This Is Your Brain on Social Media with Anna Lembke, MD

Can you get addicted to anything? Neil deGrasse Tyson and co-hosts Chuck Nice and Gary O’Reilly explore the science of addiction, dopamine pathways, and what social media is doing to our brains with psychiatrist, Anna Lembke.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Neil deGrasse Tyson?

  Coming up on StarTalk Special Edition, this one is on addiction. And we have as our special guest Anna Lembke. She's a professor of psychiatry at Stanford University. And we discuss social media. Is that addicting? If it is, how does it addict us? We also talk about other emergent modern addictions like gambling. We always known it was out there, but now it seems to be more prevalent than ever. We talk about the science of dopamine, how it works in what parts of your brain? And can we control it? Should we control it? Why is it there at all? Where did it come from evolutionarily? All that and more on StarTalk, coming up.

• 0:46Neil deGrasse Tyson?

  Welcome to StarTalk, your place in the universe where science and pop culture collide. StarTalk begins right now.

• 1:08Neil deGrasse Tyson?

  Hey, everybody. Neil deGrasse Tyson here.

• 1:10Speaker 01

  And I'm Lindsay Nix Walker. And Neil and I, we just co-authored a brand new StarTalk book, and it's coming out very soon.

• 1:16Neil deGrasse Tyson?

  Yeah, this is the third in a series of collaborations with National Geographic Books. And this one is titled To Infinity and Beyond. And it's available for preorder from the StarTalk website, starTalkMedia.com/books. If you preorder it, you gain access to a live stream that Lindsay Walker and I will do from this office. And you have the occasion to submit questions that we will answer.

• 1:45Speaker 01

  Yep, that's right. So if they go to starTalkMedia.com/books, they can preorder and ask us their query, whatever they want. I mean, I know that StarTalk fans can ask some really fun, off-the-wall questions, so I'm looking forward to seeing what they come up with here.

• 2:00Neil deGrasse Tyson?

  All right. Right now, get ready for the next episode of StarTalk.

• 2:06Neil deGrasse Tyson?

  This is StarTalk. Neil deGrasse Tyson here, your personal astrophysicist. And today, it's a StarTalk special edition, completely, completely devoted to addiction. What does it mean? What role does it play in our lives? And is it good? Is it bad? Where did it come from? Where's it going? And before we introduce our special guest for this, let me get my co-host here. Chuck Nice. Chuck.

• 2:35Chuck Nice?

  Hey, Neil. Speaking of addiction, Chuck Nice.

• 2:41Neil deGrasse Tyson?

  Okay, fine. Okay. And we got Gary O'Reilly. Gary.

• 2:46Gary O'Reilly?

  Hi, Neil.

• 2:47Neil deGrasse Tyson?

  Hey, good. Gary, former soccer pro and soccer sports announcer. And we got him for our show. We're borrowing him from all the others, from all the others. So Gary, you and your fellow producers put this show together. What do you have in mind for us?

• 3:02Chuck Nice?

  And are you reaching out for help, Gary? Is this a clandestine cry for help?

• 3:09Gary O'Reilly?

  Yeah, this is, it's all about me, darling. So there are many things that we can get addicted to. There's alcohol, there's drugs, there's gambling. The list is endless.

• 3:21Chuck Nice?

  Food, anything.

• 3:23Gary O'Reilly?

  And food. So there are modern addictions, which we will get into later into the show. I mean, there's that point where you ask the question, does the relentless pursuit of pleasure always lead to pain? What role does dopamine and serotonin play in addiction? Have our minds been manipulated and tricked into addictive behavioral patterns? And what can be done to avoid? What can we do with our brains and stop them being rewired in sort of a case of social media? So for that, we're going to need someone really rather special. Chief of Stanford Addiction Medicine Dual Diagnosis Clinic at Stanford University,

• 4:04Gary O'Reilly?

  author of Drug Dealer MD and also Dopamine Nation. May I introduce Anna Lembke.

• 4:11Neil deGrasse Tyson?

  Anna Lembke, welcome to StarTalk.

• 4:13Speaker 04

  Thank you for inviting me. I'm happy to be here.

• 4:16Neil deGrasse Tyson?

  Yeah, and we learned that your background is as a psychiatrist. So you can authentically prescribe medicines in ways that many therapists cannot.

• 4:25Chuck Nice?

  The best kind of doctor. Only the best, ones that can give you the good drugs.

• 4:33Neil deGrasse Tyson?

  I'm delighted that you exist in this capacity because it's taken such a toll on society, not only in the past, but especially most recently. And let's take our first segment and focus on dopamine. Could you just, yeah, yeah. So, so first, is there such a thing as an addictive personality? Does some people release more dopamine than others when subject to the same stimulus?

• 5:06Speaker 04

  The short answer is yes, but we don't use that terminology anymore. The terminology of the addicted personality. Now, now we talk more about people being vulnerable to addiction or having a genetic load for addiction. So we think of it more in the sort of disease model or the disease diathesis rather than, you know, this person's personality.

• 5:32Chuck Nice?

  That makes sense when you think about it because if you make it about a person's personality, then what you're doing is you're handing over control of the addiction to the person. When addiction is just the opposite of that, you will never meet an addict who says, hey, man, I lost all my teeth. I lost my job. I can't see my kids, but this is great. I want to keep doing this.

• 5:59Neil deGrasse Tyson?

  I'm in control.

• 5:59Chuck Nice?

  I want to keep doing this.

• 6:00Neil deGrasse Tyson?

  Yeah.

• 6:01Speaker 04

  Yeah.

• 6:02Neil deGrasse Tyson?

  So what is dopamine specifically?

• 6:04Speaker 04

  So dopamine is a chemical that we make in our brains. It has many different functions, but one of the most important functions is that it's central to the experience of pleasure, reward, and motivation. And it may be even more important for motivation than for actual pleasure itself.

• 6:23Neil deGrasse Tyson?

  But what do I hear about serotonin? When I hear about serotonin, is it synonymous with dopamine?

• 6:29Speaker 04

  It's not synonymous, but serotonin and dopamine are both neurotransmitters. Neurotransmitters are the molecules that bridge the gap between synapses to allow for finer tuning of our electrical circuits that make us who we are. And so dopamine and serotonin are related. They have distinct functions, however. And although serotonin is involved in mediating addiction to certain types of substances and behaviors, dopamine is considered the final common pathway for all reinforcing substances and behaviors, which is why neuroscientists tend to use it as a kind of universal currency for measuring addiction.

• 7:09Gary O'Reilly?

