Dopamine and Addiction – Dr. Anna Lembke Interview

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Salam aleikum wa rahmatullah wa barakato. How're you guys doing and welcome to another episode of The MH podcast, one of the most irregular podcasts on the internet. But we're joined with very special guests, whose book I've just read cover to cover a fantastic one at that. It's called dopamine nation. And it's all about addiction. It's all about dopamine. It's all about how you can moderate yourself. It's all about how you can get a balance between pain and pleasure in life. And we're going to be exploring that. But just a quick introduction. On the professor

Anna Lemke is a professor of psychology, psychiatry at Stanford University School of Medicine and chief of the Stanford Addiction Medicine, dual diagnosis, diagnosis clinic, clinician scholar, she has published more than 100 Peer Reviewed papers, books, chapters, and commentaries. She sits on the board of several state and national addiction focused organizations has testified before various committees in the United States, House of Representatives and Senate, keeps an active speaking calendar and maintains a thriving clinical practice. In 2016, she published a drug dealer. And of course, she's also published dopamine nation, which is book that I have just referenced that How are

you, doctor? I'm doing well. Thank you. How are you doing? Not bad at all. We're in the month, the holy month of Ramadan. And we're partaking in fasting, which of course you kind of mentioned, but you definitely allude to restricted practices, like for fasting and your book.

Why I wanted to do is start off by asking simple questions. So what is dopamine and why is it important?

Dopamine is a chemical that we make in our brains. It is a neurotransmitter neurotransmitters are molecules that bridge the gap between neurons. Neurons are those long, spindly cells that work by conducting an electrical signal from one to another. And they don't touch end to end, there's a space between them that space is called the synapse. And it's bridged by molecules or chemicals called neurotransmitters. And dopamine is one of those neurotransmitters. Dopamine is essential for the experience of pleasure, reward and motivation. We have a dedicated circuit in our in our brains called the reward pathway that is rich in dopamine releasing neurons. And it's where we mediate the

experience of pleasure also happens to be co located with where we mediate the experience of pain. And it's also the neurotransmitter that can get out of balance when people go from recreational adaptive use of a substance or behavior to addictive, maladaptive use. Dopamine is also really important for movement. And it's probably no coincidence that the same neurotransmitter involved in pleasure reward motivation is also important for movement. Because for most of an organism's existence, it has to move and do work to get the rewards that it needs to survive. That's actually no longer true for many humans on the planet, which is part of the problem that we're facing. So you

mentioned that dopamine is very, very important for pleasure. There are other things that have been mentioned and also prescribed. Well, not necessarily prescribed in the sense that now if people get antidepressants, they get something called SSRIs which tackles or deals with or inhibits serotonin. So why is it that we're for example prescribed so total inhibitors and not dopamine inhibitors? For example, why? Why is it Why the focus on serotonin?

Yeah, so

antidepressants actually function by not by inhibiting serotonin but by augmenting serotonin in the brain. They do that by inhibiting an enzyme that breaks the serotonin down or actually brings it back up into the presynaptic neuron. But independent of the specific mechanism, the net effect is to make for more serotonin and we know that serotonin is one of our what we would call feel good neurotransmitters along with dopamine and norepinephrine. It's part of the mono aiming system.

But to your point more broadly

Yeah, why? Why focus on dopamine.

Dopamine has become a kind of common currency for neuroscientists to measure the phenomenology of addiction.

Many addictive substances work by different chemical cascades. But the final common pathway for all reinforcing substances and behaviors that are addictive, is to release dopamine in the brain's reward pathway. The more dopamine that is released in the faster that it's released, the more likely that substance or behavior is to be addictive. But certainly serotonin is a is an important mediator. For example, when we think about love and sex addiction, that definitely works on the serotonergic system, social media addiction works on the search nergic system. But again, the final common pathway is to release dopamine. So that's why dopamine is sort of a focus of neuroscientific

research. I see. Okay, so let's get into more practical discussion. Then.

