Anna Lembke

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Anna Lembke
Anna Lembke Tanner Lectures Discussion Seminar.jpg
Lembke speaks at Stanford University in 2019
Born (1967-11-27) November 27, 1967 (age 55)
Alma mater Yale University (BS)
Stanford University (MD)
Known for Addiction medicine
Scientific career
Institutions Stanford University
Website https://www.annalembke.com

Anna Lembke (born November 27, 1967) is an American psychiatrist who is Chief of the Stanford Addiction Medicine Dual Diagnosis Clinic at Stanford University. She is a specialist in the opioid epidemic in the United States, and the author of Drug Dealer, MD, How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop. [1] Her latest book, a New York Times bestseller, Dopamine Nation: Finding Balance in the Age of Indulgence, was released in August 2021. [2]

Contents

Lembke appeared in the 2020 Netflix documentary The Social Dilemma . [3]

Early life and education

Lembke was an undergraduate student at Yale University, graduating with a B.A. in humanities in 1989. [4] She earned her M.D. at Stanford University School of Medicine in 1995 and completed her residency in psychiatry, also at Stanford, in 1998. She interned at the Alameda County Highland Hospital, specializing in adult psychiatry and addiction. [4] She was board certified in 2003. [4]

Research and career

At Stanford University School of Medicine, Lembke is Professor and Medical Director of Addiction Medicine. She is also Program Director of the Stanford Addiction Medicine Fellowship and Chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. [4] The mission of Stanford's Dual Diagnosis Clinic is to support patients with substance use disorders, behavioral addictions, and co-occurring psychiatric disorders. [5]

Lembke wrote the popular science book, Drug Dealer, MD and traveled around the United States and delivered expert testimony to legislators. [6] She has also delivered a TED talk on the opioid epidemic and pain management at TEDx Stanford. [7]

Lembke has studied addiction in relation to substances like drugs and alcohol, but she has taken special interest in addictions to smartphones and other technology. [8] However, smartphone and technology "addictions" are not currently recognized as formal clinical disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or in the International Classification of Diseases (ICD-10 and ICD-11). [9] [10] [11] [12] [13] Despite this, Lembke believes that smartphones are not only addictive on their own, but she purports that smartphones can exacerbate the problems of other addiction behaviors by increasing access and social contagion. [8] Lembke appeared in the 2020 Netflix docudrama The Social Dilemma , in which she argued that "social media is a drug" that exploits the brain's evolutionary need for interpersonal connection. [14] Lembke's children also appeared in the film, and the family commented that they believe most people significantly underestimate their screen time. [15]

Select publications

Related Research Articles

Hypersexuality is a term used for a presumed mental disorder causing people to engage in or think about sex to a point of distress or impairment. It is controversial whether it should be included as a clinical diagnosis used by mental healthcare professionals. Nymphomania and satyriasis were terms previously used for the condition in women and men, respectively.

<span class="mw-page-title-main">Substance-related disorder</span> Medical condition

Substance-related disorders, also known as substance use disorders, can lead to large societal problems. It is found to be greatest in individuals ages 18–25, with a higher likelihood occurring in men compared to women, and urban residents compared to rural residents. On average, general medical facilities hold 20% of patients with substance-related disorders, possibly leading to psychiatric disorders later on. Over 50% of individuals with substance-related disorders will often have a "dual diagnosis," where they are diagnosed with the substance use, as well as a psychiatric diagnosis, the most common being major depression, personality disorder, anxiety disorders, and dysthymia.

Self-medication is a human behavior in which an individual uses a substance or any exogenous influence to self-administer treatment for physical or psychological conditions: for example headaches or fatigue.

According to proponents of the concept, sexual addiction, also known as sex addiction, is a state characterized by compulsive participation or engagement in sexual activity, particularly sexual intercourse, despite negative consequences. The concept is contentious; neither of the two major mainstream medical categorization systems recognise sex addiction as a real medical condition, instead categorizing such behavior under labels such as compulsive sexual behavior.

A methadone clinic is a medical facility where medications for opioid use disorder (MOUD) are dispensed-—historically and most commonly methadone, although buprenorphine is also increasingly prescribed. Medically assisted drug therapy treatment is indicated in patients who are opioid-dependent or have a history of opioid dependence. Methadone is a schedule II (USA) opioid analgesic, that is also prescribed for pain management. It is a long-acting opioid that can delay the opioid withdrawal symptoms that patients experience from taking short-acting opioids, like heroin, and allow time for withdrawal management. In the United States, by law, patients must receive methadone under the supervision of a physician, and dispensed through an Opioid Treatment Program (OTP) certified by the Substance Abuse and Mental Health Services Administration and registered with the Drug Enforcement Administration.

