Lembke begins the chapter with another anecdote from her clinical practice, this one about a teenager named Delilah. Delilah’s parents requested that she seek help for her cannabis use. Delilah saw her use of cannabis as a way of treating her anxiety and stress and saw no reason to quit using cannabis. Lembke then transitions into discussing an acronym she uses, DOPAMINE, and then identifies what each letter represents, describing each in varying detail. She refers to this as a framework she has developed to work through patients’ compulsive tendencies.

The D stands for Data. Lembke says that the first thing she does is gather as much initial data as she can about the patient and their level of substance use. The O stands for Objective, which Lembke uses to identify how a person with an addiction perceives the reasons and expectations for their usage. The P stands for Problems, which Lembke claims almost always occur with high-dopamine drugs. She then discusses why Delilah was unable to see the problems that cannabis may have been causing. She attributes some of this to Delilah’s young age and says that the immediate consequences of using drugs become more apparent as people age.