainly to sports, and the excitement that you're feeling about the potential that you could win, but that it's a novel combination of things, might prevent, hopefully, somebody from becoming a gambling addict or might help people realize that what they're addicted to, if not already shame, might actually just be the novelty, and that's why they're losing all their money.

安德鲁·胡伯曼：我认为知道这一点肯定会延续到体育运动中，以及你对自己可能获胜的潜力感到兴奋，但这是一种新颖的组合，可能会希望防止某人成为赌博成瘾者，或者可能帮助人们意识到他们沉迷的东西，如果不是已经羞耻的话，实际上可能只是新奇的东西，这就是他们输掉所有钱的原因。

Keith Humphreys: Yeah, there's an industry term for that.

Keith Humphreys：是的，有一个行业术语。

It's LDWs: Losses Disguised as Wins.

这就是 LDW：伪装成胜利的损失。

So, you put in a dollar, and you get 100 credits, and then you pull the thing, and it does its thing, and then it goes like, da, da, da, da, da.

所以，你投入一美元，你会得到 100 个积分，然后你拉动这个东西，它就会做它的事情，然后它就像，da，da，da，da，da。

You've matched this way.

你已经这样匹配了。

You've won 10.

你已经赢了10个了

And it goes off, and you've matched that way, 20.

然后它就响了，你就这样匹配了，20。

Oh my God, I've won again.

天哪，我又赢了。

40.

I've won 40, 20, and 10 with all these exciting things.

我凭借所有这些令人兴奋的事情赢得了 40 场、20 场和 10 场比赛。

I just lost 30% of what I put in.

我刚刚损失了 30% 的投入。

But it feels like a win.

但感觉像是一场胜利。

And they realized, as you say, people will keep playing even while objectively they're just pouring money down a sewer.

他们意识到，正如你所说，人们会继续玩游戏，即使客观上他们只是把钱倒进下水道。

Andrew Huberman: So glad I'm not addicted to gambling.

Andrew Huberman：很高兴我没有沉迷于赌博。

But I could see how I could be.

但我知道我会怎样。

Even though I would like to say I couldn't be, I could see how I could be, because the brain is just so prone to these kinds of things.

尽管我想说我不可能，但我可以看到我怎么可能，因为大脑很容易发生这些事情。

We all have these circuits.

我们都有这些电路。

Keith Humphreys: Absolutely.

基思·汉弗莱斯：当然。

And it's interesting, to...

有趣的是，...

Casinos are one of the few places where you can still smoke indoors, and you get free drinks, and so it's really an absolute dense pack of addictions.

赌场是少数几个你仍然可以在室内吸烟的地方之一，而且你还可以得到免费饮料，所以这确实是一个绝对让人上瘾的地方。

And a huge amount of people, problem gamers are problem drinkers, and also are addicted to cigarettes.

还有大量的人，有问题的游戏玩家和有问题的饮酒者，而且还沉迷于香烟。

And so, when I go to Las Vegas, it's almost like a anthropology experience for me.

因此，当我去拉斯维加斯时，这对我来说几乎就像是一次人类学经历。

I just look at all this like, "Wow."

我只是看着这一切，“哇”。

Keith Humphreys: And there was a story in Schüll's book, which I just found amazing, with a bunch of people playing, playing, playing, playing, and somebody had a heart attack at one of the machines, fell over on the floor in a group of them, and none of them even reacted.

Keith Humphreys：Schüll 的书中有一个故事，我觉得很神奇，一群人玩啊玩啊玩啊，有人在一台机器上心脏病发作，和一群人一起倒在地板上，没有人做出反应。

They just kept playing as this person died.

当这个人死了时，他们只是继续玩。

Andrew Huberman: What a metaphor for society.

安德鲁·休伯曼：这是一个社会的隐喻。

Well, I just decided if I'm ever going to Las Vegas, I'm going with you.

好吧，我刚刚决定，如果我要去拉斯维加斯，我就和你一起去。

Keith Humphreys: Okay.

基思·汉弗莱斯：好的。

That'd be great.

那太好了。

Andrew Huberman: Sorry to invite myself, but you seem like a safe person to go there with.

Andrew Huberman：很抱歉邀请我自己，但和你一起去那里似乎是一个安全的人。

Keith Humphreys: I'm pretty safe, yes.

Keith Humphreys：是的，我很安全。

You may win or lose five bucks, and that'll be the end of it, so.

你可能会赢或输五块钱，然后一切就结束了，所以。

Andrew Huberman: Love it!

安德鲁·休伯曼：喜欢它！

So industries that drive this stuff, okay, alcohol, cannabis, it's going to be very interesting to see what happens with cannabis now and going forward.

因此，推动这些东西的行业，好吧，酒精，大麻，看看大麻现在和未来会发生什么将会非常有趣。

Is it the case that in states where it's legalized or decriminalized, that the state collects its taxes on it?

在大麻合法化或非刑事化的州，州政府是否对其征税？

Keith Humphreys: Yeah, it depends.

基思·汉弗莱斯：是的，这要看情况。

Those are different regimes.

这些是不同的政权。

And this is a really important point to get into when you think about policy.

当你考虑政策时，这是一个非常重要的问题。

So decriminalization is about the user, and that's to say, "Look, we're not going to punish you for using pot, okay?" And it's been a popular policy for a long time, and doesn't seem to really affect use that much.

因此，非刑事化是关于用户的，也就是说，“听着，我们不会因为你使用大麻而惩罚你，好吗？”而且它已经成为很长一段时间以来的流行政策，并且似乎并没有真正影响使用。

Maybe a little bit, but not a lot.

也许有一点，但不是很多。

Legalization is making the production, processing, marketing, and sale legal, bringing in a corporation.

合法化就是使生产、加工、营销和销售合法化，引入公司。

Andrew Huberman: Mm.

安德鲁·休伯曼：嗯。

Keith Humphreys: And that is fundamentally different, because the corporation is going to have very smart people who are good at selling, and they will increase consumption of the product.

Keith Humphreys：这是根本不同的，因为公司将拥有擅长销售的非常聪明的人，他们会增加产品的消费。

At this point, I don't know the exact state count, but it's most people in the United States, population-wise, have access at this point to recreational cannabis.

目前，我不知道确切的州数，但就人口而言，美国大多数人目前都可以使用休闲大麻。

And virtually every state, I believe, has something.

我相信，几乎每个州都有一些东西。

If it's not recreational, it's medical.

如果不是娱乐性的，那就是医疗性的。

Keith Humphreys: Or due to hemp, there was sort of a way, a mistake they made in regulation, there's a way to process hemp that you can make these delta-8s and delta-9s.

Keith Humphreys：或者由于大麻，有一种方法，他们在监管中犯了一个错误，有一种处理大麻的方法，你可以制作这些 delta-8 和 delta-9。

So even in states that are prohibited, there's quite a bit of hemp-laced beverages, which are quite strong.

因此，即使在被禁止的州，也有相当多的含有大麻的饮料，而且味道很烈。

Andrew Huberman: Is cannabis a gateway drug?

安德鲁·休伯曼：大麻是入门毒品吗？

We were told that when we were in school.

我们上学的时候就被告知了。

Keith Humphreys: Yeah so, all drugs are gateway drugs.

Keith Humphreys：是的，所有药物都是入门药物。

The lie in that was that cannabis had some unique role that was going to lead you to use heroin use.

谎言是大麻有一些独特的作用，会导致你使用海洛因。

But the truth is anything, like, if you're a teenager and you start smoking or you start drinking or you start using cannabis or stealing prescription opioids from your parents or whatever, that will increase your likelihood of progressing to other substances for multiple reasons.

但事实是，例如，如果您是青少年，开始吸烟或开始饮酒，或开始使用大麻或从父母那里偷窃处方阿片类药物或其他什么，这将增加您因多种原因而发展为其他药物的可能性。

One, you might like it.

一，你可能会喜欢它。

Keith Humphreys: Say, "Okay, well, I guess I'm kind of .

Keith Humphreys：说，“好吧，我想我有点……”

Let me try some others." Two, your social networks may change.

让我试试其他的。”第二，你的社交网络可能会改变。

So you're around other people who do this, and so, you're comfortable with them, they're comfortable with you, and they're also more likely to have something else you might want to try.

所以你周围有其他这样做的人，所以，你对他们感到舒服，他们对你感到舒服，而且他们也更有可能有你可能想尝试的其他事情。

And then the third thing is, it could be some brain sensitization going on that makes drugs more rewarding.

第三件事是，可能是大脑发生了某种敏化，使得药物更有价值。

Keith Humphreys: And there is some interesting work with identical twins in different states which seem to suggest that you could be starting some unfolding process when you expose a young brain to it.

Keith Humphreys：有一些针对不同状态的同卵双胞胎的有趣研究似乎表明，当你将年轻的大脑暴露在其中时，你可能会开始一些展开过程。

So, all those processes is how gateways work.

因此，所有这些过程就是网关的工作方式。

The lie was that it was just cannabis.

谎言是这只是大麻。

And this actually fits with the general lie, I would say, is that alcohol is a drug, and we pretend that it isn't.

我想说，这实际上符合普遍的谎言，即酒精是一种毒品，而我们假装它不是。

So you mentioned people getting drunk at science conferences or health conferences.

所以你提到人们在科学会议或健康会议上喝醉了。

Keith Humphreys: I have seen conferences, political events, where people spend all day demonizing drug users, and talking about the threat of drugs and how evil drugs are, and how we have to destroy all drugs.

基思·汉弗莱斯：我见过一些会议、政治活动，人们整天妖魔化吸毒者，谈论毒品的威胁、毒品有多么邪恶，以及我们必须如何销毁所有毒品。

And then, they all go to the bar and get drunk as if they are not drug users.

然后，他们都去酒吧喝得烂醉，就好像他们不是吸毒者一样。

Not wanting to admit that alcohol is a drug is, A, very useful for the industry, but it was also just useful politically because, you could say, well, the big threat to kids is cannabis when it's much more likely a kid was going to get in trouble with alcohol than with cannabis.

不想承认酒精是一种毒品，这对这个行业非常有用，但它在政治上也很有用，因为，你可以说，对孩子来说，最大的威胁是大麻，因为孩子因酒精而陷入麻烦的可能性比大麻更大。

Andrew Huberman: These days, there's a lot of discussion about psychedelics.

安德鲁·休伯曼：这些天，有很多关于迷幻药的讨论。

Broad category of drugs.

药品类别广泛。

LSD, psilocybin.

LSD，裸盖菇素。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: MDMA is an empathogen, not a psychedelic, but somehow it's been lumped into it.

Andrew Huberman：摇头丸是一种移情剂，而不是致幻剂，但不知何故它被归入其中。

Well, it's a methylenedioxymethamphetamine.

嗯，它是一种亚甲二氧基甲基苯丙胺。

MDMA, ecstasy, folks, it's methamphetamine with some modification.

MDMA，摇头丸，伙计们，它是经过一些修改的甲基苯丙胺。

So, it's not a psychedelic.

所以，这不是迷幻药。

It's an empathogen.

它是一种移情剂。

But it gets lumped with that.

但它与此混为一谈。

Ketamine gets lumped with it.

氯胺酮与它混在一起。

Dissociative anesthetic.

解离麻醉剂。

It's not a psychedelic.

这不是迷幻药。

So, if we're going to have a conversation about psychedelics, I want to be really clear.

所以，如果我们要讨论迷幻药，我想说得非常清楚。

Andrew Huberman: Maybe we just put psilocybin and LSD on the table, and then talk about the empathogens and ketamine and all the rest separately, because so often these get lumped, and it leads to a lot of confusion.

安德鲁·休伯曼（Andrew Huberman）：也许我们只是把裸盖菇素和LSD放在桌子上，然后分别讨论移情剂和氯胺酮以及其他所有东西，因为这些东西经常被混为一谈，并导致很多混乱。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: I know several people who feel they've benefited tremendously from doing clinical work, meaning with a guide in safe setting, et cetera, on high-dose psilocybin, maybe only two or three times total, and that's it.

安德鲁·休伯曼：我认识一些人，他们觉得自己从临床工作中受益匪浅，这意味着在安全环境下的指导下服用高剂量裸盖菇素，可能总共只有两到三倍，仅此而已。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: For treatment of depression, sometimes for alcohol issues and other issues.

Andrew Huberman：用于治疗抑郁症，有时用于治疗酒精问题和其他问题。

I'm not talking about microdosing.

我不是在谈论微剂量。

They do a high dose, so two to five grams.

他们的剂量很高，所以两到五克。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: A lot of addicts who use other things are interested in or currently using or considering using psilocybin, LSD less so, as a means to get over their addiction.

Andrew Huberman：许多使用其他东西的成瘾者有兴趣或正在使用或考虑使用裸盖菇素（LSD）作为戒除毒瘾的手段。

I'd like your thoughts about that, and your thoughts about these compounds specifically.

我想知道您对此的想法，以及您对这些化合物的具体想法。

Keith Humphreys: Yeah, I mean, they're exciting in part because we haven't really made much progress in pharmacotherapy in the last 20 years.

Keith Humphreys：是的，我的意思是，它们令人兴奋，部分原因是我们在过去 20 年里在药物治疗方面并没有真正取得太大进展。

You know, for lots of things, for depression, for addiction.

你知道，对于很多事情，对于抑郁症，对于成瘾。

So the thought that these might work, and I think other than the GLP-1s, one of the...

所以我认为这些可能有效，我认为除了 GLP-1 之外，其中之一......

Probably say the second...

大概是说第二个吧……

I'd say put my second bet on that.

我想说，我的第二次赌注就在于此。

I'd put my first one in GLP-1 agonist.

我将第一个药物放入 GLP-1 激动剂中。

There is an awful lot of hype, but real things can be hyped.

有很多炒作，但真实的事情可以被炒作。

Keith Humphreys: So the fact that there are a lot of extravagant claims being made, and also again, talking about industry, there are people who are hoping to make a huge sum of money on these medications.

Keith Humphreys：事实上，有很多夸大其词的说法，而且再次谈到行业，有人希望通过这些药物赚大钱。

But there's also something there.

但也有一些东西在那里。

You could look at different pilot studies, small trials.

你可以看看不同的试点研究、小型试验。

They are encouraging, and I'm glad that it's a lot easier now to do these types of studies.

他们令人鼓舞，我很高兴现在进行此类研究变得容易多了。

We just had my friend Dr. Todd Korthuis down to Stanford; he's from Oregon.

我们刚刚邀请我的朋友 Todd Korthuis 博士来到斯坦福大学；他来自俄勒冈州。

You know, Oregon is doing these things, probably similar experience to what your friend had, where you get...

你知道，俄勒冈州正在做这些事情，可能与你朋友的经历类似，你在哪里得到......

You know, you have preparation with a trained person.

你知道，你已经和训练有素的人一起做好了准备。

Keith Humphreys: You get the medication, and then you do the integration session afterwards, and there are...

基思·汉弗莱斯：你得到药物，然后进行整合课程，还有......

And people would say, it was transformative for them.

人们会说，这对他们来说是变革性的。

There are also people who have very bad experiences on them, too, though, it has to be said, and that's why we don't just say, "All right, let's just use this as our frontline med."

不过，也有一些人有过非常糟糕的经历，但不得不说，这就是为什么我们不只是说，“好吧，让我们用它作为我们的前线药物。”

Andrew Huberman: You mean during the psychedelic experience and afterwards?

安德鲁·休伯曼：你是说在迷幻体验期间和之后？

Keith Humphreys: Or afterwards, like flashbacks.

Keith Humphreys：或者之后，比如闪回。

You're driving along, and then you have a flashback, and that is both upsetting and depending on what you're doing at the time, could carry some risk to it.

你正在开车，然后你会出现闪回，这既令人不安，又取决于你当时在做什么，可能会带来一些风险。

We don't know how well these or exactly how these drugs work, the sort of serotonergic kinds of drugs.

我们不知道这些药物的效果如何，也不知道这些药物到底是如何发挥作用的，属于血清素类药物。

The one thing we do know, good though, keeping on the topic of addiction, is thankfully, there's no evidence that people get addicted to psilocybin or to LSD.

我们确实知道的一件事是，庆幸的是，没有证据表明人们会对裸盖菇素或迷幻药上瘾。

Keith Humphreys: If they have abuse potential, it's extremely, extremely slight.

Keith Humphreys：如果他们有虐待的可能性，那也是非常非常轻微的。

So, I've always worried about them far less as a class of drugs than I do things like stimulants, which I know, and alcohol.

因此，我一直对它们的担心远远少于我对兴奋剂（我知道）和酒精等药物的担心。

Andrew Huberman: My read of the literature, and this might have been updated since is that there is zero evidence that microdosing psilocybin has any benefit.

安德鲁·休伯曼：我读过的文献（这可能已经更新了）是零证据表明微剂量裸盖菇素有任何益处。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

I think that's just silly.

我认为这很愚蠢。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: There is solid evidence that in a clinical setting, as you pointed out, and thank you for pointing it out, we're talking about at least two or three talk sessions without psilocybin, then a psilocybin journey that's typically two guides for safety purposes.

安德鲁·休伯曼：有确凿的证据表明，在临床环境中，正如您所指出的，并感谢您指出这一点，我们正在谈论至少两到三个没有裸盖菇素的谈话会议，然后是裸盖菇素之旅，出于安全目的，通常有两个指南。

Now, that's kind of how it's being explored, so they're to avoid exploitation conditions, because there has been some exploitation mainly in the MDMA trials.

现在，这就是探索的方式，所以他们要避免利用条件，因为主要是在 MDMA 试验中进行了一些利用。

Keith Humphreys: Mm.

基思·汉弗莱斯：嗯。

Keith Humphreys: Right, and there has been some of that.

Keith Humphreys：是的，确实有一些这样的情况。

Yeah.

是的。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: And then follow-up, that it's been somewhere between 60 and 70% of people who go into that sort of thing with major depression, that hasn't been resolved by other approaches, get either significant relief or full remission after two full versions of what I just described at fairly high dosages.

Andrew Huberman：接下来，有 60% 到 70% 的患有重度抑郁症的人，在使用我刚才描述的相当高剂量的两个完整版本后，没有通过其他方法得到解决，得到了显着缓解或完全缓解。

Andrew Huberman: When I think about the negative impacts, certainly there's the, quote-unquote, "bad trip phenomenon." What I've observed quite a lot, and I hear from a lot of people in this psychedelic space, is that post-MDMA for trauma, post-psilocybin for major depression and addiction issues, there's the, not euphoria, but the feeling that something significant has changed in the weeks and months afterwards, and then some period of time later, a significant, sudden drop in mood and that frightens them, and that they're able to recover from, but that it's a real thing, a real trough.

安德鲁·休伯曼：当我想到负面影响时，肯定会出现“糟糕的旅行现象”。我观察到的情况很多，而且我从这个迷幻领域的很多人那里听到的是，在使用MDMA治疗创伤后，在使用裸盖菇素治疗严重抑郁症和成瘾问题后，人们会感觉到，不是欣快感，而是一种感觉，在几周和几个月后，一些重大的事情发生了变化，然后一段时间后，情绪突然显着下降，这让他们感到害怕，他们能够从中恢复过来，但这是真实的事情，真实的事情。槽。

Keith Humphreys: Mm.

基思·汉弗莱斯：嗯。

Andrew Huberman: And this, by the way, is separate from the very well-known trough that comes two days after MDMA use.

Andrew Huberman：顺便说一下，这与使用 MDMA 两天后出现的众所周知的低谷是分开的。

We could talk about that.

我们可以谈谈这个。

But you get high, and then there's a low.

但你会变得很高，然后就会有一个低点。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: You know, very well explained.

Andrew Huberman：你知道，解释得很好。

Keith Humphreys: As with stimulants.

Keith Humphreys：就像兴奋剂一样。

Andrew Huberman: As with stimulants.

安德鲁·休伯曼：就像兴奋剂一样。

Right.

正确的。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: I'm divided on this psilocybin to treat addiction thing.

安德鲁·休伯曼：我对裸盖菇素治疗成瘾的问题存在分歧。

Keith Humphreys: Mm.

基思·汉弗莱斯：嗯。

Andrew Huberman: It seems very precarious because of the lack of kind of standardization of how this would be done outside a clinical trial.

Andrew Huberman：这似乎非常不稳定，因为在临床试验之外如何进行这方面缺乏标准化。

Keith Humphreys: It's hard.

基思·汉弗莱斯：这很难。

It's hard.

这很难。

Andrew Huberman: You know what I mean?

安德鲁·休伯曼：你明白我的意思吗？

You hear shaman, practitioner, guide, and because it's illegal, there's no Yelp reviews for these people.

你会听到萨满、练习者、向导，因为这是非法的，所以 Yelp 上没有对这些人的评论。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: There's no board that's overseeing it.

Andrew Huberman：没有董事会对其进行监督。

Keith Humphreys: Well, there is in Oregon.

Keith Humphreys：嗯，在俄勒冈州。

That's actually what Todd was presenting at, which is...

这实际上就是托德的演讲内容，那就是……

Andrew Huberman: I see.

安德鲁·休伯曼：我明白了。

Keith Humphreys: Yeah, because it is legal.

Keith Humphreys：是的，因为这是合法的。

Andrew Huberman: It's legal, not just decriminalized.

Andrew Huberman：这是合法的，而不仅仅是合法化。

Keith Humphreys: Correct.

基思·汉弗莱斯：正确。

Yeah.

是的。

The state...

国家...

Andrew Huberman: Okay, because in Oakland, California, it's decriminalized.

安德鲁·休伯曼：好的，因为在加利福尼亚州奥克兰，它已经合法化。

Psilocybin is decriminalized.

裸盖菇素已合法化。

Keith Humphreys: Oh, yeah.

基思·汉弗莱斯：哦，是的。

Yeah.

是的。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: Oakland's very different.

Keith Humphreys：奥克兰非常不同。

Yeah, no, in Oregon, you are licensed by the state to do this.

是的，不，在俄勒冈州，你获得了州政府的许可可以这样做。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Andrew Huberman: Ah, I see.

安德鲁·休伯曼：啊，我明白了。

Okay.

好的。

Keith Humphreys: So, yeah.

基思·汉弗莱斯：所以，是的。

So that's what we'll find out.

这就是我们会发现的。

To me, this is like pretty...

对我来说，这就像漂亮...

Probably this is a case where it's easy to be a scientist.

大概这就是当科学家很容易的情况吧。

Sometimes it's annoying to be a scientist.

有时候，成为一名科学家是很烦人的。

Makes life harder, makes it easier.

让生活变得更困难，让生活变得更容易。

It's like, I don't know if this works.

就像，我不知道这是否有效。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: It's really important to figure out if it works.

Keith Humphreys：弄清楚它是否有效非常重要。

We have really good methods to do that, so let's spend the dollars to get good people to do those studies.

我们有很好的方法来做到这一点，所以让我们花钱让优秀的人来做这些研究。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And this is the NIDA view, the National Institute on Drug Abuse.

Keith Humphreys：这就是 NIDA（国家药物滥用研究所）的观点。

They are funding quite a few studies of this sort.

他们正在资助相当多的此类研究。

And I imagine NIAAA, which is the alcohol institute, is doing it also.

我想 NIAAA（酒精研究所）也在这样做。

I say good, because to me, it's really...

我说很好，因为对我来说，这真的...

I think people get a little scared of these drugs, and they sort of think, "Well, you can't use them in medicine." It's like, well, we use lots of things in medicine that are a lot riskier than this, right?

我认为人们有点害怕这些药物，他们会想，“好吧，你不能将它们用于医学。”就像，我们在医学上使用的很多东西比这危险得多，对吧？

It's just a question of what is the effect on the patient, what is the balance?

问题只是对病人的影响是什么，平衡点是什么？

Andrew Huberman: Electric shock treatment.

安德鲁·休伯曼：电击治疗。

Keith Humphreys: Oh, yeah.

基思·汉弗莱斯：哦，是的。

OxyContin, there's all kinds of things, right?

奥施康定，有各种各样的东西，对吧？

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: But we figured that out by running really good research, and that's what this area needs, and I'm glad it's getting the investment.

Keith Humphreys：但是我们通过进行非常好的研究发现了这一点，这就是这个领域所需要的，我很高兴它获得了投资。

It's getting a fair amount of philanthropic investment, too.

它还获得了大量的慈善投资。

Another important thing is that the people doing the studies are at equipoise.

另一件重要的事情是，进行研究的人们处于平衡状态。

Keith Humphreys: So, there's been some bad work in this area over the last 50 years or so, because it was people who were super enthusiastic to the point that they weren't careful and critical about what the evidence said, and they sort of overclaimed what they found because they believed in themselves, maybe because they'd had very positive experiences themselves.

Keith Humphreys：所以，在过去 50 年左右的时间里，这个领域出现了一些糟糕的工作，因为人们非常热情，以至于他们对证据所说的内容不仔细和批判，他们有点夸大了他们的发现，因为他们相信自己，也许是因为他们自己有过非常积极的经历。

And just like that is not in the long run a good way to do science.

从长远来看，这并不是开展科学研究的好方法。

Keith Humphreys: You really want people who design a good study and then let the chips fall where they may, and then tell us all, and then we can decide.

Keith Humphreys：你真的希望人们能够设计出一项好的研究，然后让筹码落在他们可能的地方，然后告诉我们一切，然后我们就可以做出决定。

But you shouldn't be a spin doctor.

但你不应该成为一名旋转医生。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: That's not good.

基思·汉弗莱斯：这不好。

Andrew Huberman: Fun little factoid, and then another note about psilocybin.

Andrew Huberman：有趣的小事实，然后是关于裸盖菇素的另一个注释。

I was curious as to why there's so few studies about LSD, and a colleague of mine who works in this space, he runs clinical trials at UCSF, said, "Oh, it's very straightforward." Most of the studies on LSD clinical trials are done in Switzerland, because the LSD trip can last up to 13 hours, and they'll work very long, hard hours.

我很好奇为什么关于 LSD 的研究这么少，我的一位在这个领域工作的同事在加州大学旧金山分校负责临床试验，他说：“哦，这非常简单。”大多数关于LSD临床试验的研究都是在瑞士进行的，因为LSD之旅可以持续长达13个小时，而且他们会工作很长时间、很辛苦。

In the United States, it's hard to get the staff to come in two hours before a four to eight-hour psilocybin session, and then make sure that the person is okay enough and taken care enough to go.

在美国，很难让工作人员在四到八小时的裸盖菇素治疗前两小时到达，然后确保患者身体状况良好并得到充分照顾才能离开。

Andrew Huberman: So, I'm not suggesting we extend work hours any more than we already have.

Andrew Huberman：所以，我并不是建议我们延长工作时间。

But it's kind of interesting that...

但有趣的是...

I mention it because sometimes practical issues drive the science.

我提到它是因为有时实际问题驱动着科学。

It's just as simple as that.

就是这么简单。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

It would drive also a healthcare system.

它还将推动医疗保健系统。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: So if it took that long to do, the odds that this would ever be scaled up in the health system are pretty low, right?

Keith Humphreys：因此，如果需要这么长时间，那么在卫生系统中扩大规模的可能性非常低，对吗？

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: So there are real reasons why if you can do something in less time, you do it.

Keith Humphreys：所以，如果你能在更短的时间内完成某件事，你就会这么做，这是有真正原因的。

Andrew Huberman: And there is a movement now, meaning a solid effort in laboratories to figure out whether or not there are non-hallucinogenic, non-psychedelic experience-related compounds within these compounds, meaning the psychedelic experience may not actually be critical to the antidepressant effect.

安德鲁·休伯曼：现在有一项运动，意味着在实验室中进行扎实的努力，以确定这些化合物中是否存在非致幻性、非迷幻体验相关的化合物，这意味着迷幻体验实际上可能对抗抑郁作用并不重要。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Keith Humphreys: Right.

基思·汉弗莱斯：是的。

No, so that's one of the interesting things about ketamine.

不，这就是氯胺酮的有趣之处之一。

Like, if you blocked...

就像，如果你阻止...

Our late great friend, Nolan Williams, was looking at if you could block, like say, with some kind of naltrexone molecule, block the blink of lights and the visions and all that stuff, would it still have the same effect?

我们已故的好朋友诺兰·威廉姆斯（Nolan Williams）正在研究是否可以用某种纳曲酮分子来阻止，比如阻止灯光的闪烁和幻觉以及所有这些东西，它还会有同样的效果吗？

That is a great question for science to figure out.

这是科学需要解决的一个重要问题。

Now, some people say, "But I like that part." It's like, okay, but a lot of people find that actually pretty upsetting.

现在，有些人说：“但我喜欢那部分。”就好像，好吧，但很多人发现这实际上非常令人沮丧。

Keith Humphreys: But they could take ketamine and not have that kind of vivid dissociation stuff, and they were depressed, and it helped them, that would be a good medicine to have, right?

基思·汉弗莱斯：但是他们可以服用氯胺酮，而不需要那种生动的解离物质，他们很沮丧，这对他们有帮助，这将是一种很好的药物，对吗？

Andrew Huberman: I'd like to take a quick break and acknowledge our sponsor, Helix Sleep.

Andrew Huberman：我想稍微休息一下，并向我们的赞助商 Helix Sleep 表示感谢。

Helix Sleep makes mattresses and pillows that are customized to your unique sleep needs.

Helix Sleep 生产根据您独特的睡眠需求定制的床垫和枕头。

Now, I've spoken many times before on this, and on other podcasts about the fact that getting a great night's sleep is the foundation of mental health, physical health, and performance.

现在，我之前曾多次谈到过这一点，并在其他播客上谈到这样一个事实：睡个好觉是心理健康、身体健康和表现的基础。

When we aren't getting great sleep on a consistent basis, everything suffers.

当我们不能持续获得良好的睡眠时，一切都会受到影响。

And when we are sleeping well and enough, our mental health, physical health, and performance in all endeavors improve markedly.

当我们睡眠充足且良好时，我们的心理健康、身体健康和所有努力的表现都会显着改善。

Andrew Huberman: Now, the mattress you sleep on makes a huge difference in the quality of sleep that you get each night.

Andrew Huberman：现在，您所睡的床垫会对您每晚的睡眠质量产生巨大影响。

How soft it is or how firm it is all play into your comfort and need to be tailored to your unique sleep needs.

它的柔软度或硬度都会影响您的舒适度，并且需要根据您独特的睡眠需求进行定制。

If you go to the Helix website, you can take a brief two-minute quiz, and it will ask you questions such as, "Do you sleep on your back, your side, or your stomach?" Maybe you know, maybe you don't.

如果你访问 Helix 网站，你可以做一个两分钟的简短测验，它会问你一些问题，比如“你睡的是仰卧、侧卧还是俯卧？”也许你知道，也许你不知道。

"Do you tend to run hot or cold during the night?" Things of that sort.

“你晚上容易发热还是怕冷？”诸如此类的事情。

You answer those questions, and Helix will match you to the ideal mattress for you.

您回答这些问题，Helix 将为您匹配理想的床垫。

Andrew Huberman: For me, that turned out to be the Dusk, D-U-S-K Mattress.

Andrew Huberman：对我来说，这就是 Dusk D-U-S-K 床垫。

I've been sleeping on a Dusk Mattress for more than four years now, and it's been far and away the best sleep that I've ever had.

我已经睡在 Dusk 床垫上四年多了，这无疑是我睡过的最好的睡眠。

If you'd like to try Helix, you can go to helixsleep.com/huberman, take that two-minute sleep quiz, and Helix will match you to a mattress that's customized for you.

如果您想尝试 Helix，可以访问 helixsleep.com/huberman，参加两分钟的睡眠测验，Helix 将为您匹配专为您定制的床垫。

Right now, Helix is giving up to 27% off their entire site.

目前，Helix 整个网站提供高达 27% 的折扣。

Andrew Huberman: Helix has also teamed up with TrueMed, which allows you to use your HSA, FSA dollars to shop Helix's award winning mattresses.

Andrew Huberman：Helix 还与 TrueMed 合作，允许您使用 HSA、FSA 资金购买 Helix 屡获殊荣的床垫。

Again, that's helixsleep.com/huberman to get up to 27% off.

再次强调，helixsleep.com/huberman 提供高达 27% 的折扣。

Andrew Huberman: SSRIs, Selective Serotonin Reuptake Inhibitors, and all the other antidepressants have gotten kind of a bad rap in recent years.

Andrew Huberman：SSRIs、选择性血清素再摄取抑制剂和所有其他抗抑郁药近年来都受到了不好的批评。

There's the idea that all the school shooters were on SSRIs.

有一种观点认为，所有校园枪击案的凶手都服用了 SSRIs。

Whether or not that can be separated from the data on how many kids are on SSRIs, you'll tell us.

无论是否可以将其与有多少儿童服用 SSRI 的数据分开，您都会告诉我们。

Talk therapy, SSRIs, and other prescription antidepressants, psilocybin, and any psychedelic for the treatment of depression, and on and on, all funnel into brain plasticity.

