A couple of years ago, we received an unexpected order: an addiction treatment center purchased one of our ice baths for cold-plunging. Yes, it sounded unusual to us at first.

That place was the Dispositivo Pavlovsky, a space in Buenos Aires specialized in helping people recover from addiction. And that’s when the questions started to emerge: can cold exposure help in addiction treatment? How and why is it used? What effects does it have on a patient’s mental health?

This article answers all of these questions (and more) through a conversation with Dr. Federico Pavlovsky, director of the center.

 

What Is Addiction and How Does It Affect the Brain?

 

How would you define addiction to someone who has never had any contact with it?

Addiction is a complex and very long process. It’s a learned behavior (or set of behaviors) developed over time that systematically damages your quality of life, your relationships with others, and your ability to experience enjoyment, among other things.

Possibly, in the beginning, that behavior had a purpose, some level of pleasure and gratification. But over time, it develops into a nightmare.

The “curious” thing is that, once addiction is established, the person continues consuming in order to avoid feeling bad, no longer because of the pleasure it produces.

 

Do people lose the ability to feel pleasure?

Anna Lembke addresses this in her book Dopamine Nation: the systematic pursuit of pleasure leads to pain. When we constantly chase pleasure, we end up in apathy, pain, and emotional numbness.

In this article, we dive into the world of dopamine and its relationship with cold exposure.

 

Cold Exposure in Addiction Treatment: How It Started at the Dispositivo Pavlovsky 

 

How did you discover cold exposure?

Marcelo Aprile, a very particular Uruguayan friend and psychologist (he surfs with patients, for example), introduced me to the world of Wim Hof during a trip to Uruguay three years ago.

He invited me, along with other colleagues and patients, to experience this practice of breathing exercises and voluntary cold immersion. The moment I did it, I immediately thought: “this is for patients.” I experienced a deep sense of peace and joy, and I felt really good.

It became the turning point of my vacation, because until then I hadn’t been able to disconnect from the exhaustion I was carrying.

I discovered it on a personal level, but as a physician, whenever I try something that helps me, I bring it to my patients. Three months after that experience with my friend, we opened a dedicated cold-exposure space at the Pavlovsky Center.

 

Effects of Cold Exposure on Mental Health

 

From a mental health perspective, what does cold exposure generate?

Cold exposure produces the release of neurotransmitters such as endorphins, dopamine, and norepinephrine. This creates a state of controlled excitement, mental clarity, euphoria, and relief.

This “physiological high” can last for several hours (up to four), and it’s very different from the effect of drugs, which tends to be faster, more violent, and short-lived.

Wim Hof has studied this phenomenon in depth, and today there is solid evidence that voluntary cold exposure can generate meaningful changes in a person’s neurobiology.

In this article, we explore the effects of cold-plunging and sauna on mental health. 

 

 

Limitations of Conventional Addiction Treatments

 

Have you found limitations in traditional treatments?

Addiction treatments, in general, have historically failed to meet the needs of the people who require them.

A very punitive approach has been followed, tied to the “war on drugs” paradigm, where the consumer was viewed as a criminal or a bad person. But reality is far more complex.

People consume substances for many reasons: to work and feel functional, to tolerate a certain reality, or simply to have fun.

Additionally, today we live in a hyperstimulated society, with social media, technology, and a constant-consumption environment. The fight against addiction is not one-on-one; it’s far more complex and involves many fronts.

At Dispositivo Pavlovsky, they don’t only work with substance abuse. They also treat patients struggling with online gambling addiction, pornography addiction, or compulsive shopping.

In this context, conventional treatments often become outdated.

 

Cold Exposure as a Complementary Tool in Addiction Treatment

 

How do treatments work at Dispositivo Pavlovsky? Why incorporate tools like cold exposure?

We are developing, and even testing on ourselves, complementary tools (without replacing psychotherapy or psychiatry) that help patients not only stop consuming, but also build a life project.

Overcoming addiction does not have to be a solemn, apathetic, or moralistic process. Along the way, pleasurable and meaningful experiences can emerge. I always say that sobriety can also be fun.

Author’s note:

When I went to conduct this interview, I passed through the common area where patients were doing karaoke and passionately singing “Qué ganas de no verte nunca más” by Valeria Lynch. Spectacular.

Additionally, Marcela Sueiro and Chiara Vallone, two professionals from the Center, told me how they implement breathing practices (similar to the Wim Hof Method) and the positive impact these practices generate in patients. Vallone is also currently completing the official Wim Hof Method training.

Many patients discover that, by training for a marathon or exposing themselves to cold, they can achieve transformations they could not reach through traditional therapy alone. In some way, I believe we are amplifying the possibility of success.

Additionally, these are physical experiences. Unlike therapy, where the focus is on words, cold exposure, training, and breathing work through the body, generating intense sensations without the need to talk.

 

How is cold exposure integrated into Dispositivo Pavlovsky?

It’s a voluntary space, available to all patients. However, there are certain prerequisites: toxicology and cardiology evaluations, as well as signing a detailed informed consent form.

It is not a mandatory tool, nor is it presented as a single solution. That said, those who come and explore this tool keep coming back.

Members of the therapeutic team also use it. This is important because working in addiction treatment involves a high emotional burden, and these spaces also function as a form of regulation for professionals.

 

What happens to the patient through cold exposure and other tools?

Addiction treatments are long, difficult, and deeply introspective. They often involve distancing oneself from people and activities associated with substance use. Moments of loneliness, boredom, or disconnection emerge.

In this context, experiences like cold exposure can be profoundly revealing. Reconnecting with the body, feeling emotions again, experiencing intensity, regaining control.

We often hear patients say: “I didn’t know I could feel this way again without using drugs.”

That is incredibly valuable, because it gives them access once again to short-term rewarding experiences, something fundamental for people whose reward systems have been severely damaged by addiction.

 

Cold Exposure: Evidence, Limits, and the Future

 

What would you say to someone skeptical about cold exposure and mental health?

There are published studies in reputable journals showing positive results regarding the impact of cold exposure on mental health.

However, we are still in a gray area: more studies and more evidence are needed. That said, I believe professionals should expand their menu of therapeutic tools.

These are not miracle solutions, but additional resources that can strengthen treatments.

Conclusions

We want to sincerely thank Fede Pavlovsky for trusting Alfa Humans and for opening the doors of his center to us.

This conversation broadens the perspective on the impact that cold exposure (and other complementary tools) can have on a person’s life.

It is important to remember:

• Cold exposure is not recommended for people with cardiovascular conditions, neurological or respiratory disorders, or for pregnant women. If you have any doubts, consult a healthcare professional before starting.

• If you are going through addiction or a difficult emotional moment, seek professional help. Asking for help saves lives.

In our Wellness Journal, you can find more articles about cold exposure, its benefits, and the scientific evidence behind these practices.

Recommended Reading

Lembke, A. (2021). Dopamine Nation: Finding Balance in the Age of Indulgence. Dutton.

Hoff, W. (2020). The Wim Hof Method. Gaia Editions.

Rosales, J. & Hoff, W. (2017). The Iceman. Gaia Editions.