The Truth About Addiction: Dr. Ben Shapiro & Dr. Brett Shurman Break It Down

Summary

Podcast Summary: "The Truth About Addiction: Dr. Ben Shapiro & Dr. Brett Sherman Break It Down"

We're Out of Time Podcast
Host: Richard Taite
Guests: Dr. Ben Shapiro, Dr. Brett Sherman
Date: December 2, 2025

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Main Theme & Purpose

This episode dives deep into the realities and raw truths of addiction, discussing its psychological and neurological underpinnings, the fentanyl crisis, and modern treatment innovations. Host Richard Taite—an addiction recovery expert—tackles essential but under-discussed aspects of addiction care with two renowned psychiatrists, Dr. Ben Shapiro and Dr. Brett Sherman. The conversation moves from cutting-edge neuromodulation with TMS (Transcranial Magnetic Stimulation), to family heartbreak, misdiagnosis, boundaries in treatment, trauma roots, and the promise (and pitfalls) of emerging psychedelic therapies.

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Key Discussion Points & Insights

1. Reframing Addiction: More Than a Chemical Dependency

• Addiction as Relationship to Self:
  • "Addiction isn't just a relationship with a drug. It's a relationship with yourself." — Dr. Ben Shapiro [00:00]
  • The core of addiction lies in trauma, individual experiences, and self-knowledge.
• Chemistry vs. Experience:
  • "You're not just a bunch of chemistry. You're a bunch of your experiences and your traumas." — Dr. Ben Shapiro [00:06]
  • Both doctors stress that understanding one’s story and trauma is essential—not just biochemistry.

2. Innovations in Treatment: TMS and Neuromodulation

• Introduction to TMS:
  • Explained as a "powerful magnetic field to either stimulate or inhibit brain circuits" — Dr. Sherman [01:33].
  • Used increasingly for trauma, depression, OCD, and now, addiction [01:49–07:12].
• Efficacy & Protocols:
  • "Crazy effective, especially with new accelerated protocols—the Saint Protocol from Stanford had remission rates over 90% for depression." — Dr. Sherman [04:22, 05:21].
  • Limitations include insurance coverage and high costs (about $100K/machine, $20–30K/year to maintain) [16:52–17:08].
• Beyond Depression:
  • TMS now FDA-approved for OCD, anxious depression, adolescent depression, migraine, nicotine dependence—and being studied widely for addiction [07:12].
  • Multi-site TMS (stimulating various brain regions) may offer promise, especially as science catches up with real-world practice [10:03–10:59].

3. The Fentanyl Crisis: Death, Grief, and Systemic Issues

• Testimonies from the Trenches:
  • "I have so many fentanyl deaths, I've lost count. I don't want to count." — Dr. Sherman [11:47]
  • Many deaths are accidental overdoses: "None of them are suicide. They're accidental overdose or being unaware that there's fentanyl." — Dr. Sherman [12:04]
• Families in Crisis:
  • "It rips them apart... it's unbelievable grief to lose a family member, particularly a child." — Dr. Sherman [12:33]
  • The randomness and lethality—"It's not if, it's when you’re going to die"—is more severe than past heroin waves [15:28]
  • "Even weed gets laced with it. It's crazy." [15:52]
  • "You gotta get a script from a doctor... that’s it, the end." — Host [16:12]

4. Barriers to Treatment & Underutilization of Effective Tools

• Insurance, Cost, and Public Awareness:
  • Insurance restrictions and high cost make TMS underused [16:40, 17:29].
  • Even most clinicians know only of TMS for depression, not its broader uses or latest protocols [17:29–18:13].
  • The default is still "diagnose as depression" to get TMS covered, since "nobody gets to treatment on a winning streak." — Host [18:13]

5. Addiction and Psychiatric Illness: Overlapping Pathways

• "Addiction’s a psychiatric illness, no question." — Dr. Shapiro [18:48]
• Treatment isn’t about a strict division: "It all has to be treated the same; if you can't treat it the same, the roots don't take hold." — Host [19:14–19:17]
• Trauma, childhood attachment, and the family system play central roles in both addiction and mood disorders [20:47–26:34].
• "A lot of it's trauma." — Dr. Sherman [21:50]

6. Therapeutic Alliance: Empathy, Detachment, and Outcomes

• Burnout and Empathy:
  • Host describes being re-injured by client stories; doctors share how their training taught them detachment, but real caring remains crucial [27:20–29:50].
• Therapeutic Relationship Predicts Success:
  • "The biggest variable that predicts outcome in any therapeutic experience is the relationship with the patient, the level of empathy the patient feels from the therapist." — Dr. Sherman [30:00]
  • Even medication “works better” when the alliance is strong [32:25].

7. Misdiagnosis & Prescription Pitfalls

• Misdiagnosis Is Common:
  • Host: "How often are people misdiagnosed, given antidepressants or stimulants when what they really need is addiction treatment?"
  • "High." — Dr. Sherman [35:12]
  • Overuse/misuse of meds like Adderall, benzos, and opioids often comes from inadequate addiction training in psychiatry [35:44–46:55].
• Systemic Training Gaps:
  • "In medical school you get one week of addiction." — Host [47:00]
  • Only 1,500 addiction psychiatrists in the entire country; a massive shortfall [47:36].

8. Why Therapy-First, Individual Care Works

• Carrera’s Approach Vs. 12-Step:
  • "Addiction isn't just a relationship with a drug. It's a relationship with yourself that comes first, like some kind of early trauma." — Dr. Shapiro [48:51]
  • "AA is great, but it's a support group... it is not specific to you and your problems." — Dr. Sherman [50:54, 50:57]
  • Therapy is about unpacking trauma, building insight, and replacing drugs—once a meaningful ‘attachment’—with something of equal or greater value [51:05–51:44].

9. Psychedelics, Promise & Caution

• On Psychedelic Therapies (Ibogaine, Psilocybin, MDMA, Ketamine):
  • These can be transformative short-term, but "if that's all you did... you're good for two months." — Dr. Sherman [40:35]
  • Lasting benefit depends on follow-up therapy; psychedelics can be risky or destabilizing in certain patients [39:34, 41:28].
  • "There's promise in psychedelics, but that's what it is—promise. It is not here." — Dr. Sherman [39:34]

10. Family Education: The Hardest Truths

• What Families Get Wrong:
  • "It's a disease that kind of takes over your will... They don't realize how deep it is, how it just controls their life." — Dr. Shapiro [36:39]
  • Support requires boundaries, not enabling: "With addiction, you set very strict limits—like, I can't help you unless you go to treatment." — Dr. Sherman [36:57]

11. Advice and Hope for the Next Generation

• What Would You Tell a 16-Year-Old About to Try Drugs?
  • "Don't do that, you're gonna die." — Dr. Sherman [52:06]
  • "What are you trying to get out of it?" — Dr. Shapiro [52:11]
• Holding Hope for the Hopeless:
  • Finding a reason to live, often by leveraging love for family, can be a critical anchor [54:00–54:34].

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Notable Quotes & Memorable Moments

• "Addiction isn't just a relationship with a drug. It's a relationship with yourself."
  — Dr. Ben Shapiro [00:00 & 48:51]

• "You have to know yourself. You have to have somebody who can guide you through it."
  — Dr. Ben Shapiro [00:06]

• "I have so many fentanyl deaths, I've lost count. I don't want to count."
  — Dr. Brett Sherman [11:47]

• "It's not if, it's when you're going to die. I have no heroin overdose death in my practice... but fentanyl? I can't count."
  — Dr. Brett Sherman [15:28]

• "The biggest variable that predicts outcome in any therapeutic experience is the relationship with the patient—the level of empathy the patient feels from the therapist."
  — Dr. Brett Sherman [30:00]

• "If you can't treat [addiction and depression] the same, the roots don't take hold."
  — Host [19:17]

• "No medication management appointment because there's always a therapeutic element to it."
  — Dr. Brett Sherman [32:32]

• "You need to restructure... so other elements in your life bring meaning out. You replace it."
  — Dr. Ben Shapiro [51:05]

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Important Segment Timestamps

• Defining Addiction & Trauma: [00:00–01:00]
• Explaining TMS & Company Details: [01:27–05:00]
• TMS for Addiction & Stanford Protocol: [05:12–07:12]
• Multi-site TMS & Future of AI in Psychiatry: [10:01–10:59]
• Reality of Fentanyl & Accidental Deaths: [11:43–16:12]
• Treatment Barriers—Insurance, Costs: [16:33–18:13]
• Overlap of Psychiatry and Addiction: [18:47–20:47]
• Therapeutic Alliance/Detachment: [27:20–32:25]
• Misdiagnosis, Overprescription: [34:41–36:39]
• Advice to Families: [36:39–37:51]
• Cutting-edge Therapies (TMS, Psychedelics): [38:08–43:51]
• Why Individual Therapy Beats Cookie-Cutter Approaches: [48:35–51:00]
• Role Play: Helping a Suicidal Teen: [52:06–54:34]

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Tone & Style

The conversation is direct, compassionate, and often darkly humorous. The host mixes personal testimony with raw honesty and sometimes biting commentary. Both doctors balance scientific rigor with accessible explanation and practical wisdom, making the material relatable and urgent for families, clients, and clinicians alike.

