Do I Really Need To Worry About Too Much Dopamine?
Dopamine isn't something to be afraid of. Here's the science.
This week, I saw three embarrassing articles about dopamine on NPR’s website.
Too much pleasure can lead to addiction. How to break the cycle and find balance.
Anti-dopamine parenting’ can curb a kid’s craving for screens or sweets.
In ‘Dopamine Nation,’ Overabundance Keeps Us Craving More, which was featured on Terry Gross’ show Fresh Air.
The premise?
Dopamine underpins all addictions.
So, the simple version is, if you don’t vigilantly monitor the things that could stimulate dopamine in your brain, you’ll end up overindulging in an array of everyday things, from sex to smartphones to sweets. That’s the soft version of the message.
The unalloyed version of the message says that these things are not only habit-forming but addictive “like a drug” and that we’re not actually addicted to heroin or alcohol. What we’re really addicted to is the dopamine “hit” we receive from the anticipation of these things.
Readers of this Substack, The Science of Sex, know that this claim sounds familiar. There, I’ve debunked the twin myths of “porn addiction” (here) and “sex addiction” (here) with prominent researchers Dr. Nicole Prause, Ph.D. and Dr. David Ley, Ph.D., respectively.
You should know right off the bat I’m extremely skeptical of such sweeping claims. They garner clicks and attention in the attention economy, but statements like these almost always rest on dubious science. The dopamine hypothesis of addiction is no exception.
The Replication Crisis in Psychology
I recently covered the replication crisis in psychology (here) and the fake news epidemic that’s spawned from it. According to a 2015 research paper, some researchers are inventing fake mental illnesses (the so-called “behavioral addictions”) to get their names out there.
Behavioral addiction is the idea that you can become addicted to something that isn’t a drug. They’re pushed heavily by rehab centers and therapists who treat the condition, even though none of these “addictions” except gambling addiction are in the DSM-V, the diagnostic manual for mental disorders.
The study is called Are we overpathologizing everyday life? A tenable blueprint for behavioral addiction research. The study does not assert that behavioral addictions do not exist, but it does criticize the research of the past two decades for being sensationalist, inventing a plethora of fake illnesses, and generally scaring the crap out of people.
If a psychologist wants to solidify their budding career, they can investigate benign activities like cell phone use or even having friends in real life (yes, a study ridiculously suggested we might all be “social addicts” in person).
Journalists will pick up the study and write about it, and the researcher gets fame and fortune.
The study never gets replicated—which is essential to the scientific process—so the results are meaningless (but the public doesn’t know that). Then, with all the attention and clickbait headlines, they’ll get book deals and maybe even a podcast.
Everyone wins except the media consumer, who loses out when they believe the fake news and radically change their lives to avoid an addiction that doesn’t actually exist.
How many marriages have been ruined because of the idea of “porn addiction,” which has proven not to be real? How many people have paid exorbitant sums of money to cure “love addiction” or because they falsely believe they’re addicted to their cell phones?
Dopamine Nation?
Those three NPR articles were promoting a book. Right, because when I’m looking for actionable answers to questions about my health, I want someone selling a book to me (read: sarcasm).
The book is called Dopamine Nation by Anna Lembke, M.D. I’ve encountered this book in the Amazon Kindle store. My eyes rolled into the back of my head as I read the description, which implies that Instagram is as dangerous as heroin. No joke.
Echoing similar fears to anti-drug propaganda of centuries past, the description for the book Dopamine Nation evokes a connection with heroin, saying, “The smartphone is the modern-day hypodermic needle, delivering digital dopamine 24/7 for a wired generation.”
Oh, the melodrama!
It’s the modern version of Reefer Madness, the old 1930s documentaries about how smoking marijuana would make you jump out of the windows of tall buildings and go mad like a rabid dog, tearing into the flesh of your neighbors. Only this time, instead of reefer, it’s Reddit.
But is there any truth to these claims? Are things like food, social media, and other everyday behaviors actually addictive?
Let’s find out.
First, a bit about critical thinking.
The “Buzz” of Skepticism
It’s good to be skeptical. There are a lot of people trying to bamboozle you out of money. Financial predators usually capitalize on current trends. Last year, it was NFTs. The year before that, it was Bitcoin. This year, it’s AI.
People who want to take your money want to cast the widest net possible to lure as many potential victims into their schemes as possible.
