Addiction Explained, Rises & Falls in Dopamine | Dr. Andrew Huberman

Summary

The video script discusses addiction, focusing on the role of dopamine in the cycle of addiction. It explains how substances like cocaine cause a rapid and intense increase in dopamine, creating a euphoric high, followed by a steep drop below normal levels. This drop triggers cravings for more, leading to a vicious cycle of addiction. The script also highlights that behavioral addictions, such as those related to video games or pornography, follow similar patterns. It emphasizes the dangers of chasing short-term dopamine spikes and recommends avoiding addictive substances entirely.

Takeaways

• 💊 Addiction is common and involves both biological and psychological aspects, with extreme cases offering valuable insights.
• 📈 There's been an 80% increase in alcohol use disorder among women in the last 30 years.
• 🍷 While two drinks a week may be considered safe for health, zero alcohol is the healthiest option.
• ⚠️ Addiction to substances like alcohol, methamphetamine, and cocaine shares similarities with behavioral addictions like video games or sex.
• 🧠 Addiction leverages the dopamine system, causing a 'progressive narrowing' of pleasurable activities, leading to a focus only on the addictive behavior or substance.
• 🚀 Cocaine causes a rapid spike in dopamine levels, creating a quick but intense reward response, making it highly addictive.
• 📉 After the dopamine peak caused by drugs like cocaine, dopamine levels drop below baseline, leading to cravings for more.
• 🔄 The cycle of addiction involves short, intense dopamine spikes followed by long, deep troughs, driving individuals to seek more immediate rewards.
• 📚 Behavioral and drug addictions make it hard to pursue long-term goals since they provide much shorter dopamine rewards than activities like education or fitness.
• 📖 Dr. Anna Lembke's book, *Dopamine Nation*, explores the science of dopamine and addiction, showing how the brain's reward system shifts toward pain and the pursuit of the addictive substance.

Q & A

What role does dopamine play in addiction?

Dopamine plays a central role in addiction by reinforcing the pleasure and reward systems in the brain. Addictive substances and behaviors cause a sharp increase in dopamine levels, which leads to feelings of pleasure and euphoria. This encourages the person to repeat the behavior or use the substance, despite potential negative consequences.

Why does addiction become more difficult to overcome over time?

Over time, addiction becomes harder to overcome because the brain adapts to the dopamine spikes caused by the addictive substance or behavior. As a result, the peaks of pleasure become lower, while the drops below baseline become deeper, creating a cycle where the person constantly craves more of the substance to feel normal.

What is the significance of the time gap between desire and effect in addiction?

In addiction, the time gap between desire and effect is critical. A short or 'hyper-short' gap, such as that seen with substances like cocaine, leads to faster dopamine peaks, reinforcing the brain's expectation for instant rewards. This makes it harder for individuals to pursue longer-term goals that provide delayed gratification.

How does cocaine impact dopamine levels compared to other activities?

Cocaine causes a dramatic and rapid increase in dopamine levels, much faster than normal activities. The spike is steep and is followed by a sharp drop below baseline. This extreme fluctuation is much greater than what occurs with everyday rewarding activities, which leads to the brain associating cocaine with intense pleasure and craving it more.

What happens to dopamine levels after the initial peak caused by cocaine use?

After the initial peak caused by cocaine use, dopamine levels rapidly drop below baseline, which leads to a feeling of lack of pleasure or even pain. This deep trough in dopamine levels triggers cravings for more cocaine, which starts the cycle of addiction.

How does addiction affect the brain's reward system over time?

Over time, addiction causes the brain’s reward system to shift. The peaks in dopamine become progressively lower with continued substance use, while the drops below baseline become deeper. This leads to less pleasure from the substance and more pain or discomfort in its absence, making the person chase the drug just to feel normal.

What is the relationship between dopamine and long-term goals?

Dopamine plays a role in motivation and pursuit of rewards, but addiction shortens the brain’s reward cycle. Long-term goals, which require delayed gratification, do not provide the immediate dopamine spikes that addictive substances do. This makes it harder for people with addictions to stay motivated for goals that take longer to achieve.

What are process addictions, and how do they relate to dopamine?

