How accurate is the conventional wisdom about dopamine?

Here are some excerpts by the Harvard Health Publishing.

Dopamine is most notably involved in helping us feel pleasure as part of the brain's reward system. Sex, shopping, smelling cookies baking in the oven — all these things can trigger dopamine release, or a "dopamine rush."

(...)

Dopamine also plays a role in these functions:
learning and attention
mood
movement
heart rate
kidney function
blood vessel function
sleep
pain processing
lactation.

Mind that this is not simply about feeling good in general, but feeling good in the context of a reward system. So, dopamine is definitely a central part of the brain's reward system, and it is associated with positive feelings that "reward" you for seeking certain behaviors.

However, the literature suggests it's not the only neurotransmitter that plays a role in that. For example, gamma aminobutyric acid (GABA), another neurotransmitter, is also part of the reward system.

VTA GABA neurons have increasingly been recognized as potent mediators of reward and aversion in their own right, as well as potential targets for the treatment of addiction, depression, and other stress-linked disorders.

Another example is orexin, another neurotransmitter produced in the brain.. Here are two highlights about its function from a recent review from 2022.

• Orexins increase reward-related and anxiety-like behaviors, and stress responses.
• Orexinergic antagonists induce anti-reward effects.

Here's a quote from another review from 2015.

... orexins also have an established role in reward seeking.

The wiki entry for it lists its interactions with other neurotransmitters and neurotransmitter systems.

Orexinergic neurons have been shown to be sensitive to inputs from Group III metabotropic glutamate receptors,[57] cannabinoid receptor 1 and CB1–OX1 receptor heterodimers,[58][59][60] adenosine A1 receptors,[61] muscarinic M3 receptors,[62] serotonin 5-HT1A receptors,[63] neuropeptide Y receptors,[64] cholecystokinin A receptors,[65] and catecholamines,[66][67] as well as to ghrelin, leptin, and glucose.[68] Orexinergic neurons themselves regulate release of acetylcholine,[69][70] serotonin, and noradrenaline.[71]

Brain chemistry is not my expertise, but I'd say the common layperson understanding of dopamine's role in the reward system, and the associated positive feelings, is an oversimplification. On an abstracted level, it's not exactly wrong, but it definitely oversimplifies very complex processes down to a single neurotransmitter, which is the misguided part. It's also worth reminding once more that dopamine is associated with regulating these feelings in the context of a reward, but "positive vibes" are not solely about the reward system, and definitely has a bunch of other systems and neurotransmitters involved, some of which you mentioned. It's also worth mentioning that neurotransmitters are not reducible to a "more = good" equation. It's much more complex than that. If it was that simple, we already would have much better pharmaceutical solutions to diseases like depression. For example, "increases in dopamine activity in certain parts of the brain can contribute to the positive symptoms of schizophrenia.

In conclusion, while dopamine has a central role in positive feelings associated with reward-seeking behavior, it's part of a bigger and complex system.

Note: not a neuroscientist, just a person who read lots of papers.

There’s a seemingly widespread understanding that dopamine makes us feel good and that it can be used against us to make us do things we don’t necessarily like (like endlessly scroll feeds).

These two things are not the same! A lot of the research of the past 20+ years on the role of dopamine in reward has leaned in the direction of separating reward from reward seeking, or "wanting" from "liking". There's some evidence that dopamine motivates reward seeking behavior, but may not necessarily be involved in the actual reward itself. It enhances the anticipation of pleasure, and can even motivate you to do things that you know rationally aren't going to be pleasurable. But it's likely that the primary modulator of the actual feel-good feelings isn't dopamine.

When researchers look for "hedonic hotspots", which are areas of the brain that are involving in causing an increase in pleasurable feelings, they tend to be activated by opioid or endocannabinoid stimulation, rather than dopamine. Some may also be modulated by GABA.

Of course, the brain is a super complex thing and the common idea of one chemical for each feeling or whatever is a vast oversimplification, but I'm sure you suspected as much.

Here is a source that discusses hedonic hotspots and gets into the role, or lack thereof, of dopamine at the end (in-line citations removed for ease of reading):

Perhaps the most famous candidate for a brain substrate that generates pleasure were so-called “pleasure electrodes”, which used brain electrical stimulation of the subcortical limbic forebrain to reinforce self-administration behavior such as pressing a lever or pushing a button. Pleasure electrodes were typically
aimed at the septum or lateral hypothalamus, though a number of the sites fell within what neuroanatomists would now call the nucleus accumbens, and most electrodes likely activated mesolimbic dopamine systems. Some patients stimulated these ‘pleasure electrodes’ thousands of times in a single 3-hour session. Many textbooks cite these cases as examples of intense brain-induced pleasure. But despite such dramatic self-administration, it is questionable whether many of those electrodes ever actually caused pleasure.

For example, “B-19”, a young man with chronic electrodes implanted by Heath and colleagues in the 1960s, voraciously self-stimulated his electrode located in septum and nucleus accumbens, and protested when the stimulation button was taken away. Still, B-19 was never reported to utter exclamations of delight or to say that the electrodes caused pleasure thrills. Instead, B19 reported that stimulating his electrode evoked desire to stimulate again, as well as a strong desire to engage in sexual activities. Another Heath patient said his electrode “made him feel as if he were building up to sexual orgasm” but left him “unable to achieve the orgastic end point”, an outcome which often was frustrating and produced a “nervous feeling” that seems nearly opposite to pleasure.
(...)

