Blocked and Reported Katie and Dr. Joe Volpicelli on Addiction Medicine
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Oct 29, 2025 Dr. Joe Volpicelli, MD, PhD, director of the Volpicelli Center and a leading expert on addiction medicine, shares insights on treating alcoholism. He discusses how stress influences drinking behavior and the role of endogenous opioids in addiction. The conversation delves into the evolution of addiction theories from the 1970s, contrasting reward-driven versus relief-driven drinking, and the effectiveness of naltrexone. Volpicelli emphasizes personalized treatment methods like the Sinclair method, which has transformed patient experiences with alcohol cravings.
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Control Over Stress Reduces Alcohol Use
- Joe Volpicelli describes rat experiments showing uncontrollable stress increased alcohol drinking while controllable stress did not.
- Rats with control showed far better survival in a cancer-cell study, illustrating resilience from control.
Endogenous Opioid Deficit Drives Drinking
- Volpicelli links post-trauma decreases in endogenous opioids to increased alcohol use as self-compensation.
- Alcohol stimulates endogenous opiates, so drinking may offset a relative opioid deficiency after stress.
Addiction As A Motivational Disorder
- Volpicelli defines addiction as a motivational disorder where the behavior creates more need to do it.
- He compares it to an uncontrolled growth that takes over other motivations, an "unnatural hunger."
