This note is from the video 心河擺渡-成瘾始于痛苦，戒瘾终于平衡！深度解读多巴胺，用身体内稳态戒瘾 The video contains insights from the author as well as his analysis of Anna Lembke’s book Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop. The content is very useful, and I made notes to remind myself.

Underlying Principles

• The reason behind addiction is the increase in dopamine.
  • Chocolate increases it by 55%.
  • Nicotine raises it by 150%.
  • Amphetamine boosts it by 1000%.
• The main role of dopamine is not to make us feel happy after receiving a reward but to drive people to seek rewards.
  • For example, when you see chocolate, dopamine activates the brain’s reward circuit, making you feel pleasure even before having it and prompting you to eat it.
• The regions in the brain responsible for pleasure and pain overlap.
  • Pleasure and pain have self-regulating functions. When you’re currently experiencing pleasure, the brain will generate enough pain on the other side to balance it out.
• Reward Prediction Error
  • Due to neural adaptation, the actual reward must exceed expectations to have a positive dopamine effect.
  • In severe addiction, the threshold for feeling pleasure increases, resulting in a lack of enjoyment.

Utilizing the Dopamine Mechanism

• According to clinical experience, recreating the brain’s reward circuit takes at least a month.
• Using pain to treat pain
  • The brain uses pain to balance out pleasure and vice versa.
    • According to research, dopamine levels in the blood plasma increase by 250% when people immerse themselves in cold water, and this effect lasts longer than the immersion time.
  • Exercise is the best option.
• Physical separation
  • Completely separate from the addictive substance.
• Radical honesty
  • The prefrontal cortex is responsible for rational decision-making.
  • When the dopamine reward circuit is active, lying inhibits the prefrontal cortex’s function, releasing the restraint on the reward circuit, leading the brain to believe it’s not addicted.
  • An essential part of addiction recovery is rebuilding the relationship between the prefrontal cortex and the dopamine circuit.
  • Strengthen the prefrontal cortex by “telling the truth” and enhance self-control.
    • During addiction, engage in self-talk or announce your addiction to people around you.