What are neuroadaptation gremlins?

Neuroadaptation gremlins refer to the brain's response to increased dopamine during pleasurable experiences, where the brain adapts by down-regulating its own dopamine receptors and production, leading to imbalance. When a person consumes a substance or engages in a behavior that causes dopamine release, the reward circuit is activated and pleasure is experienced. The brain then adapts, likened by Dr. Anna Lembke to the idea of "neuroadaptation gremlins" hopping onto the pain side of a metaphorical balance to bring it back to level, but they don't leave once balance is achieved. Instead, they stay until the balance tips to the side of pain, resulting in the come down or craving for more of the substance to restore balance. This is part of the mechanism that can lead to addiction, where the individual needs more or stronger forms of the substance just to feel normal, as those gremlins accumulate and camp out on the side representing pain 1.

Additionally, Anna Lembke explains that with abstinence, typically around 30 days minimum, those neuroadaptation gremlins will hop off, and dopamine homeostasis can be restored, alleviating symptoms such as depression and anxiety that are often comorbid with addiction 2.