谈话疗法、SSRIs 和其他处方抗抑郁药、裸盖菇素和任何治疗抑郁症的迷幻药等等，都会影响大脑的可塑性。

Andrew Huberman: If I sit in your office, and I tell you what's bothering me and you give me insights, and over time, I work with that, that's...

安德鲁·胡伯曼：如果我坐在你的办公室，我告诉你什么困扰着我，你给我见解，随着时间的推移，我会处理这个问题，那就是......

And I get better, it's the consequence of brain plasticity.

我变得更好了，这是大脑可塑性的结果。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: So, I think of all of these things, whether or not pharmacologic or talk therapy or a combination both.

安德鲁·休伯曼：所以，我想到了所有这些事情，无论是药物疗法还是谈话疗法还是两者的结合。

Keith Humphreys: Or TMS.

Keith Humphreys：或者 TMS。

Andrew Huberman: Or TMS, Transcranial Magnetic Stimulation.

Andrew Huberman：或者 TMS，经颅磁刺激。

Thank you.

谢谢。

Yeah, it's all about rewiring brain circuits.

是的，这都是关于大脑回路的重新布线。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: And so, it's not about the psychedelic experience.

安德鲁·休伯曼：所以，这与迷幻体验无关。

Where I get frustrated is when people say, "Oh, you know, these things open plasticity." I think to myself, "Oh, my God, as somebody who studied plasticity, David Hubel and Torsten Wiesel, who essentially got the Nobel Prize for it, were my scientific great-grandparents," they would be ro...

当人们说“哦，你知道，这些东西开启了可塑性”时，我感到沮丧。我心里想，“哦，天啊，作为研究可塑性的人，大卫·休贝尔和托斯顿·威塞尔，他们基本上因此获得了诺贝尔奖，是我科学界的曾祖父母，”他们会是...

I think Torsten's still alive, but David would be rolling over in his grave or like...

我认为托斯顿还活着，但大卫会在坟墓里翻滚或者类似的……

No, you don't want to open plasticity because it can go in any direction.

不，你不想打开可塑性，因为它可以朝任何方向发展。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: You want directed plasticity.

Andrew Huberman：你想要定向可塑性。

And so, while talk therapy is slower, while TMS might be slower, I mean, plasticity needs to be funneled.

因此，虽然谈话疗法较慢，而 TMS 可能较慢，但我的意思是，可塑性需要漏斗。

It just can't be, "Let's just open plasticity," and I think people are very intrigued by the idea of just opening plasticity as if that's going to solve the issue.

不可能是“让我们开放可塑性”，我认为人们对开放可塑性的想法非常感兴趣，好像这就能解决问题。

Keith Humphreys: Plasticity, which we have naturally the most when we're young, is absolutely a two-edged sword.

Keith Humphreys：可塑性是我们年轻时最自然拥有的，它绝对是一把两刃剑。

So, if you try to learn French at my age, it's just reallly, really hard to pick up that new habit, whereas if you grow up speaking it or you try to learn as a second language when you're a teenager, you're going to have much more capacity to get it and retain it.

所以，如果你在我这个年纪尝试学习法语，那么要养成这种新习惯真的非常非常困难，而如果你从小就讲法语，或者在青少年时期尝试将法语作为第二语言学习，那么你将有更多的能力来获得并保留它。

That's true.

这是真的。

It's also true that if you start smoking cigarettes in my age, you probably will not get addicted, and if you start smoking cigarettes when you're 13, you almost certainly will.

确实，如果你在我这个年纪开始吸烟，你可能不会上瘾，而如果你在 13 岁时开始吸烟，你几乎肯定会上瘾。

Andrew Huberman: Is that true?

安德鲁·休伯曼：这是真的吗？

Keith Humphreys: Yes, same thing.

基思·汉弗莱斯：是的，同样的事情。

Plasticity.

可塑性。

Almost all addictions start when people are young.

几乎所有的成瘾都是从人们年轻时开始的。

And you can think of it as a learned, you know, it's maladaptive learning, but it is learning, that you acquire those things and you stay all the way through.

你可以把它看作是一种学习，你知道，这是一种适应不良的学习，但它就是学习，你获得了这些东西，并且一直坚持下去。

It's why...

这就是为什么...

Sometimes older people, I can remember getting mad, like shows they like got canceled, and people were watching them.

我记得有时年纪较大的人会生气，比如他们喜欢的节目被取消了，而人们却在观看它们。

I remember the show because my parents watched it, "Dr. Quinn, Medicine Woman." Well, why?

我记得这个节目是因为我的父母看过它，“奎因博士，女巫”。嗯，为什么？

Andrew Huberman: Oh, yeah.

安德鲁·休伯曼：哦，是的。

Keith Humphreys: Because old people watched it, and advertisers don't want to pay for old people.

Keith Humphreys：因为老年人看它，而广告商不想为老年人付费。

The advertisers want young people because...

广告商想要年轻人，因为……

Andrew Huberman: Want lifetime users.

Andrew Huberman：想要终身用户。

Keith Humphreys: That's right.

基思·汉弗莱斯：没错。

And to instill those habits when people are young is how you get them to do it for 50 years.

在人们年轻时就灌输这些习惯，就是让他们坚持 50 年的方法。

Andrew Huberman: Oh my gosh!

安德鲁·休伯曼：天哪！

Andrew Huberman: Okay.

安德鲁·休伯曼：好的。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: You can't really persuade many people my age to start eating Cheerios or Frosted Flakes or whatever, but you start it when people are young, and that just underscores the point you're making of, like, if plasticity isn't good or bad, it's this capacity the brain has, and it can be used in very different ways.

基思·汉弗莱斯：你无法真正说服我这个年纪的许多人开始吃麦片或磨砂片或其他什么东西，但你在人们年轻的时候就开始吃，这正好强调了你的观点，比如，如果可塑性没有好坏之分，那就是大脑拥有的这种能力，它可以以非常不同的方式使用。

Andrew Huberman: Maybe it explains why, despite some minimal effort, I can't get addicted to TikTok.

Andrew Huberman：也许这可以解释为什么尽管做了一些最小的努力，我还是无法对 TikTok 上瘾。

It's just aversive to me, thank goodness.

谢天谢地，这对我来说只是令人厌恶。

Keith Humphreys: But maybe if you'd started when you were 13, it didn't exist then, but if it did, you might have.

Keith Humphreys：但也许如果你在 13 岁时就开始了，那么那时它还不存在，但如果存在的话，你可能已经存在了。

You might have found it far more engaging and picked up that habit.

你可能会发现它更有吸引力并养成了这个习惯。

Andrew Huberman: Chances are, based on what I observe, in knowing myself.

安德鲁·休伯曼：根据我的观察，有机会了解自己。

You mentioned ketamine.

你提到了氯胺酮。

Ketamine's an interesting one.

氯胺酮是一种有趣的药物。

A, not a psychedelic, dissociative anesthetic, has some proven benefit for depression, although maybe transient.

A不是迷幻的解离麻醉剂，它对抑郁症有一定的疗效，尽管可能是短暂的。

Keith Humphreys: Mm.

基思·汉弗莱斯：嗯。

Yeah.

是的。

Andrew Huberman: But high abuse potential, and here in Los Angeles, not six months goes by without hearing about some famous person dying of ketamine, which means that a lot more non-famous people are dying of ketamine, and we're not hearing about it.

安德鲁·胡伯曼：但是滥用的可能性很高，在洛杉矶，每六个月都会听到一些名人死于氯胺酮的消息，这意味着更多的非名人死于氯胺酮，而我们却没有听说过。

Keith Humphreys: That's a good point.

基思·汉弗莱斯：这是一个很好的观点。

Yeah, and I don't know if you can post articles, but we did a review, Todd Korthuis and some other colleagues, of the potential therapeutic effect of this whole drugs.

是的，我不知道你是否可以发表文章，但托德·科特修斯和其他一些同事对整个药物的潜在治疗效果进行了审查。

And the thing about ketamine that struck me, yes, it is FDA approved for treatment-resistant depression, so it is approved.

关于氯胺酮的事情让我印象深刻，是的，它被 FDA 批准用于治疗难治性抑郁症，所以它被批准了。

There's a lot of negative trials for depression.

有很多针对抑郁症的负面试验。

I mean, it didn't vault over the efficacy thing.

我的意思是，它并没有超越功效。

It cleared it.

它清除了它。

There are some positive trials, and I can say I know a couple people whose judgment I trust said it was very, very valuable to them in a deep depression.

有一些积极的试验，我可以说我认识一些我相信他们的判断的人，他们说这对处于深度抑郁症中的他们来说非常非常有价值。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: But I didn't view it as quite the knockout I thought it was going to be before I read all these studies.

基思·汉弗莱斯：但在我阅读所有这些研究之前，我并不认为它会是一场彻底的淘汰赛。

And then, you do have that problem.

然后，你确实遇到了这个问题。

It is addictive.

它会让人上瘾。

And so, we have a lot of people getting addicted, and then also the bladder damage you get from it.

因此，我们有很多人上瘾，并且膀胱也因此受到损害。

You get young people with sort of, 60-year-old bladders from ketamine.

氯胺酮让年轻人的膀胱像 60 岁一样。

And like that is, I mean, most urologists have seen this now.

我的意思是，大多数泌尿科医生现在都看到了这一点。

Andrew Huberman: Mm.

安德鲁·休伯曼：嗯。

Keith Humphreys: It's like, why is someone at 25 coming in with this?

Keith Humphreys：这就像，为什么 25 岁的人会带着这个进来？

It's like because their bladder's been damaged by ketamine.

这就像因为他们的膀胱被氯胺酮损坏了。

So those are significant side effects.

所以这些都是显着的副作用。

So would not be the thing I would jump to.

所以不会是我会跳到的事情。

If I had treatment-resistant depression, which has got to be said, is a terribly challenging condition to deal with, I'd be far more likely to actually do the SAINT protocol that Nolan Williams developed with rTMS, because the effects of that for treatment-resistant depression are so much clearer in my view, and the downsides are, as far as I can see, virtually nil.

如果我患有难治性抑郁症（不得不说，这是一种非常具有挑战性的病症），那么我更有可能实际执行诺兰·威廉姆斯（Nolan Williams）用 rTMS 开发的 SAINT 方案，因为在我看来，该方案对难治性抑郁症的影响要清楚得多，而且据我所知，其缺点几乎为零。

Andrew Huberman: Thanks for bringing it up again.

安德鲁·休伯曼：感谢您再次提出这个问题。

TMS, Transcranial Magnetic Stimulation, is a non-invasive brain stimulation that can either activate or decrease neural activity in specific brain areas.

TMS（经颅磁刺激）是一种非侵入性脑刺激，可以激活或减少特定大脑区域的神经活动。

Keith Humphreys: Right.

基思·汉弗莱斯：是的。

Andrew Huberman: Very good data on this.

Andrew Huberman：这方面的数据非常好。

How soon will that be available to folks in all parts of the country and the world?

全国和世界各地的人们多久才能使用它？

Keith Humphreys: In our country, I mean, rTMS for depression is approved, and so you can get it at clinics that have this technology.

Keith Humphreys：我的意思是，在我们国家，rTMS 治疗抑郁症已获得批准，因此您可以在拥有这项技术的诊所获得它。

These are big, expensive machines, so I'm sure there's lots of places where they're not local.

这些都是又大又贵的机器，所以我确信有很多地方它们不是本地的。

But yeah, it's covered.

但是，是的，它被覆盖了。

I think Medicare actually covers it.

我认为医疗保险实际上涵盖了它。

Keith Humphreys: Whether they cover the specific protocol that Nolan did, I'm honestly not sure, because there was a lower intensity one, and Nolan's genius was to compress this treatment.

基思·汉弗莱斯：老实说，我不确定他们是否涵盖了诺兰所做的具体方案，因为有一个强度较低的方案，而诺兰的天才在于压缩了这种治疗。

So, people would come in five days in a row and have 10 minutes on, 50 minutes off, I believe that's the rate, all day long, five days, and with a theta burst setting for rTMS.

所以，人们会连续五天来，工作 10 分钟，休息 50 分钟，我相信这就是速率，一整天，五天，并且对 rTMS 进行 θ 爆发设置。

Keith Humphreys: And I've seen some people's lives just absolutely changed by that.

Keith Humphreys：我看到一些人的生活因此而彻底改变。

And you can see his tri...

你可以看到他的三...

I mean, it's a trial.

我的意思是，这是一次审判。

It's a good trial.

这是一次很好的尝试。

Unlike with psychedelics, you really can fool people that they're getting rTMS.

与迷幻药不同的是，你确实可以欺骗人们，让他们相信他们正在接受 rTMS。

It's always tough to interpret psychedelic research because everybody knows when they've gotten a psychedelic drug.

解释迷幻剂研究总是很困难，因为每个人都知道他们什么时候服用了迷幻药。

Andrew Huberman: The people in the control experiment know they're in the control experiment.

Andrew Huberman：参与对照实验的人知道他们参与了对照实验。

Keith Humphreys: That's correct.

基思·汉弗莱斯：没错。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: But not true in rTMS.

Keith Humphreys：但 rTMS 并非如此。

You can put these coils on the head.

您可以将这些线圈放在头上。

I've actually tried it, and it feels like something's happening, and it's just a sham.

我确实尝试过，感觉好像有什么事情发生，但那只是一个骗局。

And when you ask people at the end, "Guess which condition they are in," they can't guess.

当你最后问人们“猜猜他们处于哪种状态”时，他们猜不出来。

So, this is really some good science, and that's where I would go next if I were...

所以，这确实是一些很好的科学，如果我......

I would look at the SAINT protocol is the name of it.

我会看看 SAINT 协议就是它的名字。

Andrew Huberman: Mm.

安德鲁·休伯曼：嗯。

Keith Humphreys: Maybe we can...

基思·汉弗莱斯：也许我们可以……

I don't know if we can put a link up.

不知道能不能放个链接

Andrew Huberman: Yeah, we have links.

Andrew Huberman：是的，我们有联系。

We'll put links to any papers, any outlets.

我们将放置任何报纸、任何媒体的链接。

Keith Humphreys: Terrific.

基思·汉弗莱斯：太棒了。

Andrew Huberman: You know, I hear from a lot of people with depression issues.

安德鲁·休伯曼：你知道，我听到很多患有抑郁症的人的来信。

People have become very wary of SSRIs, because of the side effect profiles, probably also because of what they've heard.

人们对 SSRI 变得非常警惕，因为其副作用，也可能是因为他们所听到的。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: I remind people that SSRIs have been very, very helpful to the community of people who suffer from true OCD.

Andrew Huberman：我提醒人们，SSRIs 对于患有真正强迫症的人来说非常非常有帮助。

Not like, "Oh, they're so OCD," people who have debilitating levels of obsessions, excuse me, and compulsions.

不像，“哦，他们太强迫症了”，那些有令人衰弱程度的强迫症的人，对不起，还有强迫症。

So I don't like to demonize any compound.

所以我不喜欢妖魔化任何化合物。

Keith Humphreys: No, we shouldn't do that.

Keith Humphreys：不，我们不应该这样做。

There's lots of people who benefit from SSRIs.

有很多人受益于 SSRIs。

There's no question.

毫无疑问。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: But maybe TMS would be something where people would want to explore.

Andrew Huberman：但也许 TMS 会是人们想要探索的东西。

But as long as we're on SSRIs, do SSRIs make people shoot other people or themselves?

但只要我们服用 SSRIs，SSRIs 就会让人开枪射杀他人或自己吗？

Keith Humphreys: No. No, I don't believe that the mass shooting thing.

基思·汉弗莱斯：不，不，我不相信大规模枪击事件。

I mean, it doesn't fit the data where mass shootings are.

我的意思是，它不符合大规模枪击事件的数据。

There was just a mass shooting in Australia.

澳大利亚刚刚发生了大规模枪击事件。

Just think that is so rare that you see these in developed countries other than the United States.

想想看，这种情况非常罕见，在美国以外的发达国家也能看到。

That was their first mass shooting in 30 years.

这是他们 30 年来的第一次大规模枪击事件。

There's plenty of people who take SSRIs in Australia.

在澳大利亚有很多人服用 SSRIs。

Why weren't there mass shootings?

为什么没有发生大规模枪击事件？

In Europe, many people take SSRIs.

在欧洲，许多人服用 SSRIs。

They don't have the level of mass shootings.

他们没有达到大规模枪击事件的水平。

So, I don't think that is the explanatory variable.

所以，我认为这不是解释变量。

Keith Humphreys: I think the explanatory variable is that it's extremely easy to get high-powered weaponry in our country, and it's harder, pretty much in the rest of the developed world.

基思·汉弗莱斯：我认为解释变量是，在我们国家获得高性能武器非常容易，而在其他发达国家则更难。

Andrew Huberman: Not pushing back for sake of pushing back, but I've seen data, I don't know how solid the data are, that something like 70-plus percent of the prescription drugs for depression are consumed by the United States, so that the relative percentages of a population, maybe that's a better way to frame it, taking SSRIs is much, much higher in the United States than it is, say, in Northern Europe, or in Australia.

Andrew Huberman：不是为了反驳而反驳，但我看到了数据，我不知道这些数据有多可靠，大约 70% 以上的抑郁症处方药是在美国消费的，因此人口的相对百分比，也许这是一个更好的框架方式，美国服用 SSRI 的比例比北欧或澳大利亚要高得多。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: So yes, they take SSRIs, but at a much lower frequency.

Andrew Huberman：是的，他们服用 SSRI，但频率要低得多。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

But if there were a significant risk, you wouldn't go 30 years without a mass shooting in a country.

但如果存在重大风险，一个国家就不可能 30 年不发生大规模枪击事件。

Australia, what does it have?

澳大利亚，它有什么？

They have 25-30 million people in it.

他们有25-3000万人。

Even at a lower rate, there would be...

即使利率较低，也会...

The disparity is so huge in where mass shootings occur that that's just not going to be the likely explanatory variable.

大规模枪击事件发生地点的差异如此之大，以至于这不会成为可能的解释变量。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Andrew Huberman: What about suicides?

安德鲁·胡伯曼：那自杀呢？

Keith Humphreys: There is some worry about adolescents on SSRIs.

Keith Humphreys：人们对青少年服用 SSRI 类药物存在一些担忧。

This has been a really hard-fought, debated issue for years, and it's tough because depression, of course, raises suicide risk, right?

多年来，这一直是一个非常激烈的争论问题，这很困难，因为抑郁症当然会增加自杀风险，对吗？

So by definition, if someone's getting an SSRI, they already have some risk present.

因此，根据定义，如果有人服用 SSRI，他们就已经存在一些风险。

I think there's some legitimate worry with teenagers.

我认为青少年有一些合理的担忧。

I would say it's non-zero, but to be honest, it's not completely in my wheelhouse, so I'm just going to leave it at that.

我会说它是非零的，但说实话，它并不完全在我的掌控范围内，所以我就将其保留。

There are people who've worked on this much more deeply than I can.

有些人在这方面的研究比我深入得多。

Still, though, I would say there are many teenagers on these medications who benefit from them also.

不过，我想说的是，许多服用这些药物的青少年也从中受益。

There's no doubt about that.

毫无疑问。

Andrew Huberman: Yeah, and folks who are interested in this, I'm working on an episode with a guest about some of these long-term effects of SSRIs that some people seem to experience.

Andrew Huberman：是的，对此感兴趣的人们，我正在与一位嘉宾一起制作一集，讲述一些人似乎经历过的 SSRI 的长期影响。

There is a cohort of people out there.

那里有一群人。

This is one of the great things about the internet, who have rallied together and saying, "Hey we have the same constellation of symptoms.

这是互联网的伟大之处之一，人们聚集在一起说：“嘿，我们有同样的症状。

Andrew Huberman: We don't have any bias against the medical industry, but we were prescribed SSRIs in our teen years and early 20s, and there's a constellation of mainly sexual side effects and mood-related side effects that don't seem to resolve even after coming off." We also see this with Finasteride, which was used to treat baldness.

Andrew Huberman：我们对医疗行业没有任何偏见，但我们在十几岁和二十出头的时候就服用了 SSRI，主要是性副作用和情绪相关副作用，即使停药后似乎也没有解决。”我们在用于治疗秃头的非那雄胺中也看到了这一点。

Keith Humphreys: Oh, yeah.

基思·汉弗莱斯：哦，是的。

Andrew Huberman: And our colleague, Michael Eisenberg, came on here and said, "Look, the data aren't really there, but I hear from a lot of young guys who were given these anti-hair loss drugs, and they come off the drugs, and they're still experiencing debilitating sexual side effects." And so, it is true that the medical profession sometimes takes 10, 20 years to catch up to what many people are experiencing.

安德鲁·胡伯曼（Andrew Huberman）：我们的同事迈克尔·艾森伯格（Michael Eisenberg）来到这里说：“看，数据并不存在，但我听说很多年轻人服用了这些抗脱发药物，他们戒掉了药物，但他们仍然在经历令人衰弱的性副作用。”因此，确实，医学界有时需要 10、20 年才能赶上许多人正在经历的事情。

Keith Humphreys: That is true.

基思·汉弗莱斯：确实如此。

Yeah.

是的。

Andrew Huberman: So, I'm not trying to make an anti-SSRI statement here, but I think there are people walking around out there that are convinced one way or the other that SSRIs messed them up pretty bad, and they have loud voices.

Andrew Huberman：所以，我并不是想在这里发表反 SSRI 声明，但我认为有些人以某种方式相信 SSRIs 把他们搞得一团糟，而且他们的声音很大。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: And so, I think that's where the concern comes from.

安德鲁·休伯曼：所以，我认为这就是担忧的根源。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

I honestly don't know what the evidence is in that particular case.

老实说，我不知道该特定案件的证据是什么。

I will say just something very general about medications, how we approve them.

我只想说一些关于药物的非常笼统的内容，以及我们如何批准它们。

They're approved on short-term trials.

它们在短期试验中获得批准。

I mean, if you look at the typical trial for opioids and pain, it's like 9 weeks or 12 weeks.

我的意思是，如果你看一下阿片类药物和疼痛的典型试验，就会发现大约需要 9 周或 12 周。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And there's lots of medications, and opioids are a good example, that doesn't necessarily mean that taking them for a year gives you the same effects, because, for example, you become tolerant to them, or you might become addicted to them and all that.

Keith Humphreys：有很多药物，阿片类药物就是一个很好的例子，这并不一定意味着服用它们一年会给你带来同样的效果，因为，例如，你会对它们产生耐受性，或者你可能会对它们上瘾等等。

And that is a general just challenge of how we regulate these medications.

这是我们如何监管这些药物的普遍公正挑战。

Keith Humphreys: There are post-marketing studies that are done.

Keith Humphreys：已经完成了上市后研究。

But particularly if something is complicated and rare from a widely used medication, it's hard to figure that out.

但特别是如果某些东西对于广泛使用的药物来说是复杂且罕见的，那么就很难弄清楚。

I mean, doctors will make reports.

我的意思是，医生会做出报告。

They get aggregated up, but that's hard.

他们聚集在一起，但这很难。

That's hard to figure out.

这很难弄清楚。

Andrew Huberman: Before moving on from the discussion about psychedelics, our late and indeed great colleague, Nolan Williams, sadly, he passed a few months ago.

安德鲁·胡伯曼：在结束关于迷幻药的讨论之前，我们已故的、确实很伟大的同事诺兰·威廉姆斯，遗憾的是，他几个月前去世了。

We may talk about that later, maybe not.

我们稍后可能会讨论这个问题，也许不会。

Either way, I'll put a link to his information, because he's a critical figure in this general space around the treatment of depression.

不管怎样，我都会放一个他的信息的链接，因为他是抑郁症治疗领域的关键人物。

Because of his work on TMS, the "SAINT Protocol," as it's referred to, as well as ibogaine, which is a very unusual psychedelic.

因为他对 TMS（即所谓的“SAINT 协议”）以及伊博加因（一种非常不寻常的迷幻药）的研究。

But he was running trials on veterans, mainly taking ibogaine out of the country, illegal in the United States, so he had to do it out of the country.

但他正在对退伍军人进行试验，主要是把伊博加因带出国，这在美国是非法的，所以他不得不把它带出国。

Andrew Huberman: It's a 22-hour-long psychedelic experience.

Andrew Huberman：这是一次长达 22 小时的迷幻体验。

You have to be heart rate monitored.

您必须接受心率监测。

Nobody does this recreationally, and nobody should do it recreationally.

没有人为了消遣而这样做，也不应该为了消遣而这样做。

Sometimes it was followed up with DMT, sometimes no. But from my last discussion about Nolan before he passed, it seemed like the data were very encouraging, such that veterans who had PTSD and/or addiction issues would do ibogaine once under this intense supervision, sometimes followed by DMT, and would experience a total remission of everything bad, frankly.

有时会进行 DMT 随访，有时则不会。但从我在诺兰去世前的最后一次讨论来看，这些数据似乎非常令人鼓舞，以至于患有创伤后应激障碍和/或成瘾问题的退伍军人在这种严格的监督下服用一次伊博加因，有时随后服用DMT，坦率地说，所有不好的事情都会得到完全缓解。

They're back to life.

他们又复活了。

And it was pretty striking, at least the way it was being described.

这非常引人注目，至少从描述的方式来看是这样。

Andrew Huberman: So much so that I was anticipating that ibogaine would be the first FDA-approved psychedelic, in part, because it's not the kind of thing you can just do hanging around with your friends, and you wouldn't want to.

Andrew Huberman：以至于我预计伊博加因将成为第一个 FDA 批准的致幻剂，部分原因是因为它不是那种你可以和朋友闲逛时做的事情，而且你也不想这样做。

It involves a lot of scary experiences in there that one works through.

它涉及到人们在那里经历的许多可怕的经历。

Andrew Huberman: What are your thoughts about the ibogaine work and ibogaine as a potential first through the legal door of psychedelics?

Andrew Huberman：您对伊博加因工作以及伊博加因作为第一个通过迷幻药合法大门的潜力有何看法？

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

So, Nolan and I were office neighbors, and I really liked him.

所以，诺兰和我是办公室邻居，我真的很喜欢他。

It was a huge loss.

这是一个巨大的损失。

I think he was one of the great psychiatrists of his generation.

我认为他是他这一代最伟大的精神病学家之一。

Just enormous respect for him as a person and as a scientist.

作为一个人和一个科学家，我对他表示极大的尊重。

And I miss him every day when I walk by his office.

每天当我经过他的办公室时我都会想念他。

I think what he's doing with ibogaine is really fascinating, in part because he did...

我认为他对伊博加因所做的事情非常令人着迷，部分原因是他……

The important thing, he imaged people.

重要的是，他塑造了人们的形象。

He neuroimaged them before and afterwards, and he was able to see a lot of these changes.

他在之前和之后对它们进行了神经成像，他能够看到很多这些变化。

Keith Humphreys: And why does that matter?

Keith Humphreys：为什么这很重要？

Because there's certain experiences people might have, described very enthusiastically and think they're really different, but they aren't in fact different.

因为人们可能会非常热情地描述某些经历，并认为它们确实不同，但实际上并没有不同。

But he actually documents that it's different.

但他实际上证明了这是不同的。

So, I think that was really groundbreaking, and it's sad he's not going to get to continue that work.

所以，我认为这确实具有开创性，但令人遗憾的是他无法继续这项工作。

The thing to say is that this is an open-label trial with no control group.

需要说的是，这是一项开放标签试验，没有对照组。

So, that's what we have so far.

这就是我们目前所拥有的。

Keith Humphreys: So, now the thing is to do a proper trial and see.

Keith Humphreys：所以，现在要做的就是进行适当的试验并观察。

There is a lot, also, sort of a ceremony around this.

围绕此还有很多仪式。

It's sort of like, as a colleague might describe it, "It's like the final mission for the soldiers.

正如一位同事所描述的那样，这有点像“这就像士兵们的最后任务。

They go down to Mexico.

他们下到墨西哥。

They do this." There's a lot of camaraderie.

他们这样做。”有很多友情。

There's a lot of other good stuff packed around it.

周围还有很多其他好东西。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And so, is that part of the therapeutic experience?

Keith Humphreys：那么，这是治疗体验的一部分吗？

Or is it entirely a chemical experience?

或者这完全是一种化学体验？

That's the thing you would find out in a trial.

这就是你在审判中会发现的事情。

You know, you do all that other stuff, but you wouldn't have the ibogaine at the end.

你知道，你做了所有其他的事情，但最后你不会得到伊博加因。

And absolutely worth studying.

并且绝对值得学习。

And newer hands will have to pick this up, but I really hope people will.

新人必须学会这个，但我真的希望人们会这样做。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

I'm very curious as to where that work is going to go now that...

我很好奇这项工作现在要去哪里......

Because it really was Nolan spearheading that work.

因为这项工作确实是诺兰带头的。

But there are people who are working hard to keep it going forward.

但也有人正在努力让其继续前进。

Andrew Huberman: Stimulants.

安德鲁·休伯曼：兴奋剂。

I'm a heavy caffeine user.

我是一个重度咖啡因使用者。

Keith Humphreys: Okay.

基思·汉弗莱斯：好的。

Andrew Huberman: My caffeine tolerance is insanely high.

Andrew Huberman：我的咖啡因耐受性非常高。

Keith Humphreys: Uh-huh.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: I mean, people have teased me online, "There's no way that's true, 800 milligrams a day of caffeine?" Child's play.

Andrew Huberman：我的意思是，人们在网上取笑我，“这不可能是真的，每天 800 毫克咖啡因？”孩子的游戏。

Meaning, when I was a kid, I've got a photograph of me drinking Yerba Mate, my father's Argentine, out of the gourd, which is barely stimulatory, although nice, even, flat ride, you know?

意思是，当我还是个孩子的时候，我有一张我用葫芦喝马黛茶的照片，这是我父亲的阿根廷产的，虽然喝起来没什么刺激性，但喝起来很舒服，均匀，平淡，你知道吗？

You can tell I like stimulants by the way I talk about them.

从我谈论兴奋剂的方式你就能看出我喜欢兴奋剂。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: When I was three or four years old, 800 milligrams of caffeine, no big deal.

Andrew Huberman：当我三四岁时，摄入 800 毫克咖啡因，没什么大不了的。

A gram of caffeine a day, that's kind of like where I'm nearing my limit.

每天一克咖啡因，我已经接近极限了。

I can drink caffeine all day long.

我可以整天喝咖啡因。

I stop around 2:00 PM so I can sleep well.

我会在下午 2:00 左右停下来，这样我就能睡个好觉。

Not a problem.

不是问题。

I think 90% of the world uses caffeine, adult world uses caffeine.

我认为世界上90%的人都使用咖啡因，成人世界也使用咖啡因。

I'm asking this for my own reasons, is caffeine addictive?

我出于自己的原因问这个问题，咖啡因会上瘾吗？

Is it dangerously addictive?

它会让人上瘾吗？

It makes me more productive.

它让我更有效率。

Andrew Huberman: I love life on caffeine.

安德鲁·休伯曼：我喜欢咖啡因的生活。

I can handle life without caffeine if I have a flu or cold.

如果我得了流感或感冒，我可以在不喝咖啡的情况下生活。

Andrew Huberman: Otherwise, I'm not interested in finding out what life without caffeine is like.

安德鲁·休伯曼：否则，我对了解没有咖啡因的生活是什么样子没有兴趣。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Keith Humphreys: I'm probably the worst person to answer this because I love coffee.

Keith Humphreys：我可能是最不适合回答这个问题的人，因为我喜欢咖啡。

And as I like to say, I don't have a problem with coffee.

正如我想说的，我对咖啡没有任何问题。

If I had to choose between coffee and my children, I could make that decision.

如果我必须在咖啡和孩子之间做出选择，我可以做出这个决定。

Andrew Huberman: Sure.

安德鲁·休伯曼：当然。

Keith Humphreys: But I would really miss them.

Keith Humphreys：但我真的很想念他们。

Andrew Huberman: You got me with that one.

安德鲁·休伯曼：你让我明白了。

Keith Humphreys: I knew that was an okay joke to say because my sons laughed when I told it to them.

基思·汉弗莱斯：我知道这是一个不错的笑话，因为当我告诉我的儿子们时，他们笑了。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: But, yeah, it's a stimulant, so it's rewarding, and it is potentially addictive.

Keith Humphreys：但是，是的，它是一种兴奋剂，所以它是有益的，而且可能会让人上瘾。

But what would you see if someone were addicted?

但如果有人上瘾了，你会看到什么？

Someone comes in and says, "I'm drinking so much, I'm retching.

有人进来说：“我喝太多了，我想吐。

I'm having shooting stomach pains.

我胃痛得厉害。

I can't sleep." You say, "Are you going to stop?" You know, I've actually never met...

我睡不着。”你说：“你要停下来吗？”你知道吗，我其实从未见过……

But perhaps there are some people that say, "No, I can't seem to stop using." I was like, "Okay, that would be addictive."