We talk about addiction. Obviously, that's your focus. In your book, you have all these case studies in your book for people who have suffered from addiction very interesting.

And insightful. I was gonna ask you now, what have you seen works on a practical level, someone who is suffering from some of the stuff that you've mentioned, let's say drug addiction, alcohol addiction, and let's say, marijuana addiction, let's, let's say sex addiction, or pornography addiction? How would you help somebody in that situation?

Well, first of all, it's important to individualize the treatment for that person. Because you know, addiction is a spectrum disorder. So you can be mildly moderately or severely addicted. You can even have kind of a predictive state where you're not quite crossing over addiction before we continue. I mean, how would you? How would you find it? Yeah, yeah, great. So addiction is the continued compulsive use of a substance or a behavior, despite harm to self and or others. Sometimes that's harm that the individual who is addicted can see and appreciate sometimes the harm that they can't appreciate. Importantly, we we base the diagnosis on something we call phenomenology, that is to say

patterns of behavior through time, there is no brain scan, or blood test to diagnose addiction. It's really based on pattern recognition of these continued compulsive behaviors that lead to is there a threshold something must meet before it meets the bar of addiction? So for example, at what point do we, this might sound silly, but at what point? Do we call somebody a alcoholic? Well, at what point do we call them a an addict to pornography or an addict to anything? Is that a number that must be reached? Or is it quite subjective?

I mean, both in the sense that the Diagnostic and Statistical Manual of Mental Disorders has 11 criteria, which need to be met in order to diagnose addiction. If you meet two of those criteria, two to three, you have a mild form of addiction, if you meet four to five, you have a moderate form, and six or more, you have a severe form. But determining who meets those criteria is highly subjective, right? You could go to 10 Different psychiatrists, and maybe they would give you 10 different, you know, gradations on the mild, moderate, severe spectrum? Or maybe they would think, no, you're not on that spectrum at all. Those numbers that you mentioned, what was the time period?

And what's the frequency? And what kind of addiction are we talking about? Well, first of all, let me just say that drug and alcohol addiction

is something that's clearly established within the Diagnostic and Statistical Manual of Mental Disorders, process or behavioral addictions. These are addictions to things that we do, rather than things that we put into our bodies. Only gambling addiction has made it into the Diagnostic and Statistical Manual, also sex addiction and pornography addiction that has not made in there. No, not yet. Not yet in their social media.

Well, I think it will eventually be in there because I I am I to me, it's non ambiguous that these are bonafide addictions. The same natural history or course of disease that we see with drug and alcohol addiction we see with sex pornography, compulsive masturbation addiction. So I think all of that will eventually make its way but at this point, there's still controversy and people some people you know, in the field of mental health don't believe that you can get addicted to sex. They think that it's like a social construct overlaid upon

you know, the sexual behaviors that interpret someone's lifestyle choice as an addiction, when in fact it's Can I ask you on that because, yeah. How would you know if someone's a six out of

It's

so the

continued compulsive use despite harm to self and our others. So I'll just give you like a little, you know,

somebody who read my book wrote me quite a sort of a nasty note saying that I was harming people, specifically, you know, in the book, there's a case of a patient who has a severe sex addiction to the point where he

makes a masturbation machine, that he can allow other people to manipulate his genitalia using electricity remotely, extremely dangerous, right. So the potential for harm to him is great, just even physical harm, but also it destroyed his marriage, it was destroying his professional life, it was contributing to anxiety and depression. And ultimately, he wanted to end his life. So he came to me wanting help for a behavior that he wanted to stop. She was not not able to stop on his own. So to me, he's a very clear case of continued compulsive use despite harm to self enter. Yeah. Right.

