We hear a lot about dopamine. This is a neurotransmitter in the brain that is essential for feelings of satiety, pleasure, satisfaction, and reward. It also affects mood, memory, and motivation. Dopamine is one of several neurotransmitters produced naturally in our brain. It has receptors that are sensitive to and highly affected by various substances that we take into our body. Dopamine “hits” occur both naturally and when we ingest some substance that targets our dopamine receptors.
High satiety foods (calorie dense and ultraprocessed), alcohol, drugs (recreational and psychotropic prescription) target these dopamine receptors to induce feelings of satisfaction and pleasure.
The word “dope” has long been slang for hard drugs (especially heroin and other opioids), and has somewhat recently become a slang buzzword for something that is excellent or awesome—as in “that’s really dope, man.” I’m usure of whether the original “dope” vernacular was derived from a reference to dopamine, perhaps that heroin makes you dopey, or something else. Regardless of the derivations, we like dopamine—it is a principal feel-good neurotransmitter.
Unfortunately, our internal dopamine receptors can, over time, become jaded and hijacked to expect, crave, and need external hits of dopamine stimulation. As this occurs, our brain circuits become rewired, we become more dependent on substances that promote dopamine, and the tolerance increases so that we need more and more to achieve the previously experienced levels of pleasure and satiety. This establishes a vicious cycle of addiction: craving, indulgence, temporary relief, and withdrawal. It becomes a trap from which escape is very difficult.
We literally develop and strengthen addictive brain circuits. This makes breaking addictions to alcohol and drugs a hard road. It’s about behavior, habits, and appetites; but it also involves physiological dependence, and this complicates attempts to exert “willpower” in recovering from addictions.
Recent science is bringing to light the changes in the brain that occur through the use of addictive chemicals, but also through diets containing foods manufactured and designed to hook us into eating more of them (and more in general). We have current epidemics of obesity and related diseases and health problems directly attributable to diet and particularly the proliferation of highly palatable and accessible unnatural, ultraprocessed foods, loaded with sugar, salt, fat, and other ingredients that make these foods addictive. Thus, it is the combination of our changed tastes, genetic predispositions, reinforced habits, brain circuits, and the foods themselves that transform our physiology (gut and brain) to compulsive overeating, weight gain, and bad health.
Among the many books explaining these processes is the recent blockbuster book by Dr. David Kessler entitled Diet, Drugs, and Dopamine: The New Science of Achieving a Healthy Weight. This magnificent book is filled with solid science, personal experiences, lots of credible research, and is written in cohesive, accessible language. Dr. Kessler emphasizes three main issues underlying the weight and health problems that plague a high percentage of the population:
Dr. Kessler reveals in comprehensible and methodical detail how these processes interrelate among food substances, dietary habits, and brain and gut physiology. He also explains the contemporary and evolving role of the newer anti-obesity GLP-1 medications that are revolutionizing weight loss. He documents additional findings that the method by which GLP-1 medications work has unanticipated positive side effects in reducing cravings for alcohol and recreational drugs, as well as literally changing appetite, tastes, and choices toward healthier foods! (One theory for this is that the medications cause feelings of fullness and slower digestion that deters the craving for fatty foods.) Thus, the physiological mechanisms that induce weight loss may also create new pathways for appetite and food selection.
It is Dr. Kessler’s brilliant uncovering of the addictive brain circuits problem that I would like to address and expand in this article. In addition to losing a hundred pounds and publishing my own book on weight loss and control—I’m Losing It—and My Genes Don’t Fit: Weight Loss and Control Without Deprivation or Suffering—I have long been an advocate, acolyte, and practicing neuropsychologist involved in helping people rewire their brain circuits. This is key, both cause and effect, to overcoming a host of conditions that affect mental health and overall well-being: anxiety, depression, addictions, traumas, attention problems, sleep disorders, headaches, anger, to name a few.
Our brain and gut are intimately connected. Sometimes the gut is called “the second brain.” It should not therefore be surprising that what we eat affects our brain (cognitively and emotionally) as well as out behavior. The chemicals we use, whether by prescription or self-medication, to feel better have the potential to alter our neuronal firing patterns. One negative result or side effect can be the establishment of addictive brain circuits. Persistent use of alcohol, narcotics, and—yes—cannabis can lead to brain damage as well as the formulation and strengthening of addictive brain circuits. We can gradually become prisoners of the cravings and needs (both physiological and psychological) to depend upon the dopamine inducing substances that are ruinous. Though the biochemical actions of foods and drugs have differences, the addictive mechanisms follow similar patterns and outcomes.