  So what triggers the release? What triggers the release, professor, of dopamine? Because it can't just be, you know, what? Brain says you have that now. Something must be triggering.

• 7:18Neil deGrasse Tyson?

  Why can't it?

• 7:19Gary O'Reilly?

  Where is it triggering and what's it? Well, there you are. Why can't it?

• 7:21Neil deGrasse Tyson?

  Why can't it?

• 7:22Speaker 04

  Yeah, so dopamine is released in response to reinforcing substances and behaviors. And by reinforcing, I mean things that are something that we deem necessary for survival, that typically feel good, or that our brains tell us this is important, you need to pay attention to it. So even like novelty, dopamine is very sensitive to novelty and newness. But for example, intoxicants, the sort of difference between something that is thought of as a drug or as very addictive and something that's thought of as not particularly addictive is how much dopamine is released in the reward pathway and how quickly it's released. And substances and behaviors that are highly addictive release a lot of dopamine all at

• 8:07Speaker 04

  once in this dedicated part of the brain called the reward pathway.

• 8:11Gary O'Reilly?

  Right, okay, reward pathway. New phrase. Phrase of the day so far.

• 8:15Neil deGrasse Tyson?

  Okay, okay.

• 8:16Gary O'Reilly?

  What do we, what do we call it? What is a reward pathway?

• 8:21Speaker 04

  One of the exciting findings in neuroscience in the past hundred years or so is the discovery of a dedicated circuit in the brain that is central to this reward function, this motivation function. It consists broadly of the nucleus accumbens and the ventral tegmental area. These are sort of basal forebrain nuclear structures. And then the prefrontal cortex, that large gray matter area right behind our foreheads. So that's a gross oversimplification. It's a very complex pathway, but that's, you know, in sort of a reductionistic way, what the reward pathway consists of. And that area is very rich in dopamine-releasing neurons.

• 9:00Neil deGrasse Tyson?

  So you gave us the location in the brain where that occurs, is what you're saying there, right?

• 9:08Speaker 04

  That's right.

• 9:09Neil deGrasse Tyson?

  Yeah, okay.

• 9:10Chuck Nice?

  But it's also that prefrontal cortex is also attached to our executive function, right?

• 9:19Speaker 04

  Exactly right, yes.

• 9:20Chuck Nice?

  Yeah, so that when that gets hijacked, then that puts us at risk of not being able to make the right decisions, or to say no when we should say no, or to be extremely capricious without even realizing why we're doing it.

• 9:36Speaker 04

  Yeah, very well said. So the prefrontal cortex is central to the ability to delay gratification, to appreciate future consequences, to tell autobiographical narratives or stories. And you might think of the prefrontal cortex as the brakes on the car, and then the nucleus accumbens and ventral tegmental area, which is really rich in dopamine-releasing neurons, as the accelerator. So addiction is some kind of problem either with the brakes, or the accelerator, or both.

• 10:03Chuck Nice?

  Wow.

• 10:04Gary O'Reilly?

  Right, so, Doctor, come across the phrase, phrase, rather, of dopamine rush.

• 10:12Chuck Nice?

  That's called cocaine, Gary. I'll handle this one for you, Doc. Uh, yeah, Gary, that's called cocaine. You got that one, okay. Chuck will take it from here. Yeah, here we go.

• 10:24Gary O'Reilly?

  Yeah, okay. All right, I'm with you. So, they say when you get lovestruck, it's about a dopamine rush. So, if we're falling in love, are we now, is it kind of that in a form of addiction?

• 10:36Speaker 04

  So, maybe I can go back to some basic science experiments, looking at the response in terms of the release of dopamine to various stimuli. So, we're always releasing dopamine at a kind of baseline tonic level. It's sort of like the heartbeat of the brain, in some sense. But experiments in which a probe was stuck deep into this reward circuitry in rodents to measure a dopamine release in response to different stimuli showed that dopamine firing increased above baseline 50% in response to chocolate, 100% in response to sex, 150% in response to nicotine, something like 225% in response to cocaine, and approximately

• 11:21Speaker 04

  1,000% in response to methamphetamine. And indeed, if you match that behaviorally to whether or not a rodent will press a lever to get that substance, or to engage in that behavior, you find that the more dopamine that's released, the more likely that rat is to press that lever until it dies.

• 11:40Chuck Nice?

  And when it gets, when it comes to meth, they just rip the lever out of them.

• 11:44Speaker 04

  Right, essentially, essentially. Now, there is, there is something a little artifactal about that, in the sense that the way that meth works is to directly increase dopamine within the synapse, whereas something like food or sex works through other chemical cascades, like serotonin, for example, as we talked about. But the final common pathway, again, for all of these, is to release dopamine, which is why neuroscientists like to use it as this kind of common currency.

• 12:12Chuck Nice?

  And that goes back to what you were saying earlier about motivation. So when we eat, we get a little hit of dopamine because that satisfaction allows us to say, "Hey, I should do this again."

• 12:23Speaker 04

  Right.

• 12:23Chuck Nice?

  Otherwise, we would just not eat. It would be like, "Yeah, whatever, who cares?" You know, which is why sometimes when people are really depressed, one of the things they do not do is eat.

• 12:34Speaker 04

  Right, yeah, very well said. And furthermore, if I eat a piece of broccoli, I personally will get very little dopamine release, most likely. But if I eat-

• 12:44Chuck Nice?

  Neither does anyone.

• 12:45Speaker 04

  Yes.

• 12:45Chuck Nice?

  Neither will anyone.

• 12:46Speaker 04

  Right, exactly, exactly. But if I eat-

• 12:50Chuck Nice?

  Yeah, I said it.

• 12:51Speaker 04

  A chocolate cupcake, I'll get a lot more dopamine. But now, qualifying the broccoli idea, if I haven't eaten for two days and you give me a piece of broccoli, that's gonna, that's gonna be really yummy to me, right? That's gonna release more dopamine, at least from, you know, my baseline than, than not. So, and yes, I thought it was really important that Chuck talked about sort of other contextual factors like depression, right? Which then sort of hypothetically decrease baseline dopamine firing levels, such that almost everything loses its salience or its attractiveness. Likewise, other co-occurring mental health disorders can have other impacts on our experience of reward.

• 13:34Speaker 04

  It's thought, for example, that people with attention deficit disorder might be relatively insensitive to dopamine firing, which is why they maybe tend to be sensation seekers and need more rewards to get any kind of response at all, or furthermore-

• 13:50Chuck Nice?

  Everybody's got a different baseline. It's a baseline thing, right?