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For Listeners: Key Takeaways

• Addiction is deeply personal, rooted in relationships, trauma, and meaning—not just biochemistry.
• New neuromodulation tools like TMS offer real hope, especially when coupled with individual therapy and holistic, community support.
• The fentanyl crisis is rewriting the risk landscape: any street drug could be lethal; families and users must understand this.
• Strong, empathetic relationships—whether in medicine, therapy, or family—are at the heart of every lasting recovery.
• Systemic gaps in training, diagnosis, and insurance still leave far too many vulnerable—and innovation is needed, fast.
• No single tool, whether TMS or psychedelics, is a magic bullet—lasting change is always anchored in honest self-examination and supportive care.

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"We're Out of Time" challenges listeners not just to understand addiction, but to act—demanding better from medicine, community, and ourselves.

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Transcript

[Dr. Ben Shapiro]

Addiction isn't just a relationship with a drug. It's a relationship with yourself.

[Dr. Brett Sherman]

You're not just a bunch of chemistry.

[Dr. Ben Shapiro]

You know, you're a bunch of your experiences and your traumas. And like, that's what. That's the underpinning of, like, any of those drugs. And you have to know yourself. You have to have somebody who can guide you through it.

[Podcast Host]

If someone has a problem with substance use disorder, please call one call placement. That's 888-831-1581. And if we can't help you, we'll make a referral to someone who can. One call placement is affiliated with Carrera Treatment Wellness and spa and one method treatment centers. Got Dr. Ben Shapiro and Dr. Brett Sherman here today. Why don't you guys do me a favor and we'll do a little character development for these folks. Why don't you start, Dr. Sherman?

[Dr. Brett Sherman]

Okay. I'm an adult psychiatrist and addiction psychiatrist. I have a private practice and I also practice at Lawson Sinas Hospital, both in the inpatient and the chemical dependency program there. And we have a new TMS company, Pacific Neuromodulation, for about a year.

[Podcast Host]

That's fantastic. So what's tms?

[Dr. Brett Sherman]

What is cms?

[Podcast Host]

Well, I know what it is, but.

[Dr. Brett Sherman]

Tell the viewers what it is TMS is using first.

[Podcast Host]

Tell them what it is.

[Dr. Brett Sherman]

Oh, Transcranial Magnetic simulation is the. Yeah, it's the name. It's using a powerful magnet, powerful magnetic field to either stimulate or inhibit brain circuits. It's the simplest explanation.

[Podcast Host]

And it's used for trauma.

[Dr. Brett Sherman]

It's used for numerous psychiatric and neurological applications. Yes, trauma is one of the things it's used for. It's used.

[Podcast Host]

It's big with the veterans community.

[Dr. Brett Sherman]

It is. And getting bigger. Yeah, it's really effective for PTSD in our experience.

[Podcast Host]

Right. Well, no, it's definitely. Definitely. It's amazing. Yeah, it's amazing. How about you, Dr. Shapiro?

[Dr. Ben Shapiro]

I'm also Dr. Ben Shapiro. I'm also an addiction psychiatrist. I'm also a geriatric psychiatrist. I'm a little jack of all trades. I have a background in adolescent psychiatry. I also do a lot of work in eating disorders. I'll just an eating disorder specialty and then. Do a lot of substance abuse stuff in general. So I work at a few different rehabs.

[Podcast Host]

Um, one of.

[Dr. Ben Shapiro]

Including your own? Um, I also do some work for UCLA with Dr. Fong, right? Not directly. I do know Dr. Fong, though. Yeah, we go back and I interest. You know, Brett and I share ownership of this Pacific Neuromodulation RTMS company. I'm the cmo.

[Podcast Host]

Where is it?

[Dr. Brett Sherman]

There's going to be. There are three clinics. One we're buying. So there's one in Pasadena, there's one in Westlake inside the CURE Clinic in a Four Seasons Hotel. And there's going to be one in West LA that we're purchasing hopefully in the next three months. And we also have from that guy.

[Podcast Host]

What's that guy's name? The one on the one. It's the one on Olympic. In Bundy, right? Yeah. What's his name again? Dr. Stubman. But he's going to stay on and run this.

[Dr. Brett Sherman]

Run the stuff, not so much.

[Podcast Host]

Why?

[Dr. Brett Sherman]

Because moving to Thailand, she's retiring.

[Podcast Host]

Oh, you found a little Thai girlfriend. No comment. No comment. Yeah, exactly. That's awesome.

[Dr. Brett Sherman]

Maybe more than one. Yeah. And we have mobile capacity as well, so we can bring the TMS to someone's home or a residential program or. We actually did a case in Colorado and there are new devices coming out that weigh a lot less, which we're grateful for because these things are over 100 pounds. The cooling systems are very heavy.

[Podcast Host]

How many, how many people are you currently seeing a day in your TMS practice? Well, we just.

[Dr. Brett Sherman]

Right now it would be 3As. Because we just started, you know, about. In March.

[Podcast Host]

So why TMS guys? Why? Explain that to me. I want to do it even more. Tell me why.

[Dr. Ben Shapiro]

Crazy effective.

[Dr. Brett Sherman]

Crazy effective. Especially starting about five years ago, I've referred to TMS. Not been in TMS practitioner for like 25 years. It started out in 1985. It's interesting because the engineer who created it actually just gave it away. Got no patents. Poor guy. So he made no money. He made billions. But in 2022, 2020 was the first.

[Podcast Host]

The fact that he didn't do that. Hate to interrupt, but the fact that he didn't do that, man, made the practice accessible. You know, the science is always 15 years or so ahead in the practice, but by him doing that, it. It shortened that.

[Dr. Ben Shapiro]

Yeah, it helps humanity. It sure, yeah.

[Dr. Brett Sherman]

Did he actually gives talks now at TMS conferences?

[Podcast Host]

Well, he's got to now because he just gave away all.

[Dr. Brett Sherman]

Yeah, exactly. So he's got to look good.

[Podcast Host]

He's got to look good for it.

[Dr. Ben Shapiro]

He's some kind of job.

[Dr. Brett Sherman]

Sweet guy.

[Dr. Ben Shapiro]

Yeah.

[Dr. Brett Sherman]

So why tms? I mean, TMS was always reasonably effective for depression. That's what everybody knows.

[Podcast Host]

That's right.

[Dr. Brett Sherman]

But it still wasn't really much better than. And depressants for remission rates until five years Ago, Stanford. Stanford came out with an accelerated protocol, it's called the Saint Protocol. And they were getting remission rates in the 90 plus. Sorry, Stanford came out with a.

[Podcast Host]

For what rates?

[Dr. Brett Sherman]

Remit, as in getting completely better remission rates.

[Podcast Host]

So you're wellness. So you're telling remission rates. Is that relapse rates?

[Dr. Brett Sherman]

It's a different question.

[Podcast Host]

Okay, so what the. So, okay, so hold on. For that.

[Dr. Ben Shapiro]

For that.

[Podcast Host]

So what is a remission rate? That. So, so someone's not depressed anymore.

[Dr. Brett Sherman]

It means they're not. They have no depressive symptoms.

[Podcast Host]

That's really.

[Dr. Ben Shapiro]

Yeah, within. And they go, they go into remission often two to three days.

[Dr. Brett Sherman]

It always was effective at a reasonable remission rate up until 2020. And it was always non invasive, no side effects, basically no risk. So if people were failing traditional treatment therapy or meds, I would refer to it. In fact, that insurance won't cover it. Unless. Used to be four meds, now it's two. So it hasn't, it has improved.

[Podcast Host]

That's right.

[Dr. Brett Sherman]

Yeah. And it only covers it is the.

[Dr. Ben Shapiro]

Big limitation of insurance.

[Dr. Brett Sherman]

It is a limitation.

[Podcast Host]

It's, it's, it's, it's a limitation.

[Dr. Brett Sherman]

Yeah.

[Podcast Host]

You know, because they don't want to have to pay for it right away. Even if they don't want to have.

