With the new year in full swing, people are considering resolutions and asking themselves what habits they need to change. For me, my negative habits almost entirely revolve around technology. Too much time checking social media, email, browsing Twitter and YouTube, going down the cat video abyss. Skimming news, articles, photos, and videos, diminishes the attention span and leaves one feeling empty, restless, and in greater need of a “fix.” It’s a socially acceptable drug, but no less addicting than the others.
Lembke, medical director of Stanford Addiction Medicine, asks us in her book Dopamine Nation: Finding Balance in the Age of Indulgence (Dutton 2021),
Why, in a time of unprecedented wealth, freedom, technological progress, and medical advancement, do we appear to be unhappier and in more pain than ever?
Her thesis? In short, we’re addicted to dopamine, commonly referred to as the “pleasure chemical” in the brain. Lembke asserts that indulging in pleasure and comfort paradoxically lessens our pain tolerance. Addiction to pleasure creates a void of pain. She writes,
“We’ve transformed the world from a place of scarcity to a place of overwhelming abundance: Drugs, good, news, gambling, shopping, gaming, texting, sexting, Facebooking, YouTubing, tweeting…the increased numbers, variety, and potency of highly rewarding stimuli today is staggering. The smartphone is the modern-day hypodermic needle, delivering digital dopamine 24/7 for a wired generation.”
The addictive cycle in the brain, called “neuroadaptation,” causes us to need the drug in question more intensely after every use but with ever-diminishing returns. Experts point this out about pornography addiction. The longer one watches pornography, the more the user needs hardcore material to deliver the same “hit.” But after each use, the sense of emptiness and pain is palpable. Lembke relates this problem to the opioid crisis, writing about patients who seemed to be experiencing more pain after taking such drugs:
“Exposure to opioids had caused their brain to reset its pleasure-pain balance to the side of pain. Now their original pain was worse, and they had new pain in parts of their body that were formerly fine.”
While of course, some patients do have psychiatric disorders that require such medication, Lembke believes that many people are making their problems far worse by “self-medicating.” She notes how one teenager came to her with anxiety about her cannabis addiction, but in fact, it was the pot and her dependency on it that was causing her real issues. The teen, Delilah, said, “I put so much time and mental effort into organizing my next high, rushing off to do it. It’s such a relief not to have to do that anymore.” Lembke connects this adolescent experience to her adult patients’ addiction to opioids and other pain-relieving drugs.
Lembke also believes brutal honesty and truth-telling are the only way to heal from one’s addictions. We must take responsibility to be free. She even references Alcoholics Anonymous as a model for recovery. Telling the truth within safe relationships is key. She writes,
While truth-telling promotes human attachment, compulsive overconsumption of high-dopamine goods is the antithesis of human attachment. Consuming leads to isolation and indifference, as the drug comes to replace the reward obtained from being in relationship with others.”
While resolving to spend less time on the phone or to quit smoking or porn or over-shopping might be a short-term solution, Lembke notes that the addict must replace those habits with relationship and honesty.
Lembke encourages readers to abstain from the sources of dopamine overload for at least a month to regain their pleasure/pain balance and to “immerse yourself fully in the life you’ve been given. To stop running from whatever you’re trying to escape, and instead to stop, and turn and face whatever it is.”