• 13:53Speaker 04

  Yeah, that's right. Everybody's got a different baseline.

• 13:56Gary O'Reilly?

  What I wanted to ask you, Professor, was, with the meth being as addictive as it is, is it working purely to detonate the dopamine? Or does it have other- Little techniques that are engaging and triggering.

• 14:13Speaker 04

  Well, it's, yeah, it's, you know, the, the talk about dopamine is like an oversimplification of a very complex process. Um, you know, meth works through other chemical cascades, other neurotransmitters. Also, you know, when, when we, uh, when we look at these experiments in rodents, you know, rodents at the end of the day are not people and our brains are much more complex and we cannot ignore the very important concept of drug of choice, which is to say, my particular wiring might lead me to be more attracted to certain, um, types of reinforcers that are different from what your particular brain is wired for,

• 14:54Speaker 04

  such that I might work very, very hard, uh, you know, uh, to repeat an experience I have on social media, but not necessarily for meth or alcohol or, or something else because my wiring is just my wiring.

• 15:08Chuck Nice?

  Right. Yeah. That's, that's, that's so wild because you hear people say it all the time. Well, I, I shouldn't say you hear people say it all the time. I've heard people say it often where, oh, I tried this and it just did nothing for me. It just did. Yeah. You know, I tried to have alcohol, but it did nothing for me. Or, you know, I, I smoked Veramano once. It did. I mean, it just didn't do a damn thing to me. I got sleepy and that was it. So, you know, it, that's what you're talking about, which is kind of fascinating.

• 15:40Speaker 04

  Yeah.

• 15:40Neil deGrasse Tyson?

  But Anna, what about, what of this, what of the, uh, this stereotype depressed person who just broke up with, okay, a woman just breaks up with a boyfriend and you see her, this is in movies all the time, in rom coms, where she is sitting on the bed, eating a box of chocolates, looking at some sad movie. So they're, they're eating in that case rather than not eating. Is that a different kind of depression that responds? So they're, they're basically compensating for that loss of pleasure because now all they have access, access to is a box of chocolates.

• 16:15Speaker 04

  Yeah, so there are many different risk factors for addiction, but one very well-known risk factor is severe stress. So if we have some kind of giant stressor in our life, it's very natural for us to reflexively turn to substances or behaviors that will release those feel-good neurotransmitters as a way to cope or compensate. One of my favorite experiments in the neuroscience literature in rodents is a rodent was or a group of rodents was trained to press a lever for intravenous cocaine and rats and mice will press that lever until exhaustion or death. If you then take the cocaine away, eventually that behavior of pressing that lever will extinguish,

• 17:00Speaker 04

  which is to say they'll stop pressing the lever. But if you then expose that rat or that mouse to a severe painful foot shock, the rodent will immediately run over to the lever and start pressing it again.

• 17:13Chuck Nice?

  Whoa.

• 17:14Speaker 04

  So that's a very nice paradigm for what we as humans do, that, you know, stressor is something that can kick off, exacerbate, contribute to maladaptive consumptive consumptive behaviors. And for people who are in recovery or abstaining from their drug of choice, if they then experience acute stressor, they will almost reflexively turn to or want to turn to, you know, their addictive behaviors as a way to shore themselves up again.

• 17:42Chuck Nice?

  That is fascinating.

• 17:44Speaker 04

  I'm glad you like it, Chuck.

• 17:46Chuck Nice?

  That is amazing.

• 17:48Neil deGrasse Tyson?

  Did you use the phrase maladaptive consumptive behavior? Isn't that the same thing as overeating?

• 17:53Speaker 04

  Yeah, so maladaptive consumptive behavior can can apply to almost anything.

• 17:59Neil deGrasse Tyson?

  That's overeating. Okay. Or something that might not otherwise be good for you, whether or not it's food.

• 18:19Gary O'Reilly?

  So professor, is there a way naturally or through intervention chemically to regulate, to manage this dopamine release rather than just have it gushing and be out of control?

• 18:32Speaker 04

  Sure, I mean that's what treatment and recovery is all about. We think of addiction as a bio-psycho-social disease, that means there are biological, psychological, and social risk factors, and we have to intervene at the biological, psychological, and social level. So in terms of the biological level, we have medicines that can treat addiction. For example, we use a medicine that blocks opioid receptors, and it's FDA-approved not just to treat opioid addiction, but also alcohol addiction, because we know that alcohol works not just on the GABA systems, but also on our endogenous opioid systems. And by blocking the opioid receptor, what we're probably doing is blocking the reinforcing

• 19:13Speaker 04

  effects of alcohol, such that people will describe that when they drink alcohol while they're taking naltrexone, it just doesn't taste as good. They're not as interested in having another drink, which is great, because we can use it then to help people not just abstain, but to moderate their use. So that's one example of a biological intervention. Psychological interventions, there are many. One of the things we teach people is to kind of surf their urges or think through the drink. So these are like mindfulness practices, where they can learn to identify their triggers, not react to those triggers, to distance themselves, to wait those triggers out. And then in terms of social interventions, we, you know, 12 steps, Alcoholics Anonymous,

• 19:57Speaker 04

  Lycotics Anonymous, other 12-step groups, is basically a way to contextualize and socialize recovery, so that you're in a sober social network, so that you can reach out to another person when you're having urges or cravings, and then that person can help you co-regulate. That's just one example of how 12-step works.

• 20:17Neil deGrasse Tyson?

  Yeah, but if you know that there's chemistry going on in the brain, why would 12 steps work at all?

• 20:24Speaker 04

  Well, because 12-step changes bring chemistry. And we don't just...

• 20:27Chuck Nice?

  Okay.

• 20:28Speaker 04

  Yeah, yeah.

• 20:28Chuck Nice?

  Okay. Is it more the social interaction? Or is it the disciplines that they introduce to your life? Or is it merely having a community around you that you're familiar with, that understands you, that brings you compassion? All these things that we tend to take for granted when we're living in normal social sets?

• 20:54Speaker 04

  I really think it's all of the above. So I think it's the foundational philosophy, the shifting the locus of control from inside of us to a power outside of ourselves, something greater than ourselves. It doesn't have to be a deified entity. It could just be the 12-step community. It's the working of the steps, all 12 of them, including especially step four, where we acknowledge what we have contributed to the problem, what our character defects are, which allow us to create a more valid narrative about our lives, which then also gives us access to more information to make better choices going forward. And then, of course, it is the social network, both the de-shaming that happens when you interact with other people struggling with addiction.