Pro-tip: when someone tells you something sensational (i.e., not boring), I suggest running a simple check of search terms through Google Trends. See if there’s a “buzz” going on about something that someone’s telling you to be afraid of before you believe it.
Fear sells.
While this doesn’t prove or disprove anything, it’ll give you an idea of where the source material is coming from.
Is it coming from bloggers and influencers? Is it coming from a single doctor or scientist? Or a scientific consensus made by researchers after a thorough investigation and robust debate?
Scientific consensus is essential to the scientific process. Scientific consensus is the collective agreement among a majority of experts in a particular field, based on extensive research and evidence, and after much debate, regarding a specific theory, hypothesis, or phenomenon.
A lone doctor or researcher has as much credibility as an Instagram influencer with me (which is none at all). People with M.D. and Ph.D. behind their names aren’t saints.
When you look at the frequency of Google searches for dopamine, you notice a sudden uptick beginning in late 2021 through early 2022.
That instantly makes me skeptical about claims that dopamine could be detrimental to your health. But let’s dig into the science.
The Dopamine Hypothesis
The dopamine hypothesis of addiction, as postulated by Lembke, stipulates that every single addiction is rooted in one thing: dopamine. Dopamine is a neurotransmitter in the brain that plays a role in motivation.
When we’re about to do something enjoyable, dopamine rises significantly in the brain. This has led to dopamine being called “the pleasure chemical,” which isn’t exactly accurate.
Dr. Lembke somewhat accurately says that dopamine is more about wanting than enjoying. It’s the “desire” chemical, which is why it’s linked to so many addictive behaviors.
Dopamine levels rise when we anticipate something good, not when we actually experience it.
When you smoke a cigarette, you get a small boost in dopamine, about 150% (yes, that’s small compared to other drugs). When you snort cocaine or methamphetamine, you get a small and large boost of dopamine, respectively. This much is true.
Thus, the theory goes, you’re never actually addicted to the chemicals themselves—i.e., the cocaine or methamphetamine—it’s the dopamine that we’re all after.
Problems With the Dopamine Hypothesis of Addiction
There are so many problems with this hypothesis. First, it’s inaccurate when we reduce neurotransmitters—which play a role in a whole host of mind and body processes—to a single trait.
You may have heard people refer to Serotonin as “the happy hormone” because it plays a role in mood and anxiety. The words “play a role” are emboldened because we don’t understand the cause-and-effect relationship yet.
We know that SSRIs make depressed people happier, we know that ecstasy and cocaine—two serotonin-stimulating drugs—make people extremely happy, and we know that serotonin plays a role in sleep regulation, appetite, and anxiety.
The risk is this: when we reduce a chemical to singular traits, we ignore other traits. Serotonin also plays a role in psychopathy (anti-social personality disorder). Too much serotonin plays a role in people being psychopaths. Hardly a good outcome.
So, which is it? Is it the happiness hormone or the psychopath hormone?
The answer is neither. It’s one of many hormones and neurotransmitters that come together to make up the physical and conscious experience of each individual person.
And when we fixate on singular links between hormones (and neurotransmitters) and our behavior, we wind up with a skewed picture of what these chemicals do.
This meme is an example of such piss-poor reasoning:
Like conspiracy theories and pop science, the dopamine hypothesis of addiction takes this kernel of truth and then liberally invents profitable narratives to sell.
Some people theorize that a rise in dopamine is present when we engage in addictive events. Therefore, everything is addictive. They might cite research like this 2020 review called Dopamine and Addiction.
Proponents of the hypothesis might say that because drugs, sex, gambling, you name it, all stimulate dopamine, they must all be addictive, right? We often see this kind of logic used to make the case that something non-chemical is addictive.
Do you know what else all of these things caused? Sweating. Cocaine, ecstasy, sex, gambling your last $5,000 on a single hand of poker — all of it causes the human body to sweat profusely.
We don’t say that drugs cause sweating because jogging causes sweating. Conversely, we sweat when we get excited, anxious, nervous, or aroused in any way. So why is it that nobody’s trying to blame addiction on sweating?
Because it sounds ridiculous.
And guess what jogging does — it increases dopamine.