Process addictions, such as sex addiction, video game addiction, or pornography addiction, involve compulsive engagement in behaviors rather than substances. Like substance addictions, they leverage the brain’s dopamine system, causing a similar narrowing of pleasure sources, where the addictive behavior becomes the main focus of reward.

Why is avoiding cocaine altogether recommended in the context of addiction?

Avoiding cocaine is recommended because its powerful effects on the brain’s dopamine system make it highly addictive. Even recreational use can quickly lead to financial, psychological, and physical problems, as cocaine reinforces a cycle of extreme pleasure followed by deep lows, driving a person to continue using.

What insight does Dr. Anna Lembke’s book 'Dopamine Nation' offer on addiction?

Dr. Anna Lembke’s book 'Dopamine Nation' explores the role of dopamine in addiction, both for substances and behaviors. It highlights how our modern society, with its abundance of dopamine-triggering activities, contributes to an epidemic of addiction by overloading the brain’s reward circuits and making it harder to experience pleasure from everyday activities.

Outlines

00:00

💉 Understanding Addiction Through Dopamine and Fast Stimuli

The speaker introduces the concept of addiction by exploring its biological and psychological underpinnings, focusing on how the extremes help in understanding more typical cases. Addiction, now more prevalent than ever, can affect both genders, with a striking rise in alcohol use disorder among women. While moderate alcohol consumption is discussed as generally acceptable, the speaker highlights the broader issue of addiction, which includes substances like cocaine and methamphetamine, as well as behavioral addictions (e.g., sex, video games, or pornography). Central to addiction is dopamine, a neurotransmitter that spikes quickly with certain substances or behaviors, like cocaine, leading to intense pleasure and reinforcing the desire for more. The speed at which dopamine levels rise in response to drugs like cocaine creates a strong, almost automatic association between the stimulus (drug) and the reward (dopamine rush), making longer-term goals less appealing. The more immediate and steep the dopamine surge, the harder it becomes to focus on delayed gratification, which helps explain the addictive pull of substances like cocaine.

05:03

⚠️ The Vicious Cycle of Dopamine and Addiction

Addiction doesn’t just cause a drop in pleasure; it triggers a continuous desire for more, setting up a cycle where individuals chase fast dopamine peaks, like those from drugs such as cocaine. The speaker emphasizes the dangers of even trying highly addictive substances like cocaine. Quoting Dr. Anna Lembke's 'Dopamine Nation,' the speaker explains that after a significant dopamine peak from drug use, the drop below baseline becomes more prolonged, making it harder to feel normal without more of the drug. Over time, the body adapts, leading to lower dopamine peaks and deeper troughs, shifting the individual away from experiencing pleasure and more toward avoiding pain and withdrawal. This explains the escalating pattern of use in addiction.

Keywords

💡Addiction

Addiction refers to a compulsive engagement in rewarding stimuli, despite negative consequences. In the video, addiction is a central theme and is linked to both substance use (e.g., alcohol, cocaine) and behaviors (e.g., video games, sex). The speaker highlights how addiction leverages the dopamine system, causing individuals to focus on one source of pleasure while ignoring other, healthier activities.

💡Dopamine

Dopamine is a neurotransmitter that plays a key role in the brain’s reward system. In the context of the video, dopamine is crucial to understanding addiction. When someone engages in addictive behavior, dopamine levels rise sharply, causing a temporary feeling of pleasure or euphoria. However, this is followed by a drop below baseline, which drives the individual to seek more of the substance or behavior.

💡Alcohol Use Disorder

Alcohol use disorder is a condition characterized by the inability to control alcohol consumption despite negative consequences. The video mentions an alarming statistic showing an 80% increase in alcohol use disorder among women in the last 30 years. The speaker warns that while moderate alcohol consumption might be acceptable for some, excessive drinking can lead to addiction.

💡Dopamine Peak

A dopamine peak refers to the rapid and high increase in dopamine levels that occurs when someone engages in addictive behavior, such as using cocaine. In the video, the speaker explains that the faster and higher the dopamine peak, the more addictive the substance or behavior becomes, reinforcing a cycle of dependency.

💡Below Baseline

Below baseline describes the drop in dopamine levels after a dopamine peak, which can lead to feelings of discomfort or pain. In addiction, this drop prompts the individual to seek more of the addictive substance to avoid the negative feelings. The video emphasizes how the dopamine levels fall below normal after using drugs like cocaine, leading to a vicious cycle of addiction.