[Dr. Ben Shapiro]

To pay for it. What, what's the most effective? And that's the biggest, the biggest thing we run into.

[Dr. Brett Sherman]

Yes. So the most effective are these accelerated treatments where you can get somebody better potentially. Now there's a one day treatment. It's amazing. But there's five day. We do one day, five days or 10 days. So in 2020, these protocols came out that were super powerful and they actually got FDA approved in 2022. That's when I started getting very excited and very interested. And that's between that and a personal story I have. That's why I got into it. But it doesn't just apply to depression. It applies to 20 psychiatric disorders, neurotypin, you know, so, so, so the FD. There's. The FDA has actually approved six.

[Podcast Host]

Give me that.

[Dr. Brett Sherman]

And those are OCD. Okay. Anxious depression, anxious depression, anxiety, basically depression. Yeah. Adolescent depression, migraine pain, chronic nicotine dependence. But it actually spreads to all addiction. There are, there are studies now on many, many different substances. And as you know, there are no real medical treatments for many substances of abuse.

[Dr. Ben Shapiro]

So.

[Podcast Host]

So tell me about that. How, how does TMS assist in the addiction. In addiction treatment?

[Dr. Ben Shapiro]

Just the basic protocols. I can. There's different kinds of. There's different kinds of. If you talk about alcohol abuse, there's different reasons people drink. You know, some people drink to avoid withdrawal symptom symptoms. Some people drink due to underlying anxiety or other things. Some people use it for reinforcement. And those are actually different brain networks. And it's still in development. But if you target those different brain networks, you can really focus on. You have the potential to focus on the reason for the addiction and have really out kind of next level improvement.

[Podcast Host]

Just so you know, anybody that is drinking to get well.

[Dr. Ben Shapiro]

Right.

[Podcast Host]

Is started drinking not to get well, but to quiet the mind, obviously, the other stuff. Right. All right.

[Dr. Brett Sherman]

But I want to answer your question a little more specifically. So you know, there are certain circuits that affect impulsivity. There are certain circuits that affect reward. So depending on the clinical reason someone's doing drugs, it could be all the above. You can hit all those circuits.

[Podcast Host]

That's right. And it usually is. That's, that's, that's my point. Okay. Because this is like kind of like, you know, you guys have the education, but I have. It's not just an opinion. It's 25 years of field research. Right, right, right. Both using and getting sober. Right. So from the ground level, it's usually all of it.

[Dr. Brett Sherman]

Yeah.

[Podcast Host]

So that's why all of the touch points need to be pushed even if you got. Because otherwise what's going to happen is the human error aspect of it. Right. Is going to get in the way. You're going to miss a touch point and that's. It's not visible. Yeah. It's not just that they're vulnerable. They've got, they are not gliding through life. Right. They're, they're white knuckling a little bit because they're unsure. So they're spending all their time kissing God's ass. Please help me stay sober. Please help me stay sober. Right. And there's no thriving or growth in that.

[Dr. Brett Sherman]

Couldn't agree with you more.

[Podcast Host]

Well, that's why you're here. Only the people that agree with me get to come off.

[Dr. Brett Sherman]

I'll try not to disagree, but I sometimes am disagreeable.

[Podcast Host]

Please be disagreeable. It's better ratings.

[Dr. Brett Sherman]

So there's an interesting dilemma slash conflict within tms because most of the studies only look at one site. So multi site protocols, which is what we favor for exactly the reason you said are not well studied and we're super excited about.

[Podcast Host]

What about in Europe?

[Dr. Brett Sherman]

Even there, it's there. Maybe they'll hit two sites.

[Podcast Host]

Okay. So check this out. They're looking at each site Individually, Right?

[Dr. Brett Sherman]

Correct.

[Podcast Host]

Okay, so who gives a. If they're looking at each site individually, collectively, they deal with the same thing.

[Dr. Brett Sherman]

That's our motto. That's why we do what we do. We hit multi sites, especially because at this point, the science doesn't support. It's exactly this circuit. We're getting there. You know, looking at the brain, it's.

[Dr. Ben Shapiro]

Still hard to find what those are.

[Podcast Host]

You're a year off, man. You're a year off with AI every six weeks. And it's coming, getting better.

[Dr. Ben Shapiro]

That's why we're in this business. Yeah.

[Podcast Host]

You're going to be able to tell. You're going to be able to do that. Exactly.

[Dr. Brett Sherman]

So the accelerated studies of depression are one site, but imagine using accelerated protocols in five sites. That's basically what we do.

[Podcast Host]

Can you help erectile dysfunction?

[Dr. Brett Sherman]

Yes.

[Podcast Host]

Asking. Asking for a friend.

[Dr. Brett Sherman]

Asking for a friend. Viagra?

[Podcast Host]

No, I'm talking about tms. I'm talking about without the pills. Without.

[Dr. Brett Sherman]

No, but maybe ultrasound. Maybe TMS is actually just hits cortical structures. Yeah.

[Podcast Host]

Both of you have decades of treating addiction. If you had to describe what the crisis looks like from inside your office. What are you seeing right now that the public has no idea about?

[Dr. Brett Sherman]

That is a painful question.

[Dr. Ben Shapiro]

Death.

[Dr. Brett Sherman]

It's my. You know, I pride myself that in my practice over 30 years, more or less, I have literally two suicides and I treat very sick people. I should have four years, statistically. But I have so many fentanyl deaths, I've lost count. I don't want to count. So that's what we're seeing.

[Dr. Ben Shapiro]

Death.

[Dr. Brett Sherman]

Unintentional deaths. In fact, all of my deaths, none of them are suicide. They're accidental overdose or being unaware that there's fentanyl in whatever, you know, Xanax the person bought. And that's just unbelievably, profoundly sad. I have at least 20.

[Podcast Host]

Tell me about. And Marie, get to you in a minute because I want to ask the same exact question. But do you meet with the families afterwards? Absolutely. Talk about what it does to the families?

[Dr. Brett Sherman]

It rips them apart. I gotten the most harrowing phone calls during one in particular. This kid was a rocket scientist, literally. And he had gotten sober and he went back to school and unfortunately there were parties and all he took was some Vicodin and Xanax. But there was. It was definitely lace of the Was, you know, in the autopsy report and talking to that mom first. I talked to her when it happened because she found him in his room, blue. He was still staying at home. And there were 400 people at his funeral because he was an outstanding human being. And she'll never be the same. That, you know, it's unbelievable grief to lose a family member, particularly a child. It's unspeakable that, that's my answer.

[Podcast Host]

How about you, dad?

[Dr. Ben Shapiro]

As a doctor, what I'd add to that is it's, it's unnerving, it's, it's absolutely frightening to take care of a patient with like, who's strung on. It's like Russian roulette, you know. And you, you see them this come in, not really having the size of what they're doing and really having the danger. I had multiple patients that like three, four, near, near death overdoses. And you try to explain them just, it's just death. It's tough.

[Podcast Host]

You know, it's different about this. You know, people are always dying of heroin, right? Sure. But the reason they died is because they overshot the mark. And what most people don't know and you guys can't explain it this way, okay? You explain it in a way that gives people brain damage. Okay? But really what heroin. An intravenous heroin user is feeling what feels the best for him is to get as close to death as humanly possible without actually dying. Now that sounds really scary, but that's the truth. But it's also the only way you could die when you are shooting heroin. Okay? Now people are dying all over the place. And the kids that are dying are the straight A students, ab student kids on the weekend going to the concert, going to the party, going to the rave, right? And they're taking one pill or a half a pill and dropping dead within minutes. Okay? That's what's going on now. And the reason it's going on is because these kids have no tolerance for anything. So even a non lethal dose to a user who's built the tolerance is killing these kids.

[Dr. Ben Shapiro]

They don't even know they're using it sometimes.

[Podcast Host]

That's the whole idea.

[Dr. Ben Shapiro]

It's.

[Podcast Host]

They're buying, they're buying something, they're bargaining for something and they're getting something entirely different.

[Dr. Brett Sherman]

It was never safe to be a drug addict, but now it's like.

[Podcast Host]

It'S.

[Dr. Brett Sherman]

Lethal in a moment.

[Podcast Host]

It's not, it's not if it's when you're going to die, it's not if.

[Dr. Brett Sherman]

I have no heroin overdose death in my practice do what I have no one who died from heroin because I deliver good care.

[Dr. Ben Shapiro]

But I.

[Dr. Brett Sherman]

Here's how I put doesn't matter how much people love you, it doesn't matter how good your doctor is or how good the treatment is, you're going to die anyway. 20 deaths today. Yeah. Now currently, if you're using it.

