The Adversity Advantage with Doug Bopst CANNABIS SERIES | Dr. Anna Lembke: Addiction, Dopamine, Anxiety & Is It A Gateway Drug?
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Oct 12, 2023 
Dr. Anna Lembke, Chief of the Stanford Medicine Dual Diagnosis Clinic and addiction expert, dives into the complex world of cannabis. She discusses whether cannabis truly acts as a gateway drug and highlights its psychological and physical addictive qualities. Anna reveals that cannabis may not be a reliable remedy for anxiety and explores its interaction with dopamine. They also talk about the withdrawal challenges individuals face when quitting and why embracing abstinence can enhance life quality. Prepare for a thought-provoking journey into addiction and mental health!
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Gateway Is About Access, Not Magic
- The "gateway" label is mostly about accessibility and social normalization, not a unique physiological effect of one drug causing use of another.
- Once reward pathways are primed by addictive substances, vulnerability to other addictions increases due to neuroadaptation.
How Neuroadaptation Drives Escalation
- Addiction follows neuroadaptation: the drug that once relieved symptoms can later cause the opposite problem and require higher potency.
- Learned "chemical coping" makes substances the reflexive response to discomfort, reinforcing cross-addiction risk.
Short Relief, No Long-Term Psychiatric Evidence
- There is no reliable evidence that cannabis effectively treats psychiatric disorders long-term.
- Short-term relief exists, but rapid efficacy makes cannabis vulnerable to neuroadaptation and later worsened symptoms.
