Let's just think about addiction, because in biology and in psychology, frankly, it really often pays to think about the extremes first and then work our way towards more typical circumstances. And with that said, addiction, unfortunately, is very common nowadays. I just heard a statistic, in fact, that there is an 80, 80% increase in alcohol use disorder among women in the last 30 years.

I talked a little bit about this in the episode that I did about alcohol and health. Again, I want to be very clear. I'm not somebody that is completely against alcohol for adults, provided they're not alcoholics. Turns out two drinks a week, probably fine health-wise. Zero would be better, if we're honest.

Zero is better than any alcohol. But two drinks a week is probably fine. Past two drinks, you start running into problems. And yet many, many people out there, male and female alike, suffer from alcohol use disorder, also called alcoholism. The same is also true for things like methamphetamine or cocaine or other types of substance addictions.

And the same is also true for a lot of behavioral or what are sometimes called process addictions, things like sex addiction or video game addiction or any type of behavior that, frankly, is leveraging the dopamine system, but that engages this progressive narrowing of the things that bring someone pleasure, such that nothing else is really salient.

Nothing else is really pulling them in in the way that their video games or sex or pornography or alcohol, pick your substance or behavior that you see out there, or hopefully not, but that you might suffer from an addiction to. So what's happening in addiction? Well, addiction involves dopamine, among other things, often, the opioid system, et cetera.

But if we were to think about what's the stimulus in an addiction and what's the peak in dopamine, and then what happens after that peak, it all becomes very clear as to why addiction happens and why it's so pernicious. So for instance, let's take cocaine. Cocaine causes dramatic increases in dopamine very, very fast.

So if somebody craves cocaine, what are they craving? They're craving that dopamine peak. They're craving the increased level of alertness. They're craving a number of things associated with the feeling of being under the influence of the drug, but the stimulus for it simply becomes that line of cocaine, or in the case of crack, that crack rock that they're going to smoke, and God forbid, they're mainlining it.

You know, they're shooting into a vein. What happens is they snort, smoke, or inject cocaine, and dopamine levels almost immediately go up, up, up, up, up, up to a very high peak, okay? So the time gap between the stimulus and the dopamine is very, very short, so short, in fact, that there's really no other contingencies in between that the mesocortical system has to learn.

In fact, what does the system quote-unquote learn? It learns cocaine equals massive amounts of dopamine equals feeling euphoric and energetic, et cetera, and in doing that, it reinforces the whole circuit so that that short, we can even say hyper short contingency, is really what the system wants, so much so that longer contingencies of, say, putting in the hard work of, you know, generating a fitness program or a professional program for yourself or a education program, which takes not just many days, but many weeks and years, well, none of that is going to lead to peaks in dopamine that are as high as the peak in dopamine associated with cocaine.

So that tells us something critical. It is both the duration between desire and effect, and when I say effect, I mean the rewarding properties of dopamine that are experienced, that's important, so very short gaps teach the system to expect and want short gaps, makes it very hard to pursue things that take longer.

So when we say it's the short, or in this case, hyper short distance or time between the stimulus and the dopamine, what we're really talking about, if we were to plot this out on a board or on a piece of paper, is the steepness of the rise of that peak.

It's very, very steep. The peak in dopamine is coming up very fast after the desire. And in addition to that, and this is very important, the higher the peak in dopamine and the faster the rise to that peak, the further below baseline the dopamine drops after the drug wears off.

Okay, so in the case of cocaine, it's a very fast and very large rise in dopamine followed by a steep drop and very deep trough in dopamine below baseline. You say, okay, so there's pleasure, then there's lack of pleasure. Ah, but it's worse than that because it's not just lack of pleasure.

If you recall what we talked about a little bit earlier, that drop below baseline triggers the desire and the pursuit for what? For more. And so this sets in motion a vicious loop where people start pursuing peaks in dopamine that can come very fast without much effort. And that's one of the ways in which addictions start to take hold.

Now, there's a simple way to think about this and to remember if you want to avoid this whole thing. I mean, the first one is obvious. Don't do cocaine, don't try it, don't use it. Certainly don't get addicted to it. Those are all sort of one in the same, frankly.

I don't know many people that, despite opinions to the contrary, that use cocaine recreationally, that don't at some point run into either a financial, psychological, physical, or some other problem. The other thing that's absolutely critical to keep in mind, and this was discussed in my colleague, Dr. Anna Lemke's book, "Dopamine Nation," and on this podcast.

Excellent book, by the way. I highly recommend it if you haven't read it already. It's a fascinating exploration into dopamine as it relates to addiction, not just drug addiction, but other types of addiction. Again, the name of that book is "Dopamine Nation." We'll provide a link to it in the show note captions.

The other thing that happens after those big, fast increases in dopamine caused by things like cocaine is afterwards, when it quickly drops below baseline, it takes a much longer time to get back to the original baseline than it did prior to using the drug. And worse still is that the peaks in dopamine that are created from more consumption of cocaine leads to progressively lower peaks and deeper troughs below baseline.

So the whole system is shifting away from pleasure and more to pain and the desire for pursuit of the drug. (upbeat music) (upbeat music) (upbeat music)