So if the person is just is, like, one aspects of that definition was,

was in place, but the other aspect wasn't. So for example, if someone is continually having intercourse, and to the point where if they were by themselves, and they could not have access to that, that they would feel it was kind of withdrawal of impact that would have a psychological impact. But it doesn't necessarily the act of intercourse, say wouldn't have harm a harmful effect on themselves or on another person? Would you still consider that to be an addiction? Or? No, no, I wouldn't normally. Okay, yeah. So somebody if that person, you know, was engaging in a sexual behavior that was not harming other people, and it was not perceived by that person to be harming

themselves, even if when they stop, they experience some degree of physical withdrawal, as we typically would, when we stop a physical behavior that we've been doing habitually.

You know, but that, but that's not addiction, right? That's, that's, that's, that doesn't meet the criteria. I see. Now, it could be it could be, though, that that person was actually harming somebody else, and didn't realize it or didn't see it with the kind of clarity that they might have seen had they not been caught up in addiction, or maybe they were actually harming themselves, but again, didn't see it clearly. So these, this is where the art and the science meet. And that's what I was gonna say to you, because the point about harm is,

it's also deeply psychological. Because if somebody, for example, has a moral reasoning for not doing something, obviously, in the religious tradition, that's very, you mentioned a few case studies and factor of religious people, Catholics and others, who consider something to be wrong. So therefore, they, they,

they feel guilt if they do it. And in the sense that can be conceived as a kind of harm. So maybe, yes, yes, absolutely. So part of what happens in addiction is people act outside of their own moral compass, and that causes them moral injury, right? causes them spiritual injury, you know, it's, we often talk about addiction as a bio, psychosocial, spiritual disease.

And you know, all of those elements are part of it. So then, that would probably like impact something like pornography addiction, a lot more, because I can imagine a lot of people watching pornography and being compulsive uses of it. But

you know, a group or a subset of people could say that, well, there's nothing in my morality, which doesn't permit such a thing. Whereas a group or a subset of another people would say that actually, this is causing me a lot of guilt and anxiety and depression. And for these people, it would be, then addiction and for these people wouldn't be addiction, according to this definition. Yes, exactly. Okay. So in that case, let's stick with with that, because let's save these behaviors. Someone is addicted, and they do want to get rid of it.

I'll give you a couple of case studies or a couple of things that people could be addicted to. And you tell me what you think. I know. This is very simplistic, and it's, oh, no, no, no, these are these are actually good. These are good questions. You're getting at some of the you know, the finer nuanced points. So for example, if someone is, you know, addicted to substances, and your your specialism was opioids, I think it was in the flesh, I treat all addictions, so not just opioids. Yeah. But say opioid addiction, or let's say, for example, alcohol addiction or anything else. What would be the way because you mentioned the AAA, the 12 steps of the AAA. Are you a believer of that

of the 12 steps of VA or what would be the way in which you deal with that person who has a substance problem?

While you're sort of asking me to kind of condense the you know,

On the sort of the treatment of Addictive Disorders, you know, it's hard to to condense all that in five minutes, or even 10 or even an hour. But, you know, broadly speaking, I think it's, it's important to conceptualize addiction as a bio psychosocial disease. That means that there are biological components to the D disease, both genetic risk factors, inborn risk factors, plus the way that people change their brains over time, after exposing themselves to the reinforcing substance or behavior. So you've got a biological component, you've got a psychological component, which happens on many levels, right, you've got the trauma that can come from being addicted and the fallout from

that you've got other psychological factors that may be contributing to that, that's persons seeking, you know, addictive substances and behaviors. And then you've got the social piece, that's the environmental piece, we're very social creatures, and addiction moves through populations, like an infectious disease with vectors. So if you're living in a place where everybody is using or a lot of people are using, or you're raising a family, we're using his model, then that contextual piece is going to impact it. And we know that one of the biggest risk factors for addiction is simple access to a drug. If you have easy access, you're more likely to try it and more likely to get

