Essentials: Understanding & Treating Addiction | Dr. Anna Lembke

Andrew Huberman

Jun 26, 2025

Episode description

In this Huberman Lab Essentials episode, my guest is Dr. Anna Lembke, MD, Chief of the Stanford Addiction Medicine Dual Diagnosis Clinic at Stanford University School of Medicine.

We discuss how dopamine drives reward, motivation and addictive behaviors. Dr. Lembke explains the concept of the pleasure-pain balance of dopamine and how this cycle plays a key role in the development and persistence of addiction. We also discuss some of the challenges of addiction recovery, including withdrawal, relapses and the potential benefits of psychedelic-assisted therapy.

Episode show notes: https://go.hubermanlab.com/xbtub2m

Huberman Lab Essentials are short episodes focused on essential science and protocol takeaways from past full-length Huberman Lab episodes. Watch the full-length episode: https://youtu.be/p3JLaF_4Tz8

Watch more Huberman Lab Essentials episodes: https://youtube.com/playlist?list=PLPNW_gerXa4OGNy1yE-W9IX-tPu-tJa7S

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*Dr. Anna Lembke*
Website: https://www.annalembke.com

*Timestamps*
00:00:00 Anna Lembke
00:00:15 Dopamine, Reward & Movement
00:01:54 Baseline Dopamine; Genetics, Temperament & Addiction
00:05:24 Addiction, Modern Life & Boredom
00:07:18 Pleasure-Pain Balance, Dopamine, Addiction
00:12:39 Resetting Dopamine, Substance or Behavior Recovery, Tool: 30-Day Abstinence
00:14:26 Relapse, Addiction, Reflexive Behavior, Empathy
00:18:39 Triggers, Relapse, Dopamine
00:21:37 Shame, Truth Telling & Recovery
00:23:58 Addiction, Psychedelic-Assisted Therapy, Psilocybin, MDMA
00:29:01 Social Media & Addiction, Tool: Intentionality

Disclaimer & Disclosures: https://www.hubermanlab.com/disclaimer

Mindsip insights from this episode:

Balance pleasure and pain for optimal homeostasis

The same parts of the brain that process pleasure also process pain, and they work like a balance that always tries to restore a neutral state called homeostasis.

#brain

#homeostasis

Reframe boredom to combat addiction in modern life

Many people with addiction are not inherently flawed but are unsuited for a modern world that is "boring" and lacks the necessary friction their brains require to be happy.

#addiction

#mind

Strengthen brain circuits by practicing truthfulness

The practice of telling the truth may strengthen prefrontal cortical circuits and their connection to the brain's reward pathway, which is crucial for overcoming addiction.

#addiction

#brain

Use social media intentionally to avoid its addictive nature

Social media is not a neutral tool but is engineered to be a drug, meaning we must use it with intention and pre-planned boundaries to avoid being used by it.

#addiction

#social-media

Understand dopamine as a baseline for pleasure and pain experience

We are always releasing dopamine at a baseline rate, and it's the deviation from this baseline, rather than isolated hits, that determines our experience of pleasure or pain.

#dopamine

#mood

Reset dopamine pathways with a 30-day fast

It takes an average of 30 days of abstinence from a high-dopamine substance or behavior for the brain to reset its reward pathways and regenerate dopamine transmission.

#dopamine

#fasting

Prepare for initial discomfort during dopamine fast

When starting a dopamine fast, you will likely feel worse for the first two weeks before you start feeling significantly better in weeks three and four.

#dopamine

#stress

Recognize severe addiction as an unconscious reflex

In severe addiction, the brain's pleasure-pain balance can be permanently broken, making relapse a reflexive action like scratching an itch in your sleep, not a conscious choice.

#addiction

#cognition

Recognize positive triggers to prevent relapse

Triggers for relapse are not only negative events; positive experiences can also be triggers because the associated dopamine release can reactivate the craving cycle.