2018 Annual Meeting
San Diego, CA, USA
November 1-2

Addiction and Policy Expert is Taking a Crash Course in Neuroscience

Professor Keith Humphreys is the Esther Ting Memorial Professor in the Department of Psychiatry and Behavioral Sciences at Stanford University in California. He is also a Senior Research Career Scientist at the VA Health Services Research Center in Palo Alto and an Honorary Professor of Psychiatry at the Institute of Psychiatry, King's College in London. Professor Humphreys has served as a member of the White House Commission on Drug Free Communities, and the National Advisory Council of the U.S. Substance Abuse and Mental Health Services Administration.

Professor Humphreys will deliver the Fred Kavli Distinguished Neuroethics Lecture, featuring ‘Values, science, and public policy towards the opioid epidemic,’ at the 2018 INS Annual Meeting.

Keith Humphreys

What is your field of research?

I work on the neuroscience and clinical management of addiction, especially to opioids and alcohol, and in developing public policy with British Members of Parliament and U.S. Congress to translate what we’ve learned in the science of addiction into policies to help individuals and their families facing those conditions.

Why is addiction to and overdose from opioids the worst epidemic the United States has faced for many decades?

It started with under-regulation of companies that produce opioids. They were aggressively selling opioids to physicians that were later found to be highly addictive and abusable. From mid 1990s opioids were prescribed more than five times per capita in the United States and Canada than in European countries. Then there was a revival of heroin as so many people switched from prescribed drugs to heroin bought on the street.

What is the significance of the differences between the people involved in medical research and those seen in routine clinical practice?

Medicines are developed but clinicians don’t use them. Clinicians don’t trust clinical trials because in real life, patients have more than one illness. In clinical trials, people with only one condition are studied, meaning that someone addicted to cocaine cannot take part in a clinical trial if they are, for example, alcoholic or depressed as well. That’s not real life.

What are the ethical issues associated with the science that informs health policy?

The people for whom public policy is the most important are those who are most vulnerable. If you are healthy and wealthy, it doesn’t matter much what the policy says, but if you are ill or poor or you have a hard life, it matters. A scientist who engages in political policy may be motivated to advance his or her political views, and there is a risk they will lose sight of objective research. We need to understand the limits of our expertise and what obligations we have to science when we venture into the political arena.

What will your lecture cover?

I will focus on the opioid epidemic. The basic dilemma is an ethical one. For example, cholera is a solvable problem: you clean up the water and no one misses the cholera. But a world without opioids would be a miserable world. Some people need these drugs but at the same time they kill lots of people. How do you balance that risk with legitimate pain relief?

What appealed to you about speaking at the INS annual meeting?

I’ve never been to the INS meeting before so my interest in it comes from 20 years of clinical research into addiction and policy work. Then about four years ago, neuroscience came into my life. I developed collaborative neuroscience projects looking into addiction with experts like Rob Malenka and Brian Knutson which provided a new perspective into my clinical endeavours and how to talk to policy makers. I’m taking a crash course in neuroscience! This meeting will enable me to talk with neuroscientists, neurologists, lawyers and philosophers. And I can help neuroscientists understand policy. Politics sometimes seems irrational and crazy, but I can explain how it can actually make sense.

What do you and your colleagues in addiction disorders need from the neuroethics community?

There are a lot of issues to explain to the public about how to think about moral issues like how we understand self-control and responsibility, and how we should have compassion for people who are impaired by addiction. It is easy to think that people should just stop taking heroin, and if they had strength of character, they would. But after taking opioids repeatedly, the brain changes. Telling people to stop is like telling someone who has just walked through a desert not to drink ice cold water: it’s possible for them but it’s way, way, harder than it is for you. The neuroethics community is in a good position to make the case for medical treatment and getting addicts back into family life to function well in society.

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