• 21:38Speaker 04

  But also, as I talk about in my book, Dopamine Nation, a kind of leveraging the shame within the group such that people would not want to relapse because they would want to have to come back and declare themselves as a newcomer, something that I label pro-social shame.

• 21:55Gary O'Reilly?

  So Professor, when you've got these pathways and the dopamine is running, and you talk about drug of choice, what else is out there that's triggering apart from some very obvious, well-known ones?

• 22:10Speaker 04

  Well, it's important to recognize that you can get addicted not just to substances that we ingest, but also behaviors that we do. And because this motivational reward pathway is conserved over millions of years of evolution across species, it's really fundamental to survival and to get us to be motivated to do anything. So theoretically, theoretically, you could get addicted to just about anything. And what we are seeing in the modern age, especially as more and more substances and behaviors have been made more potent, more reinforcing, more novel, more accessible, and come in greater and greater quantities, is that we're seeing people get addicted to

• 22:53Speaker 04

  all kinds of things today that we would not have imagined possible in prior generations.

• 22:59Chuck Nice?

  Now, is it, is it still considered an addiction if the behavior itself is not only acceptable, but maybe beneficial? I'm, I get up every day, by the way, this is an example, people, this is not my life. I get up every day at 6:00 a.m. and I head straight to the gym, because I can't, my day isn't right unless I get up and head straight to the gym. And I do that, if I could do it seven days a week, I'd do it seven days a week. If I could go twice a day, I'd go twice a day. You know, you know, if you meet a person like that, I mean, the behavior is seen as good. So we don't say, hey, man,

• 23:44Chuck Nice?

  you, you might have a problem.

• 23:46Speaker 04

  Yeah, an excellent point, and a good opportunity to define addiction. Addiction is the continued compulsive use of a substance or behavior despite harm to self and/or others. So just very broadly speaking, if we're diagnosing addiction, we have to identify that it's doing some kind of harm. It might be a harm that that person sees for themselves. It may be a harm that they don't recognize, but that other recognize, others recognize. Having said that, you are absolutely right that this is contextualized within a given time and place, and that if society has deemed certain behaviors healthy, even when people do them to the detriment of their own health potentially, or the other, other people's

• 24:29Speaker 04

  harm, then we might not call it an addiction. And you use exercise for that. And people can actually get addicted to exercise, you know, where they're continuing to engage in that activity despite being injured, despite not spending time doing other things that they value. Um, workaholism is another great example, people who are compulsively focused on work, money, achievement, and one that we celebrate in our culture and that we usually don't call out. So addiction is an interesting field because there is this, um, what I think is a fascinating intersection between culture and biology.

• 25:05Gary O'Reilly?

  So Professor, if it's something that's core and necessary for life, say water, how about then?

• 25:14Chuck Nice?

  Man, if you're addicted to water, you you are the most boring person in the world. You you need help. It is tasteless, it has zero calories.

• 25:25Gary O'Reilly?

  I know, but.

• 25:26Chuck Nice?

  And you'll pee, and you'll pee a lot.

• 25:28Gary O'Reilly?

  And, and right.

• 25:30Gary O'Reilly?

  So Professor, has that, has that been a, a notified addiction?

• 25:35Speaker 04

  Yeah, so I've seen one case of that in my career. Um, it was actually very sad. It was a woman with a very severe alcohol addiction who got into recovery from her alcohol addiction. Um, that is to say, she was no longer consuming alcohol, she was actively working on her health. But somehow or another, she discovered that if she drank water in copious amounts, she could feel altered. And she got addicted to that process and ultimately died of hypo, uh, well, she, she had several very severe, severe episodes of hyponatremia. Um, and almost died from those episodes. Yeah.

• 26:12Chuck Nice?

  Wow, washing out the electrolytes, you can't drink that kind of.

• 26:15Speaker 04

  No, no.

• 26:16Chuck Nice?

  Yeah, that's, it's very dangerous. Holy crap, I was only joking. Now I feel like a jackass.

• 26:21Speaker 04

  No, no, it's okay.

• 26:22Chuck Nice?

  That's right.

• 26:23Speaker 04

  But.

• 26:24Gary O'Reilly?

  We're all learning, Chuck. We are all learning. Okay, so.

• 26:28Chuck Nice?

  Chuck especially. You guys are the worst.

• 26:32Gary O'Reilly?

  So Professor, then, there's this term sort of dopamine cleansing, dopamine fasting.

• 26:39Gary O'Reilly?

  Didn't they used to call that cold turkey or something similar back in the day?

• 26:43Neil deGrasse Tyson?

  Hmm.

• 26:44Speaker 04

  Yeah, so the term.

• 26:45Neil deGrasse Tyson?

  I haven't heard that term. I haven't heard that term lately, cold turkey.

• 26:47Chuck Nice?

  Yeah, dopamine fastie and cold turkey. Yeah, I haven't heard cold turkey. Nobody does anything cold turkey anymore.

• 26:54Neil deGrasse Tyson?

  Yeah.

• 26:54Chuck Nice?

  That used to, that used to mean that you had the right stuff.

• 26:57Speaker 04

  Well, cold turkey is a term that comes from what happens to um our skin when we abruptly stop something like an opioid. Um, we get this kind of, you know, goose flesh um as part of the opioid withdrawal syndrome. So um that is a term that's sort of um used more broadly um to describe, you know, just quitting something just completely all at once rather than.

• 27:24Neil deGrasse Tyson?

  So it's not cold turkey, it's cold goose.

• 27:27Speaker 04

  Right, it's cold goose or something like that. Yeah, exactly. Or for that matter, the term kicking the habit um is related to the same kind of opioid withdrawal phenomenon. People tend to get muscle fasciculations and will have involuntary muscle movements. So um you know, kicking the habit, going cold turkey, those are all terms that come from uh the withdrawal syndrome associated with opioids and quitting opioids all at once is really, really hard to do. Um, so we still do, do um, you know, ask people to quit cold turkey as long as they're not at risk for life-threatening withdrawal. It's important to remember that people with severe physiologic dependence to alcohol,

• 28:09Speaker 04

  benterazopenes like Xanax, or in some cases opioids, um can have such a severe withdrawal syndrome that they could actually die from that withdrawal syndrome. So we would not ask, ask that of people who were at risk of a life-threatening withdrawal. We also wouldn't ask people to stop abruptly if they had tried repeatedly to do that on their own and weren't able to. But it is an intervention that we do use as kind of an early intervention for people who are a little bit addicted, all the way up to moderately addicted, but not yet severely physiologically dependent. And we ask them typically, you know, in clinic to sort of um try to wrap their heads around stopping for thirty days.

