Huberman Lab

Tools for Overcoming Substance & Behavioral Addictions | Ryan Soave

Huberman Lab with Ryan Soave 2025-04-21

Summary

Andrew Huberman speaks with Ryan Soave, a clinical expert in addiction treatment and trauma recovery who serves as Chief Clinical Officer for Guardian Recovery. They explore the nature of addiction as a solution to underlying pain rather than the problem itself, with Soave emphasizing the key question: "Does it have you, or do you have it?" The conversation covers the spectrum from substance use disorders (alcohol, opioids, fentanyl, cannabis) to behavioral addictions (gambling, video games, pornography, social media), and how the distinction between casual use and addiction often lies in whether the behavior is driven by avoidance of discomfort.

Soave describes the clinical treatment process from acute medical detox through longer-term residential programs (7-90 days), explaining that simply stopping substance use often makes people feel worse initially because they have lost their primary coping mechanism. The core of effective treatment involves building distress tolerance -- learning to feel uncomfortable emotions without reaching for immediate relief. They discuss how childhood adaptive strategies and trauma create limiting beliefs that drive addictive patterns later in life, the importance of understanding biological, psychological, and social factors in each individual case, and why treatment environments are designed as microcosms of the patient's social universe to practice facing stressors in a supported setting.

Key Points

  • Addiction is best understood as a solution to underlying pain rather than the problem itself -- the key question is "does it have you, or do you have it?"
  • The core of effective addiction treatment is building distress tolerance: learning to experience difficult emotions without reaching for immediate relief
  • Alcohol withdrawal can be life-threatening (seizures, death) and requires medical supervision -- simply stopping is not safe for dependent individuals
  • Treatment programs create a microcosm of the patient's social environment so they can practice facing stressors with clinical support
  • Childhood adaptive survival strategies that were appropriate in formative environments often become the limiting beliefs driving addiction in adulthood
  • Modern THC products are dramatically more concentrated than previous generations, with delivery methods that reduce barriers to use among young people
  • The self-test for addiction: if you stop for a month and all you think about is doing it or when you can do it again, that behavior has control over you

Key Moments

Yoga nidra twice daily transformed an anxious single mom -- her kids seemed to change but she did

A stressed single mom practiced yoga nidra twice daily. She said her boys changed, but she built distress tolerance -- the boys were the same.

