The Dopamine Hypothesis Updated for 2026 (The topic for this session was previously "4E" Cognition - A New Approach to Addiction and Recovery)

Since its debut in the 2010 film Pleasure Unwoven, the “Periodic Table of the Intoxicants” has served treatment providers as a humorous and insightful tool for summarizing the primary neuroscientific framework used to explain addiction: the Dopamine Hypothesis. Dr. Kevin McCauley has recently updated the Table to reflect the evolving understanding of dopamine’s role in motivation, reward learning, and addiction. This lecture examines how the Dopamine Hypothesis establishes common rules that all drug classes follow, while also highlighting the unique characteristics of individual intoxicants—for example, why fentanyl poses far greater risks than traditional opioids like heroin, how cannabinoids can lead users from therapeutic to problematic use, and how the distinctive properties of psychedelics have led to the current enthusiasm over their role in psychotherapy.