This week’s episode with Dr. Anna Lembke explores what drives addictions and how to overcome them. Dr. Lembke is the medical director of Stanford's Addiction Medicine center, in addition to being a practicing psychiatrist and helping patients with their addictions. Her recent book, Dopamine Nation: Finding Balance in the Age of Indulgence takes a deep look at the epidemic of addition -- not only to opioids and other hard drugs, but to a surprisingly broad range of rewarding activities including food, gambling, sex, shopping, the internet and smartphones. In Dopamine Nation, Anna lays out the behaviors and brain processes that underly addictions, including the central role played by dopamine. Her book also describes a number of practical and successful strategies that people use to overcome their addictive behaviors, restore balance to their lives, and keep dopamine in check. Here is a guide to topics discussed in this podcast episode. Time Topic0:00 Intro1:20 How Anna got involved in treating addiction disorders.3:30 The definition and diagnosis of addiction, beyond hard drugs9:44 How food has become addictive.10:15 Addiction to smart phones and digital media11:25 Addiction to exercise12:10 Addition to cannabis13:10 The role of evolutionary mismatch in addiction15:00 Four reasons that modern humans are more vulnerable to addiction.17:30 How “gamification” makes experiences more addictive20:20 The role of dopamine in normal behavior and addiction27:35 How cravings arise from a maladaptive dopamine deficit state30:15 The Opponent Process theory and hedonic setpoint change33:40 Anna’s metaphor of a “see-saw” balance of pleasure and pain41:10 Neurotransmitters other than dopamineStrategies to overcome addiction and restore balance:43:25 Strategy 1: Abstinence48:15 Strategy 2: Cue exposure therapy53:05 Strategy 3: Hormesis58:12 Strategy 4: Helping others through small acts1:00:00 Strategy 5: Radical honesty This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit ancestralhealth.substack.com

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