addicted. I'll leave the spiritual piece out that's sometimes that we bring that into But just for now, we'll call it bio psychosocial. So that means our interventions also need to be potentially biological, psychological, and social. So just to give examples for an opioid addiction, a biological intervention might be a methadone maintenance program. Right or a buprenorphine. These are medications that are evidence based for the treatment of addiction. Lots of placebo controlled trials across decades and continents, showing that people with severe opioid addiction, who get on methadone maintenance, maintenance, or buprenorphine maintenance, have better outcomes and people

with severe opioid addiction who do not okay, we'll leave that aside, then you've got psychological components. This is where once people get into some degree of recovery, kind of looking deeply at what some of the psychological reasons that might contribute to their addictive behaviors. I don't like to say psychological reasons that cause addictive behaviors, because really addictive substances cause addictive behaviors, you don't need to have a psychological trauma to explain it. But certainly traumas can contribute. And then so there, you might do individual psychotherapy or group psychotherapy, and then you've got your contextual or social, that's things like all of my

friends use. And if I don't use, I can't hang out with my friends, I have nothing to do, I'm completely bored. That's where Alcoholics Anonymous Narcotics Anonymous help people reestablish a sober, sober social network of non using peers that can then act as supports through the sponsorship program and working the 12 steps, which is also a psycho spiritual program that helps people get into recovery. And there's evidence to support the you know, a Alcoholics Anonymous narcotics. So that would be sort of an example. Excellent. So that's moving with like substance. What about behavioral things? So some of the things you mentioned, we mentioned the beginning. So things like

pornography addiction, sex addiction, any other thing that you can imagine what would be would it be broadly the same approach? Would it be a different approach? It's broadly the same approach. So for example, someone in the early stages of recovery from a sex pornography or compulsive masturbation addiction, we might prescribe a selective serotonin reuptake inhibitor. Why? Because it turns out one of the side effects of SSRIs is to decrease libido. Yeah, decrease the sex drive. So that can help people with sort of appetitive control around sexual impulses, a psychological intervention would be to do group or individual psychotherapy, talking about sort of their sexual identity, their

sexual impulses, and fantasies and experiences and trying to understand that, and then, you know, the, the environmental or contextual sexaholics anonymous, Sex Addicts Anonymous, these are 12 Step groups, sex and porn Addicts Anonymous, a lot of them are online now to help people also, you know, often couples because there's a lot of betrayal shame that happens with a sex addiction. So trying to get couples to, you know, come back. And in all of these, you know, well, no matter what the drug is, the early intervention, except, you know, in some cases, is to get people to abstain from their drug of choice long enough to kind of reset reward pathways. So when when we're talking about sex

addiction, that's where we encourage people not to have any orgasms with themselves or others for 30 days. Why 30 days, because 30 days is about the amount of time it takes

To kind of reset reward pathways and get people out of that state of constant craving, days of Ramadan that the Muslim can can benefit from the Yeah, yeah, it is really interesting that like neuroscience and clinical experience that points to 30 days being kind of the magic number, not where people are cured of their addiction. 30 days is not enough to cure anybody.

And in essence, it's a chronic, relapsing remitting disease that people often have to face for their whole lives. But it is often enough to sort of get people again, out of that vortex of craving. And every major religion of the world, as far as I can tell, also has a recommendation for about 30 days of fasting from something, whether it's Ramadan, or Lent, or you know, other traditions that recommend that kind of thing.

So what I find really interesting, near the end of your book is where you speak about pain and pleasure. And I've seen some of your presentations online as well, where you, where you talk about this delicate balance between pain and pleasure. And one part of the book actually stuck out to me where you mentioned that

you mentioned basically, that in order to we need to think of embracing pain as a new way of dealing with it, in fact, and you mentioned exposure therapy, obviously is known psychological mechanism.

What, how would you know we're living in the age of overconsumption? How would you characterize this? How is it that can someone can balance, pain and pleasure? Practically speaking?