💡Short Contingency

Short contingency refers to the brief time gap between a stimulus (such as taking a drug) and the resulting dopamine spike. The video explains that addiction is often reinforced by this short contingency, as the brain quickly learns to associate the substance with a rapid dopamine increase, making it harder to resist and favoring instant gratification over long-term rewards.

💡Process Addiction

Process addiction involves compulsive engagement in a behavior that triggers the brain’s reward system, such as video gaming, gambling, or pornography use. The video discusses how process addictions, like substance addictions, manipulate the dopamine system, causing individuals to focus on a single activity to the detriment of other areas of their lives.

💡Cocaine

Cocaine is a powerful stimulant drug that dramatically increases dopamine levels in the brain. In the video, cocaine is used as an example of a substance that causes rapid dopamine peaks, reinforcing its addictive potential. The speaker explains that cocaine's effects on the brain’s reward system make it highly addictive, with severe psychological and physical consequences.

💡Opioid System

The opioid system in the brain is responsible for regulating pain and reward. In the video, the speaker briefly mentions that addiction involves not only dopamine but also the opioid system, which contributes to the reinforcing effects of addictive substances. Drugs like heroin and prescription painkillers primarily affect the opioid system, leading to a powerful addiction.

💡Dopamine Nation

Dopamine Nation is a book by Dr. Anna Lembke that explores how dopamine influences addiction, not just in terms of drug use but also behavioral addictions. The video recommends this book as an excellent resource for understanding the science behind dopamine and addiction, and how modern society has created an environment ripe for addiction due to the easy access to dopamine-inducing stimuli.

Highlights

Addiction is often best understood by examining the extremes first, which helps to clarify more typical cases.

There has been an 80% increase in alcohol use disorder among women in the past 30 years.

While alcohol in moderation is generally fine, two drinks per week is likely acceptable from a health perspective, but zero is ideal.

Alcoholism, along with addictions to methamphetamine, cocaine, and behaviors like sex or video games, involves dopamine and the brain's reward systems.

Addictions involve a progressive narrowing of what brings a person pleasure, making it hard for anything other than the addiction to feel satisfying.

In addiction, dopamine is central, but other systems like the opioid system can also be involved.

Addictive substances like cocaine produce rapid and high peaks in dopamine, which the brain learns to associate with the substance.

Because the time between using cocaine and feeling the effects is so short, the brain is trained to expect instant gratification.

This short-term reward system makes it harder to pursue long-term goals, like fitness or education, because they do not offer quick dopamine rewards.

Higher dopamine peaks are followed by steep drops below baseline, which can create feelings of discomfort and craving for more.

The cycle of craving and seeking dopamine becomes a vicious loop, making addiction very difficult to break.

One of the key strategies to avoid addiction is simply not to try substances like cocaine, as even recreational use can quickly lead to problems.

Dopamine Nation, a book by Dr. Anna Lembke, explores the concept of addiction through the lens of dopamine, offering insight into both drug and behavioral addictions.

After a dopamine peak from substance use, it takes a much longer time for dopamine levels to return to baseline.

Repeated substance use results in progressively lower dopamine peaks and deeper troughs, shifting the system towards pain and the pursuit of the drug rather than pleasure.

Transcripts

Let's just think about addiction,

because in biology and in psychology, frankly,

it really often pays to think about the extremes first

and then work our way towards more typical circumstances.

Now with that said,

addiction unfortunately, is very common nowadays.

I just heard a statistic, in fact, that there is an 80% increase

in alcohol use disorder among women in the last 30 years.

I talked a little bit about this

in the episode that I did about alcohol and health.

Again, I want to be very clear.

I'm not somebody that is completely against alcohol for adults,

provided they're not alcoholics.

Turns out two drinks a week, probably fine health-wise.

Zero would be better if we're honest.

Zero is better than any alcohol.

But two drinks a week is probably fine.

Past two drinks, you start running into problems.

Yet many, many people out there, male and female alike

suffer from alcohol use disorder, also called alcoholism.

The same is also true for things like methamphetamine

or cocaine or other types of substance addictions.

The same is also true for a lot of behavioral

or what are sometimes called process addictions.

