Firstly, it’s important to know that addiction is messy and complicated and individual. I’m no expert and even the experts don’t have all the answers. I’ve included some links at the bottom for further reading and further help.

Why Do We Get Addicted to Things?

Go back in time and the roots of addiction become clear. The reward system of the brain is one of our most primitive features, designed to reinforce behaviours that we needed to survive. There was a time where this largely involved searching for berries, having sex and learning how to bash rocks together. We did these things, they triggered the release of dopamine, dopamine feels great, so we did them again. Supposedly, the more dopamine that is released in the brain’s reward pathway and the faster it is released can be roughly equated to how addictive something is.

Unfortunately, our lives are overwhelmed with stuff we could get addicted to. Drugs, food, sex, gambling, shopping, smoking, gaming, porn and more, and that’s not even including the beast that is TikTok and all its variants. Not encountering any of this stuff is almost impossible nowadays. These things are often far more potent than our monkey brains our used to and unfortunately, these monkey brains aren’t designed to resist. In a process called experience-dependent plasticity, our brains will literally change shape and rewire in response to high dopamine activities. Addiction is not just choosing the same thing over and over; it is the brain’s newly wired neural networks creating a new existence where this high-dopamine activity is a top priority.

Why Don’t People with Addictions Just Stop?

For those that have never dealt with addiction, this is a perfectly legitimate question, for those that have, it’s a crazy thing to ask. If you are dealing with someone struggling with addiction I’d strongly advise against the question ‘have you ever considered just stopping?’ The logic is – we have free will and we choose what we do, why can’t anyone just choose not to engage in their addiction. It’s not necessarily a wrong argument but it ignores the very powerful neurological effect of high-dopamine activities. 

As mentioned earlier, the plasticity of the brain means it rewires in the direction of high-dopamine activities. The basal output of dopamine is the amount of dopamine we produce normally. Roughly speaking, chocolate increases this output by 55%, sex by 100%, nicotine by 150%, cocaine by 225%, and amphetamines by 1000%. When faced with certain extremely high-dopamine activities, the neural rewiring is profound. This is why many of those recovering from addiction relapse, and why there often has to be complete abstinence – even a single bit of their former addiction will reignite these powerful neural networks and reactivate the addiction. This is why addiction often seems so irrational – people lose jobs, families, sometimes their entire lives. The issue is addiction and its dopamine related neural pathways all exist in a subconscious part of the brain that doesn’t care about consequences.

If TV is more your thing,  I would highly recommend watching the Netflix series PAINKILLER that deals with the Opioid epidemic in the US. I watched it while reading this book and it was a great combination.

How Can I Find Balance?

To find balance, think of an actual balance; pleasure on one side and pain on the other. When we experience pleasure the balance tips to the pleasure side and vice versa. The more the balance tips and the faster it tips, the more pleasure we feel. Unfortunately, there is a reason why we can’t stay in eternal pleasure. The body loves equilibrium and so every tip of the balance to one side will cause a powerful self-regulating tip to the other in a process called homeostasis. These regulating mechanisms happen unconsciously, the same way we sweat when we’re hot or release insulin when we eat too much sugar. This is also the reason why withdrawal from high-dopamine activities like drugs is often so painful. The body is restoring equilibrium.

The more you engage in a particular high-dopamine activity, the harder the body has to work to restore this equilibrium. In a process called neuroadaptation, more commonly known as tolerance, repeated exposure to a pleasure stimulus will make the pleasure weaker and shorter, and the pain stronger and longer.

This pleasure-pain balance is also the key to controlling our addictions. Press on the pain side of the balance and the body will reward you with pleasure. It also develops your tolerance to pain. This is part of the reason exercise, cold showers, acupuncture and according to some YouTube gurus, the dopamine detox, feel good. Hormesis has been the focus of scientists stemming back to the ancient Greeks, focussing on how low doses of negative things can have positive effects in the long run.

With regards to interacting with people struggling with addiction, the importance of prosocial shame cannot be understated. It is one of the AA’s fundamental ideals, and I feel is a really important aspect in caring for someone in this situation.

Lembke argues that this, and radical honesty are two key strategies are key in facilitating the recovery from addiction, both for the addicted individual and for the people around them. I’ve included a bit more information about them at the bottom – in the book there are some very powerful anecdotes that demonstrate how effective these tools can be.

Find balance is key, but abstinence is vital in resetting these powerful dopamine-motivated neural pathways. Self-binding is a key tool in creating space between desire and consumption. There are chronological strategies (e.g., ‘I’ll only have a drink on weekends and birthdays’), categorical strategies that avoid not just the addictive substance but the triggers themselves (e.g., ‘I won’t watch any sports so I never even think about gambling’) and physical strategies (e.g., ‘I’ll tell my wife to hide the family bag of crisps somewhere I won’t find them’). There’s no set method for finding balance, you have to listen honestly to your mind and body and find what works for you.

3 of 10 of Dr. Lembke’s Lessons of the Balance:

1. The relentless pursuit of pleasure (and avoidance of pain) leads to pain.
2. Recovery begins with abstinence.
3. Pressing on the pain side resets our balance to the side of pleasure.

An interesting article about rigorous/radical honesty

https://aaforagnostics.com/blog/what-is-rigorous-honesty-in-aa/

Alcoholics Anonymous (AA)

0800 9177 650
[email protected] (email helpline)
alcoholics-anonymous.org.uk
Help and support for anyone with alcohol problems.

FRANK

0300 123 6600
talktofrank.com
Confidential advice and information about drugs, their effects and the law.

London Friend

londonfriend.org.uk
Offers services to support LGBTQ+ health and wellbeing, including support groups and counselling. These are available online, as well as in person around London. And provides information for on topics including mental health, coming out, and drug and alcohol use. 

We Are With You

wearewithyou.org.uk
Supports people with drug, alcohol or mental health problems, and their friends and family.

Cocaine Anonymous UK

0800 612 0225
[email protected]
cauk.org.uk
Help and support for anyone who wants to stop using cocaine.

And More:

https://www.mind.org.uk/information-support/types-of-mental-health-problems/recreational-drugs-alcohol-and-addiction/drug-and-alcohol-addiction-useful-contacts