We discuss: 0:01:11 - The role of dopamine and the prefrontal cortex in addiction 0:12:18 - The clinical definition of addiction and the behavioral criteria for diagnosing it 0:16:44 - Assessing alcohol use: patterns, risks, and addiction diagnosis 0:21:38 - Applying the addiction diagnosis framework using gambling as an example 0:25:48 - Exploring addiction variability: how nature, nurture, and access shape individual vulnerability and drug of choice 0:43:33 - How abstinence from addictive behaviors can help reset the brain’s reward system and improve mental health 0:54:29 - Safely abstaining from addiction substances, drugs needing medical supervision, and other key considerations 1:02:40 - Transitioning from abstinence to long-term recovery: tools and considerations 1:13:18 - Exploring behavioral addictions like sex addiction, and the gender differences in addiction patterns 1:19:13 - Factors contributing to the increasing levels of addiction across the world 1:30:21 - How online pornography can affect young boys' developing brains and lead to addictive behaviors, and strategies for parents to address this issue 1:43:05 - The link between social media use and declines in mental health, potential solutions, and protective measures 1:53:32 - How exercise affects brain chemistry, the role of dopamine and endorphins, and how exercise can become addictive 1:57:04 - Cold-water immersion for mood regulation, and other healthy coping strategies 2:04:47 - The “marshmallow experiment”: how broken promises affect behavior and trustworthy environments help children develop self-control 2:09:30 - Can GLP-1 agonists be useful in treating addiction? 2:17:57 - The benefits of 12-step programs 2:24:14 - Why understanding a patient’s story is essential for meaningful psychiatric care
What a great interview Peter ! Anna Lembke is clearly an exceptional person with so much to give. I am grateful for her honesty and insights. Thankyou !
It's sad I thought this was a botted comment at first just because of how many bot book reccomendations I've seen lately. Wish I didn't have to automatically doubt everything I read nowadays :(
Haven't checked out her book quite yet but Outlive DEFINITELY changed the way I look at health, also I'm coming from a background with most of my life struggling with addiction issues, and I'm only 33, i believe her book will be the one that makes sense for my life
Great to see Dr. Anna Lembke on the show… I read her book “Dopamine Nation” awhile back, and watched her talks. It is so great to hear her talking about this topic in depth again.
Thank you Dr Lembke for all your insights on this subject matter. Your knowledge level and communication skills makes it easy to grasp the complexities of addiction
Dr lembke is a great resource for learning about addiction . Always learn a lot from her talks. Glad to see her on here . Must read dopamine nation soon
Most addicts whose physical addiction has ended discover the memories or emotions that their addiction(s) are blocking, and then address them. It really isn't that baffling. It IS really, really hard to face.
Dr.Peter I would have never guessed in a million years you went through addiction. Thank you for sharing this, for those of us who have, and are currently struggling - it’s very inspirational.
So many have dealt with issues like addiction or depression or whatever illness (sign of the times) but good to see them overcome it and spread the knowledge about how to do it along.
This is kind of random but regarding the marshmallow test...it just occurred to me, did they offer other treat choices? I don't like marshmallows at all. If you tell me I get two if I wait fifteen minutes my main question would be if I can leave immediately if I eat it. We assume all kids are incentivized by food to equivalent degrees but some kids have treats at home and some don't, we have a whole category of garbage foods in our house and if someone offers them to the kids at school (chocolate milk for example) they're either just things we don't eat OR there's a precedent of an at-home reward for making the hard choice to skip it. So offer my son two marshmallows and he's going to wonder if that will mean he has to do extra exercise for the day or if he won't get carrot juice+kefir etc.
