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How Will Our Children Balance Pain and Pleasure in 2040?

by | Aug 9, 2023 | Book Review, Children, Future, North Carolina, Well-being | 0 comments

Once in a while, a book comes along that makes you think about things in a different way. Dopamine Nation: Finding Balance in the Age of Indulgence by Anna Lembke is that kind of book. The Hidden Brain podcast also has an insightful interview that introduced me to her work.

Lembke is a practicing psychiatrist who helps patients escape from addictions. My image of addiction before reading her book was a guy in an alley shooting up heroin. Lembke argues that addictions come in many forms including illegal drugs, but also an endless list that includes junk foods, prescription opiates, social media, news, gaming, porn, shopping, gambling, alcohol, nicotine, sex, romance novels, and even work.

The fact that people can become addicted to any of these substances or behaviors is not a surprise. A new insight (for me) in Lembke’s book is that addiction to any of them works through the same brain mechanism. There are specific regions of the brain that recognize whether something is pleasurable or painful. People react differently to the various substances and behaviors, but for all of them, it is the release of the chemical dopamine in our brains that gives us the feeling of pleasure.

Why does this matter to the next generation?

Most of us want our children and grandchildren to be healthy, creative souls, to be happy, to have meaningful relationships with others, to find work they enjoy that provides a decent living, and to feel safe. Lembke gives example after example – both from statistics and from her experience with patients – of people losing their marriages, jobs, health, and going bankrupt because of their addictions.

Perhaps the first thing most people lose is their integrity as they try to hide their addiction from family members, spouses and employers. As a relative of mine who had been sober for five years joked, “How do you know an alcoholic is lying? Their lips are moving.”

Another thing they lose, according to Lembke, is their ability to plan ahead. As an addiction grows, they focus on how to satisfy it from day to day instead of steps they could take to achieve a better future.

Most occasional pleasures do not lead to addiction. However, as an individual starts using a substance or engaging in a behavior that gives them pleasure, it is easy to lose control. If they become a frequent user, the brain adapts and provides less feelings of pleasure with each event. That motivates a user to increase the frequency of use or the size of their dose. Eventually, even frequent use gives little pleasure, but quitting is painful. Without the feeling of pleasure they initially had, many of Lembke’s patients became anxious and depressed.

Addiction will be an increasing problem for the next generation

The second part of Lembke’s title – In an Age of Indulgence — gives a clue about why we should fear for the next generation. Her argument is that our species evolved in times of scarcity when pleasures were few. For most people, society provided few opportunities to become addicted. That started to change in the 1800s as alcohol and cigarettes became affordable. The twentieth century brought declining costs for every type of addictive substance and behavior.

Think about the environment for our kids today:

  • Most of the addictive substances and behaviors I mentioned above have become cheap or free.
  • The Internet, cell phones, and quick delivery services have made access easy.
  • For most of the substances and behaviors, someone – whether a drug cartel or a corporation — has a financial interest in getting our kids hooked.
  • Legal penalties seem to be dropping. Witness the legalization of sports betting in North Carolina.

In summary, our kids have stone age brains facing pleasurable addictions their great-grandparents could only dream of. The impact of this mismatch can be seen in statistics for “alcohol and drug use disorder deaths” between 2000 and 2019. According to the World Health Organization, they increased from 21,000 per year to 89,000 in the U.S. If they increase by the same rate, there will be 364,000 deaths per year by 2038 – almost 1,000 per day.

Are there solutions?

It is doubtful that there will be widespread changes in the biology of the human brain by 2040. It is doubtful that drug cartels and corporations will lose their profit motive by then. So, can we protect our kids from the growing threat of addiction? Lembke’s book offers sound research-based advice on what individuals can do to protect themselves and their kids. However, she has little to say on what states can do through legislation, funding, and institutions. Next week, I will focus on what North Carolina is doing to help kids resist addiction.




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