Bringing neuroscience to bear on addiction policy

Keith Humphreys has worked both to treat patients with mental illness and to inf

Keith Humphreys has worked both to treat patients with mental illness and to inform policies surrounding mental health and addiction. (Image credit: L.A. Cicero)

Keith Humphreys founded the Stanford Network on Addiction Policy to help bring more science to debates over drug policy. He talked to Stanford News about why he started SNAP and how it works.

Psychiatrist Keith Humphreys has long taken two very different approaches to improving people’s lives. He’s a therapist who has treated people with mental illness. But he’s also worked to make a difference in public policy, an approach he regards as complementary to - and in some ways more effective than - his one-on-one work.

To advance that work, he started the Stanford Network on Addiction Policy (SNAP), a group that brings policymakers and scientists together to foster informed conversations about addiction. In March, SNAP members testified in Rhode Island on a range of topics related to addiction, and including the effects of flavored e-cigarettes on children. In September, Rhode Island Gov. Gina Raimondo signed an executive order banning the sale of flavored e-cigarettes.

Most recently, Humphreys, who is the Esther Ting Memorial Professor, a professor of psychiatry and behavioral sciences and a member of the Wu Tsai Neurosciences Institute ’s NeuroChoice Initiative , published a commentary on how researchers can translate neuroscience to public policy. Here, Humphreys talks about why scientific research often doesn’t get policymakers’ attention, what scientists can do to change that and why he got interested in public policy in the first place.

How can research on neuroscience or psychiatry help inform addiction policy?

Understanding how chronic use of addictive drugs changes people’s emotions, memory and motivations is really important for understanding, for example, why throwing them in jail doesn’t do anything. That is something people have done to addicted people for thousands of years. People get really mad at them, but it’s not that they’re mean and it’s not that they’re selfish, it’s that they’ve got really deep maladaptation in the brain, and that’s important to know.

It’s also really important to know that this is not hopeless. This person can recover, and they can function and be a good mom, dad, teacher, friend or all the things we hope that people can be.

So if there is potentially policy-relevant science out there, why doesn’t it have more impact?

You have very little time to seek information as a policymaker. People in the House of Representatives might have 15 minutes a day when they can actually read what they would like. They tend to pick up the big headlines, because they know their constituents and their colleagues will see them. There’s also a quality detection problem. What you need is a really efficient way to detect quality, and what I have concluded is that’s largely done through social networks.

SNAP is one such network. How did that come about, and what does it do?

I worked in the White House and so I know people in politics. I rang up a bunch of my policymaker friends and asked, "If you could have efficient contact with a whole range of really good scientists who care about addiction, would that help you do your work?" And being at Stanford and being associated with Wu Tsai, it’s easy to find good scientists to compose the other half of the network. I asked them, "If you had a venue to disseminate your science, say talk to a mayor or a state legislator, would you want to do it?" And they all said yes.

Typically, SNAP members communicate remotely, but we meet together every other year, and we take trips where a few SNAP scientists visit a policymaking body together, like we did in Rhode Island. We also host events, consult with lawmakers and provide policymaker-friendly scientific briefings on our website.

What are some features of SNAP that make it work?

One feature is that SNAP is nonpartisan. I think a mix of political views makes people smarter. If everyone had the same views, we might start making the mistake of saying, "It’s a fact you should implement this policy," when what we really mean is, "My politically like-minded friends and I think you should do this," and that’s not the same.

We’re also philanthropically funded, thanks to the Wu Tsai Neurosciences Institute. Because we don’t take any corporate money - like from the alcohol or pharmaceutical industry - SNAP’s not going to make any money and we’re not going to lose any money based on our policy advice. We’re just here to tell policymakers the facts: Here’s what we know about cannabis, what we know about opioids, what we know about vaping. And they like that, because they don’t normally get disinterested policy analysis.

Has it been successful?

It’s fundamentally challenging to know if you have had an impact on public policy. I think one reason why sometimes therapy is gratifying as a provider is it really feels like you’re in a rowboat with one other person, and you can kind of see that you steered the boat. Policy is this ocean liner, and you hope the ship ends up in France instead of Great Britain because of your efforts to steer it, but you won’t know for a long time or maybe ever.

At the same time, I take heart from the expressions of gratitude from lawmakers and the fact that people are still calling and writing SNAP and saying things like, "We have a bill coming up on driving under the influence, and what is the answer?" In Rhode Island, we were testifying and there was a state senator who was a little skeptical, and afterward he said it was really something to have a hearing where everybody is just trying to tell you information and not pitch something.

What inspired you to pursue public policy in the first place?

It’s kind of a weird story. My last summer before graduate school, I suffered a terrible accident playing basketball. I couldn’t walk all summer and so I read a lot, and I read Yale University professor Seymour Sarason. He talked about how most of well-being gains come through changes in policy - things like mentally ill people getting Social Security Disability Insurance.

I did end up learning how to treat patients, and I still think that’s valuable. But it just really made sense, since my goal was to have a positive impact on society, that really you need to change the rules of the game and not just approach things one person at a time.

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