Sign in

Carl Erik Fisher

@drcarlerik.bsky.social
710 followers 413 following 47 posts

Addiction psychiatrist, bioethicist, associate professor at Columbia University. | The Urge: Our History of Addiction (Penguin Press, 2022) | Rat Park newsletter--> carlerikfisher.substack.com

PostsRepliesMedia
Carl Erik Fisher @drcarlerik.bsky.social · 16/12/2025
I spoke with Dr David Nutt of @Drug_Science on one of addiction science’s biggest errors: dopamine as the whole story. “Patently daft,” he says. (We also talk psychedelics, drug development, and circuit models) Read more and listen here: carlerikfisher.substack.com/p/what-addic...
carlerikfisher.substack.com
What Addiction Science Got Wrong About Dopamine, with Dr. David Nutt | Flourishing After Addiction #45
"It's inconceivable there can be just a single chemical that mediates all the effects of what addicted drugs have. That was so patently daft."
051
Reposted by Carl Erik Fisher
Melissa Febos @melissafebos.bsky.social · 03/06/2025
This book is out TODAY! I put my whole heart into it. You can buy it wherever you buy books. www.penguinrandomhouse.com/books/725681...
15214
Reposted by Carl Erik Fisher
Melissa Febos @melissafebos.bsky.social · 31/05/2025
My event on June 10 at The Strand is sold out but there are a few tickets left for the Brooklyn launch with Leslie Jamison at Public Records via Books Are Magic: www.eventbrite.com/e/offsite-me...
eventbrite.com
Offsite: Melissa Febos: The Dry Season w/ Leslie Jamison
“Only Melissa Febos could convince us of the ecstasy of abstinence. She never fails in her candor and precision.” —Katherine May
062
Carl Erik Fisher @drcarlerik.bsky.social · 22/04/2025
and now tagging @owenflanagan.bsky.social now, who i didn't realize was on bluesky!
030
Carl Erik Fisher @drcarlerik.bsky.social · 22/04/2025
Thanks Josh!
110
Reposted by Carl Erik Fisher
Joshua Richardson @schizosemia.bsky.social · 22/04/2025
I’m excited for this podcast with @drcarlerik.bsky.social and @owenflanagan.bsky.social. podcasts.apple.com/ca/podcast/f...
podcasts.apple.com
What Is It Like to Be an Addict? with Prof. Owen Flanagan
Podcast Episode · Flourishing After Addiction with Carl Erik Fisher · 2025-04-22 · 1h 6m
263
Carl Erik Fisher @drcarlerik.bsky.social · 22/04/2025
-what makes a behavioral addiction “real?” -the ethics of addiction, how to connect morality and virtue to addiction recovery without reinforcing stigma. And throughout, Owen shares about his own recovery process, including how it evolved over time and what he’s working on today.
130
Carl Erik Fisher @drcarlerik.bsky.social · 22/04/2025
We talk about: -the spectrum of "powerlessness" in addiction and the finer points of self-control -problems with traditional explanations of willpower -critiques of the usual stories about dopamine’s role in addiction -behavioral additions like sex, shopping, and video games
110
Carl Erik Fisher @drcarlerik.bsky.social · 22/04/2025
He brings that deep knowledge to bear on addiction to challenge oversimplified addiction narratives and offers what he calls an "ecumenical" approach—arguing that substance addictions are far more heterogeneous than we often recognize, with diverse causes, neural profiles, and lived experiences.
110
Carl Erik Fisher @drcarlerik.bsky.social · 22/04/2025
The book combines personal reflections with philosophical expertise to propose a new, integrated model for understanding substance addiction. Owen, Professor Emeritus at Duke, is internationally acclaimed for his work in cognitive science, ethics and the philosophy of psychology and neuroscience.