• 28:50Speaker 04

  Because thirty days is on average the amount of time it takes to sort of reset these dopamine reward pathways and to sort of get that prefrontal cortex back online and be able to make informed decisions about what they want to do going forward.

• 29:05Gary O'Reilly?

  So, okay, we've talked about dopamine. What if naturally occurring within people's bodies, there's not enough, as you said, that baseline? What happens then? What, what? Because there's got to be an detrimental effect if it's below base. So what, what, what conditions come forward if there is, like I say, a lack of dopamine in the body?

• 29:28Speaker 04

  Well, you know, this is, um, there's not a whole lot of, um, deep understanding of this yet, but, but some preliminary data suggests that a depression is characterized by low levels of dopamine transmission. Um, as I said before, there's some thinking that people with attention deficit disorder, my debt baseline, have lower levels of dopamine transmission, making them less sensible or sensitive to rewards. Um, and we also know, very importantly, that with repeated exposure to highly reinforcing substances and behaviors that release a lot of dopamine all at once, the brain tries

• 30:08Speaker 04

  to adapt to that increased dopamine firing by down-regulating dopamine transmission, not just the baseline levels, but actually below baseline levels.

• 30:18Chuck Nice?

  So if you're a person who abuses a drug that floods your brain with dopamine, then your brain says, oh, man, we're making too much dopamine. We gotta chill out on this dopamine production. So then you stop doing the drug and all of a sudden you have no dopamine where you should have dopamine. And does that mean at that point you're like, man, I need some drugs because I need some, some dopamine?

• 30:43Speaker 04

  That's exactly right, Chuck. You said it, that's, you said it really, really well and, and more clearly than I could have.

• 30:49Neil deGrasse Tyson?

  Well, so Anna, why do we have you when we have Chuck? Should we, he could have just.

• 30:53Speaker 04

  I, I, I, honestly, I've been, I've been thinking that myself this whole time. I was like, the comedian could basically give the talk.

• 31:03Neil deGrasse Tyson?

  Okay.

• 31:05Speaker 04

  Yeah, that's exactly what happens is that with with repeated use of the the same or similar reinforcing substance and behaviors, we eventually end up in this kind of dopamine deficit state. Now we need more of our drug in more potent forms over time, not to get high, but just to feel normal and stop the craving. Which is exactly why people with severe addiction will relapse even weeks after they've stopped using, even though they can objectively tell you, yes, my life is much better because I'm not not using and my my spouse is back and my job is back and I, you know, from a physical health point of view, I'm doing better. But mentally, many of them are still struggling with those universal symptoms of that dopamine

• 31:47Speaker 04

  deficit state, uh, which are anxiety, irritability, insomnia, depression, and craving. And craving manifests in many different ways. It can be ruminations to want to use. It can be long-winded narratives that are essentially rationalizations for why I should use. Uh, so craving is is really, um, really a wily kind of thing that swims through our brain and catches us unaware.

• 32:14Neil deGrasse Tyson?

  So Anna, what if if for some reason dopamine stopped getting made entirely, does that itself have consequences? Is that the life of a depressed person or is there some other symptoms of that?

• 32:26Speaker 04

  It depends what part of the brain dopamine production decreased in. So for example, if we had a decrease in dopamine production in the part of the brain called the substantia nigra, which is a discreet and separate part from the reward pathway, um, then we would end up with Parkinson's disease, which is a movement disorder. So dopamine, as I said, has different functions and, um, it's also very essential for movement. And it's probably no coincidence that the same neurotransmitter that's important for movement is also important for pleasure, reward, and motivation, because we typically need to move our bodies in order to, uh, get the reward that we want. Um, unfortunately, today, that's no longer necessarily true.

• 33:09Speaker 04

  We're now living in a time and place when we can just sit on the couch and swipe right and swipe left and have it delivered to the doorstep.

• 33:16Neil deGrasse Tyson?

  Wait, well, so why can't you reverse engineer that and cure Parkinson's?

• 33:20Speaker 04

  Um, when you say reverse engineer, you mean?

• 33:25Neil deGrasse Tyson?

  You said there's a section of the brain, if it stops making dopamine, you have Parkinson's.

• 33:30Speaker 04

  Yeah.

• 33:32Neil deGrasse Tyson?

  So why not introduce dopamine back into the brain and then cure Parkinson's that way?

• 33:37Speaker 04

  So that's in effect how we do treat Parkinson's with the... So if I gave you, if you had Parkinson's and I gave you dopamine, a spoonful of dopamine, it would do absolutely nothing because it doesn't cross the blood-brain barrier. So instead, I have to give you something called L-dopa, which is a dopamine precursor that does cross the blood-brain barrier, and then that gets converted into dopamine, which then gives you more dopamine in the substantia nigra, which then allows you to have more fluid movements to counteract the disease of Parkinson's. Unfortunately, it binds non-specifically throughout the brain, so that means that that dopamine I gave you is now binding to dopamine receptors in the reward pathway, and what we see is about

• 34:19Speaker 04

  a quarter of people treated with L-dopa for Parkinson's end up with some kind of compulsive, consumptive behavior like pathological gambling, pathological shopping, etc.

• 34:49Neil deGrasse Tyson?

  Well, let's pick up some of the modern addictions that we see with gambling as legal lately as it's ever been. You know, I see ads, I see... And then, of course, the ads are accompanied with a little phone number at the bottom, "Have a gambling problem? Call this." And I just think to myself, we have people exploiting the susceptibility of innocent members of the general public to gambling urges. And I'm saddened by this because they're hijacking our neurochemistry to make this happen. And of course, that also brings up social media, the addiction to... How many likes you're gonna get? What?

• 35:30Neil deGrasse Tyson?

  Could you just reflect on this modern emergence of addiction relative to the classical addictions we all grew up with?

• 35:37Speaker 04

  Yeah, so I'm equally sad and I agree with you that these corporations are really preying on people who are vulnerable to addiction and also making us all broadly speaking more vulnerable to addiction. One of the biggest risk factors for addiction that people often discount is simple access. If you live in a neighborhood where drugs are sold on the street corner, you're more likely to try them and you're more likely to get addicted to them. And what we're seeing with gambling, especially for example, online sports betting, which has now become legal in multiple states in the Union, is that in those states, we're seeing a three hundred to five hundred percent increase in calls to pathological gambling hotlines.

• 36:20Speaker 04

  So it's very clear that as gambling becomes more accessible, especially through a mobile app, we are going to have more people who are struggling with gambling addiction. And very sadly, I would add to that, that these corporations actually often specifically prey on people who get addicted to gambling. So they track those people and they pursue them and they proffer.