42:14 Perhaps, (unconsciously) the risk of not stoping the Rx was going to be higher, and could have impacted your life at a deeper level (e.g health, career, death, etc), than the risk you are taking on online shooping (bc it is not aftecting you greatly-yet). In other words, higher risk versus lower risk. I also believe that our external actions, have an underlying internal cause (knownly or unknownly). Perhaps, we create pathways to “feel good” or “escape” to avoid feeling pain, unresolved trauma, or some sort of fear or inadequacy. I also believe that the immediacy of information and accessiblility is huge; that without even pointing out how the algorithm may be rewriring our brain, and solidifying our worse tendencies! (btw, this could be a great topic to discuss!). I also wonder if some personality traits are more prompt to lead to sound change. Great conversation! Congrats.
I’ve been taking 100 mg tramadol for about 6 years. Sometimes I wonder if im addicted but im old and an athlete w issues so i just assume its ok if i dont have to up the dose. Mr dr won’t prescribe it but he knows I take it and is fine with it. I don’t consider myself addictive type I don’t drink or shop etc.
The state during which there is an even chance of winning and losing for gamblers being an addictive 'sweet spot' is interesting and makes me wonder about how that translates to internet algorithms and what is clearly going on with this '24 election cycle. It seems that there is almost a built-in mechanism now in all media (both social and legacy media) that seems to want to make all outcomes seem possible to all people at all times. interesting stuff.
We discuss:
0:01:11 - The role of dopamine and the prefrontal cortex in addiction
0:12:18 - The clinical definition of addiction and the behavioral criteria for diagnosing it
0:16:44 - Assessing alcohol use: patterns, risks, and addiction diagnosis
0:21:38 - Applying the addiction diagnosis framework using gambling as an example
0:25:48 - Exploring addiction variability: how nature, nurture, and access shape individual vulnerability and drug of choice
0:43:33 - How abstinence from addictive behaviors can help reset the brain’s reward system and improve mental health
0:54:29 - Safely abstaining from addiction substances, drugs needing medical supervision, and other key considerations
1:02:40 - Transitioning from abstinence to long-term recovery: tools and considerations
1:13:18 - Exploring behavioral addictions like sex addiction, and the gender differences in addiction patterns
1:19:13 - Factors contributing to the increasing levels of addiction across the world
1:30:21 - How online pornography can affect young boys' developing brains and lead to addictive behaviors, and strategies for parents to address this issue
1:43:05 - The link between social media use and declines in mental health, potential solutions, and protective measures
1:53:32 - How exercise affects brain chemistry, the role of dopamine and endorphins, and how exercise can become addictive
1:57:04 - Cold-water immersion for mood regulation, and other healthy coping strategies
2:04:47 - The “marshmallow experiment”: how broken promises affect behavior and trustworthy environments help children develop self-control
2:09:30 - Can GLP-1 agonists be useful in treating addiction?
2:17:57 - The benefits of 12-step programs
2:24:14 - Why understanding a patient’s story is essential for meaningful psychiatric care
Anna Lembke is a gift to the world. Thank you Dr Attia for sharing this very important information.
What a great interview Peter ! Anna Lembke is clearly an exceptional person with so much to give. I am grateful for her honesty and insights. Thankyou !
"Dopamine Nation" and "Outlive" are life changing books. Really enjoyed both and learned a lot. This is a great collaboration!
It's sad I thought this was a botted comment at first just because of how many bot book reccomendations I've seen lately.
Wish I didn't have to automatically doubt everything I read nowadays :(
@@MrAdoinc I'm a real person!
@@MrAdoinc lol now that I read my original comment I can see how it sounds half-robotic 🤖 😂
@@MrAdoinc skepticism is, unfortunately, a wise way to navigate the world these days. I'm the same way. you're just being prudent.
Haven't checked out her book quite yet but Outlive DEFINITELY changed the way I look at health, also I'm coming from a background with most of my life struggling with addiction issues, and I'm only 33, i believe her book will be the one that makes sense for my life
Brilliant. Dr Lembke is a great teacher and subject matter expert
Great to see Dr. Anna Lembke on the show… I read her book “Dopamine Nation” awhile back, and watched her talks. It is so great to hear her talking about this topic in depth again.
