Name: Joe Rogan Experience #629 - Andrew Hill, PhD
Uploaded: 2015-03-25T05:20:55.000Z
Description: Watch the stand-up comedy video 'Joe Rogan Experience #629 - Andrew Hill, PhD' from PowerfulJRE on Comedy Buff. Published 2015-03-25. Transcript available.

Watch the stand-up comedy video 'Joe Rogan Experience #629 - Andrew Hill, PhD' from PowerfulJRE on Comedy Buff. Published 2015-03-25. Transcript available.

Joe Rogan Experience #629 - Andrew Hill, PhD

not that tight i'm not sure if playing that before you talk to somebody is a
good idea it
seems jarring it seems like all of a sudden like you have to like talk it down
so it becomes like
a conversation again because otherwise it's like oh the fuck just right you are
a neuroscientist
i am doctor yeah a cognitive neuroscientist would that not affect the way your
brain absolutely
hearing sort of you know call to actions will change how you then react to
things fucks with
you right yeah absolutely does something yep yep we were talking uh dr andrew
hill is on the podcast
today and uh we were talking before the podcast started i didn't want to talk
to you anymore i
wanted to get you in here and sit you down because you said something really
fascinating that you take
people who may have problems with substances and you instead of getting them to
abstain you get them to
use them responsibly which is yeah an alien concept in this day and age yeah i
mean this is not terribly
common in substance abuse you know sort of treatment world there's a few
companies that do it and one of
them is here in los angeles alternatives and we uh we'll take people that you
know might have an issue
with alcohol let's say and uh the only only option is not abstinence for our
program we have moderation
options controlled use options harm reduction so someone might come in and say
you know look i'm a
i consider myself an alcoholic but i want to start drinking again or you know i'm
someone who has
been abstinent for a long time and struggles with craving struggles with you
know choice and whenever
i slip i slip big help me figure out how to not be that guy how to use responsibly
or to not use so we
don't necessarily say you must be a moderate user or you must abstain we ask
clients what they want to
do and then help them figure out how to get there and for many of them they
come to us because we do offer a
moderation moderate alcohol use approach that is uh that seems pretty novel is
is it it is pretty
novel yeah one of our principles dr mark kern has been doing addiction work
with moderation focus for
about 30 years uh in la and so it's not you know the newest thing ever but it's
newer than aa of course
which has been around for you know pushing 100 years now yeah aa people seem to
think that that's the
only way to go you have to do the 12-step program you have to call everybody
you ever wronged you have to
pray to jesus you have to drink a lot of coffee and smoke cigarettes yeah it's
part it must be it must
be yeah i mean you know uh the biggest difference uh for an alternatives
approach or a harm reduction
or moderation approach compared to aa and in my perspective is that a lot of
the a approach is
disempowering you must give up control you know surrender surrender um and i
think that there's
another option out there and that's architecting more control more power let's
figure out your cues for
over drinking let's figure out what happens you know why do you get to five or
six or seven drinks like
what happens on drink two um you know what are the triggers for like going home
and you know automatically
driving into that liquor store parking lot you always pass by so we help people
figure out all the
different triggers and cues that are driving their out of control use and what
control use might look
like for them you know what sort of appropriate mindful drinking might look
like for them
um and it's if it's alcohol people spend uh the first month with us abstaining
anyways just to reset
tolerance because uh to be good at moderation you have to be good at abstinence
so the goals may not be
abstinence always in our alcohol program but everyone takes a month off resets
their tolerance you know
get some sort of clear head gets their sleep fixed and we're doing other things
besides the alcohol
interventions and therapy and biofeedback and mindfulness and another you know
sort of whole
team approach but then at the end of that month if folks decide they want to we
go to a bar with them
sit down they order a drink we give them a breathalyzer and they have their
first drink and we
you know they get breathalyzed every do you drink with them um not at this no
no later um you know i don't
typically go to the bars with our clients um there's there's some legal issues
with drinking with them
like when we go to a bar with them we buy lunch and they buy the alcohol uh to
avoid so you can't
even buy it we don't provide the drugs and alcohol yeah of course so do they
drink by themselves
sometimes um a lot of the clients that uh we work with carry around little
breathalyzers in their pocket
that several times a day ping them and ask them to blow and get a little uh
camera snapshot you know it is
them and a gps location and so we determine where they are who they are and
what their blood alcohol
is and you know unlike most other treatment programs if you blow dirty on a
breathalyzer it's usually
like you're out of here but that's it's like oh great so you drank what was
that like i see you got
this blood alcohol level and how many drinks was that was that two okay
interesting how over what
time frame how did that feel and we get people to in a very structured way
analyze what alcohol is
instead of it being sort of momentum uh you know based behavior the the there's
a certain amount of
like pull that something has a draw and attracted like an energy to something
that's forbidden yeah
and that that is very problematic for people that are addicts yeah i've seen it
firsthand many times
where people just have this overwhelming desire to do what they're not supposed
to do almost because
it's like the pressure of abstaining yeah is just overwhelming it's like that
that issue oh it's