[Podcast Host]

Yeah, for sure.

[Dr. Brett Sherman]

If you're using anything. I mean, even weed gets laced with it. It's crazy.

[Podcast Host]

Did you. Do you guys remember at the AFC championship game last year, they found those four kids face down in the snow? Yeah. From. From weed.

[Dr. Brett Sherman]

Yeah.

[Podcast Host]

Okay. Because it was lace of. If you're buying anything on the street right now or you. Yeah. On an online pharmacy.

[Dr. Brett Sherman]

Yeah.

[Podcast Host]

Okay. You're screwed. You're screwed. Okay. You got to get a script from a doctor. You gotta get it from a brick and mortar pharmacy. Okay? And that's it. The end.

[Dr. Brett Sherman]

And so therefore, when someone comes in and isn't dead yet and you're treating them, the urge, I think, to get them better is much greater and to prevent.

[Podcast Host]

And that's why you like the tms, because it's quick acting, correct and powerful and probably the Vivitrol.

[Dr. Brett Sherman]

And we use all. We use every tool available. This is just another tool that's super powerful and has no downside and is very underutilized for multiple. One is insurance. Right.

[Podcast Host]

Well, it has. Is not going to get covered by insurance unless you jump through those hoops, which makes it really, really hard. But it's not just that the machinery is. Each machine is 100 grand.

[Dr. Brett Sherman]

Yes.

[Podcast Host]

And then what is it to maintain? Like 20 grand, 30 grand a year.

[Dr. Brett Sherman]

Yeah, that's about right, actually, per. Because you have to change the magnet out. But also like that. It's not well known.

[Podcast Host]

I had no idea.

[Dr. Ben Shapiro]

Yeah.

[Dr. Brett Sherman]

You know, on my life. Good guess.

[Dr. Ben Shapiro]

Yeah, that is a pretty accurate.

[Podcast Host]

But that's the thing. Yeah, right. That's. That's. That's why I want you guys to call me. Because it's common sense. The math makes sense.

[Dr. Brett Sherman]

Also the field as a general. A general principle is terrible at what you're great at. They have not marketed themselves well. In fact, to the degree that the NIMH put out. National Institute of Mental Health put out seven videos essentially marketing TMS to clinicians. And even when people do know, they only know about depression and they often don't know about the new protocols. And so it's really underutilized and it has so many applications, including addiction. But yes, it's not covered. The only thing that's covered is depression. So you know how people get around it. Is it usually if you have another disorder, including addiction, you have some depression. So they bill it as depression, which they have. And you treat the depression well.

[Podcast Host]

They always had to. Nobody gets to treatment on a winning streak. I've never. I've never met anybody.

[Dr. Brett Sherman]

Yay.

[Podcast Host]

I don't know.

[Dr. Brett Sherman]

I've seen your. Your program, and I'm like that.

[Podcast Host]

No, that's. After they've been there for an hour. After they've been there for a couple hours, they're like, oh, this is cool. Right? But nobody. Nobody crosses the threshold like that. No. Yeah. All right, let's get in. Where do you see the line between psychiatric illness and addiction? Or is there no line anymore? Are we treating the same brain pathways?

[Dr. Ben Shapiro]

Oh, they're definitely.

[Podcast Host]

Yeah.

[Dr. Ben Shapiro]

Addiction's a psychiatric illness, no question.

[Podcast Host]

Same. So you're treating it the same way.

[Dr. Brett Sherman]

I mean, it is. It's an illness that we would view within psychiatry.

[Dr. Ben Shapiro]

Yeah, but I mean, versus depression, anxiety, like.

[Podcast Host]

Yeah, yeah.

[Dr. Brett Sherman]

But treating those illnesses are complicated, just like addiction. Like, they're not just brain circuits and chemistry. And I tell you how I explain it. Yeah, please do.

[Dr. Ben Shapiro]

Yeah.

[Podcast Host]

It's all the same.

[Dr. Brett Sherman]

Yeah.

[Podcast Host]

It all has to be treated the same.

[Dr. Brett Sherman]

Sure.

[Podcast Host]

If you can't treat it the same, it doesn't. It. The roots don't take hold.

[Dr. Brett Sherman]

I mean, I agree, because I think that is a shift that has occurred within addiction medicine. It's like a good shift.

[Podcast Host]

Right, right.

[Dr. Brett Sherman]

Because otherwise it's just AA and A is great, but there's like a support group.

[Podcast Host]

It's not.

[Dr. Brett Sherman]

Yeah. There's a whole bunch of other tools.

[Podcast Host]

Yeah, that's right. Yep. That's right. We always did it that way from 2004. We've always done it that way because I didn't know any better. That's what things to me. So if it fixed me and I was as bad as it got, you know, I was doing. You know, I don't even think they do drugs like this anymore. I was up six to eight days at a time.

[Dr. Ben Shapiro]

You have to know the reasons. You got to know the reasons why it's happening to some degree.

[Podcast Host]

A lot of times you don't know the reasons, but yes, you have to figure. You have to understand that you've been lying to yourself all along. Okay. And then it's all just been a bunch of. And then you have to show them along the arc where. Where they've been lied to. You know, a lot of times. I explain it like this all the time. A lot of times, you know, people don't know why they're doing drugs and alcohol. They have no idea. And Then you have to unpack it. And let me tell you what it usually is. It's usually. I'll give you something to cry about. What are you, stupid? Yeah, right. And so you say to yourself as a five year old, you're looking at yourself and you're go.

[Dr. Ben Shapiro]

And you're going.

[Podcast Host]

You. Your frontal cortex isn't developed enough to formulate the thought, oh, my parents are just idiots. You can't do that because you're too small. Right. And remember when you were small, everything was bigger. And if these people who brought you into the world don't love you, they then you must be bad. And that's all you got at 5. I must be bad. Totally. And then it gets reinforced. Reinforced.

[Dr. Brett Sherman]

Reinforced.

[Podcast Host]

Reinforced. Pretty soon you got this 45 year old guy being run by a 5 year old mind, okay. That got reinforced all the time. And it's like the intervention is, hey, you see how this is horseshit, right? You see that this was a lie that is keeping you beaten down. It allows you to be a victim. And there are. You guys would know as well. There's medication, there's all sorts of therapies to get you to realize what the truth is. Talk about truth. That is the truth that matters.

[Dr. Ben Shapiro]

Agreed.

[Dr. Brett Sherman]

A lot of it's trauma.

[Podcast Host]

Did that make, did that make perfect?

[Dr. Ben Shapiro]

Yeah. Okay. Totally. Yeah.

[Podcast Host]

Good.

[Dr. Brett Sherman]

And then you need to. You don't have the circuits to regulate your emotions or yourself. So you're going to find some way, some exogenous way, you're going to find drugs or alcohol because they make you feel better in the beginning.

[Podcast Host]

They, they actually save your life in the beginning. If you really have real issues. Yeah.

[Dr. Brett Sherman]

I always ask when I'm evaluating someone, I think Dr. Shapiro does too. Why did you do this drug? Like, what was it doing for you in the beginning?

[Podcast Host]

That's an excellent question. Do they know?

[Dr. Brett Sherman]

Sometimes. Sometimes they know, sometimes they don't. When they do know, it's very helpful.

[Podcast Host]

But, but a lot of times, my guess is in this interview, in this assessment process, you've got a third of the people that don't know. Maybe, maybe 10 or 15 that do. And everywhere in between, they're just horseshitting you, talking, trying to figure it out while they're telling you that that is true too.

[Dr. Brett Sherman]

Yeah. But if they do know, it's very helpful.

[Podcast Host]

Well, how do you know when they're not horseshiting you and they're. Well, I guess you.

[Dr. Brett Sherman]

How do you know? Yeah, you know. How do I know? It's clinical, it's the only thing I.

[Dr. Ben Shapiro]

Know till the end, I mean, that's a lot of. A lot of psychological stuff. You know, you could go through the process of healing and recovery and. And then sometimes the discovery is late, but it is important.

[Podcast Host]

Absolutely. Yeah, absolutely. That's great.

[Dr. Brett Sherman]

For example, somebody says, you know, I couldn't stop my mind racing. I. I couldn't sleep. I was.

[Podcast Host]

You know, she told him, take a hit, a pop.

[Dr. Brett Sherman]

Exactly. And so. And that slowed me down. Okay, now I'm thinking adhd, bipolar, some kind of impulse disorder. That helps me as a doctor.

[Podcast Host]

Do any testing?

[Dr. Brett Sherman]

I do. I do testing when I'm confused, when I can't figure out, you know, what's going on at all.

