Dr. Anna Lembke

In my clinical experience, kind of no matter the drug and no matter the sort of severity of the attachment,

If people can go for about three to four weeks, they generally, not always, but about 80% of folks feel better and experience less craving.

But if they only go for two weeks or less, they do not typically get out of that vortex of craving.

And then they don't also kind of, you know, believe in the experiment, right?

Because they feel like, oh, it didn't work for me.

It's like, well, how long did you abstain?

Because it really needs to be long enough, you know, again, for those metaphorical gremlins to hop off and for sort of baseline reward to be reset.

That's right.

Exactly.

And you're moving toward a good place.

So it's reframing the dopamine fast or the abstinence trial as not denying ourselves a reward, but actually doing something healthy, moving toward a better life.

Great.

So getting back to dopamine fasting and the pleasure pain balance, we're encouraging people to abstain for a period of time, minimum four weeks, from their drug of choice to allow those gremlins to slowly hop off.

It takes time so that homeostasis can be restored.

But hypothetically, we can speed up that process by intentionally pressing on the pain side of the balance.

So, for example, there are studies showing that people in withdrawal from alcohol and drug addiction, if they engage in vigorous exercise, they can decrease the symptoms of withdrawal.

They can get to a place where they're feeling more of a strong recovery, and they can actually prevent or decrease their risk of relapse just by engaging in exercise.

Why?

Well, again, using this metaphor to sort of visualize what might be happening in the brain is that if we intentionally now press on the pain side of the balance, those gremlins, those metaphorical gremlins will go to the pleasure side and we can get our dopamine indirectly by paying for it up front.

And the classic example of this is the runner's high, right?