The Drug Addiction Treatment Act of 2000, Title XXXV, Section 3502 of the Children's Health Act, permits physicians who meet certain qualifications to treat opioid addiction with Schedule III, IV, and V narcotic medications that have been specifically approved by the Food and Drug Administration for that indication.

<span class="mw-page-title-main">Substance abuse prevention</span> Measures to prevent the consumption of licit and illicit drugs

Substance abuse prevention, also known as drug abuse prevention, is a process that attempts to prevent the onset of substance use or limit the development of problems associated with using psychoactive substances. Prevention efforts may focus on the individual or their surroundings. A concept that is known as "environmental prevention" focuses on changing community conditions or policies so that the availability of substances is reduced as well as the demand. Individual Substance Abuse Prevention, also known as drug abuse prevention involves numerous different sessions depending on the individual to help cease or reduce the use of substances. The time period to help a specific individual can vary based upon many aspects of an individual. The type of Prevention efforts should be based upon the individual's necessities which can also vary. Substance use prevention efforts typically focus on minors and young adults – especially between 12–35 years of age. Substances typically targeted by preventive efforts include alcohol, tobacco, marijuana, inhalants, coke, methamphetamine, steroids, club drugs, and opioids. Community advocacy against substance use is imperative due to the significant increase in opioid overdoses in the United States alone. It has been estimated that about one hundred and thirty individuals continue to lose their lives daily due to opioid overdoses alone.

Drug detoxification is variously construed or interpreted as a type of “medical” intervention or technique in regards to a physical dependence mediated by a drug; as well as the process and experience of a withdrawal syndrome or any of the treatments for acute drug overdose (toxidrome). The first definition however, in relation to substance dependence and its treatment is arguably a misnomer and even directly contradictory since withdrawal is neither contingent upon nor alleviated through biological excretion or clearance of the drug. In fact, excretion of a given drug from the body is one of the very processes that leads to withdrawal since the syndrome arises largely due to the cessation itself and the drug being absent from the body; especially the blood plasma, not from ‘leftover toxins’ or traces of the drug still being in the system.

Behavioral addiction, process addiction, or non-substance-related disorder is a form of addiction that involves a compulsion to engage in a rewarding non-substance-related behavior – sometimes called a natural reward – despite any negative consequences to the person's physical, mental, social or financial well-being. In the brain's reward system, a gene transcription factor known as ΔFosB has been identified as a necessary common factor involved in both behavioral and drug addictions, which are associated with the same set of neural adaptations.

<span class="mw-page-title-main">Substance use disorder</span> Continual use of drugs (including alcohol) despite detrimental consequences

Substance use disorder (SUD) is the persistent use of drugs despite substantial harm and adverse consequences as a result of their use. The National Institute of Mental Health (NIMH) states that “Substance use disorder (SUD) is a treatable mental disorder that affects a person's brain and behavior, leading to their inability to control their use of substances like legal or illegal drugs, alcohol, or medications. Symptoms can be moderate to severe, with addiction being the most severe form of SUD”. Substance use disorders (SUD) are considered to be a serious mental illness that fluctuates with the age that symptoms first start appearing in an individual, the time during which it exists and the type of substance that is used. It is not uncommon for those who have SUD to also have other mental health disorders. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as chronic guilt; an inability to reduce or stop consuming the substance(s) despite repeated attempts; operating vehicles while intoxicated; and physiological withdrawal symptoms. Drug classes that are commonly involved in SUD include: alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics or anxiolytics, stimulants, tobacco

<span class="mw-page-title-main">Addiction</span> Disorder resulting in compulsive behaviours

Addiction is a neuropsychological disorder characterized by a persistent and intense urge to use a drug or engage in a behaviour that produces natural reward, despite substantial harm and other negative consequences. Repetitive drug use often alters brain function in ways that perpetuate craving, and weakens self-control. This phenomenon – drugs reshaping brain function – has led to an understanding of addiction as a brain disorder with a complex variety of psychosocial as well as neurobiological factors that are implicated in addiction's development. Classic signs of addiction include compulsive engagement in rewarding stimuli, preoccupation with substances or behavior, and continued use despite negative consequences. Habits and patterns associated with addiction are typically characterized by immediate gratification, coupled with delayed deleterious effects.