"I think metaphorically speaking that, you know, like the workout in the gym, people think of that as the end point, but actually, you know, we used to do physical labor as a species, right? So I look at the workout in the gym as the ability to lift boxes on moving day, to move furniture without getting hurt. I love going to the gym, but it's not an end in and of itself. Same thing like a long run is the ability to go hiking with friends without having to train for it and not worrying about, you know, gassing out half, you know, halfway through. So I think that these practices are preparation for real life stressors. They're the gym for your mind. They're the gym for your mind. And we don't talk enough about emotional fitness and the world is clearly metabolically ill with obesity, diabetes, et cetera. But we are also dealing with a massive mental health crisis that I do believe stems primarily from an inability to regulate this autonomic nervous system thing. Because we can say, well, sleep's the foundation of mental health, which it is, and physical health. A lot of people have trouble sleeping. How to get better at sleeping? Get better at relaxing. How to get better at relaxing? Yoga Nidra, NSDR. And then, you know, so I feel like the tools exist. And I'm so grateful that you pointed me in the directions of these tools. And it can be very simple. You know, one of my teachers used to say that the breath is the mind made visible. And if you want to change your mind, change your breath. I mean, of course, do a yoga nidra. It might take 30 minutes, right? But if you're in a moment where you're feeling really activated, change your breath. Specifically, like a long exhale. I love that breath is the mind made visible. It's beautiful. And, and so true. That was Amrit Desai. I should give him credit. Okay. Wonderful. It's the quickest way to, to move us to, to, to create an activation of the, of the parasympathic nerve system. Quickest way, you know, and it, this is where, you know, people will think meditation is so hard. Breath work, which there's many different forms of breath work are hard, which they can be, I suppose, you know, hard in the way that we've got to find the time and it can be uncomfortable. But, you know, I'll tell people take a minute and breathe. And if even a minute sounds long, take seven breaths. Like who can't take seven breaths at any point in the day? You're going to do it anyway, right? We never aren't breathing, but if we can bring our attention to that and you can schedule that, like, you know, I'm going to do that before I get out of the car to go to the office. I'm going to do it before I go to lunch, after a meeting, before a meeting, or you can just say, anytime that I'm feeling like this, I can take seven breaths. It might end up being two minutes, like a TV commercial. And those things add up and they build on each other. And the more that we practice those, the more that we do raise that capacity to experience distress. First, it helps us activate that part of the system and teaches us like your analogy in the gym. But we also start building a habit around doing something like this so that we can weather whatever storm's coming and we start to orient toward it. I'd like to take a brief break and acknowledge one of our sponsors, Waking Up. Waking Up is a meditation app that offers hundreds of guided meditation programs, mindfulness trainings, yoga nidra sessions, and more. I started practicing meditation when I was about 15 years old, and it made a profound impact on my life. And by now, there are thousands of quality peer-reviewed studies that emphasize how useful mindfulness meditation can be for improving our focus, managing stress and anxiety, improving our mood, and much more. In recent years, I started using the Waking Up app for my meditations because I find it to be a terrific resource for allowing me to really be consistent with my meditation practice. Many people start a meditation practice and experience some benefits, but many people also have challenges keeping up with that practice. What I and so many other people love about the Waking Up app is that it has a lot of different meditations to choose from, and those meditations are of different durations. So it makes it very easy to keep up with your meditation practice, both from the perspective of novelty. You never get tired of those meditations. There's always something new to explore and to learn about yourself and about the effectiveness of meditation. And you can always fit meditation into your schedule, even if you only have two or three minutes per day in which to meditate. I also really like doing yoga nidra or what is sometimes called non-sleep deep rest for about 10 or 20 minutes, because it is a great way to restore mental and physical vigor without the tiredness that some people experience when they wake up from a conventional nap. If you'd like to try the waking up app, please go to wakingup.com slash Huberman, where you can access a free 30 day trial. Again, that's wakingup.com slash Huberman to access a free 30-day trial. People are probably starting to realize that overcoming addiction is about more than just white knuckling it. It's about more than just going to meetings, although that can be very useful. It's about having a roadmap of the day, having a plan, knowing what weather patterns to look out for internally and externally. It's about having a way to deal with distress, having a way to calm down. Let's talk a little bit more about specific addictions. Maybe I'll mention a couple of different categories of addiction, and maybe you could reflect on some of the unique features of that in your experience, not necessarily neurobiologically, but in terms of strategies for confronting in oneself those things, right? Like strategies for trying to overcome them. Because I hear from thousands of people really about different addictions in themselves and people close to them. So let's start with alcohol. What is unique about alcohol addiction that people should know? And these could be extensive answers. They don't have to be, but that could be helpful to them. Alcohol is an interesting one. I think alcohol and most drugs have a lot of similarities, although alcohol tends to be the one that is the most socially acceptable. I mean, drinking is part of our culture. And if you don't do it, you catch some flack sometimes. Oh, yeah. I mean, I think some of that's been changing and some of it, thanks to you. I mean, I can't tell you how many people that have ended up, I've ended up talking to because they listened to your podcast on alcohol, you know, just from a health standpoint. So people are starting to look at that. It's, it's become, you know, it's less like the mad men fifties, people drinking at lunch, but it's still very much part of the culture and everything, happy hour, happy day. You know, I mean, look at the, have you ever been in one of these retirement communities like in where people are retired and just drinking all the time or, oh yeah. There's a real stigma to not being able to drink for people. You know, I, I, you know, I don't mind sharing. I've been sober for quite some time and that was a, that was a challenging thing. Like the first wedding I went to or the first, uh, you know, work event that I went to, I didn't know how to talk about it with people. Now I, it's no big deal. I don't, it doesn't bother me at all. Um, and if it does, you know, sometimes I don't like to be around people who are just getting wasted, but I, you know, so I'll leave the wedding at 10 instead of two, you know, most of the people thought I was there till two, but I, I left it, I left at 10 cause they're, they're doing whatever they're doing. But, um, it's, it's very challenging cause you know, having a glass of wine at dinner or, uh, you know, a beer after work or, you know, thinking about, you know, people, you know, it was like a, it was always a thing like the first time a dad and a son share the, share a beer, right? There's a lot of romanticizing around it. And I, alcohol, I don't, I don't, I don't think alcohol is evil. I mean, I think listening to what you've talked about, it is poison, but I don't like anything else in moderation. I don't think it's going to – it's a terrible problem. I'm not anti-alcohol."

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