Dr. S continues the podcast’s addiction theme by reframing “why can’t they just stop?” through a medical lens, emphasizing addiction as stress, attachment, and reward dysregulation rather than a simple substance problem. She explains how addictive substances and behaviors alter dopamine-based reinforcement, downregulate receptors, activate stress systems, and weaken impulse control, making addiction compulsive and self-regulating for distress. The episode prioritizes medical stabilization and supervised detox—especially for dangerous withdrawals like alcohol and benzodiazepines—and reviews treatments such as thiamine and benzodiazepines for alcohol withdrawal and methadone/buprenorphine for opioid dependence. She surveys alcohol, drugs, gambling, eating disorders, and high-performing behavioral addictions, then outlines longer-term recovery: therapy, trauma-informed work, communities, nervous system regulation, rebuilding relationships and meaning, and redirecting intensity into constructive pursuits. She advises starting with a GP, seeking urgent care for emergencies, approaching loved ones with compassionate curiosity, and using listed support resources.

00:00 Why Can’t They Stop
03:26 Addiction Is Stress
06:38 Brain Reward Circuitry
12:37 Medical Detox First
15:59 Alcohol Addiction Basics
17:19 Drug Addiction Risks
17:48 Gambling Without Substances
19:17 Eating Disorders Overview
21:33 Hidden Behavioral Addictions
23:59 Healing Underlying Drivers
30:31 Rebuilding Life in Recovery
33:57 Where to Start Getting Help
36:28 Supporting Loved Ones Safely
39:06 Resources and Final Takeaway

Practical resources:

• GP / NHS primary care
• NHS Addiction Services
• Talk to Frank (drug support)
• Alcohol Change UK
• GamCare (gambling addiction)
• Beat Eating Disorders
• Alcoholics Anonymous / Narcotics Anonymous

Connect with Dr Safia Debar

Dr Safia Debar
Speaker / Coach | Medical Doctor | Breathwork Facilitator

One of Tatler's "Top 21 private doctors in Britain" 2020
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