Right. So I mean to me, you know, in order to understand the modern quandary or dilemma, it's essential to understand the basic neuroscience of how we process pleasure and pain. Sure, at the simplest level, pleasure and pain are co located in the brain, they work like opposite sides of a balance when we experience the brain. We're talking here, we're talking about the reward pathway, the nucleus accumbens, the ventral tegmental area. These are deep, you know, limbic brain emotion brain structures, but also communicate with the prefrontal cortex, which is the large gray matter area behind our foreheads. The prefrontal cortex acts like the brakes. The nucleus accumbens acts

like the accelerator addiction is a problem either with too little breaks or too much accelerator. But more importantly, pleasure and pain. We are reflexively we're evolved over millions of years of evolution to reflexively approach pleasure and avoid pain. We don't have to think about doing that. Our brains are constantly working to address that goal, approach pleasure, avoid pain. In fact, we have to think about avoiding pleasure and approaching pain. That's a that's a heavy cognitive load for us. And you could argue, Well, why would you want to do that? Well, our brains really evolved for a world of scarcity and ever present danger where we had to work very hard for scarce rewards.

That's not the world we live in today. We live in a world where we're inundated with quick pleasures. You mentioned a quote on this.

And I find it very poignant. I don't know who you quoted, but you mentioned it's like cactuses in the rainforest. Rainforest. Yeah. Right. Yeah. So this, you remember who said, Tom, for new Ken, he's actually a diabetes specialist. Um, but it speaks to the same thing. Yeah, that we didn't know, the world that option and that we're no longer having to work and be resourceful in the same way as a cactus without to be in the desert. Right. And to understand why this is problematic, this world of overabundance, it's essential to understand the brain mechanism. Sure, that is leading us to approach pleasure and avoid pain, and essentially like a seesaw or a teeter totter. When we

experience pleasure, it's one way but when we're expected to experience pain, it's the opposite. The number one rule governing this balance is that it wants to remain level. It doesn't want to be deviated for very long to the side of pleasure or pain, such that with any deviation, our brains work very hard to restore a level balance or what neuroscientists call homeostasis. And the way our brains restore level balances first by tilting an equal and opposite amount to whatever the initial stimulus was, so when we use an intoxicant that releases dopamine, our balance tilt to the side of pleasure, no sooner has that happen, that our brain adapts. I like to imagine that as these little

neural adaptation Gremlins happening on the pain side of the balance, to bring it level again, but the Gremlins like it on the balance so they don't get off as soon as we're level. They stay on until we're tilted an equal and opposite amount to the side of pain. That's the come down the hangover, or that moment of craving. If we wait long enough without consuming the graph on top off, and homeostasis or a level balance is restored. But if we continue to consume our drug of choice over days, two weeks, two months, two years, those guys

almonds multiply on the pain side of the balance and then after a while, we've changed our hedonic or joy setpoint. Now we need more of our drug and more potent forms not to get high, but just to level the balance and feel normal. And when we're not using we're walking around with a balance, tilted to the side of pain, experiencing craving, anxiety, irritability, insomnia, dysphoria, the universal symptoms of withdrawal. So how does that relate to your question about why pursue pain? When we're living in a world of overwhelming overabundance, we're constantly bombarding our reward pathway with these high dopamine rewards, which means that possibly most if not all of us are

walking around with a changed hedonic setpoint. Finding that it's difficult to take pleasure in anything at all, and we need more and more pleasure to feel anything remotely resembling pleasure, which means that in a world of overwhelming abundance, what we need to do is abstain from intoxicants, or at least leave enough time in between, for the Gremlins to hop off and for homeostasis to restore be restored, and intentionally seek out pain. Because when we intentionally press on the pain side, those Gremlins actually hop on the pleasure side, and tilts are balanced to the side of pleasure. And we get dopamine indirectly by paying for it upfront. An example would be

