An Ancient Brain in a Modern World: Addiction Isn't About Willpower

Read the article on Substack

Here's where our modern predicament becomes clear: we've engineered a world flooded with what scientists call "super stimuli." These aren't the natural rewards our ancestors encountered. They're concentrated, intensified, and deliberately designed to hijack our ancient wiring.

Anna Lembke, author of "Dopamine Nation" and another Stanford psychiatry professor, explains that our reward pathways have been "conserved over millions of years of evolution." They're fundamental to who we are as biological beings. But when we repeatedly flood these ancient systems with substances or behaviors that create massive dopamine spikes—nicotine, alcohol, engineered foods, slot machines, social media notifications—something troubling happens.

The brain doesn't just keep producing endless dopamine. It adapts.

Reference:  Why our brains are wired for addiction: What the science says

This is Heliox: Where Evidence Meets Empathy

Independent, moderated, timely, deep, gentle, clinical, global, and community conversations about things that matter.  Breathe Easy, we go deep and lightly surface the big ideas.

Thanks for listening today!

Four recurring narratives underlie every episode: boundary dissolution, adaptive complexity, embodied knowledge, and quantum-like uncertainty. These aren’t just philosophical musings but frameworks for understanding our modern world. 

We hope you continue exploring our other podcasts, responding to the content, and checking out our related articles on the Heliox Podcast on Substack. 

