The future of substance use disorder

Keith Humphreys is an expert in substance use disorder, treatment, and drug policy whose research helped explain why fentanyl overdose deaths have dropped by a third since 2023. He laments that 10 million still die each year and millions more are incarcerated with substance use disorders. Yet he says the most harmful drugs are often the legal ones: tobacco and alcohol. For policymakers who want lasting solutions, he recommends evidence over opinion, pointing to the proven success of Alcoholics Anonymous as “the closest thing we have in public health to a free lunch.” Recently, his focus has turned to GLP-1 drugs for treating addiction. “It’s not all about the gut; these drugs clearly affect the brain,” Humphreys tells host Russ Altman on this episode of Stanford Engineering’s The Future of Everything podcast.

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Episode Reference Links:

• Stanford Profile: Keith Humphreys
• About our Stanford team’s work on the Opioid Crisis
• Learn more about the sudden fall in fentanyl deaths and what explains it

Connect With Us:

• Episode Transcripts >>> The Future of Everything Website
• Connect with Russ >>> Threads / Bluesky / Mastodon
• Connect with School of Engineering >>> Twitter/X / Instagram / LinkedIn / Facebook

Chapters:

(00:00:00) Introduction
Russ Altman introduces guest Keith Humphreys, a professor of psychiatry and behavioral sciences and health policy at Stanford University.
(00:02:55) Path into Addiction Research
How Humphreys became interested in addiction and why he stayed in the field.
(00:05:10) The State of Addiction
The scale of substance use worldwide and the harms associated with legal and illegal drugs.
(00:07:49) The Opioid Crisis
How prescription opioids, heroin, and fentanyl reshaped addiction & Keith’s research in the United States.
(00:09:42) A Global Drug Problem
How tobacco, alcohol, and illegal drug markets differ across countries.
(00:12:05) Evidence-Based Addiction Policy
Why Humphreys focuses on scientific evidence when advising policymakers across the political spectrum.
(00:15:18) Trust in Addiction Science
How transparency and scientific credibility affect public trust in addiction research.
(00:16:30) Addiction and Criminal Justice
Why substance use is deeply intertwined with incarceration and the criminal justice system.
(00:19:12) Addiction as a Chronic Condition
Why relapse is common and recovery often requires long-term management and support.
(00:21:15) Why Overdose Deaths Are Falling
What may be driving the recent decline in fentanyl overdose deaths across North America and the future of fentanyl.
(00:27:47) Alcoholics Anonymous and Mutual Aid
What research shows about AA and peer support as tools for long-term recovery.
(00:30:52) GLP-1s and Addiction Treatment
Why researchers are studying GLP-1 medications as a possible treatment for substance use disorders.
(00:33:41) Future In a Minute
Rapid-fire Q&A: GLP-1s, recovery, political will, and hope for the future.
(00:35:11) Conclusion

Connect With Us:

Episode Transcripts >>> The Future of Everything Website

Connect with Russ >>> Threads / Bluesky / Mastodon

Connect with School of Engineering >>>Twitter/X / Instagram / LinkedIn / Facebook

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