Our brain is flexible. It can adapt to changing conditions internally and externally. While this flexibility has survival value, it also allows for vulnerability through influence by what we take in and our habits. In the case of diet and food, our brain habits and tastes can become “hijacked” to form and strengthen addictive circuits that link satiety-deprivation-withdrawal cycles to repeated exposure and ingestion of the ultraprocessed foods that hook our appetite and cravings. With foods (which we must eat in one form or another), the addictive circuits respond to nutrients and additives that link gut responses to brain chemicals and reactions, including reward-seeking eating behavior.
With drugs and alcohol (different than food that is necessary), similar reaction cycles become entrenched, addicting the brain to remember and seek its previous sources of satiety. Intoxicating, high-reward substances overwhelm the dopamine receptors and flood the brain with unnaturally high pleasure. The brain responds by oversupplying dopamine. This experience catapults the brain into a dysregulated state whereby intense reward upsets the balance of neuronal firing. This, of course, feels fantastic. But then it wears off, inducing a dopamine deficit and precipitates a state of withdrawal. This withdrawal state, experienced as reward deprivation, is both physiological and psychological, triggering intense discomfort along with obsessive memories of what has previously relieved the discomfort.
It’s also worth noting and including that the brain can become addicted to the dopamine hits supplied by social media and the internet: free and accessible and nefariously compelling for so many people.
The precipitous imbalance between reward satiety and deprivation that characterizes withdrawal can result in symptoms such as intense anxiety, irritability, physical malaise including restlessness, fever, and insomnia, to name a few. The addictive brain circuits are crying out for relief. The brain desperately wants the “dope” it knows will provide comfort and the dopamine hit it wants. It could be drugs, alcohol, sugar, fat, or any combination of the reward-intensity laden substances it correlates with pleasure. Thus, the vicious cycle of withdrawal, craving, indulgence, temporary relief repeats itself—with subjective feelings of compulsion, helplessness, guilt, and confusion.
Though the preceding summary of the addiction trap is known to victims and care providers alike, this knowledge by itself is insufficient to break the cycle and empower people to function with a healthier less encumbered brain. Toward this end, it’s important to take practical steps to intercede and change the addictive brain circuits responsible for the havoc.
Fortunately, these conditions, patterns, and negative outcomes are usually reversible. The recent discoveries and developments in metabolic and weight loss science are preceded and complemented by decades of research and clinical practice confirming successful positive brain circuit changes through brainwave training in a treatment called EEG neurofeedback.
Brain function can also be improved through various avenues including diet, exercise, sleep, good self-care, many forms of learning, and potentially through supplementation and medicines. There is abundant clinical evidence that a prime and effective way to better the brain is by training its neuronal circuitry through EEG neurofeedback; this technique shows the brain its activity in real time, thus allowing and encouraging the formation of new patterns of neuronal firing that promote more optimal, flexible transmission and a generalized homeostatic balancing in self-regulation: the brain’s ability and practice of adjusting to meet the changing internal and external demands it encounters.
The importance of self-regulation is critical to understanding how addictive circuits can be revamped. Self-regulation is the functional operation of the brain and nervous system that governs our cognitive and emotional functioning, fight-or-flight responses, and a myriad of other operations. Restored and consistent self-regulation is necessary for reining in addictive circuitry, promoting more functional neural pathways, and for resilience and maintenance of biological equanimity and good habit formation. However, self-regulation alone usually does not address the acute episodic aspects of withdrawal when someone is at the effect of deprivation.
Other interventions have proven helpful and often effective in combating withdrawal and staving off relapse. As mentioned, the newer GLP-1 medications for diabetes and weight loss show surprising benefits in reducing many food and drug cravings. There are psychotropic medications that work very differently and can reduce cravings. Naltrexone and gabapentin are among the commonly used ones. In severe cases of addiction, drugs like Suboxone (buprenorphine) relieve withdrawal symptoms: although buprenorphine is in the opioid family, it eases withdrawal but not provide the “high” that addicts remember and seek. While this approach has many drawbacks, it can be a lifeline to interrupt the use of hard drugs.
In the treatment of addictions, behavioral interventions and human support are vital. Twelve-step programs and sponsors have been instrumental in recovery for multitudes.
Substitutions for the offending substances and associated behaviors are needed to give the body and brain a chance to recover. Whether it’s better food choices, more appropriate nutrition, diverting behaviors, therapist assistance, self-soothing techniques, or usually a combination thereof, relying upon willpower without substantive relief from recurring deprivation states is u unrealistic to counter the intense pull of addictive circuits.
Another method of eliminating cravings is by using Thought Field Therapy (TFT). This is a well-validated treatment of applying sequential tapping on targeted meridian points that carry signals to the brain through neural pathways. There are different versions of TFT, including self-help versions. For decades, I have used the most advanced form, Voice Technology (VT) that allows for precise diagnosis of the causal information that underlies cravings (called perturbations) and I can eliminate cravings in minutes by phone! This method has at least a 95% success rate and can serve as an expedient tool to quash cravings.