This alludes to the most grievous problem with the hypothesis. If everything is addictive, you can’t do anything. Thankfully, we know that not everything is addictive, and it’s a farce to say that the smartphone “is the modern-day hypodermic needle,” suggesting that it’s as addictive as heroin.
As Dr. David Ley, Ph.D. said on my podcast when we covered the myth of “sex addiction,” if you take away porn or sex from a self-professed sex addict, nothing bad is going to happen. They might get a little pissy. But if you take alcohol away from an alcoholic, they can have seizures and die.”
Lumping these two things together in the same category is intellectually dishonest. They’re nowhere near the same threat to the individuals.
This speaks volumes to the causation at work.
We know that drugs like heroin and nicotine (and alcohol) can take people without mental health issues and make them physically dependent upon these drugs. But when we consider behavioral addictions, we’re forced to ask ourselves, is there something else causing the person to repeatedly engage in a behavior that isn’t good for them?
Recently, Lembke was on Hidden Brain, the NPR show with Shankar Vedantam, and she described a patient who first kicked off the idea that it’s dopamine that we’re chasing. The patient is a former professional sports athlete who developed a destructive gambling addiction after retiring.
Setting aside the fact that gambling is the one behavioral addiction listed in the DSM-V, even if it was any other behavioral addiction, say, sex or pornography or a smartphone, we must ask whether it was one of these things that caused the person to become addicted, or if quitting sports made the man depressed, which subsequently led to addictive behaviors.
As Dr. Prause explained on my podcast, if pornography was really addictive, you’d just need to remove it from the lives of porn addicts, and they’d get better. But often, these people fall into another trap. They trade one set of repetitive behaviors for another, and the problem isn’t resolved.
These narratives ignore that the paper Dopamine and Addiction only mentions drugs, saying they’re addictive because they “cause elevations in extracellular levels of the neurotransmitter dopamine.”
Instagram does not — and can not — possibly cause dopamine levels to increase beyond their natural ability. Methamphetamine can.
Not to mention, some drugs that are highly addictive don’t even raise dopamine levels. Heroin alone doesn’t cause dopamine to rise. This bug in the system is particularly devastating.
If we were addicted to the dopamine and not the drug, we’d expect heroin to not be addictive or not as addictive as drugs that stimulate dopamine in the brain. But it’s not because the theory is bunk.
And if dopamine truly was addictive “like a drug,” or the only things we’re truly addicted to, and not the substances themselves, there would be an easy fix–block or reduce the dopamine.
You see books, podcasts, and lectures being sold, sometimes by prominent scientists like Stanford’s Lembke and Andrew Huberman, professing the benefits of “dopamine detox” when you remove dopamine-stimulating things from your environment. The logic is, block the dopamine from being stimulated in the brain, you’ll cure “addiction” to things and feelings of desire.
If only someone had thought of this sooner!
A 1987 study by J M Van Ree and N Ramsey challenged the dopamine addiction hypothesis. Haloperidol is a drug that blocks dopamine at the most fundamental level, the dopamine neuron.
The researchers wanted to explore whether blocking the dopamine receptors in the brain would help heroin users quit heroin. I shouldn’t have to tell you the study was unsuccessful. The opiate crisis in America would start to take hold about ten years later (the Medium version of this article has an animation
Researchers wrote:
Haloperidol was administered either systemically or locally into different brain areas with dopaminergic terminals in rats allowed to initiate and maintain intravenous heroin self-administration. Haloperidol treatment did not block heroin reward. It is concluded that dopamine is not critically involved in opiate reward and that multiple endogenous reward systems are present in the brain.
Remember when I said to check Google for trends? This is why. This issue has been settled more than thirty years ago.
Long story short, no, you don’t need to rummage through your house and clean out everything that might stimulate dopamine, mainly because everything has the potential to stimulate dopamine, but also because dopamine itself isn’t addictive.
And a further takeaway is this: my hypothesis is desire isn’t a bad thing in itself. Desires that can’t be easily fulfilled or that lead to dangerous places are bad. When we have a problem with desire, it’s usually not the desire itself but our inability to realize what we want in life.
The answer isn’t always to want nothing–sometimes, we just need to figure out a way to find a balance between what we have, what we want, and what we can obtain.
The article offers a skeptical view of the dopamine hypothesis of addiction, emphasizing the complexity of behaviors and the role of various factors. Critical evaluation is urged to avoid oversimplification.