但也许有人会说，“不行，我似乎无法停止使用”。我当时想，“好吧，那会让人上瘾的。”

Keith Humphreys: But I've never met a true, what I consider, a coffee addict person, because it's not that intense of a stimulant.

基思·汉弗莱斯：但我从未遇到过真正的咖啡成瘾者，因为我认为咖啡并不是那么强烈的兴奋剂。

And the things, you know, GI symptoms and things like that, that would be the main thing, or jitteriness and sleeplessness.

你知道，胃肠道症状和类似的事情，或者紧张不安和失眠，将是主要的事情。

But almost everybody who experiences those seems to quit.

但几乎所有经历过这些的人似乎都会放弃。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: Or at least everyone I've met seems to quit.

Keith Humphreys：或者至少我遇到的每个人似乎都放弃了。

More generally on stimulants, I have to say, this is the biggest disappointment of my career in the addiction field.

更一般地说，关于兴奋剂，我不得不说，这是我在成瘾领域职业生涯中最大的失望。

I started my career in the late '80s.

我在 80 年代末开始了我的职业生涯。

And going into the Lower East Side of Detroit, which was very rough.

并进入底特律下东区，那里非常崎岖。

The crack cocaine, it was everywhere.

强效可卡因，无处不在。

And the treatment offering to people who were addicted to crack cocaine then, in the late '80s, is not very different from what it is today, almost 40 years later.

当时 80 年代末为可卡因成瘾者提供的治疗与近 40 年后的今天没有太大不同。

Andrew Huberman: Which is?

安德鲁·休伯曼：哪个是？

Keith Humphreys: No pharmacotherapy at all.

Keith Humphreys：根本没有药物治疗。

Nothing.

没有什么。

No evidence of anything that works in pharmacotherapy.

没有任何证据表明任何药物治疗有效。

A lot of psychotherapies that don't really seem to work very well.

很多心理治疗似乎效果并不好。

And groups and stuff like that, which have sort of very, at most, modest effects.

还有诸如此类的团体之类的东西，它们的影响至多是非常有限的。

I'm talking about therapy groups.

我说的是治疗小组。

That's not a lot of development.

这并不是很大的发展。

And a lot of people have tried.

并且很多人都尝试过。

I mean, they've tried all kinds of medications for stimulants and just not been able to succeed.

我的意思是，他们尝试了各种兴奋剂药物，但都没有成功。

Keith Humphreys: The only thing that seems to work is contingency management, which are these things where you...

Keith Humphreys：唯一有效的似乎是应急管理，这些事情你......

Steve Higgins, I think, was the first person to do this, where he showed, against the idea that people have no control in addiction, which is, in fact, rare.

我认为史蒂夫·希金斯是第一个这样做的人，他反对人们无法控制成瘾的观点，事实上这种情况很少见。

They have impaired control, but not no control.

他们的控制能力受损，但并非没有控制能力。

Keith Humphreys: He started experimenting with people who were addicted to cocaine, saying, "Well, you're coming into treatment.

基思·汉弗莱斯：他开始对可卡因成瘾的人进行实验，他说：“好吧，你正在接受治疗。

How about tomorrow we'll do a urinalysis when you come in, and if it's a negative urinalysis the first day, we'll give you two bucks, and the day after we'll give you four bucks, and the day after we give you eight bucks, the day after we give you sixteen bucks?" And he found out people stopped.

明天你进来的时候我们给你做个尿检，如果第一天尿检阴性，我们给你两块钱，后天给你四块钱，后天给你八块钱，后天给你十六块钱？”他发现人们停了下来。

They wanted those rewards, and that's managing a contingency.

他们想要这些奖励，这就是管理意外事件。

Keith Humphreys: You can use that to change stimulant users' behavior.

Keith Humphreys：您可以用它来改变兴奋剂使用者的行为。

Also, for other things like, well, if you come in, there's some kind of reward, or if you fill out a job application, there's some kind of reward.

另外，对于其他事情，比如，如果你进来，就会有某种奖励，或者如果你填写一份工作申请，就会有某种奖励。

That is the only thing that really looks good for stimulant use disorder.

这是唯一真正对兴奋剂使用障碍有益的东西。

And it's fine as a behavioral technology, and I'm glad to say it's been expanded a lot.

作为一种行为技术，它很好，我很高兴地说它已经得到了很大的扩展。

You can do it.

你可以做到的。

It's covered by insurance now in most places.

现在大多数地方都有保险。

Keith Humphreys: But it's just disappointing to me that if you took Keith 2025 back to the late '80s and talked to those same people I was meeting coming to treatment, they'd say, "Wow, what new things happened for people like me over the next 40 years, man from the future?" And I'd say, "I'm sorry, basically nothing." And that is really disappointing.

Keith Humphreys：但令我失望的是，如果你把《Keith 2025》带回到 80 年代末，并与我遇到的前来接受治疗的那些人交谈，他们会说，“哇，未来 40 年里，像我这样的人发生了什么新事情，来自未来的人？”我会说：“抱歉，基本上什么都没有。”这确实令人失望。

Andrew Huberman: What about all the prescription stimulants, Adderall, Vyvanse?

Andrew Huberman：所有处方兴奋剂，Adderall，Vyvanse 怎么样？

I feel very lucky that those didn't exist when I was in high school and college and graduate school.

我感到非常幸运，当我在高中、大学和研究生院时，这些并不存在。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: Probably in part, because I like caffeine enough, that I worry that I might have liked them.

安德鲁·休伯曼：可能部分是因为我非常喜欢咖啡因，所以我担心我可能会喜欢它们。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: I've never taken any of the things I just mentioned.

Andrew Huberman：我从来没有拿过我刚才提到的任何东西。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: Back then, we had ephedra and ephedrine pills and things like that, that were sold over the counter, and that always felt too stimulatory.

安德鲁·胡伯曼：当时，我们有麻黄和麻黄碱丸之类的东西，在柜台上出售，总是感觉太刺激了。

Keith Humphreys: Sure.

基思·汉弗莱斯：当然。

Andrew Huberman: Nowadays, I would say, yes, at least half of my friends with male children, those children are on amphetamines for the treatment of ADHD.

安德鲁·胡伯曼：现在，我会说，是的，至少有一半有男孩的朋友，这些孩子正在服用安非他明来治疗多动症。

Keith Humphreys: Uh-huh.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: And they start them young, and then they call me because I have a network, not because I can treat.

安德鲁·胡伯曼：他们从小就开始治疗，然后他们打电话给我，因为我有一个网络，而不是因为我可以治疗。

I'm not a clinician.

我不是临床医生。

But then they call me because they're worried about the growth stunting effects.

但后来他们打电话给我，因为他们担心生长迟缓的影响。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: They're worried their kids aren't going to achieve maximum height.

安德鲁·休伯曼：他们担心自己的孩子无法达到最大身高。

Then they're worried that their kids aren't sleeping or eating.

然后他们担心孩子不睡觉或不吃饭。

So, all the classic symptoms of stimulant addiction and general sets of issues.

因此，兴奋剂成瘾的所有典型症状和一般问题。

So, what are your thoughts about Adderall, Vyvanse, and similar?

那么，您对 Adderall、Vyvanse 和类似产品有何看法？

Keith Humphreys: Those are tough calls for parents.

Keith Humphreys：对于父母来说，这些都是艰难的呼吁。

There are kids whose lives are transformed positively by Ritalin, who cannot sit still, cannot do their homework, and it is transformative.

有些孩子的生活因利他林而发生了积极的改变，他们不能安静地坐着，不能做作业，这是一种变革。

They are, at the same time, I would say, over-prescribed.

同时，我想说，它们的处方过多。

And maybe an example drug that is sometimes both under-prescribed and over-prescribed.

也许是一个有时处方不足和处方过多的药物示例。

There's probably people who could benefit who are not getting them, and there's a lot of people who are getting them that...

可能有些人可以受益但没有得到它们，而且有很多人正在得到它们......

Keith Humphreys: I think there's just less tolerance for some variations in how all our brains worked in medicalizing everything.

Keith Humphreys：我认为，我们的大脑在将一切事物医疗化的过程中，对某些变化的容忍度较低。

And I noticed that a lot, which makes parents anxious.

我经常注意到这一点，这让父母感到焦虑。

Your kid has this thing, and all that, as opposed to it could be, "Well, he is kind of an active kid, or he doesn't pay that much attention, but he doesn't have an illness that needs to be medicated." I worry about that just very generally.

你的孩子有这个东西，所有这些，而不是可能是，“嗯，他是一个活跃的孩子，或者他没有那么注意，但他没有需要治疗的疾病。”我非常普遍地担心这一点。

I worry a kid can't be shy anymore.

我担心孩子不能再害羞了。

Keith Humphreys: They have to be on the spectrum and carry a diagnostic label.

Keith Humphreys：他们必须属于自闭症谱系并带有诊断标签。

And I think there's a lot of that going on, unfortunately.

不幸的是，我认为有很多这样的事情正在发生。

And I sympathize with the parents.

我很同情父母。

I'm not judging any of them, because I know those calls are really, really tough to make.

我不会评判他们中的任何一个，因为我知道做出这些决定真的非常非常困难。

And again, I know some kids whose lives are meaningfully transformed by them.

再说一次，我认识一些孩子，他们的生活被它们有意义地改变了。

So, that's tough.

所以，这很难。

That's tough.

这很难。

Andrew Huberman: Tell me if you disagree with this, and forgive me for citing previous guests, because I'm not an expert.

Andrew Huberman：如果您不同意这一点，请告诉我，请原谅我引用之前的嘉宾，因为我不是专家。

But I hosted a psychiatrist on here who's an expert in ADHD, and his claim is that non-treated ADHD poses a much greater risk for addiction than treating ADHD with substances that, in non-ADHD folks, are addictive.

但我在这里接待了一位精神科医生，他是注意力缺陷多动症方面的专家，他声称，未经治疗的注意力缺陷多动症比使用对非注意力缺陷多动症患者来说会成瘾的物质治疗注意力缺陷多动症带来的成瘾风险要大得多。

In other words, if a kid or adult has ADHD and doesn't medicate, they're at much greater risk of abusing drugs.

换句话说，如果一个孩子或成人患有注意力缺陷多动症并且不接受药物治疗，他们滥用药物的风险就会大大增加。

If you do medicate, they're at much lower risk because it lowers the impulsivity.

如果你服用药物，他们的风险就会低得多，因为它会降低冲动性。

Keith Humphreys: Yeah, that could well be true.

Keith Humphreys：是的，这很可能是真的。

It's not my core area, but it could well be true.

这不是我的核心领域，但很可能是真的。

There is a very high rate of ADHD among people, in adulthood, you see are alcohol addicted, which doesn't seem to be a coincidence, you know?

人们中多动症的发病率非常高，在成年后，你会看到酒精成瘾，这似乎不是巧合，你知道吗？

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: So, that could well be true.

Keith Humphreys：所以，这很可能是真的。

Andrew Huberman: So, when you look out on the landscape of energy drinks, and nicotine has made a big comeback.

安德鲁·休伯曼：所以，当你观察能量饮料的前景时，尼古丁已经卷土重来。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: Big comeback.

安德鲁·休伯曼：大逆转。

Interesting stimulant because it's both a stimulant, but it also relaxes you to some extent.

有趣的兴奋剂，因为它既是一种兴奋剂，但它也在一定程度上让你放松。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: I tried it for a bit, the gums.

安德鲁·休伯曼：我尝试了一下，牙龈。

Despite my caffeine tolerance, I am very sensitive to drugs, so I can do like two milligrams of nicotine gum.

尽管我对咖啡因有耐受性，但我对药物非常敏感，所以我可以吃两毫克尼古丁口香糖。

And I noticed it gave me spasms in my throat when I wasn't taking it.

我注意到当我不服用它时，它会让我喉咙痉挛。

And I was told that's because the muscarinic acetylcholine stimulation.

有人告诉我这是因为毒蕈碱乙酰胆碱的刺激。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: So, your throat starts spasming, then you feel like you need it.

安德鲁·休伯曼：所以，你的喉咙开始痉挛，然后你觉得你需要它。

It's actually a physical sensation.

这实际上是一种身体感觉。

Keith Humphreys: Wow.

基思·汉弗莱斯：哇。

Andrew Huberman: Then the oral health folks tell me that it's bad for gum disease.

安德鲁·休伯曼：口腔健康人士告诉我，这对牙龈疾病有害。

And the skin folks...

还有皮肤人...

This always gets, typically women, but here in LA, men and women, it definitely ages skin faster because of the vasoconstriction in the skin.

这种情况总是会发生，尤其是女性，但在洛杉矶，无论男性还是女性，由于皮肤血管收缩，皮肤老化速度肯定更快。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: So, it makes you look older, even though you're not smoking it, the oral nicotine.

安德鲁·胡伯曼：所以，即使你不吸口服尼古丁，它也会让你看起来更老。

But here I just have to pepper with what I've heard.

但在这里我只需补充一下我所听到的。

We have a Nobel Prize-winning colleague.

我们有一位获得诺贝尔奖的同事。

I'll just name him, it's Richard Axel at Columbia, who told me long ago and many times, "Nicotine is protective against Parkinson's and Alzheimer's," which is why he chews, or did chew tons of Nicorette per day.

我只想说出他的名字，他是哥伦比亚大学的理查德·阿克塞尔，他很久以前就多次告诉我，“尼古丁可以预防帕金森氏症和阿尔茨海默氏症”，这就是他每天咀嚼或确实咀嚼大量尼古丁的原因。

Andrew Huberman: So, what's the deal?

安德鲁·休伯曼：那么，这是怎么回事？

Nicotine seems like it has some benefits.

尼古丁似乎有一些好处。

It might make you look older.

它可能会让你看起来更老。

Maybe you need to take better care of your teeth.

也许你需要更好地照顾你的牙齿。

It's a stimulant, but highly habit-forming and addictive.

它是一种兴奋剂，但很容易形成习惯并且容易上瘾。

So, what's your view on nicotine as an industry and as a substance?

那么，您对尼古丁作为一个产业和一种物质有何看法？

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

I mean, it's a poison.

我的意思是，这是一种毒药。

If you consumed all the nicotine in a carton of cigarettes, it would kill you.

如果你消耗掉一盒香烟中的所有尼古丁，它就会杀死你。

I mean, that's remarkable that it is so popular, because of that, it is exactly the reason you say.

我的意思是，它如此受欢迎真是太了不起了，正因为如此，这正是你所说的原因。

It's both I feel sharper and then yet I feel relaxed at the same time.

我既感觉更敏锐，又同时感到放松。

I think a lot of people who use it are mistaking the treatment of withdrawal for a drug benefit.

我认为很多使用它的人都将戒断治疗误认为是药物益处。

Andrew Huberman: Can you elaborate on that?

安德鲁·休伯曼：你能详细说明一下吗？

Keith Humphreys: Yeah, sure.

基思·汉弗莱斯：是的，当然。

So, let's say you smoke.

那么，假设你吸烟。

When you sleep, obviously, you're not smoking, and the nicotine blood level goes down, and you wake up feeling jittery and jangly and all that, and you have your first cigarette, and it feels great, because you're...

当你睡觉时，显然，你没有吸烟，血液中的尼古丁水平下降，你醒来时感觉紧张、刺痛等等，然后你吸了第一支烟，感觉很棒，因为你……

But that doesn't mean, wow, cigarettes are really good for you.

但这并不意味着，哇，香烟真的对你有好处。

Look, you smoke, and you feel really good.

瞧，你抽烟，感觉真好。

What you're doing is just the withdrawal that makes you agitated and angry and annoying goes away, and you attribute that to the use of the nicotine.

你所做的只是让你烦躁、愤怒和烦人的戒断症状消失，你将其归因于尼古丁的使用。

Keith Humphreys: But it could just be you are dependent on this drug, and what you actually need to do is persist through the days where you will feel cognitively sludgy and maybe a little bit keyed up and all that.

基思·汉弗莱斯：但这可能只是你依赖这种药物，而你真正需要做的是坚持度过那些你会感到认知混乱、可能有点紧张之类的日子。

But then, once you go through the withdrawal, you won't need it to get to that point.

但是，一旦您完成了提款，您就不需要它来达到这一点。

I think there's a lot of people like that.

我想这样的人有很多。

It happens with cannabis a lot, too.

大麻也经常发生这种情况。

I mean, a lot of people say, "I can't sleep without it." So, yeah, well, one sign of cannabis withdrawal is sleeplessness.

我的意思是，很多人说：“没有它我就睡不着。”所以，是的，大麻戒断的症状之一就是失眠。

Keith Humphreys: So, are you sure that you've got a sleep disorder that you're treating and not that you, basically, just are trapped in a cycle of withdrawal and medicating withdrawal?

基思·汉弗莱斯：那么，你确定你正在治疗一种睡眠障碍，而不是说你基本上只是陷入了戒断和药物戒断的循环中？

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: Happens with opioids, too, is another example.

Keith Humphreys：阿片类药物也会发生这种情况，这是另一个例子。

People think, "My pain's coming back," and it's like, "My injury." And it's like, well, could be, but it could also be you're dependent on opioids.

人们会想，“我的疼痛又回来了”，就像是“我的伤”。就像，嗯，可能是，但也可能是你依赖阿片类药物。

Andrew Huberman: What's your advice to those people?

安德鲁·休伯曼：您对这些人有什么建议？

To ride it out?

为了摆脱它？

Keith Humphreys: There are treatments that can make withdrawal easier from different types of drugs.

Keith Humphreys：有一些治疗方法可以使人们更容易戒断不同类型的药物。

But yeah, I mean, if you can get past that point, you could be free of using it at all, and wouldn't that be nice to do?

但是，是的，我的意思是，如果你能超越这一点，你就可以完全不用它了，这不是很好吗？

It's definitely worth running the experiment.

这个实验绝对值得进行。

Andrew Huberman: I'd like to take a quick break and acknowledge one of our sponsors, LMNT.

Andrew Huberman：我想稍微休息一下，并向我们的赞助商之一 LMNT 表示感谢。

LMNT is an electrolyte drink that has everything you need and nothing you don't.

LMNT 是一种电解质饮料，拥有您需要的一切，没有您不需要的东西。

That means the electrolytes, sodium, magnesium, and potassium, all in the correct ratios, but no sugar.

这意味着电解质、钠、镁和钾的比例都正确，但不含糖。

Proper hydration is critical for brain and body function.

适当的水合作用对于大脑和身体功能至关重要。

Even a slight degree of dehydration can diminish your cognitive and physical performance.

即使是轻微程度的脱水也会降低您的认知和身体表现。

It's also important that you get adequate electrolytes.

获得充足的电解质也很重要。

Andrew Huberman: The electrolytes, sodium, magnesium, and potassium, are vital for the functioning of all cells in your body, especially your neurons or your nerve cells.

Andrew Huberman：电解质、钠、镁和钾对于体内所有细胞的功能至关重要，尤其是神经元或神经细胞。

Drinking LMNT makes it very easy to ensure that you're getting adequate hydration and adequate electrolytes.

饮用 LMNT 可以轻松确保您获得足够的水分和电解质。

My days tend to start really fast, meaning I have to jump right into work or right into exercise.

我的日子往往开始得很快，这意味着我必须立即投入工作或立即锻炼。

So, to make sure that I'm hydrated and I have sufficient electrolytes, when I first wake up in the morning, I drink 16 to 32 ounces of water with an LMNT packet dissolved in it.

因此，为了确保我有足够的水分和足够的电解质，当我早上第一次醒来时，我会喝 16 至 32 盎司的水，其中溶解有 LMNT 包。

Andrew Huberman: I also drink LMNT dissolved in water during any kind of physical exercise that I'm doing, especially on hot days when I'm sweating a lot, and losing water and electrolytes.

Andrew Huberman：在进行任何体育锻炼时，我也会饮用溶解在水中的 LMNT，尤其是在炎热的日子里，当我大量出汗并失去水和电解质时。

LMNT has a bunch of great-tasting flavors.

LMNT 有很多美味的口味。

In fact, I love them all.

事实上，我爱他们所有人。

I love the watermelon, the raspberry, the citrus, and I really love the lemonade flavor.

我喜欢西瓜、覆盆子、柑橘，而且我真的很喜欢柠檬水的味道。

So, if you'd like to try LMNT, you can go to drinklmnt.com/huberman to claim a free LMNT sample pack with any purchase.

因此，如果您想尝试 LMNT，可以访问 Drinklmnt.com/huberman，购买任何产品即可领取免费的 LMNT 样品包。

Again, that's drinklmnt.com/huberman to claim a free sample pack.

再次强调，请访问 Drinklmnt.com/huberman 索取免费样品包。

Andrew Huberman: I'm certain a lot of people, including me, are interested in how to avoid getting addicted to things, and how to get over addiction to different things.

Andrew Huberman：我确信很多人，包括我在内，都对如何避免对事物上瘾以及如何克服对不同事物的上瘾感兴趣。

And I'm very curious as to whether or not the field of addiction treatment has started to parse early, middle stage, and kind of late stage addiction, or whether or not it's all just considered addiction.

我很好奇成瘾治疗领域是否已经开始解析早期、中期和晚期成瘾，或者是否都只是被认为是成瘾。

Like, for instance, a number of people now are suspecting that they might be addicted to social media or their phone or texting or something electronic.

例如，许多人现在怀疑他们可能沉迷于社交媒体、手机、短信或电子产品。

They are suspecting that they might be too dependent on food.

他们怀疑自己可能过于依赖食物。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: They might be addicted to X, Y, and Z.

Andrew Huberman：他们可能对 X、Y 和 Z 上瘾。

And I think that represents the great success of you and your colleagues, and people like Anna Lembke, and people being public advocates about what addiction is and isn't.

我认为这代表了您和您的同事、安娜·莱姆克（Anna Lembke）等人以及公众倡导什么是成瘾、什么不是成瘾的人们的巨大成功。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: But to me, it seems like independent of the substance or the behavior, if somebody is early in the experience of feeling like they're weighed down by something, and it's hurting them in some subtle way, very different than somebody who is raising a hand, hopefully, or thinking, hopefully not, about taking their own life because they're so hopelessly addicted to alcohol or drugs, they've lost everything.

安德鲁·休伯曼：但对我来说，这似乎与物质或行为无关，如果一个人很早就感觉到自己被某种东西压垮了，并且以某种微妙的方式伤害了他们，这与那些希望举手或思考（希望不是）结束自己生命的人非常不同，因为他们对酒精或毒品如此无可救药地沉迷于酒精或毒品，他们已经失去了一切。

So, as a clinician, what's your approach if somebody says, "Hey, I think I might have a problem with X"?

那么，作为一名临床医生，如果有人说“嘿，我想我可能对 X 有问题”，您会采取什么措施？

Keith Humphreys: First off, you would say, "Wow, I'm so glad you told me.

Keith Humphreys：首先，你会说，“哇，我很高兴你告诉我。

This is something that tens of millions of people experience, and many of them stay silent about it, and therefore people feel, and you may feel that you are strange or this is shameful or an odd experience when it is really an extremely common experience." And so, you're saying that so the person doesn't feel embarrassed, and they feel comfortable talking about it.

这是数以千万计的人经历过的事情，他们中的许多人对此保持沉默，因此人们会感觉到，你可能会觉得自己很奇怪，或者这是可耻的或奇怪的经历，而实际上这确实是一种极其普遍的经历。”所以，你这么说是为了让对方不会感到尴尬，并且他们会在谈论这件事时感到自在。

Keith Humphreys: The other thing is you convey optimism.

Keith Humphreys：另一件事是你传达了乐观情绪。

You know, there are probably, in surveys, something like 24 million Americans are in recovery.

你知道，根据调查，可能有大约 2400 万美国人正在康复中。

We just don't notice them, because someone in recovery looks like anybody else.

我们只是没有注意到他们，因为康复中的人看起来和其他人一样。

We notice them when they're actively addicted, but not when they're in recovery because they sort of return and they just look like, "Oh, that's just a schoolteacher, that's an accountant, that's a police officer, whatever." But there's a lot of reason for rational hope.

当他们严重上瘾时，我们会注意到他们，但当他们正在康复时，我们不会注意到他们，因为他们有点回归，他们看起来就像，“哦，那只是一名教师，那是一名会计师，那是一名警察，等等。”但我们有很多理由抱有理性的希望。

Keith Humphreys: And in the particular case you're talking about, when someone's just starting to worry, and it's early stage, the odds that they will recover are dramatically higher.

Keith Humphreys：在您谈论的特定情况下，当某人刚刚开始担心并且处于早期阶段时，他们康复的可能性会大大提高。

So, it's much, much easier to sort of pull out before you've burned your life down around you.

所以，在你把周围的生活烧毁之前，退出要容易得多。

Keith Humphreys: So, it's tough when people come in, and you say, "All right, well, do you have family support?" "Well, my family doesn't talk to me anymore." "Okay, do you have at least a safe place to live?" "No, I lost my...

Keith Humphreys：所以，当人们进来时，你会说：“好吧，你有家人支持吗？” “好吧，我的家人不再跟我说话了。” “好吧，你至少有一个安全的住处吗？” “不，我失去了我的...

I'm sleeping on a couch right now." "Well, at work are you..." "No, I lost my job." That's tough for the person to rebuild everything.

我现在正在沙发上睡觉。” “嗯，你在工作吗……” “没有，我失业了。”对于一个人来说重建一切是很困难的。

Keith Humphreys: But if you still have those resources, there's still people who love you in your life, you still have a meaningful role where you're contributing, and you also have some accountability, that's going to help you make that behavior change.

基思·汉弗莱斯：但如果你仍然拥有这些资源，生活中仍然有人爱你，你仍然扮演着有意义的角色并做出贡献，并且你还有一些责任，这将帮助你改变行为。

Whatever it is, I would say that about any behavior change, not just one connected to substances.

不管是什么，我想说的是任何行为改变，而不仅仅是与物质有关的改变。

And then what do we do when we work with people?

那么当我们与人合作时我们该怎么做呢？

Well, we always think about motivation.

嗯，我们总是考虑动机。

Keith Humphreys: It's hard.

基思·汉弗莱斯：这很难。

This may seem strange, but if someone says, "I want to quit smoking," a good clinician will say, "Why would you want to do that?" You think, like, "Well, that's dumb." You should be saying, "Yeah, good.

这可能看起来很奇怪，但如果有人说：“我想戒烟”，优秀的临床医生会说：“你为什么要这么做？”你会想，“好吧，那太愚蠢了。”你应该说：“是的，很好。

Great.

太棒了。

Good." It's like, well, if you don't want to do it, it doesn't matter what I think, right?

很好。”就像，好吧，如果你不想这样做，我怎么想并不重要，对吧？

And also, there's quite a few people, if you push on it, they actually become less likely to do it.

而且，有相当多的人，如果你坚持下去，他们实际上就不太可能这样做了。

If you sort of nag them.

如果你对他们唠叨的话。

Just say, "So tell me, why would you want to...

只需说：“那么告诉我，你为什么要...

What do you want to get out of this?

你想从中得到什么？

Because it's work.

因为这是工作。

I mean, I'm happy to work with you, but what is it?

我的意思是，我很高兴和你一起工作，但这是什么？

What are your motives?"

你的动机是什么？”

Keith Humphreys: And that's reflecting on that like, "Well, here's the thing.

基思·汉弗莱斯：这就是反思，“嗯，事情就是这样。

All my clothes stink, and I hate the way it..." "So, you would enjoy..." And help them elaborate, "So, you would get up, and your clothes would smell really good, and you'd feel good about yourself." Goes, "Yeah, yeah, yeah." It's like, "And I'm spending a lot of money." Say, "How much are you spending on?" Whatever.

我所有的衣服都很臭，我讨厌这样……”“所以，你会喜欢……”并帮助他们详细说明，“所以，你会站起来，你的衣服会闻起来很香，你也会自我感觉良好。”说：“是啊，是啊，是啊。”就像，“我花了很多钱。”说：“你花了多少钱？”任何。

"It's 2000 bucks a year." "So, if you had 2000 bucks because you hadn't smoked in a year, what would you buy for yourself?

“一年2000块钱。” “那么，如果你因为一年没抽烟而有 2000 美元，你会为自己买什么？

What would be something you'd really enjoy?

你真正喜欢的是什么？

Tell me about it."

告诉我吧。”

Keith Humphreys: And sort of helping them build up in their own mind, because again, this is about them, not you.

Keith Humphreys：有点帮助他们建立自己的思想，因为这又是关于他们的，而不是你的。

What do you get?

你得到什么？

Because this is going to be tough.

因为这会很艰难。

And maybe I want to do it today, but in three days I'm going to be in withdrawal, and I'm going to feel like I want to go back, and I need to think about, wait a minute, a year without smoking, I get that 2000 dollar trip to Cancun I've always wanted to take.

也许我今天就想这么做，但三天后我就会戒烟，我会觉得我想回去，我需要考虑一下，等一下，一年不吸烟，我就能得到我一直想参加的 2000 美元的坎昆之旅。

So, that helps motivate them.

所以，这有助于激励他们。

Keith Humphreys: And then you talk, and then we just do some sort of behavioral analysis of where do you use, how much do you use, what do you use?

Keith Humphreys：然后你说话，然后我们只是对你在哪里使用、你使用多少、你使用什么进行某种行为分析？

Are there cues to use?

有可以使用的提示吗？

Often, for many people, there are.

对于很多人来说，通常都是这样。

And also to non-use.

又以不用也。

Are there places where you would never use?

有哪些地方是你永远不会使用的？

"Oh, I'd never use at my mom's house." "Huh.

“哦，我永远不会在我妈妈家里使用。” “哈。

Okay, that's good to know.

好的，很高兴知道这一点。

Maybe you could visit your mom more often." Or "I never smoke on a holy day, and whatever my religion is."

也许你可以多去看望你妈妈。”或者“无论我的宗教信仰是什么，我在圣日从不吸烟。”

Keith Humphreys: "Oh, okay.

基思·汉弗莱斯：“哦，好吧。

So, let's talk about that.

那么，我们来谈谈这个吧。

How do you get through that day?

那天你是怎么度过的？

What are the techniques you use there that we could try on other days?

您在那里使用了哪些技术，我们可以在其他日子尝试？

And also, what are the things that get you in trouble?" Like, "I'm trying to quit drinking." "Well, if I went into your house and opened up the cabinet, what would it be?" "Well, there'd be like 20 different types." I say, "So, could that go somewhere else?

还有，是什么事情让你陷入困境的？”就像，“我正在努力戒酒。” “好吧，如果我走进你家，打开柜子，会是什么？” “嗯，大概有20种不同的类型。”我说：“那么，它可以去其他地方吗？

Could you give that away, so that it's behaviorally harder for you to get this?

你能把它放弃，这样你在行为上就更难得到它吗？

You'd have to go down the street and go to a liquor store, that kind of thing."

你必须沿着街道去一家酒类商店之类的地方。”

Keith Humphreys: Help people on stuff like that.

Keith Humphreys：帮助人们做类似的事情。

And then, there's often practical skills in learning that.

然后，在学习过程中通常会获得实用技能。

Like, how do I manage a social interaction without alcohol, for example?

例如，我如何在不喝酒的情况下进行社交互动？

Or what do I do for fun?

或者我做什么好玩的？

Things like that.

诸如此类的事情。

Or how do I hang out with my friend who loves to drink and explain to him why I can't drink anymore?

或者我该如何和喜欢喝酒的朋友出去玩并向他解释为什么我不能再喝酒了？

Those kinds of things as well.

诸如此类的事情也是如此。

And that's what the therapist does.

这就是治疗师所做的。

The other thing that's really important is that like any other, anytime you're making a behavior change, this may seem like incredibly simple, almost dumb advice, but hang out with other people who are trying to make the same change.

另一件真正重要的事情是，就像任何其他事情一样，每当你要改变行为时，这可能看起来非常简单，几乎是愚蠢的建议，但是与其他试图做出同样改变的人一起出去玩。

Keith Humphreys: You want to start jogging?

基思·汉弗莱斯：你想开始慢跑吗？

Join a jogging group.

加入慢跑小组。

You want to stop drinking?

你想戒酒吗？

I would suggest go check into an AA meeting, or one of the other fellowships we have, LifeRing Recovery or SMART Recovery.

我建议参加 AA 会议，或者我们拥有的其他奖学金之一，LifeRing Recovery 或 SMART Recovery。

Having other people on the same journey is good for us.

让其他人走上同样的旅程对我们有好处。

I mean, everything shows that, no matter what you're doing.

我的意思是，一切都表明，无论你在做什么。

I'm losing weight.

我正在减肥。

I'm exercising.

我正在锻炼。

Whatever.

任何。

I'm quitting smoking.

我要戒烟了。

Because it gives you two things.

因为它给了你两件事。

It gives you support, but it also gives you some accountability.

它给你支持，但也给你一些责任。

Keith Humphreys: It's like, "Hey, you were going jogging, and on Tuesday you weren't there.

基思·汉弗莱斯：就像是，“嘿，你本来要去慢跑，但周二你却不在那里。

What's up?