Thank you Dr Lembke for all your insights on this subject matter. Your knowledge level and communication skills makes it easy to grasp the complexities of addiction
Dr lembke is a great resource for learning about addiction . Always learn a lot from her talks. Glad to see her on here . Must read dopamine nation soon
Addiction continues to be baffling, even when I am armed with all the knowledge. Sugar and food comes to mind. Love this info. Thank you!
Most addicts whose physical addiction has ended discover the memories or emotions that their addiction(s) are blocking, and then address them. It really isn't that baffling. It IS really, really hard to face.
Thank you for the work that you do in spite of the emotional cost!
Great to see Anna Lembke here! The topic is what I often took lightly until got in a couple of them myself.
Dr.Peter I would have never guessed in a million years you went through addiction.
Thank you for sharing this, for those of us who have, and are currently struggling - it’s very inspirational.
So many have dealt with issues like addiction or depression or whatever illness (sign of the times) but good to see them overcome it and spread the knowledge about how to do it along.
Amazon shopping? I mean it could definitely be worse lol
@@SF_Nativelmao
Thanks for this superb conversation!
49:45 the "balance/teeter-totter" model I read in the book really made sense. Addicted people over-develop their "pleasure" side.
Thank you so much 🎉❤
Thank you both 🙏
I enjoyed this talk. Well done.
1:29:40 amazing. I've always known.... And much of it will continue for as long as we continue to be consumers
This is kind of random but regarding the marshmallow test...it just occurred to me, did they offer other treat choices? I don't like marshmallows at all. If you tell me I get two if I wait fifteen minutes my main question would be if I can leave immediately if I eat it. We assume all kids are incentivized by food to equivalent degrees but some kids have treats at home and some don't, we have a whole category of garbage foods in our house and if someone offers them to the kids at school (chocolate milk for example) they're either just things we don't eat OR there's a precedent of an at-home reward for making the hard choice to skip it. So offer my son two marshmallows and he's going to wonder if that will mean he has to do extra exercise for the day or if he won't get carrot juice+kefir etc.
1:42:35 OMG so true!
I think a decent definition of 'social media' is necessary to any related research. There are so many different types of social media.
Master class ✅
I now have a 3rd heroine ❤
42:14
Perhaps, (unconsciously) the risk of not stoping the Rx was going to be higher, and could have impacted your life at a deeper level (e.g health, career, death, etc), than the risk you are taking on online shooping (bc it is not aftecting you greatly-yet). In other words, higher risk versus lower risk.
I also believe that our external actions, have an underlying internal cause (knownly or unknownly). Perhaps, we create pathways to “feel good” or “escape” to avoid feeling pain, unresolved trauma, or some sort of fear or inadequacy.
I also believe that the immediacy of information and accessiblility is huge; that without even pointing out how the algorithm may be rewriring our brain, and solidifying our worse tendencies! (btw, this could be a great topic to discuss!).
I also wonder if some personality traits are more prompt to lead to sound change.
Great conversation! Congrats.
I’ve been taking 100 mg tramadol for about 6 years. Sometimes I wonder if im addicted but im old and an athlete w issues so i just assume its ok if i dont have to up the dose. Mr dr won’t prescribe it but he knows I take it and
is fine with it. I don’t consider myself addictive type I don’t drink or shop etc.
Way more insightful than Hubermans asinine takes on dopamine
She was on one of his shows, but I feel he didnt get her completely. I found about her through there
2:28:06 Last section
Glp-1 agonists make hangovers agony.
hey show notes link is broken
Phenomena
The state during which there is an even chance of winning and losing for gamblers being an addictive 'sweet spot' is interesting and makes me wonder about how that translates to internet algorithms and what is clearly going on with this '24 election cycle. It seems that there is almost a built-in mechanism now in all media (both social and legacy media) that seems to want to make all outcomes seem possible to all people at all times. interesting stuff.
4 drinks a day needing medical intervention ? Just stop it pls