The road to recovery is complicated by chronic use of substances that not only reinforce addictive circuits, but cause damaging changes to the brain itself. It is known that heavy alcohol use depletes the brain of its capacity to produce sufficient alpha waves in the appropriate brain lobes. Alpha is among the many natural EEG rhythms we all have. Alpha generation is a default state that allows the brain to rest and idle. When alpha is generated in the appropriate brain areas, it helps the brain relax and feel pleasant. It is also a restorative rhythm that’s conducive to imagination and creativity.
There is a special type of EEG neurofeedback called alphatheta training that allows the brain to re-establish its innate ability to generate sufficient alpha. Other degraded neural firings and inefficiency can also be reformed through different protocols of EEG training. A chief goal In EEG training is the restoration of the brain’s natural ability to self-soothe.
There is some evidence that EEG neurofeedback positively influences appetite control. This is thought to occur because of the taming and regulation of right hemisphere training that simultaneously reduces stress and trauma while evoking the brain’s more sentient awareness of hunger and feelings of fullness. When people are more in touch with how their body is actually feeling, they are less likely to overindulge until a critical “shutoff threshold” is reached. This effect is subtle and not dependent on the gut-brain hormonal response that is so dramatically produced by GLP-1 drugs. It is, however, a very productive effect to quell negative emotions, stress eating, and compulsive reactions to overarousal. It is complementary to other interventions to curb faulty eating.
In his Dope and Dopamine book, Dr. Kessler highlights an obvious bottom line in weight loss: no matter how you define or accomplish dietary and eating changes, what’s required to lose weight is a consistent energy deficit—that is, more calories are burned than ingested. The energy deficit (or surplus) that results in weight gain, loss, or stability is calculated in calories. This mathematical balance is affected by many variables besides the bottom-line values contained within foods consumed. There are metabolic, digestive, and appetite effects that heavily influence what and how much we eat and how our body metabolizes and stores it.
Even without measuring calories or dopamine, we can heartily improve our brain’s management and balance of stress response that directly influences our eating habits and the activation or deactivation of addictive circuits. In this model, we invoke a kind of “fuzzy logic” that targets stress reduction as a way of establishing a fight-or-flight energy deficit that favors stress reduction and the self-control and satiety necessary for enduring management of addictive circuitry and its associated behaviors.
Training the brain with neurofeedback is a successful method of creating and maintaining a stress reduction and tolerance—a brain state of continual balance in which the response to stressors evokes a calmer more functional state than the prolonged fight-or-flight response triggered by stress reactivity.
Again, addictive circuits are formed and maintained through repeated exposure to highly stimulating and satiating substances—foods and chemicals—that flood the brain with dopamine hits much more intense than normally experienced with self-regulation. The ultimate solution to defeating addictive circuitry lies in abstention from these substances that provoke, trick, and deplete the brain. This, of course, is difficult and requires planning, steady persistence, solutions to the pariah of withdrawal and deprivation, and social and medical support.
Our brain is both durable and flexible. It responds to biochemistry and learned habits. Just as our ordinary and familiar habits become strengthened and more automatic the more we practice them, addictive brain circuits react similarly. However, they are more stable and more responsive to external dopamine hits than our conscious choices. Thus, abstinence is a critical and preferred way of turning off those addictive circuits.
Realistically, people are inconsistent. Relapse occurs, and it lurks to spring seemingly without obvious provocation or prediction. Support systems and Voice technology treatment for self-sabotage can be very helpful.
After relapse, one must just pick up the pieces and resume with determination. Though interim failures are discouraging, they may be expected in the course of recovery. Relapse does not have to be a showstopper.
Our brain is very sensitive to neurotransmitters that facilitate proper functioning of the neural circuits that control internal management in highly influence behavior. Dopamine is a crucial “feel-good” neurotransmitter that occurs naturally, but can also be supplied intensely through certain foods and highly rewarding chemicals. When the brain is repeatedly flooded with externally supplied high-intensity dopamine, it transitions to expect such supply instead of producing sufficient dopamine internally. This lays the groundwork for addictive circuits to be formed and strengthened. It is an underlying physiological basis for addiction.
Treating addictions is complicated and multimodal. To facilitate success, these components must be addressed:
The brain is marvelously capable of recovery and new programming. Normalized dopamine transmission can be restored.
Change the brain’s circuits to reduce addictive urges, reduce stress, improve cognitive and emotional functioning, and supplant dopamine satiety? That’s dope, man!
— Mark Steinberg, PhD