Things like sex addiction or video game addiction,

or any type of behavior that, frankly, is leveraging the dopamine system,

but that engages this progressive narrowing

of the things that bring someone pleasure such that nothing else is really salient.

Nothing else is really pulling them in

in the way that their video games or sex or pornography or alcohol.

Pick your substance or behavior that you see out there,

or hopefully not,

that you might suffer from an addiction to.

What's happening in addiction?

Well, addiction involves dopamine, among other things,

often the opioid system, etc.

But if we were to think about what's the stimulus in an addiction

and what's the peak in dopamine,

and then what happens after that peak,

it all becomes very clear as to why addiction happens

and why it's so pernicious.

For instance, let's take cocaine.

Cocaine causes dramatic increases in dopamine very, very fast.

If somebody craves cocaine, what are they craving?

They're craving that dopamine peak.

They're craving the increased level of alertness.

They're craving a number of things associated with the feeling of being

under the influence of the drug.

But the stimulus for it simply becomes that line of cocaine.

Or in the case of crack,

that crack rock that they're going to smoke

and God forbid they're mainlining it, they're shooting into a vein.

What happens is they snort, smoke, or inject cocaine

and dopamine levels almost immediately go up to a very high peak.

The time gap between the stimulus and the dopamine is very, very short.

So short, in fact, that there's really no other contingencies in between

that the mesocortical system has to learn.

In fact, what does the system "learn"?

It learns cocaine equals massive amounts of dopamine

equals feeling euphoric and energetic, etc.

In doing that, it reinforces the whole circuit

so that that short,

we can even say hyper-short contingency is really what the system wants.

So much so that longer contingencies of, say,

putting in the hard work of generating a fitness program

or a professional program for yourself

or an education program which takes not just many days

but many weeks and years,

well, none of that is going to lead to peaks in dopamine

that are as high as the peak in dopamine associated with cocaine.

That tells us something critical.

It is both the duration between desire and effect.

When I say effect,

I mean the rewarding properties of dopamine that are experienced.

That's important.

Very short gaps teach the system to expect and want short gaps.

Makes it very hard to pursue things that take longer.

When we say it's the short, or in this case, hyper-short distance

or time between the stimulus and the dopamine,

what we're really talking about,

if we were to plot this out on a board or on a piece of paper,

is the steepness of the rise of that peak.

It's very, very steep.

The peak in dopamine is coming up very fast after the desire.

In addition to that, and this is very important,

the higher the peak in dopamine and the faster the rise to that peak,

the further below baseline the dopamine drops after the drug wears off.

In the case of cocaine,

it's a very fast and very large rise in dopamine,

followed by a steep drop

and very deep trough in dopamine below baseline.

You say, okay, so there's pleasure, then there's lack of pleasure.

But it's worse than that because it's not just lack of pleasure.

If you recall what we talked about a little bit earlier,

that drop below baseline triggers the desire and the pursuit for what?

For more.

This sets in motion a vicious loop

where people start pursuing peaks in dopamine

that can come very fast without much effort.

That's one of the ways in which addiction start to take hold.

There's a simple way to think about this

and to remember if you want to avoid this whole thing.

I mean, the first one is obvious, don't do cocaine.

Don't try it. Don't use it.

Certainly don't get addicted to it.

Those are all one in the same, frankly.

I don't know many people that despite opinions to the contrary

that use cocaine recreationally, that don't at some point run into either

a financial, psychological, physical, or some other problem.

The other thing that's absolutely critical to keep in mind,

and this was discussed in my colleague Dr. Anna Lembke's book,

Dopamine Nation and on this podcast.

Excellent book, by the way.

I highly recommend it if you haven't read it already.

It's a fascinating exploration into dopamine as it relates to addiction,

not just drug addiction, but other types of addiction.

Again, the name of that book is Dopamine Nation.

We'll provide a link to it in the show notes captions.

The other thing that happens

after those big, fast increases in dopamine caused by things like cocaine

is afterwards when it quickly drops below baseline,

it takes a much longer time to get back to the original baseline

than it did prior to using the drug.

Worse still, is that the peaks in dopamine that are created

from more consumption of cocaine leads to progressively lower peaks

and deeper troughs below baseline.

The whole system is shifting away from pleasure

and more to pain and the desire for pursuit of the drug.