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#321 – Dopamine and addiction: navigating pleasure, pain, and the path to recovery | Anna Lembke, M.D.

The Peter Attia Drive

Release Date: 10/14/2024

#328 - AMA #66: Optimizing nutrition for health and longevity: myth of a “best” diet, complexities of nutrition science, and practical steps for building a sustainable diet show art #328 - AMA #66: Optimizing nutrition for health and longevity: myth of a “best” diet, complexities of nutrition science, and practical steps for building a sustainable diet

The Peter Attia Drive

In this "Ask Me Anything" (AMA) episode, Peter dives deep into one of the most frequently discussed and often misunderstood topics: nutrition. From weight loss and maintenance to the intricate relationship between nutrition and exercise and body composition, Peter addresses the complexities of nutrition research and explores the perennial question of whether there is a "best diet." He provides practical insights on how to choose the right diet for your unique needs, discusses the role of protein and processed foods, and outlines the key questions to help you optimize your approach to...

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The Peter Attia Drive

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The Peter Attia Drive

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The Peter Attia Drive

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The Peter Attia Drive

In this quarterly podcast summary (QPS) episode, Peter summarizes his biggest takeaways from the last three months of guest interviews on the podcast. Peter shares key insights from his discussions on diverse topics such as dopamine and addiction with Anna Lembke, the current state and exciting future of CRISPR-mediated gene editing with Feng Zhang, how to build and maintain strong bones from youth to old age with Belinda Beck, how calorie restriction may influence longevity and metabolic health with Eric Ravussin, and the role of testosterone and TRT in prostate cancer with Ted Schaeffer....

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#324 ‒ Metabolism, energy balance, and aging: How diet, calorie restriction, and macronutrients influence longevity and metabolic health | Eric Ravussin, Ph.D. show art #324 ‒ Metabolism, energy balance, and aging: How diet, calorie restriction, and macronutrients influence longevity and metabolic health | Eric Ravussin, Ph.D.

The Peter Attia Drive

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The Peter Attia Drive

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The Peter Attia Drive

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#321 – Dopamine and addiction: navigating pleasure, pain, and the path to recovery | Anna Lembke, M.D. show art #321 – Dopamine and addiction: navigating pleasure, pain, and the path to recovery | Anna Lembke, M.D.

The Peter Attia Drive

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The Peter Attia Drive

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Anna Lembke is the Chief of the Stanford Addiction Medicine Dual Diagnosis Clinic and author of Dopamine Nation: Finding Balance in the Age of Indulgence. In this episode, Anna dives deep into the biochemistry and neurobiology of addiction, exploring the critical role of dopamine and the prefrontal cortex. She shares her framework for diagnosing and treating addiction, providing real-world examples involving alcohol, gambling, cannabis, social media, and more. Anna outlines the risk factors for addiction, including inherited and nurture-based risks, explores the rise of addictions in younger generations, and discusses effective ways to address these issues with children. Additionally, she touches on healthy coping strategies, the evolution of the “marshmallow experiment,” and provides insights into GLP-1 agonists as a possible tool for addiction treatment. Finally, she reflects on the value of 12-step programs and how she navigates the emotional challenges of her work.

We discuss:

  • The role of dopamine and the prefrontal cortex in addiction [3:00];
  • The clinical definition of addiction and the behavioral criteria for diagnosing it [13:00];
  • Assessing alcohol use: patterns, risks, and addiction diagnosis [17:15];
  • Applying the addiction diagnosis framework using gambling as an example [21:45];
  • Exploring addiction variability: how nature, nurture, and access shape individual vulnerability and drug of choice [25:15];
  • How abstinence from addictive behaviors can help reset the brain’s reward system and improve mental health [41:15];
  • Safely abstaining from addiction substances, drugs needing medical supervision, and other key considerations [51:30];
  • Transitioning from abstinence to long-term recovery: tools and considerations [59:00];
  • Exploring behavioral addictions like sex addiction, and the gender differences in addiction patterns [1:08:30];
  • Factors contributing to the increasing levels of addiction across the world [1:13:45];
  • How online pornography can affect young boys' developing brains and lead to addictive behaviors, and strategies for parents to address this issue [1:23:30];
  • The link between social media use and declines in mental health, potential solutions, and protective measures [1:34:45];
  • How exercise affects brain chemistry, the role of dopamine and endorphins, and how exercise can become addictive [1:44:00];
  • Cold-water immersion for mood regulation, and other healthy coping strategies [1:47:15];
  • The “marshmallow experiment”: how broken promises affect behavior and trustworthy environments help children develop self-control [1:54:00];
  • Can GLP-1 agonists be useful in treating addiction? [1:58:30];
  • The benefits of 12-step programs [2:06:00];
  • Why understanding a patient’s story is essential for meaningful psychiatric care [2:11:45]; and
  • More.

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