Anna Lembke

very severe addictions potentially, and that's probably about 10 to 15 percent of the population.

But again, I think the segment of the population struggling with addiction is growing because of our modern ecosystem.

It's true that different people have different vulnerabilities to the problem of addiction.

We used to call this the addictive personality.

Now we use the language of the disease of addiction, and some people are more vulnerable to the disease of addiction than others.

Addiction is a complex biopsychosocial illness, meaning that there are biological contributors, psychological contributors,

and social contextual contributors.

So when we look at the biological or inherited aspect of addiction, we do know that individuals who have a biological parent or grandparent addicted to alcohol in particular

are more vulnerable than the general population of becoming addicted to alcohol themselves, even if raised out of that alcohol-using home.

So that's important because the psychological piece is that if we are raised in a home where our caregivers are either explicitly or implicitly condoning substance use or other addictive behaviors, we are more likely to get addicted ourselves.

So then you have this kind of psychological or nurture aspect

which is also biological in the sense that of epigenetics and how our experiences will turn on and off certain genes making certain proteins, which also can potentially be passed on to the next generation.

This is why things like multigenerational trauma, for example, also increase the risk of addiction.

And then finally, you have the social or contextual factors, which is, for example, simple access.

If you live in an environment where drugs are readily available, you're more likely to try them and hence more likely to get addicted to them.

And of course, that's what Dopamine Nation is all about.

Right.

So addiction, when I use that word, is intended to denote a form of psychopathology or mental illness.

And it's always important to clarify that there is no brain scan or blood test or other objective measure of addiction.

We base the diagnosis on phenomenology, that is to say, patterns of behavior of continued compulsive use despite harm to self or others.