Dopamine Nation: Finding Balance in the Age of Indulgence

Addiction and addictive behaviors are the current news items that capture the attention of this affluent society. Behaviorists find that the cerebral dopamine released by the drugs or activities provides satisfying pleasure, although with time the body demands more of the pleasure stimulus, whether it be drugs, gambling, sex, sweets, etc.

Maintaining a balance between the joys of pleasure and the downside of withdrawal is the dilemma that psychiatrist Anna Lembke, medical director of Stanford Addiction Medicine, attempts to explain as the therapeutic goal of medicine. Using a series of case histories showing dopamine control through behavior changes, alternate drugs, or pursuing the AA program used for alcoholics, the doctor attempts to demonstrate how dopamine levels versus the gremlins of pain can be controlled.

The story reads more like a self-help guide for those worrying about addiction; the selected case studies fit too neatly with the apparent remedies. By focusing only on dopamine, too many other aspects of the neural control of behavior are ignored. So while it is interesting to read about the implicated dopamine levels governing the perception of pleasure, there must be many other mechanisms that have to yet be uncovered.