What Addiction Science Got Wrong About Dopamine, with Dr. David Nutt | Flourishing After Addiction #45 "It's inconceivable there can be just a single chemical that mediates all the effects of what addicted drugs have. That was so patently daft."

I spoke with Dr David Nutt of @Drug_Science
on one of addiction science’s biggest errors: dopamine as the whole story. “Patently daft,” he says.
(We also talk psychedelics, drug development, and circuit models)
Read more and listen here: carlerikfisher.substack.com/p/what-addic...

This book is out TODAY! I put my whole heart into it. You can buy it wherever you buy books. www.penguinrandomhouse.com/books/725681...

My event on June 10 at The Strand is sold out but there are a few tickets left for the Brooklyn launch with Leslie Jamison at Public Records via Books Are Magic: www.eventbrite.com/e/offsite-me...

and now tagging @owenflanagan.bsky.social now, who i didn't realize was on bluesky!

Thanks Josh!

What Is It Like to Be an Addict? with Prof. Owen Flanagan Podcast Episode · Flourishing After Addiction with Carl Erik Fisher · 2025-04-22 · 1h 6m

I’m excited for this podcast with @drcarlerik.bsky.social and @owenflanagan.bsky.social. podcasts.apple.com/ca/podcast/f...

-what makes a behavioral addiction “real?”
-the ethics of addiction, how to connect morality and virtue to addiction recovery without reinforcing stigma.
And throughout, Owen shares about his own recovery process, including how it evolved over time and what he’s working on today.

We talk about:
-the spectrum of "powerlessness" in addiction and the finer points of self-control
-problems with traditional explanations of willpower
-critiques of the usual stories about dopamine’s role in addiction
-behavioral additions like sex, shopping, and video games

He brings that deep knowledge to bear on addiction to challenge oversimplified addiction narratives and offers what he calls an "ecumenical" approach—arguing that substance addictions are far more heterogeneous than we often recognize, with diverse causes, neural profiles, and lived experiences.

The book combines personal reflections with philosophical expertise to propose a new, integrated model for understanding substance addiction. Owen, Professor Emeritus at Duke, is internationally acclaimed for his work in cognitive science, ethics and the philosophy of psychology and neuroscience.

What Is It Like to Be an Addict? with Prof. Owen Flanagan | Flourishing After Addiction #40 "One cannot have a complete theory of addiction without incorporating the addict’s experience. Listen carefully to what addicts say about what it is like to be an addict."

I got to interview Owen Flanagan, an excellent philosopher of addiction (and much more), about his new book, What Is It Like to Be an Addict?
open.substack.com/pub/carlerik...

I posted a comment about the mutual aid comparisons here

Ooooh fascinating I look forward to reading this

This is why I was glad to see the post by Freddie, from someone with lived experience of what it's actually like to be manic/psychotic. I also wonder if Delano takes the subway.

I don't know what to call it either! But I do know that even in coaching, usually quite unregulated and to my mind less formal than peer support, orgs still have ethics guidelines about seeking outside help when a client is a danger to self or others.

I'd be interested in more on that concept. For example it seems like there is an important distinction between assessing 1. Whether gaming contributes to life domains (effect) versus 2. The intention with which one comes to a gaming session (initial motivation?)

Well done! To me, "gaming life fit" is the most interesting element here. I understand from the paper that you are still developing this measure. Conceptually it seems like rich and complicated ground to assess the subjective alignment of gaming with valued life domains.

It's very meaningful to hear from you, thanks for sharing. And glad you're ok these days.

relevant front page of FT today about the Trump memecoin today, which I discuss in my gambling essay

Thanks!

My New York Times Essay: What Sports Betting Reveals About Addiction What’s different now isn’t the underlying susceptibility, it’s that technology and concentrated commercial power have made these vulnerabilities impossible to ignore.

I listed more resources and reading on this post: carlerikfisher.substack.com/p/my-new-yor...

There are lessons here for how we protect ourselves as individuals, guide our children through a world increasingly littered with gambling dynamics, and build commonsense regulations that acknowledge gambling as a public health issue.

I describe how gambling’s harms extend far beyond what we commonly understand, and how the gambling boom (a $150 billion industry!) reveals truths about the addiction in all of us. Modern tech has also transformed a simple wager into a highly targeted, always-on stream of micro-bets.

Opinion | The Price We Pay Betting on Sports

I have a new essay out in The New York Times today: "What Sports Betting Reveals About Addiction." I challenge some assumptions about addiction through the lens of America’s sports betting explosion, just in time for Super Bowl Sunday.

www.nytimes.com/2025/02/08/o...

Welcome!

Self-Control Matters in Addiction The biomechanical disease folks are right that there is a there there, that when people with addiction say they feel powerless, we should take them (us) seriously. The choice folks are right that even...

I wrote about the paradox of self-control in addiction. open.substack.com/pub/carlerik...

Keith Humphreys and John Kelly setting the record straight

RFK Jr. endorses medications for opioid addiction at confirmation hearing, but misleads on 12-step programs During his Thursday Senate confirmation hearing, RFK Jr. shed light for the first time on his attitudes toward medication-assisted treatment for opioid addiction.

RFK says he supports methadone and buprenorphine — but majorly misrepresents a study that he claimed shows 12-step programs are more effective vs. opioid addiction

(The study was exclusively about alcohol!)

www.statnews.com/2025/01/30/r...

The Society for the Study of Addiction have just joined Bluesky. Please give them a follow! @ssa-addiction.bsky.social

I think Ian McGilchrist would agree, though he puts it all in left/right brain terms