[Podcast Host]

Don't. Aren't there certain diagnoses that replicate each other? One that comes up to mind with me is bipolar and borderline personality disorder. Disorder, like, they. They kind of touch each other. One's like. One's like, I love you, I hate you, I love you, I hate you. And the other is, you know, I'm so depressed. That lasts a few days, and you pull out of it, and then you manic for a couple days, and the only time you get here is when you're blown by it.

[Dr. Brett Sherman]

The time course helps differentiate those things, but they. They do overlap. And in fact, this guy, Dr. Akiskal, famous professor at UCSD, used to think borderline was a subtype. I think he might have passed away, but he.

[Podcast Host]

He.

[Dr. Brett Sherman]

He said it was a subtype of bipolar and should be treated as. So do I. And use as, like, you know, use mood stabilizers. Huh.

[Podcast Host]

So it's not that way anymore.

[Dr. Ben Shapiro]

Borderline is much more about detachment issues that you're talking about. All that disruption, early disruption versus like, where there's a set of, like, the.

[Podcast Host]

But if that was true, then I'd have borderline personality, and I don't.

[Dr. Ben Shapiro]

It's not. It doesn't. It's. It's a lot more complicated than that.

[Podcast Host]

But.

[Dr. Ben Shapiro]

But the. The things that trigger all those changes, those mood changes, have a lot to do with relationships. More than just sort of like an internal rhythm.

[Dr. Brett Sherman]

I'll give you an example of the complications. Please. I'll use my wife's family. Okay, good.

[Podcast Host]

So do we really want to do that?

[Dr. Brett Sherman]

You can. You can. You can cut it.

[Podcast Host]

No, no. I mean, is she gonna be pissed?

[Dr. Brett Sherman]

No, I don't think she will be.

[Podcast Host]

Okay. You don't think she will be.

[Dr. Brett Sherman]

She will not be.

[Podcast Host]

Okay, good. I mean, you're not. As long as you're not sleeping in the guest room.

[Dr. Brett Sherman]

I'm not, I'm not going to use names. All right, so they, they had a very large trauma when they were little. It's like an epic Chinese opera. And their father was assassinated in Taiwan. He was a, he was a minister in the government. Taken from their home, which two of them actually witnessed. My wife was actually 1 years old, doesn't remember any of this. Okay. So that was a big, big trauma. Had to move the U.S. no money. Etc. Etc.

[Dr. Ben Shapiro]

Okay.

[Dr. Brett Sherman]

Of the three of them, the middle one had a lot of depression from the time she was little. My, my mother in law.

[Podcast Host]

How old was she when she saw.

[Dr. Brett Sherman]

She was probably six.

[Podcast Host]

There it is. So.

[Dr. Brett Sherman]

But the oldest one. Okay. Was nine. So. But the middle one had depression from the time that she. This after this happened and mother in law moved to. My mother in law moved to the US Kind of got a substitute, you know, husband, not a real husband for economic reasons. And he wasn't a great guy, wasn't abusive, but he just was sort of a nebbish, you know. And the way these three girls interpreted him was so different because the middle one's mood was depressed all the time. And so she interpreted him very, very negatively. Like little things he would do, complain about money would become, you know, she would go to bed. The father, this is a stepfather, okay. She would go to bed hoping he would die or she would die. You know, my wife would be like, ah, whatever father was taken, he killed. The biological father was killed.

[Podcast Host]

And so now, now this is in.

[Dr. Brett Sherman]

The US So now the stepfather, the.

[Podcast Host]

Little one is want some debt.

[Dr. Brett Sherman]

The middle one, middle one's my wife. And the middle one and the older one, you know, functioned fine. Basically in life they had problems because there was trauma, right? But the middle one became a borderline. The point I'm trying to make is when you have that chronic mood problem from a young age, that also affects your development, your attachment, your psychological profile. This is what I'm saying about it being complicated, right? So.

[Podcast Host]

Because when you start off that way, you're limited and you're, and you're, you interpret reality differently and your growth is also limited.

[Dr. Brett Sherman]

It's. Yeah. Yes, it's. And so she never functioned well and.

[Podcast Host]

You know, doing better. We got some heartbreaking, man.

[Dr. Brett Sherman]

Yeah, yeah, it's terrible.

[Podcast Host]

You know what, I want to just get off topic for a second. You're talking about that story and I feel myself welling up. I feel like I'm getting re. Injured every time I do a podcast, every time I talk to a Client. Because I've been doing it so long, it re injures myself all the time. Okay. How are you guys not injured the way I am over something like this?

[Dr. Ben Shapiro]

There's something about it that like reminds you about your own narrative.

[Podcast Host]

No, it's just. No, I'm heartbroken for children. See, when you're as old as. When you're, when you have children as old as I was after losing a quarter of accentuated to drug addiction, you don't think you're going to have children. You thought you missed it. And then when you get it, you're so grateful for it. You don't just love your children, you love all children.

[Dr. Brett Sherman]

Well, there you go. We do hurt. I mean, we do feel pain, you know, My answer is I, I, you know, lie to my peloton really hard, you know, after a day, you know, and pain varies depending on. I think he does have a point. If a story really resonates with your own experience, that's going to, of course, even more sane. But I'd rather have that pain and help people than not have it, you know.

[Podcast Host]

But how do you not. How do you. Like, like I'm viscerally affected. You guys are not.

[Dr. Brett Sherman]

How, how.

[Podcast Host]

It doesn't appear that way.

[Dr. Ben Shapiro]

Well, we're this, but we're kind of used to that. But. And you're, you know, he's. We're not talking. It's not. You don't have a relationship with the patient. You have a relationship with the patient and like real things who have children. I do have a, I do have a child.

[Podcast Host]

How old are your children?

[Dr. Ben Shapiro]

11.

[Podcast Host]

Okay, you've got 11 year old. So five years ago that child was six. So you don't do what I did. I've got a 12 year old. Automatically I take the 12 year old, I put him back to the 6 year old and I say oh my God. Okay. But it's not just for my personal experience, it's for yours and yours.

[Dr. Brett Sherman]

Yeah, I think also we have our training. For better or for worse does teach you to detach, detach.

[Dr. Ben Shapiro]

But, but when you're caring for somebody, you have a relationship with them. I mean, there's a lot, you go through a lot.

[Podcast Host]

Can you give somebody the same or better care when you actually care about them thousands percent?

[Dr. Brett Sherman]

Actually there's science important.

[Dr. Ben Shapiro]

Yeah.

[Podcast Host]

Give it to me.

[Dr. Brett Sherman]

Well, if you look across therapies, different kinds of therapies, you would think it would matter which kind of therapy. And it does matter some. But the biggest variable that predicts outcome in Any therapeutic experience is the relationship with the patient, the level of empathy the patient feels from the therapist. And it's true for psychiatrists, too, even.

[Dr. Ben Shapiro]

To the point where if you don't have a good relationship with the patient, it's not really, I argue, it's not responsible to take care of them, because it can be.

[Podcast Host]

I got that too. But what you just said was how the patient feels about you. The therapeutic alliance between the patient and you. Right. I'm talking about whether or not when you. Here, let me say it a different way. You've got a friend who's got a child who's struggling, but you love your friend, so you love your friend's child and you're going to do whatever you can to make certain. Then another random guy comes and he introduces you to his kid, and you know you're going to help this kid because this is what you do. Who gets the better treatment?

[Dr. Brett Sherman]

Well, I think the thing is, when you're in treatment with somebody over time, just like anybody and you, and it's a good treatment, you connect with them more and more.

[Dr. Ben Shapiro]

Yeah.

[Dr. Brett Sherman]

And you cannot deliver good care without caring. So occasionally you'll get a patient. You just don't connect. And I have referred people out, you know, like, we're just not a good match.

[Dr. Ben Shapiro]

You know, that doesn't mean there's not like turbulence, but you have to resolve it.

[Dr. Brett Sherman]

Let me tell you one other thing on the subject that I think you'll like, because this isn't just related to therapy. So I. I believe, as a UCLA psychologist, I believe who did a study that looked at the relationship between a psychiatrist and the patient. It was a big drug study that already existed. Right. So like eight psychiatrists, drug versus placebo, nothing to do with therapy. And what she. The question she asked is, do individual psychiatrists get better outcomes just with medication, MERP therapy? And the answer was yes, 25% better. The ones where the patients rated them is more connected had 25% better outcomes. Definitely with.

[Dr. Ben Shapiro]

Okay.

[Podcast Host]

But they had better outcomes with you because they trusted you and they're still talking to you at least once a month. They get better. Yeah. For an hour.