Transcript

0:25

This is Heliox, where evidence meets empathy. Independent, moderated, timely, deep, gentle, clinical, global, and community conversations about things that matter. Breathe easy, we go deep and lightly surface the big ideas. Welcome, Curious Minds, to another Deep Dive. Have you ever wondered why, despite knowing the consequences, some habits just feel impossible to break? Why quitting smoking or, you know, even just putting down your phone can feel like this huge struggle? For way too long, we've often looked at addiction as like a personal weakness, maybe a moral failing. But today, we're going to unpack the science, the cutting-edge stuff that reveals something really profound. Addiction is actually rooted in the incredible ancient design of our own brains. Our mission here is to explore how these brains, which are wired for survival, sometimes lead us into these really persistent patterns of addiction. And we'll look at what the latest science from experts at Stanford Medicine tells us about while understanding and treating it. Yeah. And what's really fascinating here is that addiction, well, at its core, it isn't some kind of flaw in us. It's actually more like an unintended consequence, though a big one, of a system that's built to actively seek out rewards. It's a survival thing. You know, Keith Humphreys, he's a Ph.D., professor of psychiatry at Stanford, puts it really well. He says, we've got an old brain in a new environment. And this vulnerability, it wasn't really a major issue for most of human history. But now, with global trade, industrial chemistry, these incredibly potent addictive substances are just, well, everywhere. Super accessible. That really does reframe it, doesn't it? But I bet for listeners, the immediate question is still, okay, if the downsides are so obvious, why do so many people struggle, you know, stopping drinking, quitting smoking, even resisting that endless scroll? What's the common idea we're pushing against here? And how does this ancient architecture concept really flip that idea? Well, think about it. For millennia, our survival literally depended on seeking pleasure and avoiding pain. It's fundamental. So when we do something beneficial, you know, eat when we're hungry, find shelter, our brain releases dopamine and that chemical messenger. It creates pleasure. Yeah. But crucially, it reinforces doing that thing again. Anna Lemka, she's an MD, also a professor of psychiatry at Stanford. She wrote Dopamine Nation. She emphasizes this. She says the reward pathways in our brains have actually been conserved over millions of years of evolution and across species. I mean, she even points to like the most primitive worm moving towards food because of this same reward system. Wow, a worm. So it's that. It's incredibly fundamental. Yes. Completely ingrained survival stuff. Okay. And that system worked perfectly, beautifully even in environments where things were scarce, right? Where chasing dopamine releasing stuff was genuinely vital. So here's where it gets really interesting, I think. What happens now in our modern world when we're just flooded with easy, almost effortless access to things that light up that pathway? But like intensely. That is exactly the modern dilemma. We've basically created these super stimuli. Think highly concentrated pleasure, sugary, salty foods, nicotine, alcohol, drugs. Yeah. But also things like slot machines, the constant ding of digital media. These aren't just natural rewards your ancestors found. They're often engineered to give a faster, much more intense dopamine spike than anything in nature. Like Dr. Humphreys points out, this reward mechanism, it went from being a minor issue to a significant liability way back in the 19th century already. Our brains, they kind of get tricked. They treat these often harmful things as if they're absolutely essential for survival. Like food or shelter. Exactly. Just like that primitive brain would prioritize finding food. Okay, so it's about that intense rush, that dopamine hit. But then you get the paradox, right? This chase often leads to so much pain and struggle, it seems backward. So how exactly does the brain flip that switch from, you know, pleasure seeker to pain producer? It's a fascinating adaptation, really, but obviously problematic. When these addictive things cause that repeated huge surge of dopamine, the brain doesn't just keep churning it out endlessly. It has this compensatory mechanism. It tries to balance things. So it responds by actually reducing the number and the sensitivity of its dopamine receptors. The docking stations, you mean? Yeah, exactly. The docking stations that detect the dopamine. It's trying to dial things back to maintain some kind of equilibrium. Right. And what's the direct hit for the person when their brain does that, when it reduces those receptors? Well, a direct consequence is that it becomes much, much harder to feel pleasure. And not just from the drug or the behavior itself, but crucially from everyday life, the normal stuff. As Dr. Lemke puts it really clearly, people use more just to feel normal. You're chasing that first high, but their brain's changed. It becomes this escalating battle just to feel okay, never mind actual joy. Can you give us a really concrete example, something to make it crystal clear for everyone listening? Absolutely. Nicotine is a perfect example. So someone smokes or vapes, right? The nicotine hits the brain fast, binds to specific receptors, and bang, releases dopamine, other signaling molecules too. And this gives those short-lived effects. Better focus, maybe a mood lift, suppressed appetite. But short-lived is the key phrase there. Exactly. Very short-lived. So to keep that feeling going, people end up dosing really frequently. Think about maybe 200 puffs a day for someone smoking a pack. And over time, the brain actually makes more receptors to handle this constant flood. Jodi Prochaska, she's a clinical psychologist at Stanford studying tobacco addiction, she explains it like this. You're no longer smoking to get high. You're smoking to avoid withdrawal. Ah, so it flips from seeking pleasure to just avoiding pain. Precisely. And this whole process, Dr. Humphreys calls it maladaptive learning. Imagine your brain, this ultimate survival machine, literally changing its priorities. It's not just a craving anymore. The brain learns to treat the substance as more important than basic needs. Food, safety, connection with others. Yeah, that's how deep the rewiring goes. So someone might start for fun or maybe to cope with something, but their brain adapts. That initial effect fades. And like Dr. Lemke says, they need more of the substance or a more potent form to get the same effect and prevent withdrawal. That's yeah, that's a critical point. And it brings up something I think a lot of us wonder about, maybe for ourselves or people we know. Why do some people seem to really struggle, get pulled deep into addiction while others don't? Even if they're exposed to similar things, it's clearly not the same experience for everyone, is it? You're absolutely right. It's not one size fits all. There are definitely key risk factors involved. First off, genetics. They play a pretty big role. Estimates are around 50% to 60% of the risk based on family and twin studies. Dr. Humphreys has some very practical advice on this. Nothing beats asking, were your parents addicted? It's a direct question, but informative. Simple, but powerful. Yeah. Then there are individual traits. Things like impulsivity, difficulty managing emotions, certain mental health conditions, ADHD, bipolar disorder, for example. Dr. Lemke notes, people who have a harder time pausing between impulse and action are more at risk. Makes sense. And finally, age is really critical. Research clearly shows the younger someone starts using a substance, the more likely they are to get addicted and faster, too. That's because, as Dr. Prochaska points out, the brain is still developing until about age 25. 