Skip to content

Workit Health Presents: A Dopey Interview of Amy Dresner · Live on YouTube · June 10, 2026 · 7pm est

  • Treatments
    • Opioid Use Disorder

    Start Suboxone treatment online with a licensed provider without judgment.

    • Alcohol Use Disorder

    Flexible goals — moderation or abstinence. Evidence-based, no 12-step requirement

    • Kratom & 7-OH

    Medication options that actually work for withdrawals and cravings.

    Anxiety · Depression · Insomnia · Hepatitis C · And more

    Substance use often goes hand-in-hand with other conditions. Your provider can prescribe for many of these, including anxiety, depression, and insomnia—so you can get back on solid ground. They can even treat hepatitis C and prescribe PrEP for HIV prevention.

    Start treatment
  • Pricing
  • Locations

    Available now

    • Arizona
    • California
    • Florida
    • Illinois
    • Michigan
    • Montana
    • New Jersey
    • New Mexico
    • New York
    • North Carolina
    • Ohio
    • Oklahoma
    • Texas
    • Washington
    Get notified if we open in your state
  • Reviews
  • About
    • About Workit Health

    Our mission, founders, and clinical team.

    • Workit Labs · Research

     Peer-reviewed publications on telehealth addiction care.

    • Blog

    Plain language guides on recovery, medication, and family-support.

    • Careers

    Join the team building the future of addiction care

  • Help Someone
Login
Get started
Get started
  • Login to my account
Treatments
  • Opioid use disorder
  • Suboxone
  • Alcohol use disorder
  • Kratom & 7-OH dependency

whole person care included

Substance use often goes hand-in-hand with other conditions. Your provider can prescribe for many of these, including anxiety, depression, insomnia, hepatitis C, and more—so you can get back on solid ground.

  • Insurance or Self-pay
Locations
  • Arizona
  • California
  • Florida
  • Illinois
  • Michigan
  • Montana
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • Ohio
  • Oklahoma
  • Texas
  • Washington
  • Get notified of new state openings →
  • Reviews
About
  • About Workit Health
  • Workit Labs · Research
  • Blog
  • Careers
  • Refer a friend
  • Help Someone
Get started

In crisis? Call or text: 988

Home > Blog > Intermittent Reinforcement: Why We Keep Going to a Dry Creek Bed Looking for Water

  • Sobriety Tips and Tools

Intermittent Reinforcement: Why We Keep Going to a Dry Creek Bed Looking for Water

BY

  • Rebecca Rush
  • Fact-checked & medically reviewed

on this page

Towards the end of my drinking, I went out to a bar near my apartment with a book and a plan to have two glasses of wine. I had three, but overall the night was a win. Three was basically two after all. I walked home, smoked some weed, and went to bed. Nothing bad happened. I woke up without a hangover.

How could this happen to a late-stage alcoholic? And why couldn’t I stop thinking about it? The time I drank and it was nice and nothing bad happened?

The answer is intermittent reinforcement. Alcoholism does not mean that every time you drink it ends badly and out of control. It means that once I start drinking, I lose control over whether or not it’s going to be a controlled drinking session.

My alcoholism means I don’t get to decide how drunk I’m going to get. Inconsistency is the hallmark of intermittent reinforcement – it’s what makes gambling so alluring.

From ScienceDirect.com: “Intermittent reinforcement is more resistant to extinction, meaning that if individuals remember occasionally checking the mirror and liking what they see in the past, they may continue to engage in mirror checking for a long time even though they infrequently get good results.”

This system of reward and punishment is more alluring than consistency.  Alcoholism, like an abusive lover, knows that it cannot knock you down every day if you are to remain in the relationship. This is how people stay – in relationship with abusers and with their various addictions – and sometimes both. It even works on rats – rats that press a lever that distributes food occasionally will become obsessed with that lever, while the levers that consistently either dispense or don’t dispense food are less alluring.

When I think back on all my relapses, it’s the rare good times – or, more accurately, not bad times, that my brain wants me to remember. The car crashes, job flameouts, peeing on the side of the road in Manhattan at 4 am on a Wednesday, finding myself in unsafe situations with men, losing friends and places to live and faith in myself – although these were the rule and not the exception, the good times lead my brain to believe that if I could just figure out the formula, I could have that three glass of wine and a book night whenever I want.