120
Carl Erik Fisher @drcarlerik.bsky.social · 22/04/2025
I got to interview Owen Flanagan, an excellent philosopher of addiction (and much more), about his new book, What Is It Like to Be an Addict? open.substack.com/pub/carlerik...
open.substack.com
What Is It Like to Be an Addict? with Prof. Owen Flanagan | Flourishing After Addiction #40
"One cannot have a complete theory of addiction without incorporating the addict’s experience. Listen carefully to what addicts say about what it is like to be an addict."
1123
Carl Erik Fisher @drcarlerik.bsky.social · 25/03/2025
I posted a comment about the mutual aid comparisons here
010
Carl Erik Fisher @drcarlerik.bsky.social · 22/03/2025
Ooooh fascinating I look forward to reading this
110
Carl Erik Fisher @drcarlerik.bsky.social · 19/03/2025
This is why I was glad to see the post by Freddie, from someone with lived experience of what it's actually like to be manic/psychotic. I also wonder if Delano takes the subway.
120
Carl Erik Fisher @drcarlerik.bsky.social · 18/03/2025
I don't know what to call it either! But I do know that even in coaching, usually quite unregulated and to my mind less formal than peer support, orgs still have ethics guidelines about seeking outside help when a client is a danger to self or others.
120
Carl Erik Fisher @drcarlerik.bsky.social · 14/03/2025
I'd be interested in more on that concept. For example it seems like there is an important distinction between assessing 1. Whether gaming contributes to life domains (effect) versus 2. The intention with which one comes to a gaming session (initial motivation?)
000
Carl Erik Fisher @drcarlerik.bsky.social · 14/03/2025
Well done! To me, "gaming life fit" is the most interesting element here. I understand from the paper that you are still developing this measure. Conceptually it seems like rich and complicated ground to assess the subjective alignment of gaming with valued life domains.
100
Carl Erik Fisher @drcarlerik.bsky.social · 09/02/2025
It's very meaningful to hear from you, thanks for sharing. And glad you're ok these days.
110
Carl Erik Fisher @drcarlerik.bsky.social · 08/02/2025
relevant front page of FT today about the Trump memecoin today, which I discuss in my gambling essay
010
Carl Erik Fisher @drcarlerik.bsky.social · 08/02/2025
Thanks!
000
Carl Erik Fisher @drcarlerik.bsky.social · 08/02/2025
I listed more resources and reading on this post: carlerikfisher.substack.com/p/my-new-yor...
carlerikfisher.substack.com
My New York Times Essay: What Sports Betting Reveals About Addiction
What’s different now isn’t the underlying susceptibility, it’s that technology and concentrated commercial power have made these vulnerabilities impossible to ignore.
010
Carl Erik Fisher @drcarlerik.bsky.social · 08/02/2025
There are lessons here for how we protect ourselves as individuals, guide our children through a world increasingly littered with gambling dynamics, and build commonsense regulations that acknowledge gambling as a public health issue.
110
Carl Erik Fisher @drcarlerik.bsky.social · 08/02/2025
I describe how gambling’s harms extend far beyond what we commonly understand, and how the gambling boom (a $150 billion industry!) reveals truths about the addiction in all of us. Modern tech has also transformed a simple wager into a highly targeted, always-on stream of micro-bets.
120
Carl Erik Fisher @drcarlerik.bsky.social · 08/02/2025
I have a new essay out in The New York Times today: "What Sports Betting Reveals About Addiction." I challenge some assumptions about addiction through the lens of America’s sports betting explosion, just in time for Super Bowl Sunday. www.nytimes.com/2025/02/08/o...
nytimes.com
Opinion | The Price We Pay Betting on Sports
231
Carl Erik Fisher @drcarlerik.bsky.social · 06/02/2025
Welcome!
000
Carl Erik Fisher @drcarlerik.bsky.social · 03/02/2025
I wrote about the paradox of self-control in addiction. open.substack.com/pub/carlerik...
open.substack.com
Self-Control Matters in Addiction
The biomechanical disease folks are right that there is a there there, that when people with addiction say they feel powerless, we should take them (us) seriously. The choice folks are right that even...