exercise so we know that exercise is immediately toxic to cells. But what happens is when the body senses injury, it starts to upregulate feel good neurotransmitters like dopamine, serotonin, norepinephrine, are endogenous opioids are endogenous cannabinoids. So we get the runner's high, right, we get that little bump. And we know that in experiments, for example, where people exercise or they immerse themselves in ice cold water bath, or take the James Bond shower, that's a cold shower at the end of the regular shower. That joke has I mean, yes, that's right. Well, and because because people get dopamine from it, and they get it indirectly by paying for it upfront, which

makes it less vulnerable to the problem of addiction, not invulnerable, but less vulnerable. And so you know, we get our dopamine rises over the latter half exercise and it stays elevated for hours afterwards. Before going back down to baseline, it never goes into that dopamine deficit state. So we don't accumulate Gremlins on the pain side of the balance, because they're working over on the pleasure side. So that's, that's the example this idea that I did like it when you when you mentioned that, and it was, it was very powerful. And you quoted some classic philosophers like Socrates, and others in the Hellenistic period who had said the same thing really a long time ago

that Yeah, it seems like it's an old

kind of understood philosophy, which is that really, if you want to have a balance in life, there's homeostasis you speak of you do have to pursue pain.

And exercise obviously, is a great example. We would probably say fasting is another I mean, I've been fasting today as well.

And the Islamic fast is that you can't have food drink, or engage in sexual behavior at all. And when I when I ate the food for all of all of Ramadan, you can't have sexual contact, or is it just dry until sundown? So from dawn till dusk, can't do that. Got it. So I've after dusk until dawn, again, you can you can do that. But what I do eat the food and drink water and other fluids, to be honest, is like the best food you've ever had. Because that's right. I mean, and you can probably explain that in the way that the dopaminergic effect or

same kind of thing. Yeah.

So that's one thing. Is there a danger? Someone could ask to play devil's advocate? Is there a danger

in just reducing human satisfaction, contentment, whatever I call it, to chemical processes, like, for example, whether we speak about

whether we speak about dopamine, serotonin or anything else, could there be a danger in doing that? How would you respond to someone asking that question? Yeah, I mean, I think anytime we simplify in order to convey, you know, a fundamental message, there's a danger there, right? We've over simplified, we've left out other aspects, like meaning and purpose. You know, we're not just some kind of, you know, sort of mechanistic robot like creatures, you know, who either have too much dopamine or too little dopamine. Yes. And plus, you know, the whole mechanistic explanation is just a frank oversimplification, because although

pleasure and pain do work in this opponent process, way to some degree

We also know that we can experience pleasure and pain at the same time, for example, when we eat spicy food, right, that's pleasurable, pleasurable and painful. So, yes, oversimplification, or over over overdoing, like a kind of a mechanistic perspective on the brain, you know, should I think it can be valuable? As long as we know, it's, it is an oversimplification.

You mentioned a few key words, very interesting.

But you also mentioned in your book that there's this paradox,

the paradox that you have high income nations,

like Western nations, for example, European nations, but also nations in Africa and Asia,

which we have the money, we have the resources now. And we in fact, we have the ability to do things at a quicker and faster pace and rate than we probably ever had in human history, before were effectively lay people living the life of kings in the pie. And

that has had a paradoxical effect, which is, with all these studies that you've cited, it's actually made people in those nations more depressed. So what do you think is, is the reason for that overconsumption? Or could it be a lack of meaning, as you mentioned, now, as well, could that also be a reason?

There is no doubt it's multifactorial, and you know, this kind of lack of meaning and purpose, social dislocation, economic inequality, multi generational trauma, there are lots of, you know, things that we could cite, contributing to our growing discontent. But what's striking to me is that if you look at happiness surveys, people in the richest nations of the world for the first time ever, are becoming less and less happy, which is different from how it was, let's say 25 years ago, where you could clearly track happiness surveys, happiness going up, as nations got wealthier, around 25 years ago, that changed and the wealthiest nations in the world are now you know, are now

home to a growing number of unhappy people. Same thing, if you sort of look at it through the lens of psychopathology, rates of addiction rates of what true rates of addiction, but also rates of anxiety, depression, are going up all over the world, but they're going up fastest in the richest nations of the world, which are the same very same places where people have the most access to modern mental health treatment, which suggests we're getting something fundamentally wrong potentially, about how we intervene. And so the hypothesis and dopamine nation is that it is over abundance and choice and quick fixes and dopamine that is essentially causing our growing despair.

