What Addiction Science Got Wrong About Dopamine, with Dr. David Nutt | Flourishing After Addiction #45

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Today I’m sharing my conversation with Dr. David Nutt—Edmond J. Safra Professor of Neuropsychopharmacology at Imperial College London—one of the most influential and outspoken figures in modern psychiatric research and drug policy. It’s a wide-ranging chat about addiction science, pharmacology, and the past and future of medication development—including his current focus on psychedelics.

In particular, we turn to the intellectual foundations of addiction science and focus on one of Dave’s core arguments: the field went down the wrong path by treating dopamine as a master explanation for addiction.

Dave argues that the dopamine narrative—this ubiquitous, unitary explanation that was “so patently daft”—created pharmacological blind spots, wasted massive research funding, and contributed to the failure of countless medication trials. We use this as a springboard for discussing what brain science can and can’t teach us about addiction and psychiatry, why we need more enriched models, and why simple mechanistic stories are so seductive.

We also discuss his work on psychedelics for addiction, including Dave’s current landmark studies on opioid use disorder and gambling. He gives us a broader perspective on some recent trials of psychedelics for addiction treatment as well as some warnings about how unrealistic expectations have harmed the field.

And, we couldn’t resist talking about his infamous dismissal as the UK’s chief drug advisor—the story behind comparing horse riding to ecstasy that got him “sacked.”

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David Nutt is a psychiatrist, the Edmond J. Safra Professor of Neuropsychopharmacology at Imperial College London, and founder of the charity DrugScience. He has held numerous senior leadership roles, including presidencies of the European Brain Council, the British Association for Psychopharmacology, the British Neuroscience Association, and the European College of Neuropsychopharmacology. He has published over 40 books and more than 1,000 research papers. His research on psychedelics has inspired a stage play and been featured in films for Netflix and the BBC. He is a frequent public communicator on pharmacology and psychiatry, hosts the widely listened-to Drug Science Podcast.

Find him on YouTube, Instagram, Bluesky, Twitter/X, and at the charity he founded, DrugScience.org.uk.

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In this episode

• The dopamine theory of addiction: 40 years of highs and lows, Nature Reviews Neuroscience

• Equasy — An overlooked addiction with implications for the current debate on drug harms, Neuron

• Neuroimaging Impaired Response Inhibition and Salience Attribution in Human Drug Addiction: A Systematic Review. Neuron. Zilverstand, Huang, Alia-Klein, and Goldstein (an updated review of six large-scale brain networks in addiction).

• His review of The Urge in The Guardian.