Dopamine is not needed to cause normal pleasure of food or drugs of abuse. For example, even massive destruction of ascending dopamine projections does not impair affective ‘liking’ reactions elicited by
a sweet taste. Similarly, complete gene-based elimination of dopamine has been suggested to not impair ‘liking’ in dopamine-deficient mutant mice. Nor does dopamine blockade by neuroleptic drugs reduce ‘liking’ facial reactions of rats to sweetness. In humans, the perceived pleasantness of chocolate milk is not reduced by the loss of brain dopamine neurons in Parkinson’s disease. Similarly, human subjective ratings of the pleasantness of amphetamine, cocaine or cigarettes have been reported to persist unsuppressed by dopamine-blocking drugs or dietary-induced dopamine depletion, even when those treatments do suppress wanting
for more of the same drug.

When I first stumbled upon this idea that you could have this brain chemical that causes you to want to do something, but doesn't actually make you like doing that thing when you're actually doing it, it kind of blew my mind. If this turns out to be the case, it has huge implications for all kinds of addictive behavior, whether it's drugs or food or doomscrolling.

Dopamine certainly can induce pleasurable feelings, but its role in the brain is quite complicated and it's not so simple as dopamine = pleasure. Really, a more critical function of dopamine is to enact a feeling of 'reward salience' - in other words, pointing the brain's attention toward a reward. I remember seeing a study where they observed the brains of tobacco users during the act of smoking, and they began releasing dopamine even prior to the first hit, pretty much as soon as the user opened the pack of cigarettes. Indeed, many drug users report that the ritual of obtaining and preparing their drug of choice is practically as enjoyable as using the drug itself.

For some dopaminergic drugs, disproportionately little euphoria is produced compared to compulsion and craving. This is sometimes said about crack cocaine, but there are worse ones, many from the substituted cathinone family. I have no personal experience with those, but from people I've talked to, really only the first few hits are pleasurable, and from that point it's an increasingly terrible experience, like trying to scratch and unscratchable itch, practically being forced to continue using the drug by the dopamine circuits of your brain despite frightening cardiovascular symptoms, paranoid delusions, formication, etc.

When you feel a 'dopamine' hit, whether it be from a more typical and benign drug or a life experience of some kind, there's usually actually a multifactorial response that involves other neurotransmitters like serotonin, GABA, endorphins, as well as higher psychological responses like emotions, memories, and beliefs that aren't intrinsically tied to a single neurotransmitter.

Other people have talked about the science more than I could. The one thing I wanted to leave a comment to emphasize is that "dopamine fasts" are bullshit and don't have any reasonable scientific basis (at least not one related to dopamine). Dopamine is a reward/motivation chemical, not a pleasure chemical, so if you were actually "fasting" from dopamine (which isn't actually accomplished by the things included in a "dopamine fast"), it would be bad.

As an illustration of why, lowered dopamine levels (as a result of some other more complex stuff) is part of the issue for people with ADHD -- it turns out when your brain can't get enough of the reward chemical from doing normal things, you start exhibiting trouble regulating your attention, executive function issues, and impulsivity. If anything, this would increase dependence on things "dopamine fasts" try to cut out like screen time and sex, since those give you an immediate hit of pleasure that you don't get when you, for instance, wash the dishes. Dopamine serves a valuable function here -- that reward signal motivates us to do things that aren't pleasurable but are good for us. "Fasting" from dopamine would be like "fasting" from your salary and still going into work.

I am trained in neuroscience, but the finer details are no longer part of my daily job. The explanation of @eyechoirs match my view of the role of dopamine in the brain with regard to your question.

The brain is not like an experience machine, you drop in some happy neurotransmitter and you feel happy, or you dump in some sad juice and feel sad. Really understanding the brain is hard if not impossible. At best, we measure activity and deduce which neurotransmitter is responsible in X area of the brain. Most studies take proxies of proxies (fMRI, or behavior in other species). I’m partial to the electrode implanting stuff.

What has been found by putting electrodes into the brain of monkeys, is that firing in neurons with dopamine receptors in the part of the brain associated with reward is more related to cues signaling reward is to be expected, or either unexpected rewards without cue. See:
Schultz, W., Dayan, P., & Montague, P. R. (1997). A neural substrate of prediction and reward. Science, 275(5306), 1593-1599.

This phenomenon is strongly implied in the near-miss effect, which is why gambling has the potential to be so addictive. Cues that are signaling incoming reward (slot machine playing 7, 7 … bar), will tickle your reward center, even without giving the reward. So let’s try again, and again, and again.

I'd say it is fairly well understood, but not in popular culture. Be careful where you get your information. Most of what's out there is just chatter without much scientific understanding behind it. If you're really curious about it, Dr. Andrew Huberman has a series of videos. I'd recommend the long form rather than the short clips which don't paint a complete picture. I'd say the best one to start with is this one. If you want something shorter, HealthyGamer has a half hour overview.

The short version - this is your body's reward mechanism, and you perturb it at your own peril. Unfortunately, most of society is built to squeeze every last drop of it out of you before lunch.

As @daywalker pointed out there's a lot more going on, the idea of dopamine as the "feel good chemical" is pretty inaccurate.

But I think dopamine has become something like popular culture shorthand for a new paradigm for understanding mood, motivation and so on from a neurochemical perspective. Which I think is really valuable, it moves us away from the illusion that our conscious selves have full control over what happens in our brain. Our large forebrains are a relatively new addon, attached to a primordial survival machine that, to some degree, can take over the whole show when it wants to.

My understanding is that the idea that dopamine makes you feel good is a long debunked misconception. Instead it seems to be more closely associated with motivation. It helps you do the things that will make you feel good but isn't responsible for the good feelings themselves.

And also, the ship has sailed, it'll be a long time before people stop talking about dopamine hits.