But there be said to be a presupposition, which

maybe is kind of not being tackled, which is that when we speak about what in nations, which are like, higher income nations, if you like, higher GDP per capita measures, whatever way you want to put it, that that leads to less happiness, whatever it may be, that happiness is being seen as the most important thing. And what the question is, why should why should we want to be happy in the first place? Why is happiness the key emotion that everyone is striving for? Is happiness, a long jivas type of happiness? In fact, what we should be opting for in the first place? Or is there something else maybe like contentment or satisfaction or some other word that can be used? And

objective? Which would be better or even a more sought after than happiness? Yeah, I mean, I do. I do think that, you know, along with the phenomenon of paradoxical over abundance, and the striving for pleasure, which really doesn't give pleasure is a is a cultural narrative that says we must be happy we should be happy if we're not happy. Something's wrong with our brains, we're ill something's wrong with our our life, we need to change our life. So a kind of expectation for happiness is something that certainly is true in American culture, for example, and I think is also goes along with kind of a successful capitalist system. Yeah. Because really, the ultimate

capitalist is an addict, right? I mean, if for if you consider sort of taking successful capitalism and taking it to its pinnacle, we would all be compulsive over consumers all the time.

So yeah, but I just think it's also it's, it's sort of part of the phenomenon is that the

narrative changes to,

you know, this narrative becomes sort of a narrative of must be happy. Otherwise, something's wrong with my life. If someone came to me this last question, because I know you've, you're tight on time is someone came to you with an addiction problem and said, I've got these substance addiction problems, I've got these behavioral addiction problems.

And you only had a few moments to spare to give them words of advice and wisdom, what would those words of advice and wisdom be?

Many times people with an addiction believe that they only have two options, they can either keep using their drug and be miserable, or they can stop using their drug and be miserable.

My job is to convey to them that there is a third way where they can stop using their drug or potentially at some point down the future, moderate or use less of their drug and, and find a place where they're not constantly miserable. So holding out hope that there is this sort of way to give up the drug, give up the addictive behaviors and still find a life worth living and in fact, find a life that's even better than it might have been had they never had the addiction in the first place. Fantastic. Excellent. Well, I would tell them is

go and read a fantastic book that I've read,

nation, which is available isn't that people can get that on, on Amazon and can listen to it as an audiobook and different kinds of things.

Thank you so much for enlightening us with an edifying us with some of your wise words. It's really good, what you've done here and explaining the mechanisms, the physiological mechanisms of how this works, I think it will be extremely helpful to people who are suffering from these addictions. And, of course, they are going to read your book as well. We'd love to have you on the show some other time.

And thank you, I appreciate it. It's very kind of you. And yeah, my goal is to teach people and get the message out and help people so I'm really happy to be able to have you know, your platform to potentially do that. Thank you.

You're welcome. And thank you very much. With that, guys. We will be concluding the show. And you are welcome to go ahead and buy Dr. Donkeys book and see many of her things. She's done many podcasts online as well. With Dr. Huberman, Dr. Andrew Huberman. She's done a various presentations, and of course, her book as well. Thank you for that was Salam Alaikum Warahmatullahi Wabarakatuh how you are you wasting your time on social media again, your brothers and sisters in Islam net from Norway are establishing a masjid a Dawa center. Establishing a masjid to convey the message of Islam is one of the best deeds a Muslim can do. There's a huge need for Norway. Do you know this and I

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