010
Carl Erik Fisher @drcarlerik.bsky.social · 30/01/2025
Keith Humphreys and John Kelly setting the record straight
030
Reposted by Carl Erik Fisher
Lev Facher @levfacher.bsky.social · 30/01/2025
RFK says he supports methadone and buprenorphine — but majorly misrepresents a study that he claimed shows 12-step programs are more effective vs. opioid addiction (The study was exclusively about alcohol!) www.statnews.com/2025/01/30/r...
statnews.com
RFK Jr. endorses medications for opioid addiction at confirmation hearing, but misleads on 12-step programs
During his Thursday Senate confirmation hearing, RFK Jr. shed light for the first time on his attitudes toward medication-assisted treatment for opioid addiction.
13418
Reposted by Carl Erik Fisher
Addiction journal @addictionjournal.bsky.social · 29/01/2025
The Society for the Study of Addiction have just joined Bluesky. Please give them a follow! @ssa-addiction.bsky.social
0124
Carl Erik Fisher @drcarlerik.bsky.social · 27/01/2025
I think Ian McGilchrist would agree, though he puts it all in left/right brain terms
000
Carl Erik Fisher @drcarlerik.bsky.social · 23/01/2025
Excellent new substack on publishing from a superstar agent!
130
Carl Erik Fisher @drcarlerik.bsky.social · 10/01/2025
To bring the study of "pleasure" (or whatever related concept) into public health research is useful, but also quite complicated, and is more than a methodological issue, as Nicholls and Hunt point out.
010
Carl Erik Fisher @drcarlerik.bsky.social · 10/01/2025
I found Against Happiness very useful. cup.columbia.edu/book/against... ( @danhaybron.bsky.social ?) Specifically, the notion that "happiness defined as subjective satisfaction or a surplus of positive emotions bears little resemblance to.. richer and more nuanced concepts of the good life".
cup.columbia.edu
Against Happiness | Columbia University Press
The “happiness agenda” is a worldwide movement that claims that happiness is the highest good, happiness can be measured, and public policy should promot... | CUP
130
Carl Erik Fisher @drcarlerik.bsky.social · 10/01/2025
Meaning, there's a need for better conceptual clarity about studying "pleasure" or "happiness". The paper touches on these points, regarding methodology, norms, and epistemology, but this is very complicated ground and will need more development.
100
Carl Erik Fisher @drcarlerik.bsky.social · 10/01/2025
As a clinician and someone in recovery from a serious alcohol use problem, I find this paper very thoughtful and useful! Very good starting point and call to action. "Alcohol research has a problem with pleasure". I agree, but I would also suggest that pleasure research has a problem with pleasure
240
Reposted by Carl Erik Fisher
James Nicholls @jamesnicholls.bsky.social · 10/01/2025
New 'For debate' paper in @addictionjournal.bsky.social in which we ask whether alcohol research needs to take pleasure more seriously. It's an invitation to discuss, so I'd be interested to hear views! onlinelibrary.wiley.com/doi/10.1111/...
onlinelibrary.wiley.com
Taking pleasure seriously: Should alcohol research say more about fun?
Background This paper invites discussion on whether pleasure should receive more attention in public health-oriented research on alcohol. While there is a history of sociological and anthropological...
13513
Reposted by Carl Erik Fisher
Awais Aftab @awaisaftab.bsky.social · 29/12/2024
Phil & psych folks, Richard Gipps @drgipps.bsky.social is on Bluesky! Give him a follow. Several years ago, when Richard joined Twitter, I made a similar announcement so that people would follow him. That was the beginning of a rewarding friendship ☺️ (1/4)
1212
Carl Erik Fisher @drcarlerik.bsky.social · 16/12/2024
congrats on an excellent first lead-author paper, @mattflathers.bsky.social ! (in my somewhat biased opinion...)
020
Carl Erik Fisher @drcarlerik.bsky.social · 14/12/2024
Thanks Jane, would be happy to talk!