怎么了？

Are you going to be part of this group or not?" And that is helpful for people, the combination of the two.

你是否愿意加入这个团体？”两者的结合对人们很有帮助。

So, all those things we encourage people to do.

所以，我们鼓励人们做所有这些事情。

Andrew Huberman: That's wonderful to hear some concrete questions that one would ask, because I think people have heard of just quit.

安德鲁·休伯曼：很高兴听到人们提出一些具体问题，因为我认为人们听说过“戒烟”。

I think a lot of people who aren't familiar with addiction as a chemical brain circuit, hormonal, full-body, full-brain issue, but mostly a brain circuit issue...

我认为很多人不熟悉成瘾是一种化学脑回路、荷尔蒙、全身、全脑问题，但主要是脑回路问题......

Keith Humphreys: Sorry, it almost makes me laugh, just think like, someone's going to say, "My God, why didn't I think of that before?

基思·汉弗莱斯：抱歉，这几乎让我笑了，就像有人会说，“天哪，为什么我以前没有想到这一点？

Thanks, doctor."

谢谢，医生。”

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: And stamp on a cigarette and walk out.

Keith Humphreys：然后踩上一支香烟，然后走出去。

Andrew Huberman: I know.

安德鲁·休伯曼：我知道。

Keith Humphreys: Well, yeah.

基思·汉弗莱斯：嗯，是的。

Andrew Huberman: It's wild, right?

Andrew Huberman：这很疯狂，对吧？

I mean, addiction used to be looked at as a character defect.

我的意思是，成瘾曾经被视为一种性格缺陷。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: And certainly, addicts have character defects, but I would argue at no greater rate than a non-addicts.

安德鲁·休伯曼：当然，成瘾者有性格缺陷，但我认为，这种缺陷并不比非成瘾者更大。

Keith Humphreys: Everybody has character defects.

基思·汉弗莱斯：每个人都有性格缺陷。

Andrew Huberman: Everybody has character defects.

安德鲁·休伯曼：每个人都有性格缺陷。

Exactly.

确切地。

And part of the reason I think it was viewed as a character defect is that A, addictions vary, and susceptibility to them varies.

我认为这被视为性格缺陷的部分原因是 A，成瘾程度各不相同，而且对成瘾的敏感性也各不相同。

So, if it's been easy for me to quit drinking alcohol and I wasn't aware of what addiction is, I might look at somebody who is having a hard time quitting drinking and just think, "Well, just quit.

所以，如果我戒酒很容易，而且我不知道什么是成瘾，我可能会看着一个很难戒酒的人，然后想：“好吧，戒掉吧。

I did it."

我做到了。”

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Yes.

是的。

Yeah

是啊

Andrew Huberman: "You can." This kind of thing.

安德鲁·休伯曼：“你可以。”这种事。

And just swap whatever substance or behavior for alcohol there.

然后用任何物质或行为来换取酒精。

Andrew Huberman: And then, I think the other reason is that, oftentimes, sadly, addicts hurt people around them in their addiction.

安德鲁·休伯曼：然后，我认为另一个原因是，可悲的是，成瘾者常常会因为成瘾而伤害周围的人。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: They lose money that wasn't theirs.

Andrew Huberman：他们损失了不属于他们的钱。

They harm themselves or others psychologically or physically.

他们在心理或身体上伤害自己或他人。

And I mean, I know drug addicts that it had to come down to their kid getting into their drugs and almost dying before they finally quit.

我的意思是，我知道吸毒成瘾者必须归结为他们的孩子吸毒并在他们最终戒烟之前几乎死去。

And even at that time, they were concerned that they might not be able to quit, even though they adore their children and wife.

即使在那时，他们也担心自己可能无法戒烟，尽管他们很爱自己的孩子和妻子。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Yeah.

是的。

Andrew Huberman: Fortunately, that person is still sober some years later.

安德鲁·休伯曼：幸运的是，几年后那个人仍然清醒。

But it's like, you can imagine, from the outside, you can come up with some pretty good character defect arguments when you observe that kind of thing.

但你可以想象，从外部来看，当你观察到这种事情时，你可以想出一些非常好的性格缺陷论点。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: But when these people get sober, it's spectacular how the real person seems to emerge.

安德鲁·休伯曼：但是当这些人清醒过来时，真实的人似乎就会出现，这是令人惊叹的。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: Which points to the fact that the addiction masks something about who they truly are, not the other way around.

安德鲁·胡伯曼（Andrew Huberman）：这表明了这样一个事实，即成瘾掩盖了他们的真实身份，而不是相反。

Keith Humphreys: No, I agree with that.

基思·汉弗莱斯：不，我同意这一点。

And I think you're right that a lot of the explanations from addiction come from people who are hurt and angry, with good reason.

我认为你是对的，很多关于成瘾的解释都来自那些受伤和愤怒的人，这是有充分理由的。

They had an addicted parent, and that was hard for them.

他们有一个上瘾的父母，这对他们来说很难。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: Or their marriage is disintegrating, and so they're mad, and so they're going to have a certain amount of venom in how they explain this, sort of understandably.

基思·汉弗莱斯：或者他们的婚姻正在瓦解，所以他们很生气，所以他们在解释这一点时会带有一定程度的恶意，这是可以理解的。

And in addiction, people do things they would not otherwise do.

在成瘾中，人们会做一些原本不会做的事情。

I mean, like you're saying, lying about lots of things that they normally wouldn't lie about.

我的意思是，就像你说的，在很多他们通常不会撒谎的事情上撒了谎。

Like, "I promise I'll show up to the baseball game and watch you play your game." Or, "Yeah, I'm going to save up some money and we're going to get the plumbing fixed," but I'm actually spending it on drugs, those types of things.

就像，“我保证我会去看棒球比赛，看你打比赛。”或者，“是的，我要存点钱，我们要把管道修好，”但我实际上把钱花在毒品上，诸如此类的事情上。

Keith Humphreys: And that hurts people.

Keith Humphreys：这会伤害人们。

And it's very important to acknowledge that, because sometimes the language, the message that sometimes the government, public health people have given about addiction as a disease, sounds scolding to people who've been harmed by addicted people.

承认这一点非常重要，因为有时政府、公共卫生人员所传达的关于成瘾是一种疾病的语言、信息，对于那些受到成瘾者伤害的人来说，听起来像是在责骂。

Keith Humphreys: Like I'm saying, "We don't feel sorry for you.

基思·汉弗莱斯：就像我说的，“我们并不为你感到难过。

We feel sorry for this person.

我们为这个人感到难过。

They're ill." And it's almost like, "How dare you be angry at your mother?

他们病了。”这几乎就像是，“你怎么敢对你妈妈生气？

She was ill.

她病了。

It wasn't her fault." It's like, it still hurts.

这不是她的错。”好像，还是很痛。

If someone who has dementia goes on an angry rant and says a lot of nasty things, it still hurts, it's still scary.

如果患有痴呆症的人愤怒地咆哮并说了很多难听的话，那仍然会很痛，仍然很可怕。

The fact that it's a disease doesn't change your experience as a person.

它是一种疾病的事实并不会改变你作为一个人的经历。

And so, I'm always trying, in public messaging, to acknowledge that the pain is enormous.

因此，我总是试图在公共信息中承认这种痛苦是巨大的。

It's really tough to live with an addicted person.

和一个上瘾的人一起生活真的很难。

It's hard.

这很难。

Andrew Huberman: It's a complicated problem from public health and just psychologically.

安德鲁·休伯曼：这是一个复杂的公共卫生问题和心理问题。

I mean, we're in the wake right now of Robert Reiner and his wife being killed by stabbing, which seems additionally violent and horrible, by their son, it seems, he's been charged anyway, who is an addict.

我的意思是，我们现在正目睹罗伯特·雷纳和他的妻子被他们的儿子刺死，这看起来也很暴力和可怕，无论如何，他似乎已经被指控，他是一个瘾君子。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: And the photos of him that are going up make him look quite angry and deranged, frankly.

安德鲁·休伯曼：坦率地说，他的照片看起来非常愤怒和精神错乱。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: It's going to be interesting to see how that shapes people's views of addicts and addiction, and the fact that he was supported by his parents for a long time in that addiction.

安德鲁·胡伯曼：看看这如何影响人们对成瘾者和成瘾的看法，以及他在成瘾中长期得到父母支持的事实，这将会很有趣。

They even made a movie together, which wasn't a very good movie, and everyone knew it.

他们甚至还一起拍了一部电影，那不是一部很好的电影，大家都知道。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: It felt like a desperate attempt to rescue his son through his profession, and it just descended as tragically as it possibly could.

安德鲁·胡伯曼：这感觉就像是一次绝望的尝试，试图通过他的职业来拯救他的儿子，而且它只是尽可能悲惨地降临。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: And then, we have this quote, unquote "homeless problem," which is perhaps also an addiction issue in part.

安德鲁·休伯曼：然后，我们有这句话，不引用“无家可归问题”，这可能也是一个成瘾问题。

Keith Humphreys: In part, yes.

Keith Humphreys：部分是的。

Andrew Huberman: Thanks for mentioning that addicts are in pain.

安德鲁·休伯曼：感谢您提到吸毒者正在承受痛苦。

But the people around them are in a lot of pain also.

但他们周围的人也承受着很大的痛苦。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: It'd be interesting if, in the future, addiction could be framed as a context, as opposed to a person.

安德鲁·胡伯曼（Andrew Huberman）：如果将来可以将成瘾视为一种背景，而不是一个人，那会很有趣。

But it's hard to separate the behavior from the person.

但很难将行为与人分开。

Keith Humphreys: That's right.

基思·汉弗莱斯：没错。

If you grow up with an addicted parent, as a kid, you won't understand all that anyway, right?

如果你和一个上瘾的父母一起长大，作为一个孩子，你无论如何也不会理解这一切，对吗？

You just know you're wanting love and attention, and you're not getting it.

你只知道你想要爱和关注，但你没有得到。

And that's a very common experience to grow up with an addicted parent.

在父母上瘾的情况下长大，这是一种非常常见的经历。

And that can generate lifelong negative feelings about it to people.

这可能会给人们带来终生的负面情绪。

Keith Humphreys: And again, I say understandably, even if you do eventually come to the view that, "Yeah, dad had a disease," or "Mom had a disease," you still didn't get what you wanted at the time.

基思·汉弗莱斯：再说一次，我可以理解的是，即使你最终确实认为“是的，爸爸得了病”或“妈妈得了病”，你当时仍然没有得到你想要的东西。

And so, there will be grief and sadness about that.

因此，会有悲伤和悲伤。

Andrew Huberman: Asking why would you want to quit is a very interesting question.

Andrew Huberman：问你为什么想戒烟是一个非常有趣的问题。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Keith Humphreys: Seems strange, doesn't it?

Keith Humphreys：看起来很奇怪，不是吗？

Andrew Huberman: Yeah, and I want to talk for a moment about the "carrots and the sticks."

Andrew Huberman：是的，我想谈谈“胡萝卜加大棒”。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: The sticks are kind of obvious, in most cases.

Andrew Huberman：在大多数情况下，这些棍子是显而易见的。

Well, if I wasn't smoking, I wouldn't have to pay for cigarettes, I wouldn't smell bad, I wouldn't cough so much.

好吧，如果我不抽烟，我就不用花钱买烟，我就不会闻起来难闻，我就不会咳嗽得那么厉害。

The "carrots" are often a little more cryptic, and probably harder for people to think about, for the addict to think about, if they're very far into their addiction.

“胡萝卜”往往更加神秘，如果人们已经沉迷其中，那么对于人们来说，对于成瘾者来说，可能更难以思考。

Recently, I observed some spectacularly enormous, frankly, weight-loss achievements of some famous people.

最近，我观察到一些名人的减肥成果，坦率地说，是惊人的、巨大的。

Andrew Huberman: Country music singer Jelly Roll.

Andrew Huberman：乡村音乐歌手 Jelly Roll。

Forgive me, that's his name.

原谅我，这是他的名字。

I didn't name him that.

我没有给他起这个名字。

That was his name.

那是他的名字。

He was a giant man.

他是一个巨人。

He was in excess of 400 pounds or something.

他的体重超过 400 磅左右。

Lost over 300 pounds, and he's a transformed human being.

体重减轻了 300 多磅，他整个人都变了。

The way he talks about what he's doing, he's running 5Ks and half marathons.

他谈论自己正在做的事情时说，他正在跑 5 公里和半程马拉松。

I mean, he's a completely different person.

我的意思是，他是一个完全不同的人。

Andrew Huberman: But for somebody who's still stuck in the very large body, they can't imagine those "carrots" because they've never really lived in them.

安德鲁·胡伯曼：但是对于那些仍然被困在巨大身体里的人来说，他们无法想象那些“胡萝卜”，因为他们从未真正生活在其中。

And so, how do you make a "carrot" motivation, a positive motivation, feel real for a patient, in a way that it can really pull them forward, as opposed to just all the stuff that they're not going to feel?

那么，如何才能让患者产生一种“胡萝卜”动机，一种积极的动机，让他们感到真实，从而真正推动他们前进，而不是仅仅让他们感受到他们不会感受到的东西呢？

Because you have to be pretty close to losing it all for the "sticks" to really matter.

因为你必须非常接近失去一切，“棍子”才真正重要。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Yeah, so all people, to some extent, discount future rewards to some.

是的，所以所有人在某种程度上都会对某些人的未来奖励打折。

So, we buy the five-dollar latte instead of putting it in our retirement, even though if we did that every day, we would have a million dollars when we were 65, right?

所以，我们买了五美元的拿铁咖啡，而不是把它存入退休金，即使我们每天都这样做，当我们 65 岁时我们就会拥有一百万美元，对吗？

And in addiction, they do it even more.

而一旦上瘾，他们就会做得更多。

So, in addition, if you ask people, would you take five dollars today or 20 dollars tomorrow?

那么，另外，如果你问别人，你今天拿5美元还是明天拿20美元？

They're more likely to say five dollars right now.

他们现在更有可能说五美元。

Almost as if tomorrow doesn't exist.

几乎就好像明天不存在一样。

Keith Humphreys: So, this really is a problem, and you can't really say to people, "If you get in recovery, after five years, I bet you'll meet a nice person, and you'll get married and settle down.

基思·汉弗莱斯：所以，这确实是一个问题，你不能对人们说，“如果你康复了，五年后，我打赌你会遇到一个好人，你会结婚并安定下来。

And then you'll go back to school and get a job." It's like that's all fantasy camp kinds of stuff, right?

然后你就会回到学校并找到一份工作。”好像这都是幻想营之类的东西，对吧？

It's okay to have those long-term goals.

拥有这些长期目标是可以的。

Sometimes those are very motivating.

有时这些非常激励人心。

Keith Humphreys: But you want to focus on things that are immediate, because that's the world they're living in, a world of immediacy.

Keith Humphreys：但是你想要关注即时的事情，因为这就是他们生活的世界，一个即时的世界。

For example, you will have more money every day.

例如，你每天都会有更多的钱。

If you're using an illegal drug, your risk of arrest will drop to zero immediately once you stop engaging in these transactions.

如果您使用非法药物，一旦您停止从事这些交易，您被捕的风险将立即降至零。

You will feel physically better very, very quickly than you feel right now.

你会比现在感觉身体好得多、快得多。

And social reinforcement really matters, too.

社会强化也确实很重要。

Keith Humphreys: There's this is one of the geniuses of the people who developed the 12-step fellowships.

Keith Humphreys：这是开发 12 步奖学金的天才之一。

The fact that you get literal status by how many days, or years, you have not used the substance, and you get respect.

事实上，你有多少天或多少年没有使用过这种物质，你就获得了真正的地位，并且你得到了尊重。

And we care about those things for very good reasons.

我们关心这些事情是有充分理由的。

They've been central to the survival of the species.

它们对于物种的生存至关重要。

I've always thought it was clever of AA to have the "one-day-at-a-time" concept, which just maybe seems hokey, like a slogan.

我一直认为 AA 提出“一次一天”的概念是很聪明的，但这可能看起来很做作，就像一个口号。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: But you can't suddenly quit drinking for the rest of your life.

Keith Humphreys：但是你不可能在余生中突然戒酒。

It's not here yet, right?

还没到，对吧？

And that just seems inconceivable.

这似乎是不可思议的。

But can you not drink today?

不过今天可以不喝酒吗？

Not drink today and go to a meeting and get some reward for that?

今天不喝酒去参加一个会议并获得一些奖励吗？

Yeah, you can probably do that.

是的，你也许可以做到。

And so, just do that every day, and then you will have 30 years, eventually.

所以，只要每天都这样做，最终你就会有30年的时间。

But you don't have to wait for all those rewards, because very, very few people can do that.

但你不必等待所有这些奖励，因为很少有人能做到这一点。

And of the ones who really can, they're probably not very prone to addiction.

而那些真正能上瘾的人，他们可能不太容易上瘾。

People who are, think that far ahead all the time, and have extremely high self-control, seem to be less likely.

那些总是认为自己遥遥领先、自我控制能力极高的人似乎不太可能做到这一点。

Andrew Huberman: And what about the addictions where people either believe or it's actually true that it helps them be more functional in other areas of their life?

安德鲁·休伯曼：人们相信或实际上确实可以帮助他们在生活的其他领域发挥更大作用的成瘾又如何呢？

Less social anxiety with two or three drinks.

喝两三杯酒可以减少社交焦虑。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: You know, taking a prescription stimulant, and get your work done.

安德鲁·胡伯曼：你知道，服用处方兴奋剂，然后完成你的工作。

Maybe they are true ADHD, but not revealing anything that isn't already known.

也许他们是真正的多动症，但没有透露任何未知的东西。

I mean, stimulants raise levels of alertness.

我的意思是，兴奋剂可以提高警觉性。

Alertness is a prerequisite for focus, and you're out of the gate, whether it's caffeine or people who are taking...

警觉性是集中注意力的先决条件，无论是咖啡因还是服用...

And I think even on our dear Stanford campus, I would bet that there are students who are not prescribed Adderall, Vyvanse, and other stimulants that take them in order to get work done.

我想，即使在我们亲爱的斯坦福大学校园里，我敢打赌，也有一些学生没有服用阿得拉、维凡斯和其他兴奋剂来完成工作。

Keith Humphreys: Surely, yeah.

基思·汉弗莱斯：当然，是的。

Andrew Huberman: It's a very competitive place, and they're driven, and no one wants to feel tired when you got work to do.

Andrew Huberman：这是一个竞争非常激烈的地方，他们充满动力，没有人愿意在有工作要做时感到疲倦。

Keith Humphreys: So, this is also part of when you look at motivation.

Keith Humphreys：所以，这也是你看待动机的一部分。

So what some people think what you do is you say, "Drugs are bad.

所以有些人认为你所做的就是说：“毒品是不好的。

Look at all these things it's ruining.

看看它正在毁坏的所有这些东西。

It does this.

它就是这样做的。

It's hurting you this way, that way, this way." In effect, you're kind of telling the person they're an idiot, right?

它以这样、那样、这样的方式伤害你。”实际上，你是在告诉那个人他们是个白痴，对吧？

If you actually do that.

如果你真的这么做的话。

So you get them to articulate.

所以你让他们表达清楚。

Well, clearly you like some things about it.

嗯，显然你喜欢其中的一些东西。

What are they?

这些是什么？

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And put them on the table.

Keith Humphreys：然后把它们放在桌子上。

"Well, it's just like, my friendship group has always drunk, and I would just love those hunting trips.

“嗯，就像，我的朋友们总是喝醉，我很喜欢那些狩猎旅行。

We all get shit-faced together, and it's real fun." Okay, so that'd be one thing you're getting.

我们都在一起搞砸了，这真的很有趣。”好吧，这就是你得到的一件事。

What else?

还有什么？

Tell me.

告诉我。

And you're not framing this as a struggle between you, as the punishing force, that's going to deny that this person has enjoyed something about this, or gets something out of it socially.

你不会将这视为你们之间的斗争，作为惩罚性的力量，这会否认这个人对此感到高兴，或者在社交上从中得到一些东西。

And you say, "So this is what we need to decide.

你说：“所以这就是我们需要做出的决定。

These are the costs, and these are the benefits.

这些是成本，这些是收益。

It's your life, not mine.

这是你的生活，不是我的。

Do you want to go for this or not?"

你到底想不想去？”

Keith Humphreys: And you acknowledge the grief of those things.

基思·汉弗莱斯：你承认这些事情的悲伤。

Like, "Man, I'm used to be so much closer to my college buddies, and now I had to skip our annual trip for the first time because I was afraid I would relapse." Like, "Wow, that is a real cost." I mean, that has to be grieved.

就像，“伙计，我习惯了和我的大学好友走得更近，现在我不得不第一次跳过我们的年度旅行，因为我担心我会旧病复发。”就像，“哇，这是真正的成本。”我的意思是，这必须令人悲伤。

And there are many things like that.

类似的事情还有很多。

Keith Humphreys: I know people with relationships where one person nagged the other to quit drinking, and then, when the person got sober, left them.

基思·汉弗莱斯（Keith Humphreys）：我认识一些人，他们的关系中，一个人催促另一个人戒酒，然后，当对方清醒过来时，就离开了他们。

Because they changed a lot, in ways that they didn't like.

因为他们改变了很多，而且是以他们不喜欢的方式改变的。

And it turned out there were certain aspects of their drinking problem that worked for that other person.

事实证明，他们的饮酒问题的某些方面对另一个人也有效。

Whether it was, "Well, I had more control over the checkbook, because you were always drunk, and I got to make my spending decisions by myself."

是否是，“嗯，我对支票簿有更多的控制权，因为你总是喝醉了，我必须自己做出支出决定。”

Keith Humphreys: Or you know, "I find, now that we're talking more, I realize I don't like a lot of things you said before." And that's all real.

基思·汉弗莱斯：或者你知道，“我发现，现在我们谈论得更多，我意识到我不喜欢你之前说的很多事情。”这都是真的。

I mean, those kinds of things happen.

我的意思是，这类事情确实会发生。

Drugs always work in some crude sense.

药物总是在某种粗略的意义上发挥作用。

I mean, they're certainly beneficial, but they have some function, right?

我的意思是，它们当然是有益的，但它们也有一些功能，对吧？

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And you got to figure that out, because that will change if this drug use changes..

Keith Humphreys：你必须弄清楚这一点，因为如果这种药物的使用发生变化，情况就会改变。

Andrew Huberman: Yeah, the partner example is interesting, because there's this whole notion of co-dependents teaming up with, or partnering up with addicts.

安德鲁·胡伯曼：是的，伴侣的例子很有趣，因为有共同依赖者与成瘾者合作或合作的整个概念。

This is why things like "Co-Dependents Anonymous" and...

这就是为什么像“共同依赖匿名者”这样的事情和......

Keith Humphreys: Yeah, I think that's a bit overstated, honestly, but...

Keith Humphreys：是的，老实说，我认为这有点夸张，但是......

Andrew Huberman: You think so?

安德鲁·休伯曼：你这么认为吗？

Keith Humphreys: Yeah, yeah.

基思·汉弗莱斯：是的，是的。

One of the really interesting study which was done by Ruth Cronkite.

露丝·克朗凯特（Ruth Cronkite）所做的一项非常有趣的研究。

It was my colleague for a while.

这是我有一段时间的同事。

And it was of women who were married to alcoholic men, and did all the things that fit the co-dependent thing.

这是与酗酒的男人结婚的女人的故事，她们做了所有符合相互依赖的事情。

But then, when the men got sober, and they went back and studied them a year later, the women looked exactly like women of men who had never been alcoholic.

但是，当男人们清醒过来，一年后他们回去研究时，发现这些女人看起来和从未酗酒的男人的女人一模一样。

Andrew Huberman: Hmm.

安德鲁·休伯曼：嗯。

Keith Humphreys: So, a lot of the things that are attributed to the personality of the co-dependent person is actually a reaction to addiction.

基思·汉弗莱斯：所以，许多归因于相互依赖者的性格的事情实际上是对成瘾的反应。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: They're hyper responsible.

Keith Humphreys：他们非常负责任。

They have to be, because the mortgage won't get paid.

他们必须这样做，因为抵押贷款将无法偿还。

They're placating.

他们在安抚。

Well, they have to be because they've got this volatile person, potentially dangerous person.

嗯，他们必须如此，因为他们有这个反复无常的人，有潜在危险的人。

That's where a lot of that comes from.

这就是很多内容的来源。

And I think it was a bit unfair.

我认为这有点不公平。

I mean, obviously, the people have bad taste in partners.

我的意思是，很明显，人们对伴侣的品味很差。

There's no doubt about that.

毫无疑问。

But maybe a bit unfair to not appreciate a lot of things families do, are more reactive than something that was preexistent and fit with an addiction.

但如果不欣赏家庭所做的很多事情，可能有点不公平，这些事情比以前存在的、与成瘾相适应的事情更具反应性。

Andrew Huberman: That's a really important point, because I think most people think the addict-codependent pairing is almost like a prerequisite.

安德鲁·休伯曼：这是非常重要的一点，因为我认为大多数人认为成瘾者与依赖者的配对几乎是一个先决条件。

And it actually reminds me of this whole literature, which I think is an important literature that became popular about avoidant attachment versus anxious attachment, and this idea that people always pair up along these dimensions.

它实际上让我想起了整个文献，我认为这是一部重要的文献，它流行于回避型依恋与焦虑型依恋，以及人们总是沿着这些维度配对的想法。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: But the studies that have been carried out subsequent to those naming categories is that, put each of those people in a different context, and they behave very differently.

安德鲁·休伯曼：但是在这些命名类别之后进行的研究表明，将每个人置于不同的背景下，他们的行为就会非常不同。

And you can...

而且你可以...

Keith Humphreys: Ah, yeah.

基思·汉弗莱斯：啊，是的。

Andrew Huberman: So, we're more plastic in our psychologies, in our romantic pairings, than perhaps we assume.

安德鲁·休伯曼：所以，我们的心理、浪漫的配对比我们想象的更具可塑性。

Keith Humphreys: And it's also true that there are people who, 10 years into addiction, find they're not married to the person they married, because that person has changed an awful lot.

基思·汉弗莱斯：确实，有些人上瘾十年后，发现自己并没有和自己结婚的人结婚，因为那个人已经改变了很多。

So maybe they were originally pretty social, pretty competent, pretty honest, and then after 10 years of heroin use or whatever, they are none of those things.

所以也许他们本来就很社交、很能干、很诚实，但在吸食海洛因十年或其他什么之后，他们就不再是那些东西了。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And it feels like, to the married person, it's like this is just not the person I married in the first place.

基思·汉弗莱斯：对于已婚人士来说，感觉就像这不是我最初结婚的人。

That's why we don't match, not because I picked the wrong person, but that person changed, yeah.

这就是为什么我们不匹配，不是因为我选错了人，而是那个人变了，是的。

Andrew Huberman: In keeping with that, and the original question, which was different stages of addiction, perhaps, requiring different approaches, there's this idea, perhaps, trying to remove my neuroscientist lens here.

安德鲁·胡伯曼：根据这一点，以及最初的问题，即成瘾的不同阶段，也许需要不同的方法，也许有这个想法，试图去掉我的神经科学家镜头。

But I believe, I'll just be open about this, I believe that at some point, if you use certain substances long enough, the brain is changed significantly enough, that the opportunity for recovery is different depending on whether or not you go to a meeting, which certainly works for, let's just say all of the addictions early on, probably most of them in the middle.

但我相信，我会对此持开放态度，我相信在某些时候，如果你使用某些物质足够长的时间，大脑就会发生足够大的变化，恢复的机会会根据你是否参加会议而有所不同，这当然适用于早期的所有成瘾，可能大多数都在中间。

Keith Humphreys: Mm.

基思·汉弗莱斯：嗯。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: But I know a few ex-heroin addicts.

安德鲁·休伯曼：但我认识一些前海洛因成瘾者。

They're different.

他们是不同的。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: They're still different, even though they're sober.

Andrew Huberman：尽管他们很清醒，但他们仍然不同。

I knew them before.

我以前就认识他们。

Now, it's not a perfect experiment because there was time, et cetera.

现在，这不是一个完美的实验，因为还有时间等等。

But we know that certain drugs actually kill neurons.

但我们知道某些药物实际上会杀死神经元。

Keith Humphreys: Oh, yeah.

基思·汉弗莱斯：哦，是的。

Andrew Huberman: Certain drugs rewire the reward circuitry, and the person is different.

安德鲁·休伯曼：某些药物会重新连接奖励回路，而人是不同的。

It's not to say that they shouldn't quit.

这并不是说他们不应该放弃。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: They should.

安德鲁·休伯曼：他们应该这样做。

But it's harder to imagine sitting down with someone who's been using heroin or methamphetamines for a number of years and say, "All right, let's think about how you're losing.

但很难想象与一个多年来一直使用海洛因或甲基苯丙胺的人坐下来说：“好吧，让我们想想你是如何失败的。

Let's see what you could win in this circumstance." I mean, I hope that's the case.

让我们看看在这种情况下你能赢得什么。”我的意思是，我希望情况如此。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: But it seems like they're rewired.

Andrew Huberman：但它们似乎被重新布线了。

They're a different beast.

他们是不同的野兽。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Well, that is fundamental to the understanding of the disorder, i.e., a change in the brain.

嗯，这是理解这种疾病（即大脑的变化）的基础。

And you can call it a disease, you can call it a disorder.

你可以称其为疾病，也可以称其为紊乱。

I often think of it as deeply maladaptive learning.

我经常认为这是一种深度适应不良的学习。

I'm like that rat who really, really believes the most important next thing for me to do is to consume this powder.

我就像那只老鼠，真的相信我接下来要做的最重要的事情就是吃掉这种粉末。

And when I'm ignoring all of the things that I'm evolved to do instead.

当我忽略了我进化而来要做的所有事情时。

Keith Humphreys: So, it is definitely true.

Keith Humphreys：所以，这绝对是真的。

You see these changes, and you can observe them in the brain, and it's amazing.

你看到这些变化，并且可以在大脑中观察到它们，这真是太神奇了。

You can even predict things that the person can't even report on.

您甚至可以预测该人甚至无法报告的事情。

So, we did some work myself, Claudia Padula, Brian Knutson, Kelly MacNiven, up at the VA in Menlo Park, of people who were in a residential program addicted to methamphetamine.

因此，我们自己、克劳迪娅·帕杜拉 (Claudia Padula)、布莱恩·克努森 (Brian Knutson)、凯利·麦克尼文 (Kelly MacNiven) 在门洛帕克的退伍军人事务部做了一些工作，调查对象是那些在住宅项目中对甲基苯丙胺上瘾的人。

All of them were off methamphetamine while they were in the residential, okay?

他们在住宅区时都吸食了甲基苯丙胺，好吗？

And then, imaging them and showing them cues of meth-associated things, like the pipe or the powder and all that.

然后，对他们进行成像并向他们展示与冰毒相关的东西的线索，比如管道或粉末等等。

Keith Humphreys: And asking them, "How much do you like that?

基思·汉弗莱斯：然后问他们，“你们有多喜欢这个？

What do you feel towards that?" Well, independent of that, there's also nucleus accumbens activation that you can see.

你对此有何感想？”嗯，除此之外，你还可以看到伏隔核的激活。

And that predicted who relapsed.

这预测了谁会复发。

Not what they said, but what was going on in their brain.

不是他们说了什么，而是他们脑子里在想什么。

They didn't even necessarily know it.

他们甚至不一定知道。

Andrew Huberman: We should say the nucleus accumbens is a critical node within the dopamine reward circuitry of the brain that underlies the path to addiction and many other things that initially feel good.

安德鲁·休伯曼：我们应该说伏隔核是大脑多巴胺奖励回路中的一个关键节点，它是成瘾和许多其他最初感觉良好的事情的基础。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Yeah, that's right.

是的，没错。

Andrew Huberman: So, the brain was report...

安德鲁·休伯曼：所以，大脑是报告......

Nucleus accumbens, let's just put in dopamine activation as a proxy.

伏隔核，让我们用多巴胺激活作为代理。

Keith Humphreys: Yes, right, right.

基思·汉弗莱斯：是的，对，对。

Right.

正确的。

Andrew Huberman: So, levels of dopamine activation, so to speak, we're being neuroscience-y here, not technically precise, levels of dopamine activation predicted whether or not the person would relapse better than their own self-report of the subjective feeling of whether or not they would relapse.

安德鲁·休伯曼：所以，多巴胺激活水平，可以这么说，我们在这里是神经科学的，技术上并不精确，多巴胺激活水平可以更好地预测一个人是否会复发，而不是他们自己报告的主观感觉是否会复发。

Keith Humphreys: Yes.

基思·汉弗莱斯：是的。

I crave this.

我渴望这个。

Keith Humphreys: I like this.

基思·汉弗莱斯：我喜欢这个。

Andrew Huberman: Got it.

安德鲁·休伯曼：明白了。

Keith Humphreys: I want this.

