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

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

Episode Highlights

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

Resources & Links

• Learn more about Keith Humphreys
• Learn about the Stanford Network on Addiction Policy
• Read about the NeuroChoice Initiative at Stanford's Wu Tsai Neurosciences Institute
• NIH resources on addiction science and treatment
• Read Humphreys' 2024 report on "The rise and fall of Pacific Northwest drug policy reform, 2020–2024" (Brookings Institution, 2024)
• Read about CARE Courts ( "New California Court for the Mentally Ill Tests a State’s Liberal Values", New York Times, 2024)
• Read Humphreys' 2025 Op-Ed: "Does harm reduction still have a future in San Francisco?" (SF Chronicle, 2025)
• Read a policy summary, "Blue states change course on mental health policies" (Axios, 2025)

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