Addiction psychiatry is a medical subspecialty within psychiatry that focuses on the evaluation, diagnosis, and treatment of people who have one or more disorders related to addiction. This may include disorders involving legal and illegal drugs, gambling, sex, food, and other impulse control disorders. Addiction psychiatrists are substance use disorder experts. Growing amounts of scientific knowledge, such as the health effects and treatments for substance use disorders, have led to advancements in the field of addiction psychiatry. These advancements in understanding the neurobiology of rewarding behavior, along with federal funding, has allowed for ample opportunity for research in the discipline of addiction psychiatry. Addiction psychiatry is an expanding field, and currently there is a high demand for substance use disorder experts in both the private and public sector.

Compulsive sexual behaviour disorder (CSBD), otherwise known as hypersexual disorder, is a pattern of behavior involving intense preoccupation with sexual fantasies and behaviours that cause significant levels of psychological distress, are inappropriately used to cope with stress, cannot be voluntarily curtailed, and risk or cause harm to oneself or others. This disorder can also cause impairment in social, occupational, personal, or other important functions.

<span class="mw-page-title-main">Mark S. Gold</span>

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Methadone maintenance treatment (MMT) utilizes methadone to treat dependence on heroin or other opioids, and is administered on an ongoing basis. Methadone is an opioid agonist that binds to the same receptors in the brain as heroin and other opioids. MMT is administered with the objective of relieving withdrawal symptoms. Higher doses of methadone may cause respiratory depression and/or euphoria in some patients. Methadone maintenance reduces the cravings for other opioids, and reduces the risk of fatal overdose from street drugs since the purity and strength of methadone is known, whereas substances obtained from the street vary significantly in strength and purity. Methadone maintenance has been termed "a first step toward social rehabilitation" because it increases the retention of patients in treatment, relieves them from the need to find, buy, and use multiple daily doses of street opioids, and offers a legal medical alternative.

The American Academy for Addiction Psychiatry (AAAP) is a professional organization and an accredited Continuing Medical Education (CME) provider, based in East Providence, Rhode Island, USA. Its members are specialists in addiction psychiatry and other health care professionals who treat patients with addictions. AAAP provides medical education programs in the field of addiction psychiatry.

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References

  1. "'Drug Dealer, M.D.': Misunderstandings And Good Intentions Fueled Opioid Epidemic". NPR.org. Retrieved 2021-08-15.
  2. "Dopamine Nation". Anna Lembke, MD. Retrieved 2021-08-15.
  3. "Anna Lembke". IMDb. Retrieved 2021-08-15.
  4. 1 2 3 4 "Anna Lembke's Profile | Stanford Profiles". profiles.stanford.edu. Retrieved 2020-09-16.
  5. "Addiction Medicine Dual Diagnosis Clinic". stanfordhealthcare.org. Retrieved 2022-01-08.
  6. "Anna Lembke". stanfordhealthcare.org. Retrieved 2020-09-16.
  7. "Anna Lembke | TEDx Stanford". tedx.stanford.edu. Retrieved 2020-09-16.
  8. 1 2 "Q&A: Anna Lembke on smartphone technology addiction". The Stanford Daily. 2018-02-22. Retrieved 2020-09-16.
  9. Ting, Chuong Hock; Chen, Yoke Yong (2020-01-01), Essau, Cecilia A.; Delfabbro, Paul H. (eds.), "Chapter 8 - Smartphone addiction", Adolescent Addiction (Second Edition), Practical Resources for the Mental Health Professional, San Diego: Academic Press, pp. 215–240, doi:10.1016/B978-0-12-818626-8.00008-6, ISBN   9780128186268, S2CID   241191252 , retrieved 2022-01-08
  10. "Substance-Related and Addictive Disorders", Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association, 2013-05-22, doi:10.1176/appi.books.9780890425596.dsm16, ISBN   978-0-89042-555-8 , retrieved 2022-01-08
  11. "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition" (PDF). Repository Poltekkes Kemenkes Kaltim. 2013. Archived (PDF) from the original on 2021-12-08. Retrieved 2022-01-08.
  12. "ICD-10 Version:2019". icd.who.int. Retrieved 2022-01-08.
  13. "ICD-11 for Mortality and Morbidity Statistics". icd.who.int. Retrieved 2022-01-08.
  14. Girish, Devika (2020-09-09). "'The Social Dilemma' Review: Unplug and Run". The New York Times. ISSN   0362-4331 . Retrieved 2020-09-16.
  15. "Reclaim your screen time". The Social Dilemma. Retrieved 2020-09-16.