[Dr. Brett Sherman]

Yeah, absolutely. Yeah. So it's still a relationship.

[Podcast Host]

It's even met.

[Dr. Brett Sherman]

Yeah. I don't.

[Podcast Host]

But I don't think that would be the case with just straight meds without. Without having a conversation, you guys.

[Dr. Brett Sherman]

But that's the point is even meds work better if your relationship is good. That's right. That's your point.

[Dr. Ben Shapiro]

Right?

[Podcast Host]

The two.

[Dr. Brett Sherman]

Yeah.

[Podcast Host]

Yes.

[Dr. Brett Sherman]

There is No, I say there is no medication management appointment because there's always a therapeutic element to it. There's always a relationship, as, you know, the therap.

[Podcast Host]

But there are. Here's the thing. Do you know who I love? Who? Who? My favorite psychiatrist is Danny Siegel.

[Dr. Brett Sherman]

Know him well?

[Podcast Host]

Okay. You do?

[Dr. Brett Sherman]

Yeah.

[Podcast Host]

He just wrote a blurb for my book.

[Dr. Brett Sherman]

Yeah.

[Podcast Host]

And I cried.

[Dr. Brett Sherman]

It's a good writer.

[Podcast Host]

It's not even that. It's like, it just says you're legitimate. You know, it's a validation. And you see this? This is 25 years of crack, right? This is like, you know, I remember I owned my last place and I couldn't write a check for bread and eggs and the market because I was in check systems for 10 years and I had like five houses. Yeah, right. It's like you feel a certain fraudulent sureness and then you have, you know, the ambassador to the European Union in your house doing a podcast. Or you have a great, like, Danny Siegel. Right. Or you have a great, like, Dr. Amen that. That, you know, wants to come on your podcast and have you on his. Right. It's like, dude, that's not supposed to happen to people like me. But you guys get it because you take people like me all the time and you can be a testimony to the fact that we're the only group of people where you can find us in a dumpster and seven years later, you're the district attorney, have stories like that.

[Dr. Brett Sherman]

It's amazing. I'm straight.

[Podcast Host]

All right, let's move on. All right. How often are people diagnosed. I'm sorry? How often are people misdiagnosed, given antidepressants or stimulants when what they really need is addiction treatment?

[Dr. Ben Shapiro]

You take that. How often do they hide their addiction?

[Dr. Brett Sherman]

All the time.

[Dr. Ben Shapiro]

If that's what we're talking about. I'd say no, not no.

[Podcast Host]

What I think what the question was to me was how often do psychiatrists misdiagnose a client or a patient, okay. When they really should have just gone to a. A top notch treatment facility.

[Dr. Brett Sherman]

I don't know about the percentages, but I'm just going to say high.

[Dr. Ben Shapiro]

Yeah.

[Dr. Brett Sherman]

I get people all the time, inappropriately, on numerous medications, certainly addictive ones, benzo stimulants, opiates, you know, who often hid their addiction or, you know, don't really even realize they have addiction. You have to be really careful, you.

[Podcast Host]

Know, if you put somebody on Adderall without the sight testing, you're a scumbag. Okay. I mean, I've Done. That I've seen. Please.

[Dr. Brett Sherman]

I mean, that's a strong statement, but I.

[Podcast Host]

All my statements are strong statements, but I'm not married to any of them.

[Dr. Brett Sherman]

If I have any doubt, I get psych testing.

[Podcast Host]

That's right.

[Dr. Brett Sherman]

Because it's so easy now with the Internet and chat gbt. Let me just look up all the symptoms of ADHD and tell this doctor, you see it all the time.

[Podcast Host]

Right?

[Dr. Brett Sherman]

And then, you know, there's snort, natterol, you know, five minutes later. That's right. So I want objective proof. You actually have an attention problem. And the only way to get that is testing to your point.

[Podcast Host]

Right.

[Dr. Brett Sherman]

And otherwise we're doing a subjective assessment, which is easy to fake.

[Podcast Host]

That's right. You know, because drug addicts never lie, so. Never.

[Dr. Brett Sherman]

Never.

[Podcast Host]

All right, let's. We're through this thing. When families bring their loved ones to you, what's the one thing you wish they understood about addiction that almost none of them do?

[Dr. Ben Shapiro]

That it's a disease, that it kind of takes over your will? I think that they don't realize like, how profound it is, how. How deep and how it just controls their life and how important, like, really strict boundaries are and really mysterious limits.

[Dr. Brett Sherman]

I agree with that. It's a paradox, because for families, because in a normally normal family system, somebody's having a problem, you help them out, give them some money, get them an apartment, whatever. And with addiction, it's kind of the opposite. Not that you don't help them out, but you set very strict limits. Like, I can't help you unless you go to treatment. That's the hardest thing. They don't. They often don't get that for a while. It's a process to get them to that point. And since the patient has no will. Right. Someone's gonna have to exert some will.

[Podcast Host]

Yeah. Patient. Yeah.

[Dr. Ben Shapiro]

You know, that was totally way too empowered all the time.

[Podcast Host]

That was the most beautiful answer I've heard in a long time. Yeah. Truthfully. Because that's. That's exact. You're exactly right. You're exactly right. That's exactly how it works. Wow. That. I love that. And you know what I love most about it?

[Dr. Brett Sherman]

Plain spoken, trying to take notes from you. No, no, no, no. Really.

[Podcast Host]

You both trained in the golden age of psychiatry, but now you're working with cutting edge tools. Tools like neuromodulation and sip. You're doing mushrooms.

[Dr. Ben Shapiro]

Oh, I do some psilocybin research.

[Podcast Host]

Psilocybin?

[Dr. Ben Shapiro]

Yeah.

[Podcast Host]

Okay. What do you. What do you trust more? Classic psychotherapy or these new Frontiers. And I didn't mean to, to, to throw water on it. I'm. Hey, listen, I've got a blank canvas, man. I'll give you my thoughts on that, but I, I want to hear yours.

[Dr. Ben Shapiro]

Well, it's not an either or issue. I mean, like we, I'm interested in patients doing better. Like, I'm committed to, like this, their well being. I'm, I'm a patient's doctor. Like, I care about my patients, I want them to do well, and I use whatever tools are necessary, so. And usually you combine them. I mean, that's one of the amazing things with TMS is there's like, we're kind of pushing these, these agenda, this agenda to really involve aspects of therapy. Because when you go through tms, you, you have these periods where you're much more receptive and you can grow more from.

[Dr. Brett Sherman]

He means our company pushes it. And you won't see that in other TMS clinics. They just stay in their lane and give you tms.

[Dr. Ben Shapiro]

Right.

[Dr. Brett Sherman]

We would. Listen, you need to exercise, eat well, get CBT for your OCD or whatever it is, you know, and it's especially important you do that in the next two weeks, in the next two months, because your brain's going to be better at these things. It's synergistic. So. But to answer your question, I mean, I think there's promise in psychedelics, but that's what it is, promise. It is not here. And what I've seen, and you have to be very careful, careful with addicts, bipolar patients, schizophrenia, because you can really mess them up.

[Podcast Host]

Tell the audience about IBO gain. Do you guys know anything about ibo?

[Dr. Brett Sherman]

I have some experience, limited experience, only a couple of patients give it to me.

[Podcast Host]

What does it do first?

[Dr. Brett Sherman]

I, you know, honestly, I couldn't answer that question.

[Dr. Ben Shapiro]

I would. It's very, I mean, it has a lot of dangers associated with it because, because it can really get a lot of cardiac risks. And so that's one of the big issues with that. People don't always understand. I mean, there's a lot of cases that people dying from it.

[Podcast Host]

I don't know as much as I should know about it, but I'm going to know everything about it because I made a decision the other day to try all these new things because I'm in transcendence. I don't care. I couldn't do, I couldn't, I couldn't wreck myself with drugs and alcohol if my life depended on it. Now it's just, you can't treat this Many people. Okay. And do what I've done and still suffer from that particular thing. It just doesn't make sense to me. So I want to try all of this stuff now. You know, I did the toad poison, and that's complete horseshit.

[Dr. Brett Sherman]

Yes. I've had a bunch of patients do that. My experience of ibogaine isn't all that different than other dissociatives or hallucinogens. They're very effective short term. I think the long term is a question. And what I've seen is if that's all you did, whether it was a psilocybin trip, mdma, ibogaine, you did no other therapy after that. Yeah. You're good for two months.

[Podcast Host]

Can you get MDMA from a. From a doctor?

[Dr. Brett Sherman]

No.

[Dr. Ben Shapiro]

No.

[Dr. Brett Sherman]

But there are. But there are.