• 36:43Neil deGrasse Tyson?

  Because they can track them, yeah.

• 36:45Speaker 04

  Yeah, they give them money, they give them money to allow them to gamble and they also change the algorithm to make sure that they win early on. And then by getting them hooked, it's really, it's very.

• 36:58Chuck Nice?

  It's a classic drug dealer move.

• 37:01Speaker 04

  That's right.

• 37:01Chuck Nice?

  That's the oldest line in the book is the first one is always free.

• 37:05Speaker 04

  Right, exactly right. That's really, it's really, it's very distressing.

• 37:11Gary O'Reilly?

  So Professor, you talked about movement being a trigger, right? Historically, in our primal brain. We are now, the primal brain that we have is now fighting some serious modern technology. So I'm gonna upgrade to cartoon Gary's colors, I'm gonna give you a movement, I'm gonna give you. How many other strategies are out there that are keeping my attention? Because that's the, for me, the product that's generated in social media is my attention time. It's the new currency.

• 37:40Neil deGrasse Tyson?

  It's the new currency, yeah.

• 37:41Gary O'Reilly?

  That is it. So how, how are they making sure I am utterly fixated?

• 37:47Chuck Nice?

  Yes, and please, take your time explaining this so that I can take notes for my own social media accounts.

• 37:57Speaker 04

  Yeah, so, so you're getting at, uh, you know, what, what is one of the huge issues, uh, in considering these digital devices and these digital media as, um, as having genuine product liability. Just the way that we think of cigarettes as being, having inherent harm. There's now a shift toward thinking about the inherent harm of digital media of all sorts. Because of the built-in design functions. And I think the first and foremost, the design function of 24/7 portable accessibility that increases access wherever we are, whenever we are, has made an enormous impact

• 38:40Speaker 04

  on the addictive potential and the number of people struggling with digital addiction, addiction to technology and to the internet. Yeah, so in the early 2000s, uh, with the advent of, uh, you know, smartphones, um, we saw a huge increase in the number of people struggling with, um, addictive pathological gambling, pornography viewing, and then as time went on, we, we started to see video addictive video game use, addictive shopping, addictive social media use.

• 39:09Neil deGrasse Tyson?

  It's because they can take it with them. Is it because they, it's with them at all times?

• 39:13Speaker 04

  That's right. That, yeah, that's a huge part of it that people, I think, really don't fully appreciate. And it's important to realize that because that means that the intervention is going to be separating ourselves for some period of time every day from our digital devices. And that's what we're not doing. We're basically almost cybernetically enhanced with our devices with us at all times.

• 39:32Chuck Nice?

  That's so true, because, because in the eighties, when I was growing up, if you, if you wanted to take porn with you, that was really quite an undertaking.

• 39:40Speaker 04

  Right, good luck, good luck, right.

• 39:44Speaker 04

  Yes.

• 39:44Gary O'Reilly?

  Professor, how do you ensure security of the mine, particularly in the younger age groups?

• 39:52Neil deGrasse Tyson?

  I like that phrase, yeah.

• 39:53Gary O'Reilly?

  And how do you get that holistic protection? What, what, what levels of engagement and where does it come from for this to be something we can carry forward?

• 40:04Neil deGrasse Tyson?

  You gotta lock your kids in a box.

• 40:06Speaker 04

  Yeah, so, yeah, exactly.

• 40:08Chuck Nice?

  Wait a minute. You don't do that already? Am I the only one that does that way?

• 40:14Speaker 04

  You're saying red? This is both an individual problem and a collective problem. That means we, we need both bottom-up solutions where we individually change um our habits and our, as, as individuals and as families. But we also need, you know, top-down interventions, schools, corporations that make and profit from the media and the devices, the federal government who can impose regulations. It needs to be coming from both ends in order for us to get a handle on this huge uh worldwide collective problem. And specifically in terms of what can be done beyond the kinds of inter- individual and family interventions that I talk about in my book.

• 40:55Speaker 04

  When you think about it from a policy perspective, I, I think about it as in three, three categories. We can, I try to change the design, which is what you were talking about um earlier, Gary. Um, thi- this idea of like the bottomless balls, the flashing lights, the AI algorithms that learn what we've liked before and then push content uh similar but slightly different than what we've watched before, which then keeps people's engagement, their attention, makes it more compulsive, pushes them to extreme versions, more potent versions. So, you know, we, we need to change the design uh in order to decrease uh the liability of the products. Um, we also need to think about um access.

• 41:35Speaker 04

  So, you know, limiting access, as we've talked about, um it's not just what we're doing online, it's the sheer quantity and frequency of viewing that screen, which is changing our brains and leading to uh morbidity and mortality. And when I think of access, really low-hanging fruit, in my opinion, is the school system. It seems to me very obvious that children should not. Be having their smartphones with them during school, school hours, especially not during class, but also potentially not at all. And what we're seeing is some schools, typically private schools that have more resources, have taken phones away and given their students flip phones. And what you're hearing is, you're hearing about huge improvements in student well-being, student mental health.

• 42:19Speaker 04

  You're hearing teachers and administrators say, "The schools are noisy again." Why? Because kids are engaging with each other.

• 42:26Neil deGrasse Tyson?

  Okay.

• 42:27Speaker 04

  So, so this is, you know...

• 42:28Neil deGrasse Tyson?

  A flip phone is just a phone. It's not all the rest of the...

• 42:30Speaker 04

  It's boring. It's boring. A kid's not gonna, gonna spend their time on a flip phone.

• 42:34Neil deGrasse Tyson?

  But they can't complain that they don't have phone access to an emergency call at home or something.

• 42:38Speaker 04

  Right. That's exactly, that's exactly right.

• 42:40Neil deGrasse Tyson?

  So how much of this is covered in your Dopamine Nation book, which came out just a couple of years ago?

• 42:46Speaker 04

  Dopamine Nation focuses very much on what we as individuals and we as families can do, and it describes in simple terms the neuroscience of what's happening and why we get addicted to potentially almost anything, and then specifically steps that we can take. So, it's not much focused on policy, but since it came out, I, I, I've been more and more involved in policy, um, discussions and, you know, trying to consider, um, what can be done beyond the level of the individual and the individual family.

• 43:17Chuck Nice?

  And, and what, what about family policy? Because I'm sure right now, anybody who's a parent who is listening to this is thinking, "It's impossible for me to stop my kids, or get, get them off of the video games, to get them off of the tablet, to stop them from..." And by the way, there's social media companies now push out all the content everywhere.