The consequences of my use seem like bad luck. I think of the mistakes I made that have nothing to do with the only real mistake – that I knew I was an alcoholic and drank again anyway. I think well I was in a bad mood, or, with the wrong people, or, Klonopin makes me mean, or, I shouldn’t have mixed hard liquor with Red Bull. I once relapsed on organic hard cider because I’d heard some idiots from a MLM scheme say that it was grounding to have a cider at night. I once relapsed on saki because someone called it a spiritual tonic.

My first cocaine run the guy I was dating would wake up and say his nose and throat hurt so much from the air conditioning and too many cigarettes. Our brains want us to believe that we can just press the lever the right way, in the right sequence, a certain number of times, and regain control over the randomness of reward.

We can’t. It is part of the human condition that negative events stick like velcro while positive events slide off like Teflon. This is not so in the realm of intermittent reinforcement. It is the exact opposite. It is Wonderland, and we fall down that hole every time, eventually, never knowing when it will be. If this is how our brains function in terms of addiction, what can we do about it? Should we just throw up our hands and accept an alcoholic fate? It helped me so much just to have a name for this phenomenon, to understand that this was not just some weird thing that I do, to see the lie it tells.

Defining my alcoholism as not “every time I drink it’s bad” but “every time I drink I have no control over how it’s going to be” is humbling and powerful. The brain wants us to think that we are not really alcoholic because it’s not bad every time, because the addicted mind wants to keep going in it’s addiction. Vigilance is key. It’s easy to forget until some pain forces us to remember. And then, in sobriety, this still crops up with a million faces.

We find ourselves in situations with people, places, and things that operate on that principle. Any time I am trying to figure out how to control something that I know in my heart I have no control over the outcome of, I am operating from this place. There are no series of dance moves that can unlock the way an abuser treats us, whether that abuser is alcohol, a slot machine, or a human being.

It’s important to take this into consideration when we look at these things – because something that isn’t bad every time doesn’t make it not a problem. It’s not being able to control when it is bad and when it works out to our benefit.

 

PrevpreviousHow to Feel Happy After Opioid Addiction
nextTips for Enjoying Memorial Day the Sober WayNext

on this page

need help?

Stop the cycle of cravings and withdrawal

  • Suboxone prescribed online*
  • Most major insurance accepted
  • $25–$35/mo with insurance
  • ~2 days to first appointment

*as clinically appropriate

Download the app →

Learn about treatment

PrevpreviousHow to Feel Happy After Opioid Addiction
nextTips for Enjoying Memorial Day the Sober WayNext

ABOUT THE AUTHOR

Rebecca Rush is a writer and comedian from Westbrook, CT. She hosts Vulnerability: A Comedy Show at The Hollywood Improv and the Brutal Vulnerability Podcast and is a regular contributor to Workit Health. She’s been featured on Viceland and Funny or Die. Her words have appeared in numerous outlets, including Input Mag, The Miami New Times, Fodor’s Travel, and Huffington Post. Her personal essay “I’ve Been Swindled” is pending publication in a red flags-themed anthology from Running Wild Press. She holds a B.A. in English Literature with a Concentration in Creative Writing from the University of Connecticut. She lives in Los Angeles, where she is currently shopping a collection of essays.

ready when you are​

Download the app. Get back to yourself.

Sign up takes about 5 minutes. Most members have their first appointment within 2 days. Covered by most insurance.

Download the app
Learn more

KEEP READING

Why Is Suboxone Taken Sublingually?

Many medications are swallowed, but Suboxone (buprenorphine/naloxone) is taken under the tongue (sublingually) or on the cheek (buccally).

Read now

5 Questions About Online Suboxone Treatment, Answered

Workit Health treats opioid addiction with medication like Suboxone online via telehealth. How do we do it? In this post, we answer several common questions.

Read now

5 Sneaky Alcohol Myths and the Truth Behind Them

If you’ve drink at all, you’ve likely heard rumors and myths about alcohol and hangovers. Let’s go beyond the myths to face facts.

Read now

Any general advice posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical or other advice. Workit Health, Inc. and its affiliated professional entities make no representations or warranties and expressly disclaim any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app. If you have specific concerns or a situation arises in which you require medical advice, you should consult with an appropriately trained and qualified medical services provider.