[Podcast Host]

How do you. Well, how do you. How do you know that there doesn't have fentanyl in it?

[Dr. Brett Sherman]

I mean. Good question. You know, I mean, I. I don't recommend these things, but my patients find practitioners, and some of them are actually pretty good. And what you can see is an amazing transformation in mood or trauma. But then if they don't follow that up, you know, with therapy, it's return, revert. Even ketamine, which is regulated and licensed, it's same problem.

[Dr. Ben Shapiro]

Yeah, they just don't last.

[Dr. Brett Sherman]

They don't last.

[Podcast Host]

Can I tell you what my feeling is on? And I've never done ketamine, so I don't know. And I hate trying that. Man, the drugs are so stupid today. Jesus. All right, but you know, my take on this is truthfully, for the people that have never dropped acid or taken mushrooms, okay? And then their adulthood, they trip once, of course, you see God. Idiot. That's. I mean, that's my take on it, but that's my take. That's my take before prior. That's my contempt. My contemptual take prior to investigation. Okay, so I sound like I'm no different than a. Than an old timer screaming, get off my lawn.

[Dr. Ben Shapiro]

Yeah, but there's a thing that happens with psychedelics to add to that. They also, the. The reason they're therapeutic is they also see themselves in a way without. Like, they can see the trauma they experience. Their. Their ego disconnects from it. They can see some without the pain, and that, that's therapeutic, but it does not necessarily last. And that's the problem.

[Dr. Brett Sherman]

It's a beginning at best.

[Podcast Host]

I think that that's something that you are so smart that you're hoping they see, but that they have no idea that that's what they saw. And the only way to get them to see it is afterwards to kind of guide them into what they actually saw.

[Dr. Ben Shapiro]

Yeah, no, I mean they have, there's, there's a whole school of like psychedelic assistant psychotherapy. And that's what you do. I mean, you kind of guide them and, and you work with them, but you know, like you have.

[Dr. Brett Sherman]

Yeah, yeah, exactly.

[Dr. Ben Shapiro]

But you gotta do. I just, It's. Without that structure around it, it's.

[Podcast Host]

No, it's.

[Dr. Brett Sherman]

And we like science because we're nerds and because it's truth, it matters. And so there just isn't the science in terms of long term treatment. And they're working on it. And so when it comes out where we can know that we don't even know dosing for these, you know, like, well, how much do you give? So people are doing it. These cowboys are doing it, you know, and they're doing it by empirical guessing. And there are some good ones. You know, I've seen some amazing beginnings. I've seen people see stuff, you know, like, and forgive themselves in that experience. And then if they continue, it's a great beginning.

[Podcast Host]

That's right.

[Dr. Brett Sherman]

But if they don't, it just goes away.

[Dr. Ben Shapiro]

Most ketamine patients I have, they just, they returned back within three to six.

[Dr. Brett Sherman]

Months, whether we're talking about mood or trauma, actually, because they use ketamine for depression too. And it's fast, but it doesn't.

[Dr. Ben Shapiro]

That's why we like tms, because it's different.

[Podcast Host]

Which, by the way, if you're going to do TMS and it's so effective. Okay, how are you going to make money?

[Dr. Brett Sherman]

We're going to talk to you.

[Podcast Host]

No, no, my point is that Los Angeles, there's not going to be, I mean, seriously, guys, it's, it's not like you're buying toilet paper where you always need toilet paper. It's not like you're buying Advil where you, you know, it's more like, you know, the treatment that we provide, it is. Right. And so you, you and I know for me, you know, we're only marketing to like a million people in the country out of 330, 35 million people. So, you know, at a certain point that ends, you know, how you're going to treat it.

[Dr. Brett Sherman]

Well, I guess theoretically you could market internationally. Right? Because if they're, if they're getting a cash pay accelerated protocol, you don't have to deal with insurance. I'm talking big. But we don't do this yet. But you Theoretically, I know that the colleague, Dr. Stubman has had people come from China.

[Podcast Host]

Oh yeah.

[Dr. Brett Sherman]

Other countries. So there is 3.5 billion or whatever, or 8 billion, you know, to, to market to, you know, I love him on the podcast.

[Podcast Host]

Yeah, you want.

[Dr. Brett Sherman]

It'll be pretty tight weekly. He, he's on his way out to.

[Dr. Ben Shapiro]

Thailand like the die hard academic.

[Dr. Brett Sherman]

But yeah, he will not make it simple, that's for sure.

[Dr. Ben Shapiro]

But just to kind of go back to your. I mean, even with tms, you still see, you know, relapses, symptoms come back. It's not a permanent treatment. It can be durable though. Can be pretty good.

[Dr. Brett Sherman]

Yeah, it's about.

[Dr. Ben Shapiro]

And it depends on the person.

[Dr. Brett Sherman]

It depends on the person and what else they do. Right. With that.

[Dr. Ben Shapiro]

You got it. There's lots of things we can do.

[Dr. Brett Sherman]

It's about, you know, best data. 50 to 60% of people with just depression will be, well, a year later.

[Podcast Host]

Doctors prescribe opioids, benzos and stimulants, sometimes recklessly from the inside. Do you consider this medical malpractice or just the system failing?

[Dr. Brett Sherman]

It depends.

[Dr. Ben Shapiro]

I think it's a bit of the system failing. I mean, like, you know, there's, the problem is there's a range of opinions. There's like, there's like a range of practices going back to five, 10 years. And some things that people do, I, I don't think are reasonable at all. So I, I think it's a systems issue in part.

[Dr. Brett Sherman]

I, I do think most doctors are well intentioned.

[Podcast Host]

Yeah, I do, I do.

[Dr. Brett Sherman]

And, but yeah, it's a system problem. It's. Sometimes they don't do a thorough evaluation. They don't have any. Listen, when we Both trained at UCLA, okay, 1994-98 for me, there was one addiction rotation in the VA inpatient that there was no addiction fellowship that Tim Fong runs. Didn't exist. So you got a whole generation of psychiatrists that know nothing. They have no idea that probably 30% or more of what walks in their door has a substance abuse problem.

[Podcast Host]

Do you know why that is?

[Dr. Brett Sherman]

Please inform. No, it was terrible, but because in.

[Podcast Host]

Medical school you get one week of addiction. Exactly.

[Dr. Brett Sherman]

That's my point.

[Podcast Host]

Yeah, one week.

[Dr. Brett Sherman]

Yeah. The reason.

[Podcast Host]

Which is why, which is why it's so insane and not you guys, because you guys are in addiction. But when I have another doctor who's not an addiction. Yeah, talk to me about addiction. Yeah, I just like, shut him the up like now.

[Dr. Brett Sherman]

So I got very.

[Podcast Host]

Don't know anything.

[Dr. Brett Sherman]

I got very little training But I realized over time, like, oh my God, I better know something about this. This keeps coming up.

[Podcast Host]

That's right.

[Dr. Brett Sherman]

And so I.

[Podcast Host]

Well, now you're an addiction psychiatrist.

[Dr. Brett Sherman]

Correct. I got the training and you know.

[Podcast Host]

How many of you there are?

[Dr. Brett Sherman]

Not a ton.

[Podcast Host]

1500?

[Dr. Brett Sherman]

I was going to say 2000.

[Podcast Host]

Yeah. 1500 addiction psychiatrists in the country. That's.

[Dr. Brett Sherman]

That's absurd.

[Podcast Host]

It's absurd. And do you know who the president elect is?

[Dr. Ben Shapiro]

And you're.

[Dr. Brett Sherman]

Oh, Dana.

[Podcast Host]

No, no, Dana's not the president elect. Is she the president now?

[Dr. Ben Shapiro]

No, I thought she was on the Maybe.

[Podcast Host]

No, the President elect. Yeah. Dr. Fong.

[Dr. Brett Sherman]

Oh, I did know that, actually.

[Podcast Host]

Isn't that cool?

[Dr. Brett Sherman]

Yeah, actually, I came up in your podcast with him.

[Podcast Host]

Yeah, yeah, Fancy, fancy.

[Dr. Brett Sherman]

He said. Great.

[Podcast Host]

Yeah, I love him. Yeah, I thought.

[Dr. Ben Shapiro]

Yeah, he's great.

[Dr. Brett Sherman]

He was great.

[Podcast Host]

Wasn't he great? You watched the podcast?

[Dr. Brett Sherman]

I did, I did.

[Podcast Host]

He's fantastic. Isn't it?

[Dr. Brett Sherman]

Preparation?

[Podcast Host]

Yeah, yeah.

[Dr. Ben Shapiro]

Don't worry.

[Podcast Host]

I jerked him around too, like the.