000
Carl Erik Fisher @drcarlerik.bsky.social · 14/12/2024
A big thank you to my collaborator John Torous, and his team at Beth Israel Deaconess Medical Center! After following his great work for a while, it was wonderful to work on this piece together. (open access): (mentalhealth.bmj.com/content/27/1...) summary here: open.substack.com/pub/carlerik...
open.substack.com
How AI Reflects and Reinforces Mental Health Stigma
Our paper in BMJ Mental Health: AI-generated imagery often amplifies harmful stereotypes about mental disorders. How models like DALL-E 3 and Midjourney shape public perceptions of mental illness
010
Carl Erik Fisher @drcarlerik.bsky.social · 14/12/2024
Collaboration between clinicians, policymakers, and AI developers is key to creating responsible AI tools. This work may also offer new research opportunities into perceptions of mental disorders and suggest ways of counteracting stigma and misinformation.
100
Carl Erik Fisher @drcarlerik.bsky.social · 14/12/2024
We explored how gen AI visually depicts common psychiatric diagnoses. Many of these AI-generated images reflect harmful stereotypes, cultural biases, and outdated visual tropes. AI is increasingly shaping public perceptions of mental health and these biases can perpetuate stigma and misinformation.
AI-generated images of tormented portrayals of people struggling
110
Carl Erik Fisher @drcarlerik.bsky.social · 14/12/2024
With great collaborators, I have a new paper in BMJ Mental Health. AI-generated imagery often amplifies harmful stereotypes about mental disorders. How models like DALL-E 3 and Midjourney shape public perceptions of mental illness. Here's a summary with some images: open.substack.com/pub/carlerik...
AI-generated stereotypical portrayals of addiction, including images cluttered with pills, smoker with glazed-over expression, and ominous skulll.
2103
Carl Erik Fisher @drcarlerik.bsky.social · 07/12/2024
I was very happy to be involved with this study of AI depictions of psychiatric diagnoses--it shows how image generation models reflect cultural perceptions of mental disorders, including harmful bias. Open access: mentalhealth.bmj.com/content/27/1...
mentalhealth.bmj.com
AI depictions of psychiatric diagnoses: a preliminary study of generative image outputs in Midjourney V.6 and DALL-E 3
Objective This paper investigates how state-of-the-art generative artificial intelligence (AI) image models represent common psychiatric diagnoses. We offer key lessons derived from these representati...
092
Carl Erik Fisher @drcarlerik.bsky.social · 06/12/2024
I love the articulation of 'discursive pollution’ here- how commercial actors and forces "contaminate scientific and policy debates and harm public and environmental health." Nice angle on a big topic
021
Carl Erik Fisher @drcarlerik.bsky.social · 04/12/2024
a dream. there was an old columbia med professor who'd book a train to Boston, then turn around and come right back, just to write in the dining car
230
Carl Erik Fisher @drcarlerik.bsky.social · 04/12/2024
I wrote about the specific technology design features that can weaken our self-control. A brief review of some recent commentary and classification What makes the internet addictive? carlerikfisher.substack.com/p/what-makes...
carlerikfisher.substack.com
What makes the internet addictive?
The next hellsites. What makes us stay online. Bluesky. The allure of simplicity and the inexorable pull toward complex design features eroding our self-control.
152
Carl Erik Fisher @drcarlerik.bsky.social · 04/12/2024
Ah! I wrote about bluesky then forgot to post about bluesky 😅
220
Carl Erik Fisher @drcarlerik.bsky.social · 30/11/2024
Many congrats!! Well deserved!
110
Carl Erik Fisher @drcarlerik.bsky.social · 27/11/2024
This is a fascinating development: an official "Plain Language Big Book" of AA. The original book is from 1939 and uses really florid language at times, so this plain language version could be useful for anyone interested in mutual help for whom that's challenging. www.aa.org/sites/defaul...
aa.org
031