Dr. Anna Lembke

But if they're then exposed to a very painful foot shock, right, so a very extreme physical pain, which you could equate to a serious life stressor, the first thing the rat will do is run over to the lever and start pressing for cocaine.

But if they're then exposed to a very painful foot shock, right, so a very extreme physical pain, which you could equate to a serious life stressor, the first thing the rat will do is run over to the lever and start pressing for cocaine.

which tells us that once our brain has discovered a drug that releases a lot of dopamine in our reward pathway, even after we stop using that drug, if we are exposed to an extreme stressor, Our brain will tell us immediately, go and do that thing that gives us a lot of dopamine because you are under stress and I need to be relieved of stress. Does that make sense? It makes perfect sense.

which tells us that once our brain has discovered a drug that releases a lot of dopamine in our reward pathway, even after we stop using that drug, if we are exposed to an extreme stressor, Our brain will tell us immediately, go and do that thing that gives us a lot of dopamine because you are under stress and I need to be relieved of stress. Does that make sense? It makes perfect sense.

Right, and we see that again and again in people in sustained recovery from addiction, that when they are under stress, that is a trigger potentially for them to relapse. So they have to be really thoughtful in their lives for, number one, trying to avoid stressful situations. And by the way, stress can come in many different forms.

Right, and we see that again and again in people in sustained recovery from addiction, that when they are under stress, that is a trigger potentially for them to relapse. So they have to be really thoughtful in their lives for, number one, trying to avoid stressful situations. And by the way, stress can come in many different forms.

There's a great acronym in Alcoholics Anonymous called HALT—hungry, angry, lonely, tired— Those kinds of stressors, everyday stressors, which we all experience, hungry, angry, lonely, tired, can trigger us to want to use. So people in recovery have to be really thoughtful about not getting too hungry, not getting too angry, not getting too lonely, and not getting too tired.

There's a great acronym in Alcoholics Anonymous called HALT—hungry, angry, lonely, tired— Those kinds of stressors, everyday stressors, which we all experience, hungry, angry, lonely, tired, can trigger us to want to use. So people in recovery have to be really thoughtful about not getting too hungry, not getting too angry, not getting too lonely, and not getting too tired.

Oh my gosh, yeah. So that's the bulk of my career, is working with people with all different kinds of addictions.

Oh my gosh, yeah. So that's the bulk of my career, is working with people with all different kinds of addictions.

I had a patient who was addicted to water. I know, hard to imagine. You have to, though, understand her narrative. So she had a very severe alcohol addiction. She got into recovery from that addiction and gave up alcohol. But she discovered that by drinking copious amounts of water, she could become hyponatremic, meaning that she could –

I had a patient who was addicted to water. I know, hard to imagine. You have to, though, understand her narrative. So she had a very severe alcohol addiction. She got into recovery from that addiction and gave up alcohol. But she discovered that by drinking copious amounts of water, she could become hyponatremic, meaning that she could –

lower the sodium levels in her bloodstream, which would then lead her to become delirious. And so in her desire to just be checked out, she would do that. She would drink large amounts of water.

lower the sodium levels in her bloodstream, which would then lead her to become delirious. And so in her desire to just be checked out, she would do that. She would drink large amounts of water.

No, sadly, she's not. She ended up taking her own life. So that was very sad.

No, sadly, she's not. She ended up taking her own life. So that was very sad.

Yeah, you know, I'm just speaking broadly. For some patients with severe addiction, trauma is a huge factor, especially severe early childhood trauma. But there are also many folks we see who have kind of great parents and have had happy childhoods and have great social networks and work that they enjoy, and yet they still become addicted.

Yeah, you know, I'm just speaking broadly. For some patients with severe addiction, trauma is a huge factor, especially severe early childhood trauma. But there are also many folks we see who have kind of great parents and have had happy childhoods and have great social networks and work that they enjoy, and yet they still become addicted.

And that's because we, again, we are wired to consume as much as possible of whatever releases dopamine in our brains to have survived evolution to this date, and yet we're living in this world where we have access to so many different drugified substances and behaviors that we've all become vulnerable to this problem.

And that's because we, again, we are wired to consume as much as possible of whatever releases dopamine in our brains to have survived evolution to this date, and yet we're living in this world where we have access to so many different drugified substances and behaviors that we've all become vulnerable to this problem.