100% virtual addiction treatment for opioid, alcohol, and kratom use disorders. Evidence-based medication, therapy, and recovery support—from your phone.

hello@workithealth.com

Instagram Linkedin-in Facebook-f Youtube
    • TREATMENTS
    • Opioids
    • Kratom & 7-OH
    • Alcohol
    • Insurance & Cost
    • Locations
    • Get started
    • HELP SOMEONE
    • Help a loved one
    • Refer a friend
    • Recovery blog
    • Narcan guide
    • COMPANY
    • About
    • Workit Labs · Research
    • Careers
    • Partnerships
    • Contact
    • MEMBERS
    • Login
    • Create account
    • Refer a friend
    • Medical records request form
    • Fax: 833-923-0584
    • Phone: 855-659-7734
AICPA SOC
  • 42 CFR Part 2
  • WCAG 2.1 AA

contact information

Arizona
2501 N Hayden Rd.
Ste 103
Scottsdale, AZ 85257
fax (HIPAA): (833) 664-5441

California
1460 Maria Lane
Ste 300
Walnut Creek, CA 94596
fax (HIPAA): (833) 244-6705

Florida
600 Heritage Dr.
Ste 210, #17
Jupiter, FL 33458
fax (HIPAA): (813) 200-2822

Illinois
1280 Iroquois Ave
Ste 402
Naperville, IL 60563
fax (HIPAA): (833) 664-8715

Michigan
3300 Washtenaw Ave
Ste 280
Ann Arbor, MI 48104
fax (HIPAA): (855) 716-4494

Montana
415 N Higgins Ave
Ste 6
Missoula, MT 59802
fax (HIPAA): (833) 664-5486

New Jersey
5 Greentree Center
Ste 117
Marlton, NJ 08053
fax (HIPAA): (609) 855-5027

New Mexico
5901 Indian School Road, NE
Ste 212
Albuquerque, NM 87110
fax (HIPAA): (833) 664-5701

New York
845 Central Avenue
Ste 204
Albany, NY 12206
fax (HIPAA): (844) 921-1079

North Carolina
3719 Latrobe Drive
Ste 850-M
Charlotte, NC 28211-4827
fax (HIPAA): (984) 375-6710

Ohio
6855 Spring Valley Dr
Ste 110
Holland, OH 43528
fax (HIPAA): (513) 823-3247

Oklahoma
1010 24th Ave NW
Suite 100
Norman, OK 73069
fax (HIPAA): (833) 672-3125

Texas
5373 W Alabama St
Ste 204
Houston, TX 77056
fax (HIPAA): (737) 738-5046

Washington
9116 Gravelly Lake Dr SW
Ste 107 #3, PMB 1963
Lakewood, WA 98499-3148.
fax (HIPAA): (833) 328-1407

suboxone risk & concerns

Suboxone (buprenorphine/naloxone) is indicated for the treatment of opioid dependence in adults. Suboxone should not be taken by individuals who have been shown to be hypersensitive to buprenorphine or naloxone as serious adverse reactions, including anaphylactic shock, have been reported. Taking Suboxone (buprenorphine/naloxone) with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants can cause breathing problems that can lead to coma and death. Other side effects may include headaches, nausea, vomiting, constipation, insomnia, pain, increased sweating, sleepiness, dizziness, coordination problems, physical dependence or abuse, and liver problems. For more information about Suboxone (buprenorphine/naloxone) see Suboxone.com, the full Prescribing Information, and Medication Guide, or talk to your healthcare provider. You are encouraged to report negative side effects of drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

© 2026 Workit Health. All rights reserved.
Privacy Policy

Notice of Privacy Practice

Terms of Service

View Accessibility Statement

All clinical and medical services are provided by licensed physicians and clinicians who are practicing as employees or contractors of independently owned and operated professional medical practices that are owned by licensed physicians. These medical practices include Workit Health (MI), PLLC; Workit Health (CA), P.C.; Workit Health (NJ), LLC; Workit Health (OH), LLC; Virtual Physician Practice (NY), PLLC; and any other Workit Health professional entity that is established in the future.

Not ready to start? We'll send you more information:

  • Workit Health

    When I opt in, Workit Health will send information about their program and recovery resources.

    *I agree to receive marketing and member care messages by email. Messaging frequency varies. I can unsubscribe at any time.

    **I agree to receive marketing and member care messages by text (SMS). Messaging frequency varies. Message and data rates may apply. I can opt out at any time by replying STOP. I can reply HELP to receive support. If I do not consent to receive SMS, and Workit Health is unable to reach me by email, I understand that they will not be able to contact me by text.

    Carriers are not liable for delayed or undelivered messages.

    View our Privacy Policy, Terms of Service, and Consent to SMS and Email.

  • Should be Empty:

This site uses cookies to improve your experience. By using this site, you consent to our use of cookies.

Accept Cookies