基思·汉弗莱斯：我想要这个。

And it helps explain why addicted people sometimes get an unfair rap in terms of, well, they lie about what their desires are.

这有助于解释为什么上瘾的人有时会因为他们谎报自己的欲望而受到不公平的批评。

"I really, really want to stop using." Well, I would assume if they're in a residential program for 28 days, they do, in fact, want to stop using.

“我真的非常想停止使用。”好吧，我假设如果他们参加了 28 天的住宿计划，他们实际上确实想停止使用。

But they don't have complete insight into what's going on inside the brain, like anyone else's.

但他们并不像其他人那样完全了解大脑内部正在发生的事情。

Keith Humphreys: So, those two people would both say, "I really, really want to do this." And one goes out and relapses, and the other doesn't.

Keith Humphreys：所以，这两个人都会说，“我真的、真的很想这么做。”一个出去后又旧病复发，而另一个却没有。

It doesn't necessarily mean the one who relapsed lied.

这并不一定意味着旧病复发的人撒了谎。

It may just be, "I didn't realize how deeply my brain has been changed, and it's pretty hard for me, given the neighborhood I live in, to walk around and see no one using drugs ever, to see no allusions to drugs in TVs or movies, to see no pipes, to see no powders, and I'm going to relapse because I have rewired my reward system."

可能只是，“我没有意识到我的大脑已经发生了多么深刻的改变，考虑到我所居住的社区，对我来说很难看到没有人吸毒，在电视或电影中看不到任何有关毒品的暗示，看不到管道，看不到粉末，而且我会旧病复发，因为我已经重新连接了我的奖励系统。”

Andrew Huberman: So, in 12-step, when they talk about your addict brain or one's addict brain, "That's my addict brain.

安德鲁·休伯曼：所以，在 12 步中，当他们谈论你的成瘾大脑或一个人的成瘾大脑时，“那是我的成瘾大脑。

That's your addict brain talking.

那是你的瘾君子大脑在说话。

That's not you," I think this study that you refer to, I think pinpointed the addict brain is, at least in part, nucleus accumbens dopamine reward circuitry activation.

那不是你，”我认为你提到的这项研究，我认为至少部分地指出了成瘾者大脑是伏核多巴胺奖励电路的激活。

Keith Humphreys: Cue-elicited, yes.

Keith Humphreys：提示引发，是的。

Andrew Huberman: Cue-elicited, so something that anticipates or predicts the use.

Andrew Huberman：提示引发的，因此是预期或预测使用的东西。

Keith Humphreys: Yep, that's right.

基思·汉弗莱斯：是的，没错。

And you think, particularly, when you get into legal products, that is a hugely important thing.

你认为，特别是当你进入合法产品时，这是一件非常重要的事情。

It's very hard to watch TV and not see an ad for beer, for example.

例如，看电视时很难不看到啤酒广告。

Andrew Huberman: Or pharmaceuticals.

Andrew Huberman：或者药品。

Keith Humphreys: Or pharmaceuticals, yes.

Keith Humphreys：或者药品，是的。

Right.

正确的。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: And depending where you are around cigarettes, this is very driven by class, but there's still a lot of neighborhoods where quite a few people smoke, and it's pretty hard to get through the day without being exposed to the cue of the smell of tobacco smoke, or the smell of cannabis smoke, for that matter.

Keith Humphreys：取决于你在香烟周围的位置，这很大程度上是由阶层驱动的，但仍然有很多社区有相当多的人吸烟，就这一点而言，很难在不接触烟草烟雾或大麻烟雾气味的情况下度过这一天。

And so, cue-elicited craving is going to be a driver of relapse, and that is clearly something that you were not born with.

因此，暗示引发的渴望将成为旧病复发的驱动因素，而这显然不是你与生俱来的。

That is something that you learn through repeated exposure of your brain to a pretty powerful drug.

这是你通过让你的大脑反复接触一种非常强大的药物而学到的东西。

Andrew Huberman: So for folks listening, who pick up their phone and find themselves scrolling social media, knowing they have other things to do, or playing video games knowing there are other things they really need to do, and feel like they, quote-unquote, "can't stop," I think what you're pointing to really represents the divide between that inner voice that we think of as us telling us, "Oh why am I doing this?

安德鲁·休伯曼：所以，对于那些听着的人来说，他们拿起手机，发现自己在滚动社交媒体，知道自己还有其他事情要做，或者玩电子游戏，知道自己确实需要做其他事情，并且感觉自己“无法停止”，我认为你所指的真正代表了我们内心的声音之间的分歧，我们认为，当我们告诉我们，“哦，我为什么要这样做？

I know I shouldn't be doing this, but I feel like I'm compelled to do it," almost in a kind of automaton kind of way.

我知道我不应该这样做，但我觉得我不得不这样做，”几乎以一种自动的方式。

Keith Humphreys: It is extremely common experience just in life, right?

Keith Humphreys：这在生活中是极其常见的经历，对吧？

"I know I shouldn't eat that Ho Hos.

“我知道我不应该吃那个Ho Hos。

I've been trying to lose weight, but I'm tired today, and I'm going to have it." Just the fact that we have a contradiction between our idealized self in our own head and our behavior, that's probably just being a person.

我一直在努力减肥，但今天很累，所以我要减肥了。”事实上，我们头脑中理想化的自我和我们的行为之间存在矛盾，这可能就是作为一个人。

But when it gets to the point that, "I'm actually going to flunk this exam, which is important to me not to flunk, if I don't start studying, and I'm on my third hour of scrolling through TikTok, and I know, and I'm not..." Then you start to worry, right?

但当事情发展到这样的地步时，“如果我不开始学习，我实际上会在这次考试中不及格，这对我来说很重要，不要不及格，而且我正在浏览 TikTok 的第三个小时，我知道，但我不会……”然后你开始担心，对吗？

Because now you're going to do damage to yourself for the purpose of consuming this brain candy, which has no nutritive value at all, but is clearly seductive.

因为现在你为了吃这种健脑糖而对自己造成了伤害，它根本没有任何营养价值，但显然很诱人。

Andrew Huberman: I'm out of the lab these days, but if I were to go back into the lab, I'd want to team up with clinicians like you and some of our engineering, bioengineering friends and develop something which would be similar to what Nolan and company developed for depression, right?

Andrew Huberman：这些天我离开了实验室，但如果我要回到实验室，我想与像你这样的临床医生以及我们的一些工程、生物工程朋友合作，开发出类似于诺兰和公司为抑郁症开发的东西，对吗？

Brain stimulation, not just willy-nilly, but of particular brain areas and circuits, to try and undo major depression.

大脑刺激，不仅仅是随意的，而是针对特定的大脑区域和回路，以尝试消除重度抑郁症。

Andrew Huberman: Wouldn't it be wonderful if there was a brain stimulation device that could tweak the reward circuitry in the presence of a cue, that predicted methamphetamine for the amphetamine addict, or alcohol for whatever, process, behavioral addictions, and wouldn't eliminate the ability to experience reward.

安德鲁·休伯曼：如果有一种大脑刺激装置可以在存在提示的情况下调整奖励回路，预测安非他明成瘾者的甲基苯丙胺，或任何酒精、过程、行为成瘾，并且不会消除体验奖励的能力，那不是很棒吗？

Keith Humphreys: Yep.

基思·汉弗莱斯：是的。

Andrew Huberman: But would eliminate, essentially, the bad addiction, or tamp it down, tamp down the rewarding properties of the bad addiction, and at the same time do an experiment, a parallel experiment, where you ramp up the reward circuitry in the presence of something that cued for a positive behavior?

安德鲁·胡伯曼：但是会从本质上消除不良成瘾，或者抑制它，抑制不良成瘾的奖励特性，同时做一个实验，一个平行的实验，在存在暗示积极行为的东西的情况下增强奖励电路？

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: Because I don't think you can just tamp down reward circuitry.

Andrew Huberman：因为我认为你不能仅仅抑制奖励回路。

This is one of the challenges I have with the...

这是我面临的挑战之一......

Okay, obviously abstinence is going to be critical.

好吧，显然禁欲是至关重要的。

But for somebody that has a nucleus accumbens, and we all do, it's going to want to latch onto something, and I've seen so many addicts pivot to the next thing.

但对于拥有伏隔核的人来说，我们所有人都有，它会想要抓住某件事，我见过很多瘾君子转向下一件事。

Sometimes it's a healthy thing.

有时这是一件健康的事情。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: Many ultra runners are addicts.

安德鲁·休伯曼：许多超级跑者都是瘾君子。

Keith Humphreys: I've met people like that too, yeah.

Keith Humphreys：我也遇到过这样的人，是的。

Andrew Huberman: You can't go to a 12-step meeting, and this is somewhat cultural.

Andrew Huberman：你不能参加 12 步会议，这在某种程度上是文化问题。

But you can't go to a 12-step meeting and not see people with lots and lots of tattoos, if they have issues with...

但你不可能去参加 12 步会议而不见到有很多纹身的人，如果他们有以下问题：

And I'm not demonizing tattoos.

我并不是妖魔化纹身。

But if they have issues with drugs or alcohol, typically smoking will pop up in its place.

但如果他们有吸毒或酗酒的问题，通常就会出现吸烟的情况。

They need something.

他们需要一些东西。

We need something.

我们需要一些东西。

And ideally, it would be school and family and connection and community and public service.

理想情况下，这将是学校、家庭、联系、社区和公共服务。

Great.

伟大的。

Andrew Huberman: But a device that could help tune the specificity of reward, I don't think, is outside the realm of possible.

Andrew Huberman：但是我认为，一种可以帮助调整奖励特异性的设备是不可能的。

I'm thinking like a Stanford guy now.

我现在像斯坦福大学的人一样思考。

We like to engineer everything.

我们喜欢设计一切。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Yeah.

是的。

Andrew Huberman: But why not?

安德鲁·休伯曼：但为什么不呢？

It's being done for OCD.

这是针对强迫症的。

It's being done for depression.

这是为了治疗抑郁症而做的。

It's being done for PTSD.

这是针对创伤后应激障碍（PTSD）的。

It's being done for so many things.

很多事情都在这样做。

I mean, after all, it's plasticity that we're after.

我的意思是，毕竟我们追求的是可塑性。

Keith Humphreys: Yeah, I mean, and you're right that one of the challenges is, addiction is...

基思·汉弗莱斯：是的，我的意思是，你说得对，挑战之一是，成瘾是......

It's not like it's introduced something new into the body.

这并不是说它向体内引入了新的东西。

It's working on the very system we use to negotiate life.

它正在我们用来协商生活的系统上发挥作用。

It is this thing we use for learning the acquisition of knowledge, the acquisition of skills.

我们用它来学习获取知识、获取技能。

So, it's not like if we just didn't have that, we would be better off.

所以，如果我们没有这些，我们的情况并不是会更好。

We wouldn't be better off.

我们的处境不会更好。

We couldn't survive without it.

没有它我们就无法生存。

Keith Humphreys: The only neurosurgery patient at West Virginia University, who had a very uncontrollable addiction and got...

基思·汉弗莱斯（Keith Humphreys）：西弗吉尼亚大学唯一的神经外科患者，他有一种非常无法控制的毒瘾，并得到了……

I'm not exactly sure of the nature of the implant, if it's a stimulating implant.

我不太确定植入物的性质，如果它是刺激植入物。

That's happened once.

这种事就发生过一次了。

It was covered.

它被覆盖了。

People wanted to read about it.

人们想阅读相关内容。

Lenny Bernstein, a friend of mine at the Washington Post, interviewed that patient and the team.

我在《华盛顿邮报》的朋友伦尼·伯恩斯坦采访了这位患者和团队。

But I think that it is likely that we will see something like that.

但我认为我们很可能会看到类似的情况。

I suspect we will see more rTMS, right?

我怀疑我们会看到更多的 rTMS，对吧？

Transmagnetic stimulation, because it's not so invasive, not so expensive, and not so risky.

跨磁刺激，因为它没有那么侵入性，没有那么昂贵，也没有那么危险。

Keith Humphreys: We're about to start, led by Greg Sahlem, who's a really good psychiatrist, a multi-site study with rTMS to the dorsolateral prefrontal cortex for people who are cannabis use disorder, addicted to cannabis.

Keith Humphreys：我们即将在格雷格·萨勒姆（Greg Sahlem）的领导下开始，他是一位非常优秀的精神病学家，对患有大麻使用障碍和大麻成瘾的人进行背外侧前额叶皮质的 rTMS 多站点研究。

There are lots of people working on these protocols for alcohol, for cocaine.

有很多人正在研究酒精和可卡因的这些协议。

Doesn't always work.

并不总是有效。

rTMS is almost like saying, "We put them on pills," because there's "what brain region at what intensity," all that kind of stuff.

rTMS 几乎就像是说，“我们把它们放在药丸上”，因为有“什么大脑区域的强度”，诸如此类的东西。

Andrew Huberman: Right.

安德鲁·休伯曼：对。

Andrew Huberman: Sure.

安德鲁·休伯曼：当然。

Keith Humphreys: But that is a way to intervene far more directly to the brain than talk therapy, for example.

基思·汉弗莱斯：但这是一种比谈话疗法更直接地干预大脑的方法。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: So, I think that is certainly possible.

Keith Humphreys：所以，我认为这当然是可能的。

In implants, made possible.

在植入物中，这一切成为可能。

This particular case was someone who was very, very, very...

这个特殊的案例是一个非常非常非常......

Had tried everything on earth and still couldn't stop.

已经尝试了地球上的一切，但仍然无法停止。

And interestingly, even with the implant, still needs medications, goes to lots of 12-step meetings.

有趣的是，即使有了植入物，仍然需要药物治疗，参加大量的 12 步骤会议。

It didn't just make it disappear.

它不仅让它消失。

Cancer, though, I mean, we haven't talked about GLP-1 agonist.

不过，我的意思是，对于癌症，我们还没有讨论过 GLP-1 激动剂。

If we want to get into that, that is maybe something that would have a lasting effect on changing what one wanted.

如果我们想深入研究这一点，这可能会对改变人们的愿望产生持久的影响。

Andrew Huberman: I definitely want to talk about GLP-1s.

Andrew Huberman：我绝对想谈谈 GLP-1。

I think just before we pivot there.

我想就在我们转向那里之前。

Keith Humphreys: Okay.

基思·汉弗莱斯：好的。

Andrew Huberman: When I think about the quote, unquote "homeless problem" living in California, you can't help but see this.

安德鲁·休伯曼：当我想到这句话时，取消引用生活在加利福尼亚州的“无家可归问题”，你会情不自禁地看到这一点。

Keith Humphreys: Yes.

基思·汉弗莱斯：是的。

Andrew Huberman: I think of it as, at least, you tell me where my numbers are off, 50% an addiction problem, either first or also?

Andrew Huberman：我认为，至少，你告诉我我的数字在哪里，50％是成瘾问题，要么首先还是其次？

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Keith Humphreys: In this economy, yeah.

Keith Humphreys：在当前经济形势下，是的。

Andrew Huberman: Yeah, I mean, those folks aren't going to go to 12-step meetings.

Andrew Huberman：是的，我的意思是，那些人不会参加 12 步会议。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: Maybe.

安德鲁·休伯曼：也许吧。

Maybe.

或许。

I would love for them to.

我很乐意他们这样做。

They live outside my door, and I talk to some of them, and they're not going to 12-step meetings.

他们住在我门外，我和他们中的一些人交谈过，他们不会参加 12 步会议。

No way.

决不。

Keith Humphreys: Hmm.

基思·汉弗莱斯：嗯。

Mm-hmm.

嗯嗯。

Andrew Huberman: And many of them, their brain circuitry is altered.

安德鲁·休伯曼：他们中的许多人的大脑回路都发生了改变。

Maybe it was altered before.

可能是之前改过的吧。

This is not all homeless people.

这并不全是无家可归的人。

In fact, I don't even know if "homeless" is the right word.

事实上，我什至不知道“无家可归”这个词是否正确。

And I'm not going to the "unhoused" thing.

我不会去做“无家可归”的事情。

They're homeless, okay?

他们无家可归，好吗？

They don't have homes.

他们没有家。

I don't think we need to split hairs with the naming.

我认为我们不需要在命名上争论不休。

Many of them have serious substance abuse issues and/or mental health issues that may have stemmed from that.

他们中的许多人有严重的药物滥用问题和/或可能由此引起的心理健康问题。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: I'm not asking you to solve the whole problem here in five minutes or less, but how do we wrap ourselves around the legislature?

安德鲁·胡伯曼：我并不是要求你在五分钟或更短的时间内解决整个问题，但我们如何围绕立法机关解决问题？

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: I know you've been involved in things related to this.

Andrew Huberman：我知道你参与了与此相关的事情。

I mean, how do you get somebody on the street to understand what's going on and rescue themselves?

我的意思是，如何让街上的人了解正在发生的事情并自救？

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

So first off, yeah, it is a very high rate of substance use and mental illness, higher now than in other periods, because unemployment is low.

首先，是的，药物滥用和精神疾病的发生率非常高，现在比其他时期更高，因为失业率很低。

When the economy is really terrible, there are a lot more people who don't have anywhere to live, who just need a job, basically.

当经济真的很糟糕时，会有更多的人无处可住，基本上只需要一份工作。

They didn't fall out of a housing or a family.

他们没有从住房或家庭中掉下来。

They just need work.

他们只需要工作。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: But since unemployment is historically quite low now, so who's left are the people who cannot, even when we're near full employment, cannot find a shelter, and those tend to be people who have problems like mental illness, like addiction.

基思·汉弗莱斯：但由于现在失业率处于历史低位，所以剩下的就是那些即使我们接近充分就业也无法找到庇护所的人，而这些人往往是患有精神疾病、毒瘾等问题的人。

You can do some things, and with good evidence, you can do some things by combining housing, nice housing that people would want, with a recovery culture.

你可以做一些事情，并且有充分的证据，你可以通过将住房、人们想要的漂亮住房与恢复文化结合起来来做一些事情。

Keith Humphreys: So, there's a model called Oxford House, which is run by the people who live there.

Keith Humphreys：所以，有一个名为 Oxford House 的模型，由住在那里的人经营。

And they all contribute a bit to the rent, and they have a culture, which is basically, you can't fight, you can't be violent, and you can't use substances or bring them in.

他们都为房租贡献了一点，他们有一种文化，基本上就是，你不能打架，你不能暴力，你不能使用物质或将它们带进来。

But otherwise, that's it.

但除此之外，就是这样。

And they have sort of recovery communities, like 10,000 of those things.

他们有类似的恢复社区，大约有 10,000 个这样的社区。

Those kinds of things have really good evidence of benefit.

这类事情确实有很好的好处证据。

So some people will, for that, leave the streets, and live there and make that trade.

因此，有些人会为此离开街道，住在那里并进行这种贸易。

Keith Humphreys: You can't use your drugs anymore.

Keith Humphreys：你不能再使用药物了。

You can't drink anymore.

你不能再喝酒了。

But you can at least have a nice, clean place with nice people who like you and will support you.

但你至少可以拥有一个美好、干净的地方，那里有喜欢你并支持你的好人。

That can help people.

这可以帮助人们。

Some people, in my opinion, have to; it will be a court-mandated thing, and there's two mechanisms for that.

在我看来，有些人必须这么做；这将是法院强制执行的事情，有两种机制可以实现这一点。

If someone is so impaired that they're imminently gravely disabled and an imminent threat to themselves or others, you can, through the civil commitment process, make them go to treatment.

如果某人的损伤严重到即将严重残疾并对自己或他人构成迫在眉睫的威胁，您可以通过民事承诺程序让他们接受治疗。

Keith Humphreys: If someone has committed a crime, and many people do.

Keith Humphreys：如果有人犯罪，而且很多人都犯罪了。

Like, grab someone's iPhone, knock them over, and run away, and you get caught.

比如，抓起某人的 iPhone，将他们撞倒，然后逃跑，然后你就会被抓住。

That is a different type of leverage we can do through things like drug court, where you say, "Look you shoved that person.

这是我们可以通过毒品法庭之类的事情来实现的一种不同类型的杠杆，你可以说，“看你推了那个人。

You assaulted them.

你袭击了他们。

You stole their phone.

你偷了他们的电话。

We could send you to jail for this.

我们可以因此把你送进监狱。

But we don't want to send you to jail.

但我们不想把你送进监狱。

Instead, if you will comply with this treatment regimen, you will not have to serve the penalty for that, and we will expunge your record at the end." Those kinds of things are going to be necessary for some people.

相反，如果你遵守这个治疗方案，你就不必为此受到惩罚，我们最终会删除你的记录。”这些东西对于某些人来说是必要的。

Keith Humphreys: Now, there are many people who are uncomfortable with that.

Keith Humphreys：现在，很多人对此感到不舒服。

Like, you're going to use pressure to put someone into treatment?

比如，你会利用压力让某人接受治疗吗？

Isn't that really unethical?

这真的不是不道德吗？

Well, if someone with Alzheimer's disease wanders away from a nursing home, we go find them, and we bring them back, whether they want to or not.

好吧，如果患有阿尔茨海默病的人离开疗养院，我们会找到他们，然后将他们带回来，无论他们愿意与否。

Because we assume that the disease is affecting their judgment.

因为我们假设疾病正在影响他们的判断。

So, if they think they can survive out there, they're wrong, and so we take them back, whether they want to or not.

所以，如果他们认为自己可以在外面生存，那他们就错了，所以无论他们愿意与否，我们都会把他们带回来。

Well, the same thing is true, absolutely true of addiction.

嗯，同样的事情也是如此，对于成瘾来说绝对如此。

Keith Humphreys: It dramatically changes our judgment, impairs our judgment.

Keith Humphreys：它极大地改变了我们的判断，损害了我们的判断。

And without pressure, many people will not stop using it.

而且如果没有压力，很多人都不会停止使用它。

There's a study I like to quote by Doug Polcin and colleagues of people seeking help for alcohol treatment, and why this is a good one is because alcohol is legal, right?

我喜欢引用 Doug Polcin 及其同事针对寻求酒精治疗帮助的人们所做的一项研究，为什么这是一项好的研究，因为酒精是合法的，对吗？

So it's not the war on alcohol that made them go.

所以，并不是禁酒战争让他们离开的。

Alcohol is legal.

酒精是合法的。

But he asked all of them, "Has anyone leaned on you, basically, to quit drinking in the past year?" And 91% of them said yes.

但他问所有人：“过去一年里，有没有人依靠你们戒酒？” 91% 的人表示愿意。

Keith Humphreys: The wife said, "I'm moving out with the kids if this continues." The boss said, "You show up drunk one more time, you're fired." My lawyer said, "This is your third drunk driving arrest.

基思·汉弗莱斯：妻子说：“如果这种情况继续下去，我就要和孩子们一起搬出去。”老板说：“你再喝醉一次，就被解雇了。”我的律师说：“这是你第三次醉酒驾驶被捕。

You'd better get into treatment, so the judge might take some mercy on you." They're pressed in, in a way you don't have to press people to seek care for, say, chronic pain.

你最好接受治疗，这样法官可能会对你仁慈一些。”他们是被迫的，在某种程度上你不必强迫人们寻求治疗，比如慢性疼痛。

You know, chronic pain sucks.

你知道，慢性疼痛很糟糕。

Everyone was happy to leave chronic pain.

每个人都很高兴离开慢性疼痛。

But people are ambivalent about giving up substances, because again, it's rewarding.

但人们对于放弃药物的态度是矛盾的，因为这又是有益的。

That's why people do it.

这就是人们这样做的原因。

Keith Humphreys: And so, that press is necessary.

Keith Humphreys：因此，媒体报道是必要的。

And so we're going to have to do that with the sort of criminally involved, homeless, addicted population.

因此，我们将不得不对那些涉及犯罪、无家可归、吸毒成瘾的人群采取这种措施。

We're going to have to get comfortable with protections for sure, protections for civil rights, need to give them quality care, but to push them into treatment where they can regain their reason and then make better decisions for themselves.

我们必须接受保护措施，保护公民权利，需要为他们提供优质的护理，但要推动他们接受治疗，让他们重新找回理智，然后为自己做出更好的决定。

Andrew Huberman: I know you've been involved in the legislature, and it's always nice when, I guess, I can say you did that under a Republican administration and a Democratic administration.

安德鲁·胡伯曼：我知道你参与了立法机构的工作，我想，我可以说你在共和党政府和民主党政府的领导下做到了这一点，这总是很好的。

So, we don't have to get into partisan politics here.

因此，我们不必在这里陷入党派政治。

Two administrations, opposite sides of the aisle.

两个政府，在过道的两侧。

Your goal there was to get better legislation as it relates to addiction and treatment of addiction.

你们的目标是获得更好的立法，因为它涉及成瘾和成瘾治疗。

Keith Humphreys: Correct.

基思·汉弗莱斯：正确。

Yep.

是的。

Yep.

是的。

Andrew Huberman: So, where are we at?

安德鲁·休伯曼：那么，我们现在在哪里？

What do we need?

我们需要什么？

Keith Humphreys: Since 2008, up to the present moment, has been the best addiction treatment policy we've had as a country.

Keith Humphreys：自 2008 年以来，迄今为止，这是我们国家所拥有的最好的毒瘾治疗政策。

And that was because 2008 is when parity legislation came in.

那是因为 2008 年是平等立法出台的时候。

This means, like Blue Cross, Aetna, and all those, when they cover stuff, they have to cover mental health and addiction too, at a comparable level.

这意味着，像 Blue Cross、Aetna 等公司一样，当他们报道内容时，他们也必须在相当的水平上报道心理健康和成瘾问题。

And those laws have expanded to cover more and more people on the private side.

这些法律已经扩大到涵盖越来越多的私营部门人员。

Keith Humphreys: Then, on the public side, the expansion, particularly of Medicaid, has become the backbone of a substance abuse treatment system.

基思·汉弗莱斯：那么，在公共方面，扩张，特别是医疗补助的扩张，已经成为药物滥用治疗系统的支柱。

Like in places where I'm from, West Virginia, I happen to know it's the biggest spender of the addiction treatment system.

就像我来自的西弗吉尼亚州一样，我碰巧知道它是成瘾治疗系统的最大支出者。

That is good.

那很好。

That has made treatment in better quality, easier to access.

这使得治疗质量更高、更容易获得。

And because Medicaid is a mainstream healthcare player, it helps integrate addiction care better into the rest of the healthcare system.

由于医疗补助是主流医疗保健参与者，它有助于将成瘾护理更好地融入医疗保健系统的其他部分。

Andrew Huberman: So, excuse me for interrupting, but practically speaking, so somebody's got a son or a daughter who's got an opioid issue or an alcohol issue, and they want help.

安德鲁·胡伯曼：所以，请原谅我打断一下，但实际上，有人的儿子或女儿有阿片类药物问题或酒精问题，他们需要帮助。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: If they have insurance, they can go to a treatment center, and it will mostly or completely be covered by insurance.

Andrew Huberman：如果他们有保险，他们可以去治疗中心，大部分或完全由保险承保。

Keith Humphreys: It depends on the plan.

Keith Humphreys：这取决于计划。

I wouldn't promise anyone in particular, but here's what used to be legal.

我不会向任何人做出特别的承诺，但这就是曾经合法的。

It used to be a plan could say, "Your co-payment for an outpatient visit is five bucks, unless it's mental health or substance use.

曾经有一个计划可以说，“你门诊的自付费用是五美元，除非是心理健康或药物滥用。

In that case, it's 25 bucks." Or, "You're allowed to have up to six months of hospitalization a year, unless it's mental health and substance use, and you're allowed to have 14 days." Those kinds of things, which made very skimpy benefits, are now illegal in almost all plans.

那样的话，就是 25 美元。”或者，“你每年最多可以住院 6 个月，除非是因为精神健康和药物滥用，而且你可以有 14 天的住院时间。”这些福利微薄的东西现在在几乎所有计划中都是非法的。

Andrew Huberman: Interesting.

安德鲁·休伯曼：有趣。

Keith Humphreys: So, the odds, as a mom or dad, when you open up the plan today, that whatever you got through your work or wherever, will give your kids something that they need, is just way, way higher than it's ever been before.

基思·汉弗莱斯：所以，作为妈妈或爸爸，当您今天打开计划时，无论您通过工作或在其他地方获得什么，都会为您的孩子提供他们需要的东西，这种可能性比以往任何时候都高得多。

And that was due to advocacy and changing the law and changing the regulations, because obviously covering care costs money.

这是由于倡导和修改法律和法规，因为显然承保护理是要花钱的。

Insurers don't like to cover care.

保险公司不喜欢承保护理。

They have to, but they also don't want to.

他们必须这样做，但他们也不想这样做。

And so, keeping the pressure on, they have to follow the law.

因此，在持续施加压力的情况下，他们必须遵守法律。

Keith Humphreys: So in that sense, we're in a better place on the private side.

Keith Humphreys：从这个意义上说，我们在私人方面处于更好的位置。

The challenge on the public side will be the contraction of Medicaid.

公共方面面临的挑战将是医疗补助的收缩。

So, the budget bill that was passed last year takes about a trillion dollars, roughly, out of Medicaid over the coming years.

因此，去年通过的预算法案在未来几年从医疗补助中大约花费了约一万亿美元。

And a number of people on Medicaid have substance use problems.

许多享受医疗补助的人存在药物滥用问题。

So, how they will get substance use care and other care that they need is not entirely clear.

因此，他们如何获得药物滥用护理和他们需要的其他护理尚不完全清楚。

So, I'm quite worried about the impact of that, especially on low-income Americans who are dealing with addiction.

因此，我非常担心这种影响，尤其是对正在应对毒瘾的低收入美国人的影响。

Andrew Huberman: What are the options for people without insurance and/or who don't want to go to a treatment facility?

Andrew Huberman：对于没有保险和/或不想去治疗机构的人有哪些选择？

I'll just be direct about this.

我会直接说这个。

What's your opinion?

你有什么意见？

What are the data on 12-step programs?

12步计划的数据是什么？

Because 12-step programs have this phenomenal aspect to them, which is they're happening every day and night, online and in person.

因为 12 步计划有一个惊人的方面，那就是它们每天每夜都在网上和面对面地进行。

It is anonymous, every city, all over the world.

它是匿名的，每个城市，全世界。

If you go to a meeting and you don't like it, you leave, you find a different meeting.

如果你去参加一个会议，但你不喜欢它，你就会离开，然后去找另一个会议。

Andrew Huberman: You don't have to pay for it.

Andrew Huberman：您不必为此付费。

You can donate to support.

您可以捐款支持。

I mean, there's just so many things about 12-step that make it arguably the most accessible addiction treatment program ever.

我的意思是，12步法有很多优点，使其成为有史以来最容易获得的成瘾治疗方案。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Yeah.

是的。

Andrew Huberman: And if anything, it's growing right now.

Andrew Huberman：如果说有什么不同的话，那就是它现在正在增长。

But what are your thoughts?

但你的想法是什么？

Does it work?

有效吗？

Is it a cult?

这是邪教吗？

What's the upside?

有什么好处？

What's the downside?

有什么缺点？

Keith Humphreys: It is a not irrelevant that those programs were designed by people who have the problem, and therefore understood what it is, what you need when you've got that problem.

Keith Humphreys：这些程序是由遇到问题的人设计的，因此了解问题是什么，当您遇到问题时需要什么，这并非无关紧要。

So I think about this, where I am in Palo Alto.

所以我想到了这个，我现在在帕洛阿尔托。

Let's say, some engineer wakes up in Palo Alto on a Saturday morning with his 20th or 30th or 40th beastly hangover of the year and says, "What am I doing?

比方说，某个工程师周六早上在帕洛阿尔托醒来，经历了今年第 20 次、第 30 次或第 40 次宿醉，他说：“我在做什么？

I've got this great life.

我已经拥有了美好的生活。

I have this 200 million dollar one-bedroom condo that I really like, and I'm messing up my life with alcohol.

我有这套价值 2 亿美元的一居室公寓，我非常喜欢，但我却用酒精搞乱了我的生活。

Let's call Stanford Psychiatry Department, okay?

我们打电话给斯坦福大学精神病学系，好吗？

And try to get some help."

并尝试寻求一些帮助。”

Keith Humphreys: Well, they're closed on the weekend.

Keith Humphreys：嗯，他们周末不营业。

You'll get a message.

您会收到一条消息。

Then, on Monday, you can call back, and then you'll get on a waiting list, and eventually you might get in.

然后，周一，你可以回电话，然后你就会进入等候名单，最终你可能会被录取。

So, for a condition characterized by ambivalence and impulsiveness, I want to quit now, two hours later, I don't, that's like this healthcare system's the worst possible design.

所以，对于一种以矛盾心理和冲动为特征的情况，我现在就想退出，两个小时后，我不想，这就像这个医疗系统最糟糕的设计。

Keith Humphreys: Whereas, how is AA designed?

Keith Humphreys：那么，AA 是如何设计的呢？

Be like, "I'd like to go to AA." You can go on the AA website, look in the area.