25! That's older than many people think. It is, which is why she really emphasizes that delaying the start of substance use is so important. Every year counts. Okay, so we have this brain wiring, these vulnerabilities. What does that mean for us as a society now with all these potent stimuli just everywhere? Well, connecting those dots means that even people who maybe thought, oh, addiction isn't something that could happen to me, they're now running into problems. We just have so many more drugs than we used to, and they are so much more potent. Think powerful opioids for sure. But it's also compulsive behaviors, right? Gambling, getting lost in social media, sex, pornography. These all tap into those same ancient dopamine pathways. So the net of potential struggle is just, it's much wider now than we might have traditionally thought. It really underscores that the struggle to quit is incredibly real. It's not just about willpower, clearly. But the good news, I guess, is that the scientific understanding you're laying out is really changing how clinicians treat addictions. So putting it all together, what does this knowledge mean for someone who wants to make a change, wants to find that path to recovery? Well, the main goal, the big picture for addiction treatment is really to help patients get back to that healthy balance, that homeostasis in the brain. It's about helping the brain re-regulate itself, basically, so that natural pleasures, you know, the everyday joys can feel genuinely rewarding again. We know addicted brains have kind of gone off the rails outside normal balance and treatment aims to bring them back. Right. And what are some of the key strategies? How do you help someone achieve that balance? Well, the number one way, according to Dr. Lemke, is often starting with abstinence. She frequently recommends what she calls a 30-day reset. It's a way for people to really challenge their own relationship with something. Now, during this time, she warns, patients will generally feel worse before they get better. That's the brain adjusting. Right, that initial difficulty. Exactly. But going through that period gives them invaluable own data, as she puts it, their own experience to make informed choices moving forward. It's quite empowering, actually. And importantly, if that 30-day break just seems completely impossible, Dr. Prochaska's advice is clear. That's absolutely the time to talk to a medical professional. There's help available. For nicotine, for instance, common treatments involve things like patches. They give a steady dose paired with faster-acting gum or lozenges for those sudden, sharp cravings. There are also medications like varenicline, which used to be called Chantix. It helps reduce withdrawal and makes smoking less satisfying. Are there newer things coming down the pipeline, too? There are promising developments, yeah. Yeah. There's a plant-carrived drug called Cytocine, or Cytocinicline, which works similarly to Varenicline. It's in development. Looks promising. Cilcibin is also being studied. It's interesting because, as Dr. Prochaska notes, nothing new has been FDA-approved since 2006 for smoking cessation. But that may be about to change. And here's something else really interesting. Those medications originally for diabetes and weight loss. GLP-1 receptor agonists like Ozempic. Oh, yeah. You hear about those everywhere now. Exactly. Well, they've shown some unexpected benefits for people struggling with alcohol, food, even nicotine. Early research suggests they might also act on the brain's reward centers, kind of subtly turning down the volume on the drive for these things. Dr. Humphrey said, you know, these drugs weren't designed to treat addiction, but people started reporting that they just didn't want to drink as much. His take. If it holds up in trials, that's a big deal. Wow. Potentially a huge deal. So these medications sound crucial for getting through that really tough initial period, right? When the withdrawal and the cravings are just screaming at you. Precisely. They help bridge that gap. And if abstinence can stick, if someone can maintain it, then those brain receptors, they slowly, gradually return towards a healthier state, that homeostasis we talked about. The brain starts to relearn how to experience natural pleasure again. That's incredibly hopeful. It really speaks to the brain's resilience, its capacity to heal. But let's be real, too. Recovery is a journey. It takes time. And maybe the brain doesn't go all the way back to how it was before. What about those lingering challenges like withdrawal symptoms that might pop up or those really stubborn cravings? Yeah, you're right to bring that up. In the early stages, people often feel withdrawal, irritability, bad sleep, low mood, trouble concentrating. That's pretty standard. Generally, that stuff peaks within maybe three days and usually gets much better by week four. But as Dr. Prochaska points out, craving can persist for months, even years. It can linger. Years. Why so long? Well, part of it is what we call addiction memory. It's how the brain has created these really deep links between the drug or the behavior and, well, everything. Daily routines, places, people, certain emotions. Like having coffee in the morning, feeling stressed, even just driving your car might become a trigger. Ah, so it's not just the brain chemistry rebalancing. It's these embedded memories and associations, too. That sounds like a constant minefield almost. How do people navigate that, those environmental triggers popping up when they're trying to rebuild? That is exactly why understanding addiction memory is so vital for long-term recovery. It really drives home the point Dr. Lemke made. It's not about willpower, not in the simplistic way people mean it. It's about the brain adapting, and sometimes those changes are deep and persistent. So a big part of recovery is learning to proactively identify those personal triggers and then developing new coping strategies, new routines that don't involve turning back to the substance or behavior. It might mean changing your route home from work, avoiding certain situations for a while, learning new ways to handle stress or boredom. It's literally about rewiring those old learned associations and building new, healthier pathways. It really is remarkable, though, how resilient the brain can be even after these deep changes. It really is, thankfully. With the right support and sustained effort over time, people absolutely can rebuild their natural reward systems. It's like Dr. Humphrey said quite beautifully, I think. It starts to feel good again to play with your kids, to eat a good meal, to feel connected. That natural pleasure, that basic human joy, it can come back. It does come back. What an incredibly insightful deep dive. Thank you. I think the key takeaway here is just so powerful. Addiction really is this complex brain thing, isn't it? Not a moral failing. It comes from this ancient survival system bumping up against our modern world, full of these super tempting things. But understanding the science really does offer pathways to healing and, importantly, hope. Absolutely. And leaves us with a pretty big question to ponder, doesn't it? If our brains are wired this way for reward and our society just keeps throwing these supernormal stimuli at us, what changes might we need to think about societally, maybe personally, beyond just individual treatment? How do we better protect ourselves and maybe future generations from these, well, unintended consequences of our own ancient design in this new world? That is a profound thought to end on. Definitely something to chew on. Thank you so much for joining us on this deep dive. We really hope this new understanding helps reshape how you think about addiction and empowers you with this knowledge. Thanks for listening today. Four recurring narratives underlie every episode. Boundary dissolution, adaptive complexity, embodied knowledge, and quantum-like uncertainty. These aren't just philosophical musings, but frameworks for understanding our modern world. We hope you continue exploring our other podcasts, responding to the content, and checking out our related articles at heliocspodcast.substack.com. Music