• 43:36Speaker 04

  Right.

• 43:37Chuck Nice?

  So if you keep your kids off of X, Twitter, whatever that is, or Facebook or whatever, they're just gonna get it on YouTube, or YouTube Shorts, or whatever, so, or, or on Discord, or... So, what do you do to, like, curtail, aside from the draconian measure of ripping the phone away from them?

• 43:56Speaker 04

  Right.

• 43:57Chuck Nice?

  What do you do to curtail their behavior?

• 43:58Neil deGrasse Tyson?

  You put them in a box.

• 43:59Speaker 04

  Well...

• 44:00Neil deGrasse Tyson?

  We, we, we, we...

• 44:01Speaker 04

  Yeah.

• 44:02Chuck Nice?

  We already, we already talked about it.

• 44:03Speaker 04

  Yeah.

• 44:04Chuck Nice?

  I thought we moved on from that. We already decided.

• 44:06Speaker 04

  Yeah. You know, you don't put the kid in the box, but you probably should put the devices in a box.

• 44:13Chuck Nice?

  Oh, so you, you are an advocate of literally snatching it away from them, huh?

• 44:17Speaker 04

  So, let me, let me qualify that. For kids up until a certain age... And I would say this is usually around eleven or twelve. I believe that we as parents still have enough control, generally speaking, in the household, especially if we're co-parenting with somebody that agrees with us and we, you know, we can organize it together. And I think it's very possible and also good to sit down as a family and say, hey, we've been using devices in this way, but it's not healthy. And here are the reasons why. And so as a family, we need to make some changes. And I've seen families do this. And it can be very distressing for all comers, because very often, parents are as addicted as kids. But to do it together as a family with younger

• 45:01Speaker 04

  children can be so healthy for families to just really reorient. It doesn't mean your kid's never on the device, but it's on, they're on the device for a limited quantity of time after they've done their chores and their schoolwork, as a kind of thing that they've earned for good behavior for a limited amount of time and not every day. And then not every day is really key. If you want a number of hours, there's some general consensus, less than two hours a day.

• 45:26Chuck Nice?

  Less than two hours.

• 45:27Speaker 04

  Now, once you're, I know. And I'm talking, and I'm not talking about your, right.

• 45:31Chuck Nice?

  Who, who else, who's gonna raise my kids if they're only allowed to watch?

• 45:34Speaker 04

  Yeah, exactly. You, but it's important, it's important to get in there while they're little, because it lays the foundation for, you know, their wiring and their scat and their neurological scaffolding that they're gonna be left with their, you know, the rest of their adult lives. Now, once kids get to be about thirteen, it's, it, they're no longer in your control. They're gonna do what they're gonna do. But at that point, what, what we can do as parents is model the behavior that we want to see, give them feedback on what we're observing, use contingency management, which is punishments and rewards, to incentivize, you know, the kinds of behaviors that we want to see. And just talk about it openly as, as a family, and try to have a certain tech etiquette around when it's

• 46:16Speaker 04

  appropriate to use devices and when it's not. When we're having friends over for a meal, you shouldn't be on your device. You should be looking them in the eye, greeting them, spending some time talking, not just being, so these, I think these are the conversations we really have to have.

• 46:33Neil deGrasse Tyson?

  Yeah, but does that mean it's not, there's no hope through legislation or Congress or lobbying the companies themselves?

• 46:41Speaker 04

  Oh, absolutely. That's the third piece of it is, you know, the corporations accountable. And the way to do that is really through various types of nudges through policy reform and regulations. And just to give an example, I talked about thinking that we kids should have as a top-down policy, no smartphones during school hours. And, you know, the federal government could do that by, they give lots of funds to public schools. You know, they could say either, we're not going to give you as much of those funds unless you manage technology in your school in a different kind of way. Or they could sweeten the pot and say, we will give you more funds if you do something

• 47:24Speaker 04

  like, you know, implement some kind of new smartphone use policy in your school. So there are ways to get in there, and this is, there are precedents as well. So for example, the age 21 drinking laws, which are now universal in every state, really came to be because the federal government said, well, we're not going to give you highway funds if you keep your drinking age lower. So there are ways to, you know, kind of create these nudges.

• 47:49Gary O'Reilly?

  Professor, they're called smartphones, right? There must be a way, I mean, I'm not technically gifted in any way, but you build in a phone and you've got to have a trust program here where if it's going to a young person under the age of 11 or 10, say like that, then it gets timed to shut down on usage per day. As you said, no more than two hours or whatever the limit might be.

• 48:12Neil deGrasse Tyson?

  Yeah, there are apps for that.

• 48:13Gary O'Reilly?

  Surely there is a way.

• 48:14Neil deGrasse Tyson?

  There are apps for that. Yeah, they do.

• 48:15Gary O'Reilly?

  They must then be mandatory.

• 48:18Speaker 04

  Well, there are lots of software apps that do that, but they're, these kids very early on figure out all kinds of workarounds.

• 48:25Neil deGrasse Tyson?

  All kinds of ways of workarounds.

• 48:27Speaker 04

  But what you're implying is that is actually something that I don't think has been done to any great degree, which is that there should be hardware implementation. So for example, I, you know, I'm not an engineer or a computer science person, but I can imagine a school laptop that might help, especially for younger children, avoid some of the content that we want them to avoid. So not just expecting software companies, but also hardware companies. But this gets to the whole content issue, which is very hard to regulate because. Because it's in direct conflict with privacy laws. So, for example, in some states, I think Louisiana is one of them. They've, they've implemented a law that says, in order to sign up for a website like Pornhub,

• 49:12Speaker 04

  you have to prove that you are, I think, 21, and you have to do that by uploading your driver's license. But of course, nobody who's gonna go on Pornhub wants to upload their driver's license and be associated with having done that. So now they've worked out having like these third-party sites which kind of anonymously process.

• 49:30Chuck Nice?

  You can register with the third-party site. And your registration with that third-party site allows you access to the porn site.

• 49:37Neil deGrasse Tyson?

  Chuck, why do you know that? Chuck, why do you know that?

• 49:40Chuck Nice?

  Because I have a very good friend in Louisiana.

• 49:43Neil deGrasse Tyson?

  You got a friend.

• 49:45Gary O'Reilly?

  All right, okay. So, so Professor, let's, let's get to the content aspect. I mean, it's not just the porn or online gambling. There is extreme content that comes through, and it is getting extreme reactions from individuals. You're a psychiatrist. Are we hardwired to react extremely to extreme content?

• 50:09Neil deGrasse Tyson?