就像，“我想去 AA”。你可以去AA的网站上，去当地看看。

Oh my God, there's 15 meetings today.

天哪，今天有 15 个会议。

And not only are there 15 meetings, but there's a woman's meeting, a men's meeting, a spiritual focus meeting, an LGBT meeting, and you can just go.

而且不仅有15个会议，还有女性会议、男性会议、精神焦点会议、LGBT会议，你可以去。

And at that moment, you have, "At this moment I want to change." You follow through.

那一刻，你会说，“这一刻我想改变。”你坚持到底。

And then you can get an immediate reward, a social reward, for taking positive steps towards it.

然后，你可以因为采取积极的步骤而立即获得奖励，即社会奖励。

Keith Humphreys: The treatment system will never be that good at sort of being that accessible.

Keith Humphreys：治疗系统永远不会那么容易获得。

And of course, no health insurance, no paperwork, no preapproval.

当然，没有健康保险，没有文书工作，没有预先批准。

That's amazing.

太棒了。

Does it actually work when people get there?

当人们到达那里时它真的有效吗？

So, I started my career.

于是，我开始了我的职业生涯。

I didn't really know anything about addiction in my first job.

在我的第一份工作中，我对成瘾一无所知。

I took it because I was literally flipping burgers, and there was a job that paid another dollar an hour in the medical school where I didn't have to wear a costume, a Wendy's outfit.

我接受它是因为我实际上是在煎汉堡，而且医学院有一份每小时多付一美元的工作，在那里我不必穿服装，温迪服装。

Keith Humphreys: So, that's why I got into the addiction field, and that's the truth.

基思·汉弗莱斯：所以，这就是我进入成瘾领域的原因，这就是事实。

So, I didn't know anything about it.

所以，我对此一无所知。

And while I was on this job, I met some people who said they were in AA, and I thought they were like the people who get your car battery for you on a cold...

当我从事这项工作时，我遇到了一些自称是 AA 的人，我认为他们就像那些在感冒时为你获取汽车电池的人......

You know, that's what I think of when I think of AA, and I didn't know what AA was.

你知道，当我想到 AA 时，我就是这么想的，但我不知道 AA 是什么。

Keith Humphreys: And they explained it to me, and I talked to my mentors about it.

Keith Humphreys：他们向我解释了这一点，我也和我的导师讨论了这一点。

And my mentors were professors in medicine, and they were very dismissive.

我的导师是医学教授，他们非常不屑一顾。

They're like, "Well, they don't have doctors.

他们会说，“好吧，他们没有医生。

They don't have medications.

他们没有药物。

It's kind of folk medicine." Bit of professional snobbery there.

这是一种民间医学。”这里面有一点职业势利。

But I wasn't so far along in my education that I was incapable of learning.

但我的教育水平还没有达到无法学习的程度。

So, I thought, "Well, will you take me?

所以我想：“好吧，你愿意带我去吗？

Can I go?" And they're like, "Well, you can't go to a closed meeting, but there are these openings." "Okay, because I want to see this."

我可以去吗？”他们会说，“好吧，你不能参加闭门会议，但有这些空缺。”“好吧，因为我想看看这个。”

Keith Humphreys: And I was so impressed with just the authenticity and the caring and the warmth and the wisdom.

Keith Humphreys：真实性、关怀、温暖和智慧给我留下了深刻的印象。

Really, just made me think, "Maybe there is something here." And so, I started doing research on it, as a number of other people were at that time.

真的，只是让我想，“也许这里有什么东西。”因此，我开始对此进行研究，就像当时的许多其他人一样。

And it just keeps coming out really, really good in studies, you know?

而且它的学习成绩一直非常非常好，你知道吗？

And so finally, a few years ago, me, John Kelly, and Marica Ferri did what's called a Cochrane Collaboration review.

最后，几年前，我、约翰·凯利和马里卡·费里进行了所谓的 Cochrane 协作评审。

Keith Humphreys: This is the crème de la crème, most rigorous review of evidence in medicine, as a method.

Keith Humphreys：这是一种最严格的医学证据审查方法。

And looked at all these studies of Alcoholics Anonymous, done by different people, with different viewpoints, in different cities and different countries, even.

并查看了戒酒互诫协会的所有这些研究，这些研究是由不同的人、不同的观点、在不同的城市、不同的国家进行的。

And it came out extremely well, relative to very good therapies, like the one I was trained to do, like cognitive behavioral therapy, motivational enhancement therapy.

相对于非常好的疗法，比如我接受训练的认知行为疗法、动机增强疗法，它的效果非常好。

Keith Humphreys: On abstinence outcomes, if you ask, do people stop entirely?

基思·汉弗莱斯：关于禁欲的结果，如果你问，人们会完全戒掉吗？

AA and also 12-step facilitation kinds of counseling to help people get into AA was winning by 50% higher rates, routinely, of that.

AA 以及帮助人们进入 AA 的 12 步引导式咨询的成功率通常要高出 50%。

And then when you looked at other outcomes, like did the person at least cut their drinking or reduce the damage of drinking or less dependent or better family functioning, whatever, it was as good as.

然后当你观察其他结果时，比如这个人至少减少了饮酒或减少了饮酒的损害或减少了依赖或改善了家庭功能，无论如何，它都一样好。

And that's amazing for something that's free.

对于免费的东西来说，这真是太棒了。

Keith Humphreys: And so, anyone still left saying AA doesn't work, they really...

Keith Humphreys：所以，仍然有人说 AA 不起作用，他们真的......

And often people think there's no evidence.

人们常常认为没有证据。

There's a ton of evidence.

有大量证据。

There's randomized trials all over.

到处都有随机试验。

There are quasi-experimental studies.

有准实验研究。

There are healthcare utilization studies.

有医疗保健利用研究。

It's amazing.

太棒了。

And so, I always say to anybody, whether it's a patient or just a person I care about, "If you want to stop drinking, that'd be a place to try." You know?

因此，我总是对任何人说，无论是病人还是我关心的人，“如果你想戒酒，那是一个可以尝试的地方。”你知道吗？

It's really no harm to it, right?

确实对它没有什么坏处吧？

Keith Humphreys: If you go to a bad movie, you're out an evening and 15 bucks.

Keith Humphreys：如果你去看一部糟糕的电影，那么你就损失了一个晚上和 15 美元。

You go to a bad AA meeting, you're just out an evening.

你参加了一场糟糕的 AA 会议，你刚刚出去了一个晚上。

It's not like a high-risk endeavor to just give it a go.

尝试一下并不像是一项高风险的尝试。

And there are some alternatives, too, by the way.

顺便说一句，还有一些替代方案。

They are smaller, but if you live in an area like the San Francisco Bay Area, where there's more choices, there's also "Smart Recovery" and "Women for Sobriety."

它们较小，但如果你住在旧金山湾区这样的地区，那里有更多选择，还有“智能康复”和“女性清醒”。

Keith Humphreys: And I'm forgetting some of the other names.

Keith Humphreys：我忘记了其他一些名字。

But the choice is, if you don't like the particular AA model.

但如果您不喜欢特定的 AA 型号，则可以选择。

But that experience of mutual support, people are on the same journey with me.

但那种相互支持的经历，人们和我在同一条路上。

They're further along the same journey, and they're doing well.

他们在同一条道路上走得更远，而且做得很好。

It inspires hope.

它激发了希望。

They've given me useful information.

他们给了我有用的信息。

All of that is really potent.

所有这些都非常有效。

And that's why it's survived and thrived as an organization, and why 195 countries or something have AA in it?

这就是为什么它作为一个组织得以生存和发展，为什么 195 个国家或其他地方都有 AA？

Andrew Huberman: Just want to mention if people are interested in AA, and it's not like I've been sent here to advocate for AA, but they have, Keith mentioned open meetings.

Andrew Huberman：我只是想提一下人们是否对 AA 感兴趣，我并不是被派到这里来倡导 AA 的，但他们有，Keith 提到了公开会议。

If you look up, an open meeting is one that anyone can go to, even if you are not an addict and you're just curious, or you have a different addiction and you want to go to an AA meeting because the AA meetings tend to be more established, and there are more of them than the other letter anonymous meetings, for gambling and other sorts of addiction.

如果你抬头一看，开放式会议是任何人都可以参加的会议，即使你不是瘾君子而你只是好奇，或者你有不同的瘾症并且你想参加 AA 会议，因为 AA 会议往往更加成熟，而且比其他字母匿名会议有更多的赌博和其他类型的瘾症。

Andrew Huberman: I've been to many meetings.

Andrew Huberman：我参加过很多会议。

I'm super impressed by how AA can do what it does.

AA 的能力给我留下了深刻的印象。

It's really just a shining example of humans self-organizing into something that keeps going, doesn't walk around with a basket.

这确实是人类自我组织的一个光辉例子，能够持续前进，而不是提着篮子到处走。

There's no GoFundMe...

没有 GoFundMe...

Keith Humphreys: No tax dollars.

基思·汉弗莱斯：没有税金。

Andrew Huberman: No tax dollars.

安德鲁·休伯曼：没有税金。

They just stay out of politics.

他们只是远离政治。

It's really cool.

真的很酷。

And I know some people that couldn't get sober any other way that did it.

我知道有些人无法通过其他方式保持清醒。

I'm curious what the data are on the other addictions that are treated through the 12-step model.

我很好奇通过 12 步模型治疗的其他成瘾的数据是什么。

So, Narcotics Anonymous, Overeaters Anonymous, Gamblers Anonymous.

所以，匿名戒毒者协会、匿名暴食者协会、匿名赌徒协会。

There's so many of them now.

现在有很多这样的人了。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: And I imagine there aren't as many studies, but the model is pretty much the same.

Andrew Huberman：我想研究没有那么多，但模型几乎是一样的。

Keith Humphreys: Mm.

基思·汉弗莱斯：嗯。

Andrew Huberman: So, I wonder how they hold up.

Andrew Huberman：所以，我想知道他们是如何坚持下来的。

Keith Humphreys: I was very interested in this question for the drug groups.

Keith Humphreys：我对毒品组织的这个问题非常感兴趣。

There's very little on gambling and sexual addicts, those things.

关于赌博和性成瘾者之类的内容很少。

So, the other big pool of data we have, to the extent we have it, is on the NAC, Cocaine Anonymous, Narcotics Anonymous.

因此，就我们所掌握的程度而言，我们拥有的另一个大数据库是关于 NAC、可卡因匿名组织和麻醉品匿名组织的。

There were a couple of things which were interesting.

有几件事很有趣。

One is, it's harder to get people into those groups.

一是，让人们加入这些群体更加困难。

Keith Humphreys: So, we were looking at studies where there was, what's called 12-step facilitation counseling, so where you're in there, you've got somebody who knows the program, is introducing you to it, encouraging you to go, and then talking about how did the meeting go, and did you get a sponsor, and all that kind of stuff.

Keith Humphreys：所以，我们正在研究所谓的 12 步促进咨询，所以在你所在的地方，你会有一个了解该计划的人，向你介绍它，鼓励你去，然后谈论会议进展如何，你是否得到了赞助商，以及诸如此类的事情。

And the uptake was much lower.

而且采用率要低得多。

Keith Humphreys: So if you do that in an alcohol program, you get these doubling or tripling of the rate of patients going into AA, and the effect was much, much smaller with the illicit drugs to get people to attend CA.

Keith Humphreys：所以，如果你在戒酒计划中这样做，你会导致进入 AA 的患者比例增加一倍或三倍，而使用非法药物让人们参加 CA 的效果要小得多。

And we don't know why, but it wasn't as easy to get people in.

我们不知道为什么，但让人们进来并不那么容易。

Keith Humphreys: Definitely, there were correlations pretty consistently that people who were going longer were doing better, but the evidence wasn't quite as strong from an external validity view, I'm sorry, an internal validity point of view.

Keith Humphreys：当然，存在相当一致的相关性，即坚持时间更长的人做得更好，但从外部有效性的角度来看，证据并不那么有力，对不起，从内部有效性的角度来看。

In other words, they're not the same kind of trials, randomized trials that we like to have, when we draw inferences.

换句话说，当我们做出推论时，它们不是我们喜欢的同类试验、随机试验。

So, I characterize the evidence on 12-step groups for drugs as positive, encouraging.

因此，我将药物 12 步组的证据描述为积极且令人鼓舞的。

Keith Humphreys: I would certainly try it, you know, certainly not harmful, but it's not as strong.

Keith Humphreys：我当然会尝试一下，你知道，当然不会有害，但它没有那么强大。

I feel comfortable saying AA, I know positively, has a causal effect on alcohol; I have no doubt about it.

我很乐意说 AA，我确实知道，与酒精有因果关系；我对此毫不怀疑。

And I'm less sure about that, whether that's true for the 12...

我不太确定 12 是否是这样……

Maybe in an interesting case, but on average, it was harder to demonstrate that effect.

也许在一个有趣的案例中，但平均而言，更难证明这种效果。

Andrew Huberman: I was being somewhat facetious when I asked, whether you think AA is a cult, but one of the reasons why sometimes people will call it a cult is, I'm just going to be very blunt here, is that often, not always, but often enough, I should say, people who get into AA discover sobriety in the AA community or other 12-step communities, will talk a lot about it and how much it's changed their life, and they've got a new set of people they hang out with, and in the name of sobriety.

Andrew Huberman：当我问你是否认为 AA 是邪教时，我有点开玩笑，但有时人们称其为邪教的原因之一是，我在这里要非常直言不讳，是经常，不是总是，但足够经常，我应该说，加入 AA 的人在 AA 社区或其他 12 步社区中发现清醒，会谈论很多关于它的内容，以及它如何改变了他们的生活，他们已经有了一个他们以清醒的名义和一群新的人一起出去玩。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: And then if it's not handled correctly, it can be seen as somewhat of a separator by people around them.

Andrew Huberman：如果处理不当，周围的人就会将其视为某种分隔符。

That's one.

这是一个。

There will always be instances where certain groups are not in a healthy dynamic, but I would say 95% of the time, it seems to be healthy dynamics.

总会有某些群体不处于健康动态的情况，但我想说 95% 的情况下，这似乎是健康的动态。

Keith Humphreys: Mm.

基思·汉弗莱斯：嗯。

Andrew Huberman: But there's this other piece that I think sometimes gets tucked away and no one wants to talk about, which is that a critical component of 12-step is that the addict acknowledge that they're not in control of everything.

Andrew Huberman：但是我认为还有另一件事有时会被隐藏起来，没有人愿意谈论，那就是 12 步骤的一个关键组成部分是成瘾者承认他们无法控制一切。

They certainly can't control other people, but perhaps they can't even control their own mind, and they have to have a higher power in notion.

他们固然无法控制别人，但或许连自己的心灵都无法控制，还得拥有更高的意念力量。

And I think some people interpret this to think that one has to suddenly become formally religious.

我认为有些人将此解释为认为一个人必须突然变得正式虔诚。

Keith Humphreys: A Christian.

基思·汉弗莱斯：基督徒。

Yeah, yeah.

是啊，是啊。

Andrew Huberman: Either Christian or to believe in God as an entity.

安德鲁·休伯曼：要么是基督徒，要么相信上帝是一个实体。

But my understanding is that 12-step, well, I know because I've been to a lot of meetings, 12-step hinges on the acknowledgement of some sort of higher power, but people can self-assign what that higher power is.

但我的理解是，12步，嗯，我知道，因为我参加过很多会议，12步取决于对某种更高权力的认可，但人们可以自我分配更高权力是什么。

Keith Humphreys: Right.

基思·汉弗莱斯：是的。

Right.

对。

Andrew Huberman: Some people say God, some people say Jesus Christ, some people will say nature, some people say the universe, some people will say the collective.

安德鲁·休伯曼：有些人说上帝，有些人说耶稣基督，有些人会说自然，有些人会说宇宙，有些人会说集体。

So, I think that's not discussed often enough, and then people will say, "Well, I don't want to go to 12-step because it's going to be a bunch of Jesus freaks coming at me about, and I'm going to have to do a bunch of other things, and what's happening?"

所以，我认为这个讨论还不够频繁，然后人们会说，“好吧，我不想进行 12 步，因为这将是一群耶稣怪胎向我袭来，我将不得不做很多其他事情，发生了什么？”

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: So, there's a lot there in those questions.

Keith Humphreys：所以，这些问题涉及很多内容。

So on the cult thing, well, I wouldn't call it a cult.

所以关于邪教的事情，嗯，我不会称其为邪教。

Cults do two things that AA doesn't do.

邪教做了两件 AA 不做的事情。

One is cults take everybody's money.

一是邪教拿走每个人的钱。

AA literally won't let you give them money.

AA 绝对不会让你给他们钱。

I mean, it's amazing they've survived as an organization.

我的意思是，他们作为一个组织能够幸存下来真是令人惊讶。

Rockefeller offered money.

洛克菲勒提供了资金。

They said, "No, we should limit that.

他们说：“不，我们应该限制这一点。

That would be too grandiose."

那就太宏大了。”

Andrew Huberman: Mm.

安德鲁·休伯曼：嗯。

Keith Humphreys: You know, they're perpetually broke by design.

Keith Humphreys：你知道，它们的设计总是会被破坏。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: They have just enough to keep going.

Keith Humphreys：他们的钱刚刚够维持下去。

Andrew Huberman: They pass the hat.

安德鲁·休伯曼：他们传递了帽子。

Keith Humphreys: They pass the hat.

基思·汉弗莱斯：他们传递了帽子。

Andrew Huberman: You can give if you want to or not.

Andrew Huberman：无论你愿意与否，你都可以给予。

But if you don't, you are not looked down upon.

但如果你不这样做，你就不会被瞧不起。

Keith Humphreys: Yes, they give away the literature, so they don't do that.

Keith Humphreys：是的，他们会赠送文献，所以他们不会这样做。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: The other thing is they don't stop anybody from leaving.

Keith Humphreys：另一件事是他们不会阻止任何人离开。

Literally, any meeting, you can literally stand up and say, "I'm going to go get drunk." It goes, "Bye." And that's different than a cult.

从字面上看，任何会议，你都可以站起来说：“我要去喝醉了。”它说：“再见。”这与邪教不同。

Andrew Huberman: You just can't show up drunk.

Andrew Huberman：你不能喝醉了。

This is important.

这很重要。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: A desire to quit drinking or the other behavior or substance, and you can't show up intoxicated.

Andrew Huberman：想要戒酒或戒其他行为或物质，并且你不能表现得喝醉了。

Keith Humphreys: You can't.

基思·汉弗莱斯：你不能。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: They will usually let people sit as long as they're quiet, if they're drunk, rather than throw them out.

Keith Humphreys：如果人们喝醉了，他们通常会让人们安静地坐着，而不是把他们赶出去。

Andrew Huberman: Mm.

安德鲁·休伯曼：嗯。

Keith Humphreys: If they start talking drunk, then that's a different thing.

Keith Humphreys：如果他们开始喝醉酒说话，那就是另一回事了。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: But usually, they will.

Keith Humphreys：但通常情况下，他们会的。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: And relapse is a normal part of recovery, and nobody knows that better than people in AA.

Keith Humphreys：复发是康复过程中的正常现象，没有人比 AA 中的人更了解这一点。

I mean, they appreciate that, even though they don't want to hear from a drunk person, obviously.

我的意思是，他们很欣赏这一点，尽管他们显然不想听到醉酒的人的声音。

But then the religious thing, yeah, they got the word God there, right?

但宗教方面，是的，他们在那里得到了上帝这个词，对吧？

And so, there are people who just have had bad experiences, and just that word is a repellent to them.

所以，有些人刚刚经历过不好的经历，光是这个词就让他们感到厌恶。

Keith Humphreys: In a sense, it doesn't even matter if they know how the organization defines it.

Keith Humphreys：从某种意义上说，他们是否知道组织如何定义它甚至并不重要。

They're just like, "Look, I went to Catholic school.

他们就像，“看，我去了天主教学校。

I hated Catholic school.

我讨厌天主教学校。

I hate religion, and this sounds like religion, so I don't want to go." Some of those people might be happier than in programs like Smart Recovery, which doesn't have that component to it.

我讨厌宗教，这听起来像宗教，所以我不想去。”其中一些人可能比像 Smart Recovery 这样的项目更快乐，因为它没有这个成分。

But yeah, it is incredibly flexible in terms of how it's like...

但是，是的，就其方式而言，它非常灵活......

That's why it's really a spiritual, not religious organization.

这就是为什么它实际上是一个精神组织，而不是宗教组织。

Keith Humphreys: It says in the text, the 12-steps are but suggestions, okay?

Keith Humphreys：文中说，12 个步骤只是建议，好吗？

Can you imagine that in a Christian church saying, "Jesus was the Son of God, or maybe he wasn't.

你能想象在基督教会里说：“耶稣是神的儿子，或者也许不是。

Who knows?

谁知道？

It's really up to you," right?

这真的取决于你，”对吧？

That's what, in a religion, no, he was, period.

这就是，在宗教中，不，他就是，时期。

That's a non-negotiable point.

这是一个不容谈判的点。

AA, everything is negotiable other than what you believe.

AA，除了你相信的以外，一切都是可以商量的。

It's what you do.

这就是你所做的。

You go to meetings, stay sober.

你去参加会议，保持清醒。

They don't really care.

他们并不真正关心。

My friend, Barry Rosen, passed away too young, unfortunately.

不幸的是，我的朋友巴里·罗森（Barry Rosen）英年早逝。

He was an addiction psychiatrist.

他是一名成瘾精神病学家。

Keith Humphreys: He would say to people, "Look, the God in AA can be anything.

基思·汉弗莱斯：他会对人们说，“看，AA 中的上帝可以是任何东西。

It could be Buddha.

可能是佛。

It could be Jesus.

可能是耶稣。

It could be your group.

这可能是你的小组。

It could be the doorknob.

可能是门把手。

It just can't be you, you narcissistic SOB." And that's what they were really concerned about with the people who founded it, is that it was the hubris, the ego of "I am in control, and I don't need any help.

这不可能是你，你这个自恋的混蛋。”这就是他们真正担心创始人的原因，那就是“我掌控一切，我不需要任何帮助”的傲慢和自我。

I am the God, basically." And breaking that belief.

基本上，我就是上帝。”然后打破了这个信念。

It's like, no, you're whipped.

就像，不，你被鞭打了。

You have lost your control out of the sub...

你已经失去了对潜艇的控制...

And admitting that is the critical point.

承认这一点是关键点。

How you end up explaining the spiritual part is really up to you, but that part is non-negotiable.

你最终如何解释精神部分完全取决于你，但这部分是不容谈判的。

Keith Humphreys: Why else would you be there?

Keith Humphreys：不然你为什么会在那里？

If you thought, "No, I can still control my drinking." They would say, "Well, then you shouldn't come here because we can't.

如果你想：“不，我仍然可以控制饮酒。”他们会说：“好吧，那么你不应该来这里，因为我们不能。

That's why we're here."

这就是我们在这里的原因。”

Andrew Huberman: Bill and Bob, the founders, were good psychologists.

安德鲁·休伯曼：创始人比尔和鲍勃是优秀的心理学家。

They understood the juxtaposition of the narcissism and the shame that is addiction.

他们理解自恋和成瘾羞耻的并置。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Yeah, yeah.

是啊，是啊。

They were really great Americans.

他们真是伟大的美国人。

They changed the country.

他们改变了这个国家。

Andrew Huberman: Before moving on from this, again, if you're curious, you can go to an open AA meeting if you want to.

Andrew Huberman：在继续之前，再次强调，如果您好奇，可以参加公开的 AA 会议。

It's interesting, and when they go around the room, and people say, "I'm so-and-so.

这很有趣，当他们在房间里走来走去时，人们会说：“我是某某。

I'm an alcoholic," some people say, "I'm so-and-so, and I'm their first name only," of course, and they're an addict.

我是个酒鬼，”有些人说，“我是某某，我只是他们的名字，”当然，他们是个瘾君子。

But if you're a visitor, you just say...

但如果你是访客，你只需说...

You could say nothing.

你什么也不能说。

You could say pass.

可以说通过。

No one would pay much mind to it, or you could say your name and just say, "I'm just here to learn."

没有人会太在意，或者你可以说出你的名字，然后说：“我只是来这里学习的。”

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: And I've seen that a number of times, and it's usually family members of addicts or family members that want someone in their family or a friend to go to 12-step, and this is an interesting little trick tool.

Andrew Huberman：我已经见过很多次了，通常是瘾君子的家庭成员或家庭成员希望家人或朋友参加 12 步，这是一个有趣的小技巧工具。

Sometimes it's easier to get someone to go to 12-step if you yourself have gone, and if you're not an addict, and you want someone to go, saying, "I went."

有时候，如果你自己参加过 12 步舞，而且你不是瘾君子，并且你想让别人参加，你可以说“我参加了”，这样会更容易让别人参加。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: "And I'll go with you," right?

安德鲁·休伯曼：“我会和你一起去，”对吗？

I mean, this sounds kind of hokey on the one hand, but I've seen the incredible things that 12-step can do.

我的意思是，一方面这听起来有点做作，但我已经看到了 12 步可以做的令人难以置信的事情。

And it's so awesome, it's free.

而且它太棒了，而且是免费的。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: How many things are completely free, accessible all the time?

Andrew Huberman：有多少东西是完全免费、随时可用的？

It's wild.

它很狂野。

It's a wild invention.

这是一个疯狂的发明。

Keith Humphreys: John Kelly, my friend who did the review, said, "It is the closest thing we have to a free lunch in public health."

基思·汉弗莱斯：我的朋友约翰·凯利做了这篇评论，他说：“这是我们在公共卫生领域最接近免费午餐的事情。”

Andrew Huberman: Speaking of lunch, let's talk about GLPs.

Andrew Huberman：说到午餐，我们来谈谈 GLP。

Keith Humphreys: Okay.

基思·汉弗莱斯：好的。

Andrew Huberman: I'm struck by how many people have lost a lot of weight who couldn't lose weight previously.

安德鲁·休伯曼：令我震惊的是，有这么多以前无法减肥的人却体重减轻了很多。

I'm also delighted, thrilled, so, so relieved that I don't have to look at these stupid arguments online anymore about whether or not obesity was the consequence of some other thing besides overconsumption of calories relative to caloric expenditure.

我也很高兴，很兴奋，所以，很放心，我不必再在网上看这些愚蠢的争论，关于肥胖是否是除了相对于卡路里消耗而言过度消耗卡路里之外的其他原因的结果。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: You know, there's no blame in that statement, but people are going back and forth and back and forth, and the laws of thermodynamics apply.

安德鲁·休伯曼：你知道，这种说法没有任何责备，但人们总是来来回回，热力学定律也适用。

We now know, thanks to GLPs, if you eat less than you burn, you lose weight.

我们现在知道，多亏了 GLP，如果您吃的少于消耗的，您就能减肥。

It's just very hard for people who are very overweight to eat less and burn more.

对于超重的人来说，少吃多燃烧是非常困难的。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: And it runs against all the evolutionarily hardwired circuitry of desiring overconsumption.

安德鲁·休伯曼：它违背了所有进化上固有的渴望过度消费的电路。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: So, here we are at a time where there are these peptides that people can take to lose significant amounts of weight.

Andrew Huberman：所以，我们现在正处于一个人们可以服用这些肽来显着减肥的时代。

The cost on those peptides is coming down now, through the compounding pharmacies, and people are taking half doses.

现在，通过复合药房，这些肽的成本正在下降，人们正在服用一半的剂量。

By the way, people are sharing their GLPs.

顺便说一句，人们正在分享他们的 GLP。

People are splitting them.

人们正在分裂他们。

Not supposed to do that.

不应该这样做。

It's illegal.

这是非法的。

That's not a suggestion.

这不是一个建议。

It's incredible how low a dose of GLP is required for people to get the desired effect, and people are picking up on this.

令人难以置信的是，人们只需要极低的 GLP 剂量就能获得预期的效果，而且人们正在认识到这一点。

The pharmaceutical companies hate this.

制药公司讨厌这一点。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: But people are getting them through compounding pharmacies.

Andrew Huberman：但是人们正在通过复合药房购买它们。

They're extending their dosages.

他们正在延长剂量。

They're sharing their...

他们正在分享他们的...

Don't share prescriptions, but they're doing it, and people are just losing weight easily.

不要分享处方，但他们正在这样做，而且人们很容易减肥。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: Some are losing muscle, and everyone gets inflamed about that, but you can do some resistance training to offset that, and they're awesome weight loss drugs.

安德鲁·胡伯曼：有些人正在失去肌肉，每个人都会因此而发炎，但你可以做一些阻力训练来抵消这一点，它们是很棒的减肥药。

Keith Humphreys: Yeah, they're amazing.

Keith Humphreys：是的，他们太棒了。

And they...

而他们...

Andrew Huberman: I'm not on them, by the way, but I would take them if I needed them.

Andrew Huberman：顺便说一句，我不喜欢它们，但如果我需要的话，我会接受它们。

You know?

你知道？

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

And they may have other benefits too.

它们还可能有其他好处。

We haven't fully figured it out.

我们还没有完全弄清楚。

Yeah, so I'm extremely interested in their effects on substance use.

是的，所以我对它们对药物使用的影响非常感兴趣。

I have a friend who's an addiction psychiatrist.

我有一个朋友，他是成瘾心理医生。

She said, "What my patients desire is they want not to want."

她说：“我的病人想要的是他们想要不想要的东西。”

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: So, which is different than, "I want to conquer my desire.

基思·汉弗莱斯：所以，这不同于“我想征服我的欲望。

I just wish I didn't desire this drug as much as I do." And I think that was something a friend of mine said to me over lunch.

我只是希望我不要像现在一样渴望这种药物。”我想这是我的一个朋友在午餐时对我说的话。

A friend of mine, whom I noticed had lost a lot of weight, and I said, "Wow, you've lost a lot of weight." And he goes, "Yeah, I'm on GLPs." And he said, "I used to spend all day not eating, and now I don't think about it." You know, it was effortful all day long.

我注意到我的一个朋友瘦了很多，我说：“哇，你瘦了很多。”他说：“是的，我正在使用 GLP。”他说：“以前我整天不吃饭，现在不去想了。”要知道，一整天都是很辛苦的。

Don't eat, don't eat, don't eat, don't eat, and now, that voice is just gone.

不吃，不吃，不吃，不吃，现在，那个声音就消失了。

Keith Humphreys: And so, what if we could do that for, say, cocaine or alcohol?

Keith Humphreys：那么，如果我们可以用可卡因或酒精来做到这一点呢？

They are sort of in the same kind of family of behaviors, and there are some interesting studies.

它们属于同一行为家族，并且有一些有趣的研究。

Now, to be clear, there's some studies that are negative.

现在，需要明确的是，有一些研究是负面的。

Nothing ever works out perfectly for everybody.

没有什么事情对每个人来说都是完美的。

But when I look through animal studies, small trials, and opportunistic epidemiological studies.

但当我仔细研究动物研究、小型试验和机会主义流行病学研究时。

So, when you go through the hospital, here's 10,000 people who had a diagnosis of cocaine use disorder, and let's see if the ones on GLPs went to the emergency room less, something like that.

所以，当你去医院时，这里有 10,000 名被诊断出可卡因使用障碍的人，让我们看看服用 GLP 的人是否减少了去急诊室的次数，类似的事情。

Keith Humphreys: They're vulnerable to different kinds of selection effects, but still, I see this pattern particularly with Semaglutide, which is the GLP that is in Wegovy and Ozempic, and alcohol, drops in alcohol use.

Keith Humphreys：他们很容易受到不同类型的选择效应的影响，但我仍然看到这种模式，尤其是 Semaglutide（Wegovy 和 Ozempic 中的 GLP）和酒精，酒精使用量下降。

Keith Humphreys: And so, the other thing I think is perhaps important and what I'm working now with the VA and Novo and a philanthropist to do something like this, is that alcohol is the most like-eating of drug behaviors, right?

Keith Humphreys：所以，我认为另一件事也许很重要，我现在正在与 VA 和 Novo 以及一位慈善家合作做这样的事情，那就是酒精是最喜欢吃的毒品行为，对吗？

So to the extent these drugs create a sense of satiety and fullness, right?

那么这些药物在多大程度上会产生饱足感，对吧？

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: To me, that seems more likely to change, swallowing something, a drink, versus, say, injecting myself or snorting a powder.

基思·汉弗莱斯：对我来说，这似乎更有可能改变，吞下一些东西，喝一杯，而不是给自己注射或吸食粉末。

And eating-like behavior.

还有类似进食的行为。

And so, that's why I was optimistic, but at least that's where I want to start.

所以，这就是我乐观的原因，但至少这是我想开始的地方。

If that works, it'd be fantastic.

如果这有效的话，那就太棒了。

Because if you have a drinking problem, you're about 70% more likely to also be overweight, and Americans are already pretty overweight.

因为如果您有饮酒问题，您超重的可能性就会增加约 70%，而美国人已经相当超重了。

Just think of the two-fer benefit of this for transforming people's lives.