always a cloud hovering over them yeah also things that are forbidden become
attractive yeah and the
conversation about them gets shut down a little bit when things get sort of you
know put in these little
isolated bulwarks of dangerous and forbidden right so it's hard to talk about
you know problematic alcohol
use if any alcohol use is considered problematic yeah it becomes one of those
things where it everyone
has this very rigid idea of what an alcoholic is supposed to do and if you
bring up something like
what you're proposing or what you actually not just propose but you enact in
treatment that's got to
receive a lot of criticism it does and you know we get long-term sort of 12-step
type saying you're
going to kill people people are going to you know have problems the thing is
you know we've done some
research in our center and folks self-select abstinent track or moderation
track and the self-selection
appears to be what drives success not which track you're on so if people
identify their goals we help
them reach those goals but if your only goals are or if your only allowable
path is you must be abstinent
then you aren't taught any skills about how to drink a little bit you know so
when people who are on
abstinence only sort of treatment programs have slips they have big slips they
just say okay i'm off the
track yeah oh let's just pound it back there there's that there's that discounting
oh you know i've
screwed up once might as well just go for it and there's also the piece about
skills we have they
don't know how to drink two or three or four drinks if all they do is abstain
now now the common thought
on genetics and addiction is that certain people have just a predisposition for
alcoholism for drug
addiction is that a fact yeah there's a an opioid receptor in the brain um i
forget if it's the mu or
the kappa but one of the opioid receptors in the brain there's one genetic sort
of flavor you can have
where alcohol is extra rewarding where it just you know you love that sensation
you love the feeling
a little more than the average person might so but is it just that is it just
they love it more well
it's it's more rewarding and therefore learning is reinforced i mean rewarding
meaning that what you
find appetitive or interesting or yummy um if you find things extra yummy then
your behavior is modified to
get more of that thing you know right but i'm the way i've always thought of it
i don't have a genetic
predisposition to alcoholism and i've had friends who do yeah and there's this
weird thing that happens
to them when you see them drink where they they go gerbilize you know where
they're like no one's there
they have shark eyes you know what i mean when you're looking at them you're
like where are you man
are you in there like you literally don't see them anymore well these folks are
probably you know
thoroughly into a hardcore drinking you know lifestyle right this is not their
first big slip in a long
time this is sort of a uh you know go to the bar after work every day or go to
the liquor store and
grab a half bottle of wine every day this is you know reinforced behavior um i
don't think even
someone with those genes would have sort of a checkout or some you know lack of
sudden self-control
their first drink after abstaining for a while it's the the behavioral sort of
slippery slope
that we get on that causes the problem folks that have this extra rewarding
effect from alcohol
you know get pulled down that slope faster but it's still not you know predetermined
you're not
going to become an alcoholic just because you have a more rewarding effect from
alcohol or something else
see i was always confused i didn't think that it was a reward issue i i thought
and this is based
entirely on you know just talking to people no research obviously but i always
thought it was
just something happens to them where they cannot help themselves that's is that
just the common way
of discussing it because of the 12-step treatment program ideal yeah i think
partially there's this
idea of well you're powerless over alcohol therefore accept that you're
powerless um but a lot of that
powerlessness or i can't control my behavior is because of the sort of over
learning that comes where
behavior is no longer choice it's almost automatic because you've gotten so
rewarded so many times
from that behavior that then the behavior becomes reinforced i mean you know
all addiction is this
way but all addiction is just learning it's not some special form of learning
it's just learning
so what you're talking about is people that have learned to lose control
so does that like there's the common myth thought about native americans the
common um discussion when
people talk about native americans and alcohol is that they didn't have alcohol
in their diet we
introduced it to them with the europeans rather introduced it to them and then
they became almost
instantly addicted because they did not have the genetic predisposition to
process it yeah and that's yes um i think
it's partially bs i think it's more about you know if you lock a bunch of
people on a small plot of uh
non-farmable land and don't give them any mechanisms for advancement and take
away all their power and
then give them a drug to abuse they abuse it you know there's always these
studies showing that if you
give a a rat unfettered access to drugs and alcohol it sits there and you know
hits the lever until it dies
right that's actually not true if you give a rat access to cocaine or alcohol
well not alcohol but
something really rewarding um it will only self-administer the drug in the you
know and sort of
starve to death for the reward when the environment isn't interesting when the
environment's impoverished
if there's lots of you know rat toys and lots of other cute rats hanging out
they're much less
interested in becoming cocaine addicts or whatever it is it's only in the
absence of stimulating enriched
environments do these sort of automatic behaviors take over so i would argue at
least partially
the native american alcohol connection is because these are distant people who
are disenfranchised
systematically and then given an escape i had that discussion recently with dr
chris ryan and one
of the things h