  And let me, let me sharpen that question. I'm all with it, but I want to tune it specifically because we gotta wrap this up very shortly.

• 50:17Gary O'Reilly?

  Sure.

• 50:18Neil deGrasse Tyson?

  Is, we are seeing content, forget the kids now, the adults are being fed content by the algorithm that enrages us and motivates us to act in some way, and in the limiting case, it motivates us to commit violence against some group.

• 50:36Chuck Nice?

  Going to the Capitol.

• 50:38Neil deGrasse Tyson?

  Right. So, so it's not so much addiction, but there's definitely a brain thing going on there that's being fed, and that we're reacting in a way that we think is completely sensible, but it's not when you take one step back from it.

• 50:58Speaker 04

  Yeah, and I think we can hypothesize that dopamine is involved in this process too. That essentially, when we see, when our opinion is validated with a large group and then we're experiencing an emotion at the same time, that many other people are experiencing that emotion, that's one of the ways that we feel connected to other people, right? Sharing an emotional experience.

• 51:21Neil deGrasse Tyson?

  Of course.

• 51:22Speaker 04

  And we know that feeling connected to other people releases oxytocin, which is our love hormone, which binds to dopamine receptors in the reward pathway, which then release dopamine. So we, I think there is this sense in which we are kind of getting high off of this group experience, whatever it may be, whether it's, you know, people watching people, watching other people make music. Like now, you know, it's not just videos of people making music, we watch other people having a reaction to the music, and that makes it more potent because we're having a shared emotional experience.

• 51:54Neil deGrasse Tyson?

  They're called reaction videos, yeah, and they're for everything. They got it for...

• 51:58Speaker 04

  Right.

• 51:59Neil deGrasse Tyson?

  I've even been encouraged to, I've posted a reaction video to a TikTok, just for that context, because I was duly notified by... You were watching your own TikTok? I was duly notified by someone one-third my age on our staff, that that was a thing to do for a particular posting by another person who made music about the planets. And then I comment, I was reacting to the... Okay. It was cute, it was very cute. So you're watching their video? That's cool. We weren't promoting insurrection, okay?

• 52:27Gary O'Reilly?

  Good to know. Professor, this sort of safety in numbers, didn't, back in my day, you used to call that herd mentality?

• 52:34Speaker 04

  Right, herd mentality, feeding frenzy, these types of things, yeah.

• 52:39Gary O'Reilly?

  But, I mean, what's the term, is it rageaholic?

• 52:41Speaker 04

  Yeah, rageaholic, I mean, you know, it is important to realize that you can get addicted not just to sort of positive stimuli, but actually aversive or negative, you know, people are doom scroll, they get addicted to the news, they get addicted to becoming enraged. I think that the addiction phenomenon could even apply to like a domestic violence situation, where people kind of get addicted to the uncertainty of that kind of, you know, violent relationship, which is maybe why, you know, sometimes people keep going back, even though...

• 53:15Neil deGrasse Tyson?

  They can't leave it. And what about people who jump out of airplanes for fun?

• 53:19Speaker 04

  Yeah, so that's been researched to some degree. And what they find is that after the first jump, there's this kind of like paralyzed terror in the aftermath. But with subsequent jumps, people get just frankly euphoric. There's an enormous high. But also with people who jump all the time, they develop anhedonia, which is to say they develop a kind of depressed state. There's probably like a flooding of their brain of neurotransmitters. And then it's too much, and then you have this kind of compensation so that it's possible. And it's hypothesized even in the literature based on a couple of studies.

• 53:56Chuck Nice?

  Well, there's an answer.

• 53:57Speaker 04

  Yeah.

• 53:58Chuck Nice?

  There's an answer to that. The next jump you make, just do it without the chute.

• 54:00Speaker 04

  That's it. Right, or go higher and higher, or whatever it is.

• 54:04Neil deGrasse Tyson?

  Okay, thank you Chuck for solving that problem for us here. Gary, Gary, we gotta close this down.

• 54:11Gary O'Reilly?

  I know, but before we do, what's the next big addiction? Is it gonna be AI?

• 54:17Chuck Nice?

  Oh my god, that sounds like the worst reality show ever.

• 54:20Speaker 04

  Yeah.

• 54:21Chuck Nice?

  The next big addiction.

• 54:24Speaker 04

  Gosh, I know, I'm trying, I'm trying hard to prevent people from getting addicted to more stuff.

• 54:29Neil deGrasse Tyson?

  Well, we've already seen that movie, it was called Her. That movie's been made.

• 54:32Speaker 04

  Yes, yes.

• 54:33Chuck Nice?

  Oh, yeah.

• 54:34Neil deGrasse Tyson?

  Yeah, the main character's addicted to this, this, this AI woman on his phone. And then you see everybody around him addicted to their own AI lover.

• 54:44Speaker 04

  Right, their own devices, yeah.

• 54:46Neil deGrasse Tyson?

  It's because people were left to their own devices.

• 54:50Speaker 04

  There you go. Very well put.

• 54:53Chuck Nice?

  I saw what you did there.

• 54:55Neil deGrasse Tyson?

  I saw what I did there. Listen, Anna, this has been a delight. On a sad topic, you shed some important light on it for us all.

• 55:04Chuck Nice?

  Really?

• 55:05Neil deGrasse Tyson?

  And it clearly doesn't or shouldn't end here. We will totally find another reason to bring you back on, because this is a never-ending challenge that we all face, if not for ourselves, but for loved ones, or certainly for society in large. So, thank you for your expertise there. And your two books.

• 55:24Speaker 04

  You're very welcome.

• 55:25Neil deGrasse Tyson?

  And your two books, give me the names of those again. I loved the first one, Drug Doctor M.D., what was that?

• 55:30Speaker 04

  Drug Dealer M.D.

• 55:32Neil deGrasse Tyson?

  Drug Dealer M.D., great title there. Who publishes these, by the way?

• 55:37Speaker 04

  The first is Johns Hopkins University Press, and Dopamine Nation is published by Dutton Penguin Random House.

• 55:43Neil deGrasse Tyson?

  Wow, so that means it's got good distribution there. Okay, well, we'll look for that. All right, so Anna, thank you for being on StarTalk.

• 55:50Speaker 04

  You're welcome. Thank you for inviting me.

• 55:52Neil deGrasse Tyson?

  All right, Chuck, Gary, we out. Yeah. Yep, it's a pleasure. It was a pleasure, thank you. This has been Neil deGrasse Tyson, your personal astrophysicist, for a StarTalk special edition on addiction. Until next time, as always, keep flipping out.