Dopamine Nation: Finding Balance in the Age of Indulgence

In today’s dopamine-rich ecosystem, we’ve all become primed for immediate gratification. We want to buy something, and the next day it shows up on our doorstep. We want to know something, and the next second the answer appears on our screen. Are we losing the knack of puzzling things out, or being frustrated while we search for the answer, or havin

Cigarette smokers are more likely than matched controls to discount monetary rewards (that is, they value them less if they have to wait longer for them). The more they smoke, and the more nicotine they consume, the more they discount future rewards.

One in four gastric bypass surgery recipients develops a new problem with alcohol addiction. In the wake of her surgery, Emily too became addicted to alcohol. The reasons are many.

Most people who are obese have an underlying food addiction, which is not adequately addressed with surgery alone.

As one patient put it, “With disulfiram, I only need to decide once a day not to drink. I don’t have to keep deciding all day long.”

Some people, most commonly East Asians, have a genetic mutation that causes them to have a disulfiram-like reaction to alcohol without the drug. These individuals have historically had lower rates of alcohol addiction.

For decades the wisdom of Alcoholics Anonymous dictated that abstinence is the only option for people with addiction.

But emerging evidence suggests that some people who have met criteria for addiction in the past, especially those with less severe forms of addiction, can return to using their drug of choice in a controlled way. In my clinical exper

The brain encodes long-term memories of reward and their associated cues by changing the shape and size of dopamine-producing neurons. For example, the dendrites, the branches off the neuron, become longer and more numerous in response to high-dopamine rewards. This process is called experience-dependent plasticity . These brain changes can last a

With repeated exposure to the same or similar pleasure stimulus, the initial deviation to the side of pleasure gets weaker and shorter and the after-response to the side of pain gets stronger and longer, a process scientists call neuroadaptation .

Dopamine is not the only neurotransmitter involved in reward processing, but most neuroscientists agree it is among the most important. Dopamine may play a bigger role in the motivation to get a reward than the pleasure of the reward itself. Wanting more than liking . Genetically engineered mice unable to make dopamine will not seek out food, and w