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 56)
Alma mater Yale University (BA)
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

<span class="mw-page-title-main">Insomnia</span> Disorder causing trouble with sleeping

Insomnia, also known as sleeplessness, is a sleep disorder where people have trouble sleeping. They may have difficulty falling asleep, or staying asleep for as long as desired. Insomnia is typically followed by daytime sleepiness, low energy, irritability, and a depressed mood. It may result in an increased risk of accidents of all kinds as well as problems focusing and learning. Insomnia can be short term, lasting for days or weeks, or long term, lasting more than a month. The concept of the word insomnia has two possibilities: insomnia disorder (ID) and insomnia symptoms, and many abstracts of randomized controlled trials and systematic reviews often underreport on which of these two possibilities the word insomnia refers to.

Hypersexuality is a term used for a presumed mental disorder that causes unwanted or excessive sexual arousal, causing people to engage in or think about sexual activity 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 22% 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, sometime called do-it-yourself (DIY) medicine, 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.

Generalized anxiety disorder (GAD) is a mental and behavioral disorder, specifically an anxiety disorder characterized by excessive, uncontrollable and often irrational worry about events or activities. Worry often interferes with daily functioning, and individuals with GAD are often overly concerned about everyday matters such as health, finances, death, family, relationship concerns, or work difficulties. Symptoms may include excessive worry, restlessness, trouble sleeping, exhaustion, irritability, sweating, and trembling.

<span class="mw-page-title-main">Opioid use disorder</span> Medical condition

Opioid use disorder (OUD) is a substance use disorder characterized by cravings for opioids, continued use despite physical and/or psychological deterioration, increased tolerance with use, and withdrawal symptoms after discontinuing opioids. Opioid withdrawal symptoms include nausea, muscle aches, diarrhea, trouble sleeping, agitation, and a low mood. Addiction and dependence are important components of opioid use disorder.

Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has developed within the individual from psychoactive substance consumption that results in the experience of withdrawal and that necessitates the re-consumption of the drug. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions, but not dependence.

Sexual 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 the Opioid Treatment Program (OTP) certified by the Substance Abuse and Mental Health Services Administration and registered with the Drug Enforcement Administration.

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 the substantial harm and adverse consequences to one's own self and others, as a result of their use. In perspective, the effects of the wrong use of substances that are capable of causing harm to the user or others, have been extensively described in different studies using a variety of terms such as substance use problems, problematic drugs or alcohol use, and substance use disorder. 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 (alcoholism); cannabis; opioids; stimulants such as nicotine, cocaine and amphetamines; benzodiazepines; barbiturates; and other substances.

<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 behavior 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), is an impulse control disorder. CSBD manifests as 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>

Mark S. Gold is an American physician, professor, author, and researcher on the effects of opioids, cocaine, tobacco, and other drugs as well as food on the brain and behavior. He is married to Janice Finn Gold.

Ali R. Rezai is an Iranian-born American neurosurgeon and neuroscientist. His work and research has focused on neuromodulation treatments for patients with neurological and mental health conditions, including neuromodulation techniques such as deep brain stimulation (DBS) through brain chip implants to treat Parkinson's disease tremors, obsessive–compulsive disorder, Alzheimer's disease, traumatic brain injury, spinal cord injury, and addiction. Recent research since 2020 has focused on deep brain stimulation for addiction treatment, as well as focused ultrasound to treat tremor, addiction and Alzheimer's disease.

Kelly J. Clark is an American physician and psychiatrist known for her work in the fields of substance use disorder, addiction medicine, and addiction psychiatry.

Opioid agonist therapy (OAT) is a treatment in which prescribed opioid agonists are given to patients who live with Opioid use disorder (OUD). In the case of methadone maintenance treatment (MMT), methadone is used to treat dependence on heroin or other opioids, and is administered on an ongoing basis.

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.