想想这对于改变人们的生活所带来的双重好处吧。

You know, lose 30 pounds and stop your drinking problem.

你知道，减掉 30 磅就能解决酗酒问题。

Keith Humphreys: And last, when you mentioned my dear friend, Anna Lembke and my colleague, she said, "What's great is there are patients like, 'I don't really want to stop drinking, but I just love losing weight.' So, because I've been overweight my whole life, and so I will take the Ozempic here in the addiction clinic, not because I'm that motivated for the addiction part, but boy, when it comes with this other thing I really value, then I'm going to do it.'" And then they get the benefit.

基思·汉弗莱斯：最后，当你提到我亲爱的朋友安娜·伦布克和我的同事时，她说：“很棒的是，有些患者会说，‘我并不是真的想戒酒，但我只是喜欢减肥。’”所以，因为我一生都超重，所以我会在成瘾诊所服用 Ozempic，不是因为我对成瘾部分有那么大的动力，而是天哪，当它与我真正重视的另一件事一起出现时，我就会这么做。’”然后他们就得到了好处。

They stop, and their drinking cuts back.

他们停下来，饮酒量也减少了。

So, it's really thrilling.

所以，这真的很令人兴奋。

Keith Humphreys: Another nice thing is these are old drugs.

Keith Humphreys：另一件好事是这些都是老药。

They've been around like 20 years.

他们已经存在了大约20年了。

People don't realize that.

人们没有意识到这一点。

And millions and millions of people have taken them.

数以百万计的人已经拿走了它们。

So that makes it less likely that there's some awful side effect that doesn't show up for 10 years to them.

这样就不太可能出现一些 10 年后才出现的可怕副作用。

So, there's just a lot of potential upside here, and I think the next couple of years of science in this area are going to be super exciting.

因此，这里有很多潜在的好处，我认为未来几年该领域的科学发展将非常令人兴奋。

Andrew Huberman: What aspect of alcohol craving is sugar craving?

安德鲁·休伯曼：对酒精的渴望的哪一方面是对糖的渴望？

Keith Humphreys: I don't think very much.

Keith Humphreys：我想得不多。

I mean, maybe some.

我的意思是，也许有一些。

I mean, certainly the lore is, you know, when are you likely to relapse?

我的意思是，众所周知，你知道，你什么时候可能会旧病复发？

In fact, AA people say this: "Hungry, angry, lonely, tired." And some people feel that way, like if they...

事实上，AA 人是这么说的：“饿、生气、孤独、累。”有些人有这样的感觉，就像他们...

Actually, they also sometimes feel this way about carbs.

事实上，他们有时对碳水化合物也有这样的感觉。

When they are short of carbs, they want a beer.

当他们缺乏碳水化合物时，他们想要一杯啤酒。

So maybe it's something in there, but I don't think that's the fundamental thing that is the driver.

所以也许里面有什么东西，但我不认为这是驱动程序的根本因素。

I think it's more the subjective effect of consuming.

我认为更多的是消费的主观效果。

Andrew Huberman: There's a movement toward removing advertisements for pharmaceuticals on television, online.

Andrew Huberman：现在有一场运动正在取消电视和网络上的药品广告。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: I mean, on television.

安德鲁·休伯曼：我的意思是，在电视上。

Does anyone watch television anymore?

现在还有人看电视吗？

Yeah.

是的。

Keith Humphreys: That's a good question.

基思·汉弗莱斯：这是个好问题。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: I don't know what effect it's going to have now that so few people watch television, but what are your thoughts on that?

安德鲁·休伯曼：我不知道现在看电视的人越来越少了，这会产生什么影响，但你对此有何看法？

I mean, and of course, there are medications for hives and allergies and all these things, so it's a broad category.

我的意思是，当然，有治疗荨麻疹和过敏等所有药物，所以这是一个广泛的类别。

But I'm specifically thinking of things that have an addictive potential.

但我特别想到那些有可能让人上瘾的东西。

Keith Humphreys: The Lancet Commission on...

基思·汉弗莱斯：《柳叶刀》委员会...

Stanford Lancet Commission that I led, a partnership between The Lancet and the medical school, that was one of the points we made is that there's only two countries on Earth that have television ads all the time, which is us and New Zealand.

我领导的斯坦福柳叶刀委员会是《柳叶刀》和医学院的合作伙伴，我们提出的观点之一是，地球上只有两个国家一直有电视广告，那就是我们和新西兰。

I have no idea why New Zealand, but it's just that.

我不知道为什么是新西兰，但就是这样。

Andrew Huberman: Mm.

安德鲁·休伯曼：嗯。

Keith Humphreys: And when people from other countries come here, that's always a jolt to them.

Keith Humphreys：当其他国家的人们来到这里时，他们总是会感到震惊。

They're like, "What?" You come, and you go to your Super Bowl party, and like, "God, all these ads for?

他们就像，“什么？”你来了，去参加超级碗派对，然后想，“天啊，所有这些广告是为了什么？

Ask your doctor about this.

请向您的医生询问此事。

Ask your doctor about this.

请向您的医生询问此事。

Ask your doctor about this." I think it can create, and I can't prove this, but I think it can create a sense that everything is perfectible if you just bully your doctor enough, and that is just not the truth.

请向你的医生询问此事。”我认为它可以创造，我无法证明这一点，但我认为它可以创造一种感觉，如果你足够欺负你的医生，一切都是完美的，但这不是事实。

Keith Humphreys: So, that's the downside, I think, to worry about them, particularly for...

基思·汉弗莱斯：所以，我认为担心他们是不利的，特别是对于......

We don't have, thankfully, OxyContin ads on television, but we do have bank shot commercials.

值得庆幸的是，我们在电视上没有奥施康定广告，但我们有银行拍摄的广告。

So by that I mean, there was one actually in the Super Bowl, an ad for opioid-induced constipation.

所以我的意思是，超级碗中实际上有一个广告，是关于阿片类药物引起的便秘的广告。

So, who is that really for?

那么，这到底是为了谁呢？

I mean, that's a way of bringing up the subject of, "Are you on opioid painkillers?" But mostly we don't have that, and I think that's good.

我的意思是，这是提出“你服用阿片类止痛药吗？”这个话题的一种方式。但大多数情况下我们没有，我认为这很好。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: We need opioids, clearly.

Keith Humphreys：显然，我们需要阿片类药物。

I've worked in hospice for 10 years.

我在临终关怀医院工作了 10 年。

No one needs to tell me how incredibly valuable they are.

没有人需要告诉我它们有多么宝贵。

But at the same time, over-promotion was clearly part of what triggered the opioid crisis.

但与此同时，过度促销显然是引发阿片类药物危机的部分原因。

And by that, I don't just mean TV, I mean everything.

我指的不仅仅是电视，我指的是一切。

I mean, people, gifts, and other types of promotions, gifts to schools, that weren't separated enough from the industry.

我的意思是，人员、礼物和其他类型的促销活动、给学校的礼物，这些都与行业没有足够的分离。

All those things, we highlighted in the Lancet Commission.

我们在《柳叶刀》委员会中强调了所有这些事情。

Andrew Huberman: Social media probably doesn't have its own 12-step yet.

Andrew Huberman：社交媒体可能还没有自己的 12 步骤。

It probably will soon.

可能很快就会。

Social media is here to stay.

社交媒体将继续存在。

Let's be blunt.

让我们直言不讳吧。

I'm sure there's been discussions in the past about television is ruining society, and now everyone's staring at a box in the evening.

我确信过去有人讨论过电视正在破坏社会，而现在每个人都在晚上盯着电视盒子。

You know what I'm saying?

你知道我在说什么吗？

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: I mean, this has happened multiple times throughout history.

安德鲁·休伯曼：我的意思是，这种情况在历史上已经发生过多次。

But do you see true social media addicts or video game or YouTube addicts?

但你看到真正的社交媒体瘾君子、电子游戏瘾君子或 YouTube 瘾君子吗？

Do you ever observe an intervention working?

您观察过干预措施是否有效吗？

What does that look like, given that it's not quite like eating, meaning you have to eat at some point?

这看起来像什么，因为它不太像吃饭，这意味着你必须在某个时候吃东西？

But to tell a young person, or an older person, but to tell a young person, "Look, you can't ever be on social media," isn't reasonable.

但告诉一个年轻人，或者一个老年人，却告诉一个年轻人，“看，你永远不能出现在社交媒体上”，这是不合理的。

It's like saying, "You're not going to talk to your friends unless they're standing right in front of you," and it's not going to work.

这就像说：“除非你的朋友就站在你面前，否则你不会和他们说话”，这是行不通的。

It's just...

这只是...

Keith Humphreys: So, I will quote a perceptive Stanford freshman who said to me, "I hate social media.

基思·汉弗莱斯：所以，我要引用一位富有洞察力的斯坦福大学新生对我说的话：“我讨厌社交媒体。

I think it's bad for my mental health, but I have to be on it because everybody else is." And that is really tragic, and I think lots of people are in there.

我认为这对我的心理健康有害，但我必须这样做，因为其他人都是如此。”这真的很悲惨，我想很多人都在其中。

And I read another study actually, on the plane coming here of how much would you have to...

事实上，我读过另一项研究，在来这里的飞机上你需要花多少钱......

Well, how much would you demand if you had to leave social media?

那么，如果你不得不离开社交媒体，你会要求多少钱？

And people will say a certain money.

人们会说一定的钱。

Andrew Huberman: Mm.

安德鲁·休伯曼：嗯。

Keith Humphreys: But you say, "If everybody else were leaving it," the same people would say, "I would pay money to be one of them." So, that is why things like the Australian social media ban are going to be really interesting, because it's not really an individual punishment.

基思·汉弗莱斯：但是你说，“如果其他人都离开它，”同样的人会说，“我愿意付钱成为他们中的一员。”因此，这就是为什么像澳大利亚社交媒体禁令这样的事情会非常有趣，因为它并不是真正的个人惩罚。

You're not being exiled from the party.

你没有被开除出党。

It's more of life is going to happen in person for teenagers.

对于青少年来说，更多的生活将亲自发生。

And so, that will make that real life more appealing than being online.

因此，这将使现实生活比网络生活更具吸引力。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: So I'm really fascinated, I mean, we don't know what's going to happen, but really fascinated to see what happens.

Keith Humphreys：所以我真的很着迷，我的意思是，我们不知道会发生什么，但真的很着迷于看到会发生什么。

We do see all across the country, more people coming in with these types of problems, feeling like they can't stop looking at their phone, or games, or pornography is a really big one, delivered through these media, and of course, there are now gambling apps you can use on your phone, and that kind of thing.

我们确实看到在全国各地，越来越多的人遇到了此类问题，感觉他们无法停止看手机，或者游戏，或者色情内容是一个非常大的问题，通过这些媒体传播，当然，现在有可以在手机上使用的赌博应用程序，诸如此类的东西。

Keith Humphreys: And really have extremely difficult lives.

Keith Humphreys：而且确实过着极其艰难的生活。

I mean, they really have become absolutely consuming for them.

我的意思是，他们真的变得非常消耗精力。

We don't know yet of what the natural course is of this, because it's new.

我们还不知道这的自然过程是什么，因为它是新的。

Like, so what is the five-year course of social media?

那么社交媒体的五年历程是什么？

That's really, literally impossible to answer at this moment.

目前这确实是不可能回答的。

For what portion of people is a developmental thing that they will get out of?

对于哪部分人来说，他们将摆脱发展的困境？

Keith Humphreys: For example, if you go into a college campus, you'll see a lot of people drinking at levels that would qualify them for some level of alcohol use disorder, and a huge number of them, five years later, will be married and have a job and drink very little.

基思·汉弗莱斯：例如，如果你走进大学校园，你会看到很多人的饮酒水平使他们有资格患有某种程度的酒精使用障碍，而五年后，其中很大一部分人将结婚并找到工作，并且饮酒量很少。

I mean, those kinds of maturing-out effects.

我的意思是，那种成熟效应。

Is there a maturing-out effect of social media or not?

社交媒体是否有成熟效应？

For me, it was easy to...

对我来说，很容易...

I used to do a lot of X, and then I stopped, or I just do a teeny bit now.

我曾经做过很多X，然后我就停止了，或者我现在只做了一点点。

Keith Humphreys: That was particularly easy.

Keith Humphreys：这特别容易。

But of course, I had 40 years of my brain not touching it.

当然，我的大脑已经有 40 年没有碰过它了。

Will that be as easy for whatever the most popular thing with kids, probably TikTok or Instagram or something.

对于最受孩子们欢迎的事物（可能是 TikTok 或 Instagram 之类的）来说，这会那么容易吗？

If you've been doing that, again, thinking in that plastic, neuroplasticity from the time you were 8, 9, 10, 11, 12, is it developmental?

如果你从 8 岁、9 岁、10 岁、11 岁、12 岁起就一直在这样做，思考可塑性、神经可塑性，那么它是发育性的吗？

When you're 25, will you be ignoring your kids?

当你25岁的时候，你会忽视你的孩子吗？

Or will you not have kids because you don't have sex because you don't have a date because you're all day looking at the phone?

或者你会因为整天看手机而没有约会而没有性生活而没有孩子吗？

What will that course be?

那门课程会是什么？

We don't know that yet.

我们还不知道这一点。

Andrew Huberman: Yeah, I see a lot of adults addicted to social media.

安德鲁·胡伯曼：是的，我看到很多成年人沉迷于社交媒体。

I don't know if I'm addicted.

我不知道我是否上瘾了。

I don't think so.

我不这么认为。

Because if I say I'm not, it sounds like an addict, right?

因为如果我说我不是，听起来就像一个瘾君子，对吧？

So I'm just going to say I don't think so.

所以我只想说我不这么认为。

But I found great benefit to taking an old phone when I upgraded my phone, which I do far too seldom.

但当我升级手机时，我发现使用旧手机有很大好处，而我很少这样做。

But I finally upgraded my phone, and I took my old phone, and I put X and Instagram on that phone.

但我最终升级了我的手机，我拿着我的旧手机，我把X和Instagram放在那部手机上。

And it remains, much of the time, in a supermax prison lockbox that you can't code out of.

大多数时候，它都保存在监狱的超级密码箱里，你无法从中进行编码。

Andrew Huberman: So you put like one day or 19 hours or something, and you click that, and you'd have to saw it open, and that wouldn't even work.

Andrew Huberman：所以你输入一天或 19 小时之类的内容，然后你点击它，你必须看到它打开，但这根本不起作用。

And it's very helpful because once it's locked away and there's no opportunity to look at it, if people send me things, I can't open it on my other phone, and the impulse to pick it up is blocked.

这非常有帮助，因为一旦它被锁起来，就没有机会查看它，如果人们给我发东西，我就无法在我的另一部手机上打开它，并且拿起它的冲动也被阻止了。

It's very useful.

这非常有用。

It's a portable box, and it doesn't require...

这是一个便携式盒子，不需要...

Keith Humphreys: Right.

基思·汉弗莱斯：是的。

Andrew Huberman: I mean, the box costs 30 bucks.

Andrew Huberman：我的意思是，这个盒子要 30 美元。

I'm sure I recovered more than that in work output and recreation output, and just hanging out with my girlfriend and not looking at my phone.

我确信我在工作输出和娱乐输出方面恢复得更多，并且只是和我的女朋友一起出去玩，而不是看我的手机。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

I know other people who've done things like that or switched back to a dumb phone, to avoid the constant bing notification, da, da, da, da.

我知道其他人也做过类似的事情，或者换回哑手机，以避免不断的 bing 通知，da，da，da，da。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: Or there's also software you can get that will suppress a lot of that stuff unless you specifically go in and enter a code and say, "Bring it all to me." And those are useful things.

Keith Humphreys：或者，您也可以使用某些软件来抑制很多此类内容，除非您专门进去输入代码并说：“将其全部交给我。”这些都是有用的东西。

Like, it's so new, right, that we haven't got a lot of social norms about it.

就像，它太新了，对吧，我们还没有很多关于它的社会规范。

But think of something like drinking before noon, right?

但是想想像中午之前喝酒这样的事情吧？

There's no law against drinking before noon, and yet a huge number of people abide by that norm, right?

没有法律禁止中午之前喝酒，但很多人都遵守这一规范，对吧？

Keith Humphreys: And they are like, "Oh, well, I don't want to do it.

基思·汉弗莱斯：他们就像是，“哦，好吧，我不想这样做。

It's not noon, da, da, da." And we might, over time, evolve some kinds of things about social media, I would hope.

现在还不是中午啊，哒，哒，哒。”我希望，随着时间的推移，我们可能会发展出一些关于社交媒体的东西。

Like, things that we all find sensible, like don't do social media at the dinner table, would be, I think, a good one.

比如，我们都认为明智的事情，比如不要在餐桌上使用社交媒体，我认为是一件好事。

Or don't do social media in a restaurant or whatever.

或者不要在餐馆或其他地方使用社交媒体。

I hope we'll do something like...

我希望我们能做一些像...

Because you can't solve this problem just through individual clinical medicine.

因为仅仅通过个体临床医学无法解决这个问题。

That's crazy.

太疯狂了。

Keith Humphreys: I mean, there has to be some...

基思·汉弗莱斯：我的意思是，必须有一些......

Just like, "We've built a lot of norms around alcohol, we've built norms.

就像，“我们已经建立了很多关于酒精的规范，我们已经建立了规范。

Don't drink and drive." That's one that most people now broadly find believable.

不要酒后驾车。”这是大多数人现在普遍认为可信的说法。

Building some about social media, I think, is going to be a sort of task of this generation that has grown up with them.

我认为，建立一些关于社交媒体的内容将是与他们一起成长的这一代人的一项任务。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

I have three real-life examples of young guys whose parents I know, who essentially contacted me because different situation for each, but I'll just describe the overlap.

我有三个现实生活中的年轻人的例子，他们的父母我都认识，他们基本上联系了我，因为每个人的情况不同，但我只会描述重叠之处。

Each one of them was looking like a failure to launch.

他们每一个看起来都像是发射失败。

You know, graduated high school, was not highly motivated to go off to college, or went to community college, then stopped doing that, was working, then lost their job, or they were not in a career path that was going to sustain them independently.

你知道，高中毕业，没有很强的动力去上大学，或者去社区大学，然后停止这样做，工作，然后失业，或者他们没有走上一条能够独立维持他们的职业道路。

Andrew Huberman: YouTube or video game enthusiasts, to say the least, and all were convinced they had ADHD, all medicated.

Andrew Huberman：至少可以说，YouTube 或视频游戏爱好者，所有人都确信自己患有多动症，并且都接受了药物治疗。

By now, I'm happy to say, with some explanation of reward circuitry in Anna's book, giving them Anna's book, "Dopamine Nation," and obviously, really hard work on their part, is really what did it.

到目前为止，我很高兴地说，在安娜的书中对奖励电路进行了一些解释，给他们安娜的书“多巴胺国家”，显然，他们的努力工作确实做到了这一点。

All three of them, in higher education situations, great universities, off medication.

他们三人都在接受过高等教育，在伟大的大学里，都摆脱了药物治疗。

Andrew Huberman: They all had to quit video games or YouTube for some extended period of time, and recapture their attentional capabilities, and, most importantly, recapture their sense that they have agency in the world, that they can make things happen for themselves.

Andrew Huberman：他们都必须在较长一段时间内退出电子游戏或 YouTube，并重新获得他们的注意力能力，最重要的是，重新获得他们在世界上拥有代理权的感觉，他们可以自己让事情发生。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: Not incidentally, all of their parents are reasonably high-achieving, and none of them have patterns of addiction that would've predicted any of this.

安德鲁·胡伯曼（Andrew Huberman）：并非偶然，他们的父母都取得了相当高的成就，而且他们中没有一个人有可以预见到的成瘾模式。

So, there is a way to escape the vortex of this stuff.

所以，有一个办法可以逃离这个东西的漩涡。

But I mention those stories because I think, A, they're success stories, and I'm proud of those guys, but oftentimes it's multi-factorial.

但我提到这些故事是因为我认为，A，它们是成功的故事，我为这些人感到自豪，但通常这是多因素的。

I can't say, "Oh, it's the medication," or, "Oh, but the medication didn't rescue them," or, "Oh, it's YouTube," or, "Oh, it's video games." There's a sort of pattern of progressive languishing that's set in this context of media.

我不能说，“哦，这是药物”，或者，“哦，但是药物并没有救他们”，或者，“哦，这是 YouTube”，或者，“哦，这是电子游戏”。在媒体的背景下，存在着一种渐进式的衰弱模式。

They weren't talking to me about porn, although I suspect that was in the backdrop of some of these cases.

他们没有和我谈论色情，尽管我怀疑这是在其中一些案件的背景下发生的。

And they're kicking butt right now.

他们现在正在踢屁股。

Keith Humphreys: Good.

基思·汉弗莱斯：很好。

Andrew Huberman: All three of them in healthy relationships, working hard, working out, happy, which is the most important thing.

安德鲁·胡伯曼：他们三个人的关系都很健康，努力工作，锻炼身体，快乐，这是最重要的。

I mean, one kicked cannabis, the other doesn't drink, the other one can drink, it seems without any issues.

我的意思是，一个踢了大麻，另一个不喝酒，另一个可以喝酒，看起来没有任何问题。

I mean, when I think about what they have to deal with, relative to what I had to deal with growing up, when we didn't even really understand what addiction was, and there's just so many more things coming at them to impair them.

我的意思是，当我想到他们必须处理的事情时，相对于我成长过程中必须处理的事情，当时我们甚至没有真正理解成瘾是什么，而且还有很多事情会伤害他们。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: It's like they've unshackled themselves from five or six different ball and chain.

安德鲁·胡伯曼：就像他们从五六个不同的球和链子中解脱出来一样。

Keith Humphreys: That's great.

基思·汉弗莱斯：那太好了。

And the point you make, too, about there's so many pathways out of this, you see that everywhere.

你也指出，有很多途径可以解决这个问题，你随处都可以看到这种情况。

Many, many pathways to recovery.

有很多很多的恢复途径。

I mean, I know people who, like a dear friend of mine, just tried to quit smoking for years and years and years, and just felt totally defeated by it until he saw his baby.

我的意思是，我认识一些人，就像我的一位亲爱的朋友一样，多年来一直试图戒烟，但在看到自己的孩子之前，他们感到完全失败了。

As soon as he was a father, he was just like, "Man, I've got to stay around for this beautiful being," and quit that day.

当他成为父亲后，他就想，“伙计，我必须为了这个美丽的存在而留下来”，然后那天就辞职了。

Keith Humphreys: There's changes in the sort of homo-racial system because of life changes.

Keith Humphreys：由于生活的变化，同性恋系统也发生了变化。

I have another friend, a dear friend, who was going to prison, which is a terrible thing.

我还有一个朋友，一个亲爱的朋友，他要进监狱了，这是一件可怕的事情。

You think how would anybody benefit from being in prison?

你认为入狱会对任何人有什么好处？

But he said, "I just needed many, many months off of methamphetamine for my brain to heal," and I sort of realized, "Wow, that was really crazy." And he didn't get any treatment.

但他说，“我只需要戒掉甲基苯丙胺很多很多个月才能让我的大脑痊愈，”我意识到，“哇，这真的太疯狂了。”而且他没有得到任何治疗。

It was just being away from the drug for an extended period.

只是长时间远离药物而已。

Keith Humphreys: And there's an infinite number of stories like that, because this is a condition experienced by tens of millions of people, right?

Keith Humphreys：这样的故事有无数个，因为这是数以千万计的人经历过的情况，对吧？

So, there's going to be lots and lots of pathways out.

所以，将会有很多很多的出路。

That is one thing, by the way, surprises a lot of people.

顺便说一句，这是让很多人感到惊讶的一件事。

Of people who had a substance problem and are now doing well, in big representative surveys, very few of them actually went to see anybody like Stanford Psychiatry.

在大型代表性调查中，那些曾经有物质问题但现在状况良好的人中，很少有人真正去看过像斯坦福精神病学这样的机构。

That is an unusual pathway to go through addiction treatment.

这是一种不寻常的成瘾治疗途径。

Andrew Huberman: Hmm.

安德鲁·休伯曼：嗯。

Keith Humphreys: People change in all kinds of ways for all kinds of reasons.

Keith Humphreys：人们会因为各种原因而以各种方式发生变化。

Andrew Huberman: Yeah, one of our team members here has been open about this, so I feel comfortable saying it, who he managed to kick alcohol and a pretty, almost lifelong alcohol and cannabis addiction.

安德鲁·胡伯曼（Andrew Huberman）：是的，我们的一位团队成员对此持开放态度，所以我很乐意这么说，他成功戒掉了酒精和几乎终生的酒精和大麻成瘾。

Didn't go to meetings, but made the decision, and lost a bunch of weight, too.

没有去参加会议，但做出了决定，而且体重也减轻了很多。

He was already super productive.

他已经非常高效了。

He was doing well enough that it wasn't a forced thing, but he was just tired of being tired, as they say.

他做得足够好，这不是被迫的事情，但正如他们所说，他只是厌倦了疲倦。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Yeah.

是的。

Keith Humphreys: Yep.

基思·汉弗莱斯：是的。

Andrew Huberman: And he flipped the switch in one day, has never gone back.

安德鲁·休伯曼：他在一天之内打开了开关，再也没有回去过。

And I remember asking him recently, I was like, "Well, did you go to meetings?" And he's like, "No, I went to the gym." He found a replacement behavior, he got healthy, he kept doing all the other things he was doing.

我记得最近问过他，我说：“你去参加会议了吗？”他说：“不，我去了健身房。”他找到了替代行为，他变得健康，他继续做他正在做的所有其他事情。

And I don't want to take the words out of his mouth, but he's gone on a few podcasts talking about the relationship with his kids, improving tremendously professionally, and his relationship to himself, and broke a long family line of alcoholism.

我不想从他嘴里说出这些话，但他在一些播客上谈论了与孩子的关系，在职业上取得了巨大的进步，以及他与自己的关系，并打破了长期酗酒的家族血统。

Andrew Huberman: I mean, I think that's what sometimes people forget, is that you can break the chain in one generation, which is really spectacular.

安德鲁·休伯曼：我的意思是，我认为有时人们会忘记，你可以在一代人的时间内打破链条，这真的很壮观。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Genes are a risk, they're not destiny, and that's very important.

基因是一种风险，而不是命运，这一点非常重要。

Even if you come from 100 generations' worth, that doesn't mean that your life is necessarily going to come out that way.

即使你来自一百代人，也不意味着你的生活一定会这样。

And you're raising another point too, about what is beautiful for a lot of people about recovery, is then you start acquiring more reasons not to use, that you didn't have at the moment you started, because you burned those relationships out, or you'd never formed them because you have been living in your mom's basement smoking cannabis and being online all day.

你还提出了另一点，对于很多人来说，康复的美妙之处在于，你开始获得更多不使用的理由，而这些理由是你开始时没有的，因为你已经烧毁了这些关系，或者你从未建立过它们，因为你一直住在你妈妈的地下室吸大麻并整天上网。

Keith Humphreys: And then you start to get like, oh wow, having a job where I'm respected and I feel important is nice.

Keith Humphreys：然后你开始觉得，哦，哇，有一份让我受到尊重、让我感觉很重要的工作真是太好了。

Getting paid is nice.

得到报酬是件好事。

Being mentally present instead of high all the time is nice.

保持精神状态而不是一直处于兴奋状态是很好的。

And then it just makes it easier month by month, year by year, to just live the rest of your life that way.

然后，它只会让你更容易月复一月、年复一年地以这种方式度过你的余生。

Andrew Huberman: There was a question that I forgot to ask earlier.

Andrew Huberman：我之前忘记问一个问题。

Keith Humphreys: Okay.

基思·汉弗莱斯：好的。

Andrew Huberman: And it's a somewhat of a touchy subject.

Andrew Huberman：这是一个有点敏感的话题。

Keith Humphreys: Okay.

基思·汉弗莱斯：好的。

Andrew Huberman: I've observed, and I've heard that sometimes the smarter the person is, or the more intellectual they tend to be, or ideas-oriented, the worse 12-step works for them.

Andrew Huberman：我观察到，而且我听说有时一个人越聪明，或者他们越聪明，或者以想法为导向，12步法对他们的效果就越差。

Keith Humphreys: Hmm.

基思·汉弗莱斯：嗯。

Andrew Huberman: Whereas people who just kind of go, "Okay," like, "Chop wood, carry water, I can do that.

安德鲁·休伯曼（Andrew Huberman）：而那些只是说“好吧”，比如“砍柴、挑水”的人，我可以做到。

Follow step one, follow step two, follow step three.

按照第一步，按照第二步，按照第三步。

Step four is pretty uncomfortable.

第四步就很不舒服了。

I'll do that.

我会这么做的。

Okay, fine, that one's harder than the other ones," and they just kind of do it.

好吧，好吧，那个比其他的更难，”他们就这么做了。

They don't overthink it.

他们不会想太多。

I've observed this quite a lot.

我已经观察过很多次了。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: And I don't want to get into notions of IQ.

Andrew Huberman：我不想讨论智商的概念。

I think it's just some people have this prefrontal cortex that lets them see five different strategies simultaneously.

我认为只是有些人的前额叶皮层可以让他们同时看到五种不同的策略。

Other people are more plug and chug.

其他人则更多的是即插即用。

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

Andrew Huberman: And neither is better or worse, it's just different.

Andrew Huberman：没有更好或更坏，只是不同而已。

And I have observed that for people who just kind of ratchet into the work and don't overthink it, what's this about?

我观察到，对于那些只是慢慢投入工作并且不会想太多的人来说，这是怎么回事？

Is it a cult?

这是邪教吗？

What do they want?

他们想要什么？

But there's this one instance will I ever drink...

但有这样一个例子我会喝...

They don't think about it too much.

他们不会考虑太多。

They just do the steps, and they're out.

他们只是执行步骤，然后就出去了。

Keith Humphreys: That is what AA asks.

Keith Humphreys：这就是 AA 所要求的。

I mean, one expression is, "Your best thinking got you here." And in other words, keep it simple.

我的意思是，一种说法是，“你最好的想法让你来到这里。”换句话说，保持简单。

Andrew Huberman: That's a good one.

安德鲁·休伯曼：这是一件好事。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: You don't have to do a philosophical critique of the 12 steps.

Keith Humphreys：您不必对 12 个步骤进行哲学批判。

You just have to, don't drink, go to meetings.

你只需要，不要喝酒，去参加会议。

Don't drink, go to meetings.

不喝酒，去开会。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: It's that.

基思·汉弗莱斯：就是这样。

And it is an action program.

这是一个行动计划。

So, it's different in that sense from a lot of psychotherapy styles, which are more intellectual and analytical and less focused on you're actually going to do certain behaviors.

因此，从这个意义上说，它与许多心理治疗风格不同，后者更注重智力和分析，不太关注你实际上要做的某些行为。

And so, if you dislike that, yeah, I can see why AA would bother you.

所以，如果你不喜欢这样，是的，我明白为什么 AA 会打扰你。

I mean, that said, AA is just not one thing.

我的意思是，AA 并不是一回事。

Keith Humphreys: So, you can find, I'm sure, within a few miles of where we are sitting, you can find an AA meeting over a gas station with guys who are smoking tobacco and have jailhouse tattoos who are talking about the steps, and you will find meetings with professionals who will talk about angst and things like that.

基思·汉弗莱斯：所以，我确信，在我们坐的地方几英里的范围内，你可以在加油站找到一个 AA 会议，会议上有吸烟者、有监狱纹身的人正在谈论台阶，你还会发现与专业人士开会，他们会谈论焦虑之类的事情。

And you sort of find your own people.

你可以找到自己的人。

Keith Humphreys: And I've known some very intellectual people, like professors, who go to an AA meeting with other people like that, and they're still working the steps and all that, but they are also they're going to talk about Kierkegaard.

Keith Humphreys：我认识一些非常有知识的人，比如教授，他们和其他人一起参加 AA 会议，他们仍然在执行步骤等等，但他们也会谈论克尔凯郭尔。

And again, like AA's, "Fine, you can talk about Kierkegaard.

再次，就像 AA 一样，“好吧，你可以谈谈克尔凯郭尔。

Just remember, don't drink and go to meetings." You can talk about whatever you want, and you need to find your peeps.

请记住，不要喝酒和参加会议。”你可以谈论任何你想谈论的事情，但你需要找到你的窥视者。

Keith Humphreys: And that's also why when people are thinking of going, I say, "Think of this like dating." You wouldn't go on one date and say, "I didn't like that person, I guess I'm going to be alone the rest of my life." You go on a group of dates, right?

基思·汉弗莱斯：这也是为什么当人们考虑去时，我会说，“把这想象成约会。”你不会在一次约会时说：“我不喜欢那个人，我想我会孤独终老。”你们去一群人约会，对吗？

So, pick some different meetings at different times of day and different places, and they will be different.

所以，在一天的不同时间、不同地点选择一些不同的会议，它们会有所不同。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And then go back to the one that felt like home.