[Dr. Brett Sherman]

Whole time just to make all the thing about. I thought he handled your, you know, provocations pretty well, actually.

[Podcast Host]

Yeah, the ones that we didn't. The ones that he didn't handle well. You cut. We cut. Yeah, for sure. Because I want everybody to look like a king here. All right.

[Dr. Brett Sherman]

Thank you.

[Podcast Host]

Carrera was built around therapy first. You're not a 12 step clone for sure. Okay, from your perspective as psychiatrist, why is this approach different? And why does it work for the kind of clients who come here?

[Dr. Ben Shapiro]

I mean, people. You know, people are. Addiction isn't a. Just a relationship with a drug. It's a relationship with yourself that comes first, like some kind of early trauma.

[Podcast Host]

Stop. That was gorgeous. That was so good. Go on. I'm sorry I interrupted you, but it was too good.

[Dr. Ben Shapiro]

Like, it doesn't. It's.

[Podcast Host]

It's.

[Dr. Ben Shapiro]

You're not just a bunch of chemistry, you know, you're a bunch of your experiences and your traumas and like, that's what. That's the underpinning of, like any of those problems. And you have to. You have to know. Know yourself. You have to have somebody who can guide you through it, shepherd you through it.

[Podcast Host]

Those are your glasses, man. That's what you're looking through. Your life experiences and your traumas and your. Just the whole thing. And that's the only thing. You know, it's funny, you know, if I was walking around blind forever and I had my first sponsor in aa and we're driving in my Jeep and I'm literally getting out of the car to look at where we're supposed to be getting back in the car and going. Looking at this street sign. And he goes, dude, you're blind. You need to get your eyes checked. I'm like, no, I don't. Right, right. I went to the doctor for his direction, the optometrist. And he said to me, how long have you been walking around blind? Now, if that's how you see and you don't have anything to compare it to, how the hell do you know you're blind? Right. Same thing. Right.

[Dr. Brett Sherman]

Great metaphor.

[Podcast Host]

What's the metaphor?

[Dr. Brett Sherman]

You know, I'm just kidding. Gone.

[Podcast Host]

My fault.

[Dr. Brett Sherman]

We cut that.

[Podcast Host]

No, that stays.

[Dr. Brett Sherman]

Yeah, you got me. I was like, going to explain what.

[Podcast Host]

I meant for the.

[Dr. Brett Sherman]

I know. Which is ludicrous. You don't think much of me, do you? No, I think you know what I'm saying. Metaphor.

[Podcast Host]

All right, go on.

[Dr. Brett Sherman]

And any. Just answer questions. I know that you're. Therapy is also in, you know, individually specific. AA is a beautiful, you know, community support group structure. It's a support. I mean, I think it. Principles actually overlap with a bunch of different therapeutic principles.

[Dr. Ben Shapiro]

Absolutely.

[Dr. Brett Sherman]

But it is not specific to you and your problems.

[Podcast Host]

It is not.

[Dr. Brett Sherman]

That's the difference.

[Podcast Host]

That's right.

[Dr. Brett Sherman]

You need both. Ideally, you'll.

[Podcast Host]

We need. Look, we need community. Yeah. Okay. But you can find community anywhere.

[Dr. Ben Shapiro]

Yeah. The other thing though is, you know, drugs become. They end up becoming a sense of meaning for the person you. And that has to be replaced. What I'm trying to explain is that when you. When you're addicted to a substance, that substance, it's not just an addiction, it's sort of a belief. It's like an attachment to it. And you need. You need to have. You need to kind of understand. You need to restructure that so that you have your other elements of your life bring meaning out. And so. So it. You replace it.

[Dr. Brett Sherman]

It's.

[Podcast Host]

That's beautiful. You replace what you held as. As most valuable with something of equal or greater value.

[Dr. Ben Shapiro]

Absolutely. And it shouldn't be there to begin.

[Dr. Brett Sherman]

With, which is hard to do, but if you don't do it, you aren't getting clean, in my opinion. Right.

[Podcast Host]

I know somebody who says that all the time. Okay. If you could speak directly to a 16 year old who's about to try out for the first time, what would you tell him?

[Dr. Brett Sherman]

Don't do that. You're gonna die. You know, I would say, are you.

[Dr. Ben Shapiro]

Trying to get out of it?

[Dr. Brett Sherman]

Yeah.

[Podcast Host]

Yeah. What are you trying to get out of It. Yeah. Yeah, I'm. Let's. Well, let's role play that, right? I'm depressed.

[Dr. Ben Shapiro]

Yeah, that's not going to help.

[Podcast Host]

But you don't understand. I go to school every day, and these girls just talk badly about me all day long. They just won't stop. They're bullying me online. Okay? I can't take it. I have no friends. I'm laughed at.

[Dr. Ben Shapiro]

That's horrible. I'm so sorry to hear that, but that's not going to solve it.

[Podcast Host]

We got to find another way. I don't know another way.

[Dr. Ben Shapiro]

Well, that's why you're here.

[Dr. Brett Sherman]

Swear I'm.

[Podcast Host]

Well, you're not giving me any hope. What other way? Because right now the only thing I want to do. Okay. Is check out, because I'm miserable. What do you got for me, doctor?

[Dr. Ben Shapiro]

I got a solution, but it's going to take some time, and we have to kind of spend some time together understanding what. Really understanding what that is and what really understanding your. Your how you're really feeling and how else would come.

[Podcast Host]

I feel like I want to kill myself, but I'm not going to, so you don't have to 5150 me. I'm not contemplating anything. It's just. That's the overwhelming thought that I have. I just don't have the desire or the courage.

[Dr. Ben Shapiro]

But a piece of you've got yourself here today, right?

[Podcast Host]

Yeah, my mother.

[Dr. Brett Sherman]

Yeah. Yeah.

[Dr. Ben Shapiro]

But isn't. Isn't there some. Somewhere in there a piece of you that wants to still live?

[Podcast Host]

There's the piece of me that doesn't want my mother to go through any pain.

[Dr. Ben Shapiro]

So you care about her?

[Podcast Host]

I love my mother.

[Dr. Ben Shapiro]

Okay, well, that's. That's important part of it. That's. That's a. You know, that's part of your. Your part that brought you in here. Your love for her. We got to work with that.

[Podcast Host]

Okay, so you would. So you would leverage her with the love of her family?

[Dr. Ben Shapiro]

I leverage his care. His love for his mother. Not so much her. Maybe her.

[Podcast Host]

Oh. I was a woman. The guy. The guy that I was talking to. Okay. Yeah.

[Dr. Ben Shapiro]

Yeah.

[Podcast Host]

All right. That was beautiful. Yeah.

[Dr. Brett Sherman]

Find some kind of anchor, because there's usually at least something.

[Dr. Ben Shapiro]

Yeah.

[Podcast Host]

All right. Hey, did I leave anything unsaid? Do you guys want to talk about anything? Because you need to say anything. Did you get done what you wanted to get done here? Do you look good? Did you. Did you have any books to promote anything?

[Dr. Brett Sherman]

Books about addiction or books about TMS you wrote? Not yet. Working on it.

[Dr. Ben Shapiro]

He's a dating service?

[Dr. Brett Sherman]

Yeah. Yeah.

[Podcast Host]

You got a dating service?

[Dr. Brett Sherman]

Everyone tells me the app. He's talking about the dating app idea. Everyone tells me to write a book, but I've been busy treating patients for 30 plus years.

[Podcast Host]

Cool. Well, then you got to find somebody to write it with. Another doctor to write it with.

[Dr. Brett Sherman]

He's an excellent writer, actually.

[Podcast Host]

Do you have a book?

[Dr. Ben Shapiro]

Not a recent one. It's a little dry.

[Dr. Brett Sherman]

Okay. It's a little dry. What a shocker.

[Dr. Ben Shapiro]

I actually played a chapter in Ibogaine a lot for some time ago, but.

[Podcast Host]

You wrote a chapter on Ibogaine? Yeah.

[Dr. Ben Shapiro]

For like a Andrew Wild book?

[Podcast Host]

Yeah. With. Fantastic.

[Dr. Ben Shapiro]

Yeah.

[Dr. Brett Sherman]

See you next Tuesday.

[Podcast Host]

And they're good doctors, too. We're out of time. Please subscribe on YouTube. Click the thumbs up and leave a comment. Please subscribe on Apple Podcast and Spotify and leave a rating and a review and share the we're out of time.

[Dr. Ben Shapiro]

Podcast with others you know who will.

[Podcast Host]

Get value out of it.

[Dr. Ben Shapiro]

See you next Tuesday.