Keith Humphreys：然后回到那个感觉像家一样的地方。

Andrew Huberman: Speaking of carrots, there's no wisdom like the kind of wisdom you can get from a really good share from someone at an AA meeting that you thought when they stood up and started their share that you had nothing in common with this person.

Andrew Huberman：说到胡萝卜，没有什么比你在 AA 会议上从某人的精彩分享中获得的智慧更好的了，当他们站起来开始分享时，你认为你与这个人没有任何共同点。

You are from two different universes, and inevitably, there's some kernel of truth for you or something that you disagree with, and therefore, you have insight.

你们来自两个不同的宇宙，不可避免地会有一些对你来说是真理的核心或你不同意的东西，因此，你有洞察力。

It's a spectacular thing, really.

这确实是一件了不起的事情。

Keith Humphreys: Yeah, I mean, and they were very conscious about that.

Keith Humphreys：是的，我的意思是，他们对此非常有意识。

And if you read, it's called "The Big Book." It's actually just "Alcoholics Anonymous." It was called "The Big Book" because it was printed on cheap paper, so it was sort of fat and pulpy.

如果你读的话，它被称为“大书”。它实际上只是“戒酒无名会”。它被称为“大书”，因为它是用廉价的纸张印刷的，所以有点肥厚、稀烂。

This was back in the Depression, right?

那是在大萧条时期，对吗？

It says flat out, "This book is mostly stories, and we tell stories in the hopes that something in them will catch you and say, 'Gosh, that life is like mine, and look where he or she is.

它直截了当地说：“这本书主要是故事，我们讲故事是希望故事中的某些东西能吸引你，让你说，‘天哪，生活和我的一样，看看他或她在哪里。

Boy, I wish I were there.' Well, if they're kind of like me and they got to that good spot, maybe I can get to that good spot."

男孩，我希望我在那里。好吧，如果他们有点像我，并且他们到达了那个好位置，也许我也能到达那个好位置。”

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And so, it's a conscious and very, I think, clever organizational strategy to tell people, "There's a place for you here.

基思·汉弗莱斯：所以，我认为这是一个有意识的、非常聪明的组织策略，告诉人们“这里有你的位置。

There's people like you here."

这里有像你这样的人。”

Andrew Huberman: I want to ask you about death.

安德鲁·休伯曼：我想问你关于死亡的问题。

Keith Humphreys: Okay.

基思·汉弗莱斯：好的。

Andrew Huberman: You worked in hospice.

安德鲁·休伯曼：你在临终关怀医院工作。

Keith Humphreys: Great experience.

基思·汉弗莱斯：很棒的经历。

Andrew Huberman: As Americans, we're not comfortable talking about death.

安德鲁·休伯曼：作为美国人，我们不愿意谈论死亡。

It evokes sadness, fear, but I think there's a lot to learn about it from hearing about someone who's been close to it a lot.

它会引起悲伤和恐惧，但我认为从与它关系密切的人的讲述中可以学到很多东西。

And one can't live very long without losing someone, and we're all going to go eventually, and that's hard truth.

一个人不可能在不失去某人的情况下活很久，而我们最终都会离开，这是残酷的事实。

But why did you go into hospice, and then what did you learn about in hospice that has informed your sense of life and death?

但是你为什么进入临终关怀中心，然后你在临终关怀中心学到了什么，这些知识影响了你对生与死的感知？

Keith Humphreys: Yeah.

基思·汉弗莱斯：是的。

So, I loved being a hospice counselor.

所以，我喜欢成为一名临终关怀顾问。

I did it for about 10 years.

我这样做了大约10年。

And there's so many beautiful things about it.

它有很多美丽的东西。

First off, when I tell people, they go like, "Oh, God, that must be really depressing." Hospice staff were the most upbeat people I've ever worked with.

首先，当我告诉人们时，他们会说，“哦，上帝，那一定非常令人沮丧。”临终关怀中心的工作人员是我共事过的最乐观的人。

Andrew Huberman: Hmm.

安德鲁·休伯曼：嗯。

Keith Humphreys: Optimistic, compassionate, seen everything.

Keith Humphreys：乐观、富有同情心、洞察一切。

And in a way, I could sort of understand it because it's accepted the person's going to die, so what's the worst that could happen, right?

在某种程度上，我可以理解它，因为它接受了这个人会死，那么可能发生的最坏的情况是什么，对吧？

You don't think like, "Oh, if I say the wrong thing, maybe in our sessions, it'll take an extra three months to develop more trust." They're not going to be alive that long.

你不会想，“哦，如果我说错了话，也许在我们的会议上，需要额外的三个月来建立更多的信任。”他们不会活那么久。

We've accepted the worst, right?

我们已经接受了最坏的情况，对吗？

And so, then we can just do well and help this person have a good death, and help their family have a good death, and work through their grief experience.

因此，我们就可以做得很好，帮助这个人有一个好的死亡，帮助他们的家人有一个好的死亡，并努力度过他们的悲伤经历。

Keith Humphreys: And so, they're just very upbeat.

Keith Humphreys：所以，他们非常乐观。

And so, I never found it depressing at all.

所以，我从来没有觉得它令人沮丧。

I did it partly because I had shifted to doing more research, and I just missed taking care of patients.

我这样做的部分原因是我已经转向做更多的研究，而我只是怀念照顾病人的时光。

The obvious thing would've been, well, why didn't I just do more addiction thing?

显而易见的事情是，好吧，为什么我不做更多上瘾的事情呢？

I thought, "Well, I'll just do something different." And the other part was I was scared of death, and I don't like being afraid.

我想：“好吧，我会做一些不同的事情。”另一部分是我害怕死亡，但我不喜欢害怕。

I'm a counter-phobic person.

我是一个反恐惧症的人。

I am not brave, but I'm afraid of being afraid, so I do things that look brave.

我并不勇敢，但我害怕害怕，所以我做了看起来勇敢的事情。

Keith Humphreys: And I know about phobia.

Keith Humphreys：我了解恐惧症。

Like, the most basic thing is exposure reduces fear and anxiety.

就像，最基本的事情是暴露可以减少恐惧和焦虑。

Running away from things makes them scarier.

逃避事物会让它们变得更可怕。

So, I thought, "All right.

所以，我想：“好吧。

I'm scared of death.

我害怕死亡。

So, how do I solve that problem?

那么，我该如何解决这个问题呢？

I'm going to spend as much time around death as I can." And it's a very intimate experience.

我将尽可能多地度过与死亡相关的时间。”这是一次非常亲密的体验。

You're in people's homes.

你在人们家里。

It's not like when they're sitting in your office.

这不像他们坐在你的办公室里。

Keith Humphreys: But people's bedroom could have, like, "What is that?" "Well, that's my...

Keith Humphreys：但是人们的卧室可能会问，“那是什么？” “嗯，那是我的...

I was a high school baseball player.

我是一名高中棒球运动员。

We won the nationals." Or, "What's that?" "That's my wedding picture.

我们赢得了全国冠军。”或者，“那是什么？” “那是我的结婚照。

That's my wife and I, 40 years ago." It's very intimate and sweet.

那是我和我的妻子，40 年前。”这是非常亲密和甜蜜的。

Keith Humphreys: And being the last friend somebody ever makes is an incredible honor.

Keith Humphreys：成为某人结交的最后一个朋友是一种令人难以置信的荣幸。

And I always felt that when I had to say goodbye, I had been honored by them in that way, the last friend they made.

我总觉得，当我不得不说再见时，他们以这种方式让我感到荣幸，这是他们结交的最后一个朋友。

So, I just found it profoundly a moving experience.

所以，我发现这是一次非常感人的经历。

And it took away that fear, and then I was able to help other people get free of that fear.

它消除了恐惧，然后我能够帮助其他人摆脱恐惧。

Keith Humphreys: Because when you've been around it for a while, and then the family comes in, and they're scared, or maybe some of these doctors are scared of death, you can be the person who says, "This is what's going on.

基思·汉弗莱斯：因为当你已经经历了一段时间，然后家人进来，他们很害怕，或者其中一些医生害怕死亡时，你可能会说：“这就是正在发生的事情。

This is what your mom, your dad, your uncle's going through.

这就是你的妈妈、你的爸爸、你的叔叔正在经历的事情。

Here's what's going to happen, likely.

这就是可能会发生的事情。

Here's how long he's likely to live.

这是他可能活多久。

Here's what we're doing for him." And then that helps them because you are radiating that acceptance that they need to come to, which is hard.

这就是我们正在为他做的事情。”这对他们很有帮助，因为你正在散发出他们需要接受的接受，这很难。

Keith Humphreys: So, I'm just so glad I did that, and I really would recommend that to anybody who wants to give back to community but also just come to a place of peace with dying.

基思·汉弗莱斯：所以，我很高兴我这么做了，我真的会向任何想要回馈社区但又想安宁地接受死亡的人推荐这样做。

The way to do that is to be with the dying, not to run from them.

做到这一点的方法是与临终者在一起，而不是逃避他们。

Andrew Huberman: You got me.

安德鲁·休伯曼：你抓住了我。

Man, maybe it's because we both know Nolan.

伙计，也许是因为我们都认识诺兰。

I think I was just feeling your feelings.

我想我只是感受到了你的感受。

Yeah, death is, the way you describe it, it's heavy, and you wove some lightness in there, which clearly I'm not a hospice worker.

是的，死亡，正如你所描述的那样，它是沉重的，而你却在其中编织了一些轻盈，这显然我不是临终关怀工作者。

I don't have that relationship to death.

我和死亡没有那种关系。

But thank you for sharing that.

但谢谢你分享这一点。

Andrew Huberman: I think it is a universal experience.

Andrew Huberman：我认为这是一种普遍的体验。

And being in there with people alongside them, clearly something that I think many people, young and old, run from.

和人们在一起，显然是很多人，无论老少，都会逃避的事情。

It's like...

这就像...

Keith Humphreys: Yes.

基思·汉弗莱斯：是的。

Andrew Huberman: Yeah.

安德鲁·休伯曼：是的。

There's something there that...

那里有一些东西...

Keith Humphreys: And we can, in this society.

Keith Humphreys：在这个社会中我们可以。

I've done work in developing countries.

我曾在发展中国家工作过。

You can't not see death.

你不可能看不到死亡。

People die in the street, literally.

从字面上看，人们死在街上。

And so, oddly enough, there is more death and less fear than there is in our advanced technological society, where death is hidden and denied.

因此，奇怪的是，与我们隐藏和否认死亡的先进技术社会相比，死亡更多，恐惧更少。

So, Americans, I find, are much more terrified of it than people I met in Iraq, for example.

因此，我发现，美国人比我在伊拉克遇到的人更害怕它。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: So, that's why you really have to make an effort to get past those norms and those structures if you want to be in companionate connection to people who are dying.

基思·汉弗莱斯：所以，这就是为什么如果你想与垂死的人建立伙伴关系，你真的必须努力超越这些规范和结构。

Andrew Huberman: I didn't anticipate asking what I'm about to ask, but it's been on my mind a very long time, and it's directly related to the two major topics we've covered, which are addiction and death.

安德鲁·胡伯曼：我没想到会问我要问的问题，但这个问题已经在我脑海里萦绕了很长时间，而且它与我们讨论的两个主要主题直接相关，即成瘾和死亡。

I've heard it said by a gambling addict that all addiction is gambling of some sort.

我听一位赌博成瘾者说过，所有的成瘾都是某种形式的赌博。

Am I going to get in trouble this time?

这次我会遇到麻烦吗？

Am I going to get fired this time?

这次我会被解雇吗？

And I've thought a lot about addiction, and I've wondered if all addiction is an attempt to escape our fear of death.

我对成瘾问题思考了很多，我想知道是否所有的成瘾都是为了逃避我们对死亡的恐惧。

Keith Humphreys: Hmm.

基思·汉弗莱斯：嗯。

Andrew Huberman: And this is not an attempt to get philosophical or deeply psychological, but I mean, it's a weird thing...

安德鲁·休伯曼：这并不是试图获得哲学或深刻的心理学，但我的意思是，这是一件奇怪的事情......

We don't know what other species think, but it's a weird thing that the portions of our brain that let us think into the future and plan and build technologies and that made us the curators of the earth and not the house cats or the elephants or something, can logically know that we're going to die someday.

我们不知道其他物种怎么想，但奇怪的是，我们大脑的一部分让我们思考未来、计划和构建技术，使我们成为地球的管理者，而不是家猫或大象或其他什么东西，可以从逻辑上知道我们有一天会死。

Andrew Huberman: And if we really drop into that feeling, for most people, it is scary.

安德鲁·胡伯曼：如果我们真的陷入这种感觉，对大多数人来说，这是可怕的。

It's really scary and really sad.

这真的很可怕也很悲伤。

And I think if any of us dropped really deeply into that, and we've created any sort of connection to anything or anyone, it's deeply terrifying.

我认为，如果我们中的任何人真正深入其中，并且我们与任何事物或任何人建立了任何形式的联系，那是非常可怕的。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: And one thing I can say about addiction is that the states of being high, whatever the thing is for that person, they have a timelessness to them.

安德鲁·休伯曼：关于成瘾，我可以说的一件事是，无论对那个人来说是什么，兴奋的状态都是永恒的。

You're out of the real world, or you're operating in the real world as if you had superpowers, I mean, in one's mind.

你脱离了现实世界，或者你在现实世界中运作，就好像你拥有超能力一样，我的意思是，在一个人的头脑中。

And so, I wonder whether or not the fear of death is something that addicts, in particular, are running from.

因此，我想知道对死亡的恐惧是否是成瘾者尤其是正在逃避的东西。

Andrew Huberman: And that raises the question, is embracing death as a very real thing, overcoming that fear, the counter-phobia?

安德鲁·休伯曼：这就提出了一个问题，是否将死亡视为一件非常真实的事情，克服这种恐惧，反恐惧症？

Do you think that perhaps could be used to help treat addiction or avoid it?

您认为这也许可以用来帮助治疗或避免成瘾吗？

Keith Humphreys: Well, that's a really interesting idea.

Keith Humphreys：嗯，这是一个非常有趣的想法。

I mean, I think very broadly speaking, a lot of heavy substance use is some desire for oblivion, to get away from unpleasant truths.

我的意思是，我认为从广义上讲，大量使用药物是为了忘记、逃避不愉快的事实。

And I think one of those is death and suffering, but I think it's broader than that.

我认为其中之一就是死亡和痛苦，但我认为它的范围比这更广泛。

Keith Humphreys: So, it could be, "I just can't be in this PTSD anymore," or, "I was sexually abused as a child, and I just need to stamp out those visions and those memories for an hour and step outside them."

基思·汉弗莱斯：所以，可能是，“我不能再陷入创伤后应激障碍”，或者，“我小时候受到过性虐待，我只需要在一个小时内消除这些幻象和记忆，然后走出它们。”

Keith Humphreys: "My marriage has disintegrated, and I'm miserable, and my spouse and I hate each other, and this is the one moment where I am above that or unconcerned about that," that oftentimes there's something awful, and frightening, or humiliating, or painful, that this is the escape from.

基思·汉弗莱斯（Keith Humphreys）：“我的婚姻已经解体，我很痛苦，我和我的配偶互相憎恨，而这是我超越这一点或对此漠不关心的时刻，”常常有一些可怕的、可怕的、羞辱的或痛苦的事情，这是我逃避的方法。

Andrew Huberman: Mm-hmm.

安德鲁·休伯曼：嗯嗯。

Keith Humphreys: And they do provide that, at least in the short-term.

Keith Humphreys：他们确实提供了这一点，至少在短期内是这样。

The high-term costs are hard.

长期成本是很难的。

But in the short-term, everything could be falling down around you, and if you're high on a stimulant, you can still feel euphoria, at least for that brief moment.

但在短期内，你周围的一切都可能会崩溃，如果你服用了兴奋剂，你仍然可以感受到欣快感，至少在那短暂的时刻。

And what can be tough about recovery is when you stop using, those things are not gone.

恢复过程中最困难的是，当您停止使用时，这些东西并没有消失。

You're still going to die.

你还是会死。

If your marriage is bad, your marriage is bad.

如果你的婚姻不好，你的婚姻也不好。

If you were abused, you were still abused.

如果你被虐待了，你仍然会被虐待。

Keith Humphreys: And that is enough to persuade some people never to stop, because it's a lot harder to actually deal with those things head-on than avoiding them through intoxication.

基思·汉弗莱斯：这足以说服一些人永远不要停下来，因为正面处理这些事情比通过陶醉来避免它们要困难得多。

Andrew Huberman: Thank you so much for this discussion.

Andrew Huberman：非常感谢您的讨论。

You shed so much light on substances, routes to sobriety, stages of addiction.

你对物质、清醒的途径、成瘾的阶段提供了很多启示。

Very interesting work on the GLPs, 12-step.

关于 GLP 的非常有趣的工作，12 步。

We'll provide links to all these resources and papers.

我们将提供所有这些资源和论文的链接。

If you're willing, before we walked in here, I solicited X, of all places, for questions about addiction.

如果你愿意的话，在我们走进这里之前，我向所有地方的 X 询问了有关成瘾的问题。

Keith Humphreys: Oh, sure.

基思·汉弗莱斯：哦，当然。

Andrew Huberman: So, thanks to you, most of the questions that were asked are already answered by material covered before.

Andrew Huberman：所以，多亏了您，提出的大多数问题都已经通过之前介绍的材料得到了回答。

Keith Humphreys: Right.

基思·汉弗莱斯：是的。

Andrew Huberman: But there were three that I think are worth touching in on that weren't.

Andrew Huberman：但我认为有三个值得一提的问题，但事实并非如此。

And the first one is, are men getting addicted to things more than women, or are they just showing up for help more often?

第一个是，男性是否比女性更容易沉迷于事物，或者他们只是更频繁地寻求帮助？

Keith Humphreys: Men are larger consumers of addictive substances in every culture on earth and are over-represented in all the major addictions.

Keith Humphreys：在地球上的每种文化中，男性都是成瘾物质的较大消费者，并且在所有主要成瘾行为中所占比例过高。

Opioids, probably four men to every one woman.

阿片类药物，大概是四男一女。

Alcohol, probably about 60/40.

酒精度数大概是60/40。

It used to be higher, but women have been drinking more.

以前的数字更高，但女性的饮酒量越来越多。

The one thing you see in clinics that is close, the one is prescription medication, that those are a little closer to 50/50.

你在诊所看到的一件事是接近的，那就是处方药，它们有点接近 50/50。

But otherwise, it's predominantly male.

但除此之外，主要是男性。

Andrew Huberman: Why the relationship between addiction and lying, and not just lying about the addiction?

安德鲁·休伯曼：为什么成瘾和撒谎之间有关系，而不仅仅是对成瘾撒谎？

Anna Lembke, our colleague, has talked about this before.

我们的同事安娜·莱姆克（Anna Lembke）之前曾谈到过这一点。

Keith Humphreys: Mm-hmm.

基思·汉弗莱斯：嗯嗯。

Andrew Huberman: Is there overlapping circuitry there?

Andrew Huberman：那里有重叠的电路吗？

Keith Humphreys: No, I don't think so.

基思·汉弗莱斯：不，我不这么认为。

I think it's just you end up in these situations that aren't possible to cover over without lying.

我认为只是你最终陷入了这些情况，如果不撒谎就无法掩盖。

So, you know, you were supposed to...

所以，你知道，你应该...

"Dad, you were supposed to pick me up after school.

“爸爸，放学后你要来接我。

Where were you?" "I was drunk," right?

你当时在哪儿？” “我喝醉了，”对吧？

But I don't want to say that.

但我不想这么说。

So, I say, "All right, I had car trouble, I couldn't do it." Or the boss, "What happened to the money for the..." "Oh, yeah, it was an unexpected tax bill," because I'm not going to say I stole it.

所以，我说，“好吧，我的车出了问题，我做不到。”或者老板，“钱怎么了……”“哦，是的，这是一张意想不到的税单，”因为我不会说我偷了它。

And so I think that is why.

所以我认为这就是原因。

Keith Humphreys: The other thing, of course, is sometimes we make addicted people lie.

基思·汉弗莱斯：当然，另一件事是有时我们会让上瘾的人撒谎。

I always point this out to residents that if you watch how doctors sometimes ask people about their substance use, it's absolutely clear the correct answer.

我总是向居民指出这一点，如果你观察医生有时如何询问人们他们的药物使用情况，那么绝对是正确的答案。

If I say, "You don't drink, do you?" Or, "You don't use drugs, do you?" And when you're addicted, you get very good at reading people.

如果我说：“你不喝酒，是吗？”或者，“你不吸毒，是吗？”当你上瘾时，你就会变得非常擅长读人。

Like, what is this person going to say if I tell them that I use methamphetamine?

例如，如果我告诉他们我使用甲基苯丙胺，这个人会说什么？

Keith Humphreys: And sometimes they lie, not because they want to, but because they know they'll get a negative reaction from the person asking them.

基思·汉弗莱斯：有时他们撒谎，不是因为他们想撒谎，而是因为他们知道问他们的人会得到负面反应。

Andrew Huberman: The other question was about relapse.

安德鲁·休伯曼：另一个问题是关于复发。

Is it the case that relapse can occur just as easily when things are going well, as opposed to when they're going poorly?

当事情进展顺利时，是否会像事情进展不顺利时一样容易复发？

What do you see in your clinic?

您在诊所看到什么？

Keith Humphreys: Yeah, I mean, people relapse in both ways.

基思·汉弗莱斯：是的，我的意思是，人们会以两种方式复发。

A friend of mine in college, I remember his dad, after years and years of drinking, got sober and just miraculously got an extremely high-paying, respected job, despite incredibly erratic work history, and immediately relapsed, went out and drove the wrong way on a highway, and killed himself.

我的一个大学朋友，我记得他的父亲在酗酒多年后清醒过来，奇迹般地找到了一份薪水极高、受人尊敬的工作，尽管他的工作经历极其不稳定，但他的父亲立即旧病复发，出去在高速公路上逆行，然后自杀了。

Keith Humphreys: And just think, how could...

Keith Humphreys：想想看，怎么可能......

Everything was going right, but you see that a lot.

一切都很顺利，但你经常看到这样的情况。

It's sort of like, I got money in my pocket, I'm happy, I know I'm okay now, the problem's behind me, and so I'm going to do what I always did, and then be shocked that I got the same result I always did.

有点像，我口袋里有钱，我很高兴，我知道我现在没事了，问题已经过去了，所以我会做我一直做的事情，然后惊讶地发现我得到了和以前一样的结果。

You see that.

你看到了。

Keith Humphreys: Broadly speaking, though, relapse is most likely in times of stress.

Keith Humphreys：不过，从广义上讲，在有压力的时候，旧病复发最有可能。

Whether that's a transitory stress like a spat with the spouse or with the boss, or I was exhausted, didn't sleep well a couple nights in a row, that kind of thing, or something bigger, like maybe my kid's addicted also, and I'm dealing with that, and that makes me more likely to relapse.

无论是短暂的压力，比如与配偶或老板的口角，还是我精疲力尽，连续几个晚上睡不好，诸如此类的事情，或者更大的事情，比如我的孩子也上瘾了，而我正在处理这个问题，这让我更有可能旧病复发。

Andrew Huberman: Last question is from me.

安德鲁·休伯曼：最后一个问题是我问的。

Keith Humphreys: Okay.

基思·汉弗莱斯：好的。

Andrew Huberman: I'm just curious.

安德鲁·休伯曼：我只是好奇。

You're a dad of two college-aged boys.

您是两个大学生男孩的父亲。

What advice did you give them, or do you give them, about addiction?

关于成瘾，你给了他们什么建议，或者你给了他们什么？

Not assuming that they're particularly prone, but just they're in life, and to be in life now means that you're prone to addiction, period.

并不是假设他们特别容易上瘾，而是他们就在生活中，而现在就在生活中就意味着你很容易上瘾，就这样。

Keith Humphreys: I can hear them rolling their eyes even from Southern California, because they've said, "Oh, another talk about addiction." So, I talk to them a lot about fentanyl, because I've known so many families where kids like them, you'd say like nice family, middle-class kid, have died from fentanyl that they took in the form that looked like something else.

基思·汉弗莱斯：即使是在南加州，我也能听到他们翻白眼的声音，因为他们说，“哦，又是一次关于成瘾的讨论。”所以，我和他们谈论了很多关于芬太尼的事情，因为我知道很多家庭，像他们这样的孩子，你会说像好的家庭，中产阶级的孩子，死于芬太尼，他们以看起来像其他东西的形式。

Keith Humphreys: And this is happening on college campuses, it's happening in high schools, these printed pills that look exactly like an Ativan or an Adderall.

Keith Humphreys：这种情况正在大学校园、高中发生，这些印刷药丸看起来就像 Ativan 或 Adderall。

"I think I'm going to try that," and you don't realize you're taking fentanyl, and you die.

“我想我要尝试一下，”你没有意识到你正在服用芬太尼，然后你就死了。

Keith Humphreys: So, I always warn them about that, like never to take anything.

基思·汉弗莱斯：所以，我总是警告他们这一点，比如永远不要拿走任何东西。

You can't know what it is.

你无法知道它是什么。

If you didn't personally acquire it, you can't know what it is.

如果你不是亲自获得它，你无法知道它是什么。

And then the other thing I told them is the point that you're going to have to make these decisions yourself, but the only thing I can tell you is you will never get addicted to something that you choose never to use.

然后我告诉他们的另一件事是，你必须自己做出这些决定，但我唯一能告诉你的是，你永远不会沉迷于你选择不使用的东西。

That is your maximal point of control.

这是你的最大控制点。

And what happens after that point, once you've started using, is something I can't know, more importantly, something you can't know.

一旦你开始使用，在那之后会发生什么，这是我无法知道的，更重要的是，你无法知道的。

Andrew Huberman: Thank you.

安德鲁·休伯曼：谢谢。

Well, Dr. Keith Humphreys, thank you so much for coming here today to share.

基思·汉弗莱斯博士，非常感谢您今天来到这里分享。

Keith Humphreys: Thank you.

基思·汉弗莱斯：谢谢。

I really enjoyed the discussion.

我真的很喜欢这次讨论。

Andrew Huberman: I mean, it's obvious to everyone that you have immense knowledge about this area, and the fact that you have not just knowledge, but that you're a clinician and you help people get into and through recovery and stay sober in all these different dimensions is itself amazing.

安德鲁·胡伯曼：我的意思是，对每个人来说，显而易见的是，您对这个领域拥有丰富的知识，事实上，您不仅拥有知识，而且您是一名临床医生，您帮助人们进入并完成康复并在所有这些不同的方面保持清醒，这本身就令人惊奇。

Andrew Huberman: But I think I'm certain I'm not alone in saying that what's so awesome about the work you do and you, and that became evident today, is that you combine incredible expertise with incredible compassion for people.

安德鲁·休伯曼：但我想我确信我并不是唯一一个说你所做的工作和你的工作如此出色的人，这一点今天变得很明显，那就是你将令人难以置信的专业知识与对人们难以置信的同情心结合在一起。

You didn't have to say it.

你不必说出来。

It's just in every aspect of what you shared.

这体现在您所分享内容的各个方面。

And it's an honor to have you here.

很荣幸您能来到这里。

It's an honor to be colleagues and to meet you finally.

很荣幸成为同事并终于见到您。

Andrew Huberman: But mostly I'm just grateful that we were able to create an environment where you could share your knowledge and your compassion, and I'm certain that it's going to help a lot of people understand themselves, understand people around them, and hopefully take action if they need to.

安德鲁·休伯曼：但最重要的是，我很感激我们能够创造一个可以分享知识和同情心的环境，我确信这将帮助很多人了解自己，了解周围的人，并希望在需要时采取行动。

So, thank you so much.

所以，非常感谢你。

Keith Humphreys: Thank you, Andrew.

基思·汉弗莱斯：谢谢你，安德鲁。

It was a real pleasure to be on your show.

很高兴能参加你的节目。

Andrew Huberman: Thank you for joining me today for my discussion with Dr. Keith Humphreys.

Andrew Huberman：感谢您今天加入我与 Keith Humphreys 博士的讨论。

To learn more about his work, please see the links in the show note caption.

要了解有关他的作品的更多信息，请参阅演出注释标题中的链接。

If you're learning from and/or enjoying this podcast, please subscribe to our YouTube channel.

如果您正在学习和/或喜欢此播客，请订阅我们的 YouTube 频道。

That's a terrific zero-cost way to support us.

这是支持我们的绝佳零成本方式。

In addition, please follow the podcast by clicking the follow button on both Spotify and Apple.

此外，请通过单击 Spotify 和 Apple 上的关注按钮来关注播客。

And on both Spotify and Apple, you can leave us up to a five-star review.

在 Spotify 和 Apple 上，您都可以给我们五星级的评价。

And you can now leave us comments at both Spotify and Apple.

您现在可以在 Spotify 和 Apple 上给我们留下评论。

Please also check out the sponsors mentioned at the beginning and throughout today's episode.

另请查看今天节目开头和整个节目中提到的赞助商。

That's the best way to support this podcast.

这是支持这个播客的最佳方式。

Andrew Huberman: If you have questions for me, or comments about the podcast, or guests or topics that you'd like me to consider for the Huberman Lab podcast, please put those in the comments section on YouTube.

Andrew Huberman：如果您对我有疑问，或者对播客有意见，或者您希望我为 Huberman Lab 播客考虑嘉宾或主题，请将这些内容放入 YouTube 的评论部分。

I do read all the comments.

我确实阅读了所有评论。

For those of you that haven't heard, I have a new book coming out.

对于那些还没有听说过的人，我即将出版一本新书。

It's my very first book.

这是我的第一本书。

It's entitled "Protocols: An Operating Manual for the Human Body." This is a book that I've been working on for more than five years, and that's based on more than 30 years of research and experience.

它的标题是“协议：人体操作手册”。这本书是我花了五年多时间编写的，它基于 30 多年的研究和经验。

Andrew Huberman: And it covers protocols for everything from sleep, to exercise, to stress control, protocols related to focus and motivation.

Andrew Huberman：它涵盖了从睡眠、锻炼到压力控制、与注意力和动机相关的所有协议。

And, of course, I provide the scientific substantiation for the protocols that are included.

当然，我还为所包含的协议提供了科学依据。

The book is now available by presale at protocolsbook.com.

该书现已在protocolbook.com 上预售。

There, you can find links to various vendors.

在那里，您可以找到各个供应商的链接。

You can pick the one that you like best.

您可以选择您最喜欢的一个。

Again, the book is called "Protocols: An Operating Manual for the Human Body."

同样，这本书的名字是“协议：人体操作手册”。

Andrew Huberman: And if you're not already following me on social media, I am Huberman Lab on all social media platforms.

Andrew Huberman：如果您还没有在社交媒体上关注我，我是所有社交媒体平台上的 Huberman Lab。

So, that's Instagram, X, Threads, Facebook, and LinkedIn.

这就是 Instagram、X、Threads、Facebook 和 LinkedIn。

And on all those platforms, I discuss science and science-related tools, some of which overlaps with the content of the Huberman Lab podcast, but much of which is distinct from the information on the Huberman Lab podcast.

在所有这些平台上，我讨论科学和与科学相关的工具，其中一些与胡伯曼实验室播客的内容重叠，但其中大部分与胡伯曼实验室播客上的信息不同。

Again, it's Huberman Lab on all social media platforms.

同样，所有社交媒体平台上都是 Huberman Lab。

Andrew Huberman: And if you haven't already subscribed to our Neural Network Newsletter, the Neural Network Newsletter is a zero-cost monthly newsletter that includes podcast summaries, as well as what we call protocols in the form of one to three-page PDFs that cover everything from how to optimize your sleep, how to optimize dopamine, deliberate cold exposure.

Andrew Huberman：如果您还没有订阅我们的神经网络时事通讯，神经网络时事通讯是一份零成本的月度时事通讯，其中包括播客摘要，以及我们所说的一到三页 PDF 形式的协议，涵盖从如何优化睡眠、如何优化多巴胺、故意冷暴露等所有内容。

We have a foundational fitness protocol that covers cardiovascular training and resistance training.

我们有一个基本的健身方案，涵盖心血管训练和阻力训练。

All of that is available completely zero cost.

所有这些都是完全零成本可用的。

Andrew Huberman: You simply go to hubermanlab.com, go to the Menu tab in the top right corner, scroll down to Newsletter, and enter your email.

Andrew Huberman：您只需访问 hubermanlab.com，转到右上角的“菜单”选项卡，向下滚动到新闻通讯，然后输入您的电子邮件即可。

And I should emphasize that we do not share your email with anybody.

我要强调的是，我们不会与任何人分享您的电子邮件。

Thank you once again for joining me for today's discussion with Dr. Keith Humphreys.

再次感谢您参加今天与 Keith Humphreys 博士的讨论。

And last but certainly not least, thank you for your interest in science.

最后但并非最不重要的一点是，感谢您对科学的兴趣。

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