Nir’s Note: This article explores a new model for understanding addiction. I challenge the simplistic view that addictive products cause addiction. Rather, addiction is a confluence of three factors.
Gasoline is highly flammable. But without oxygen and heat, it will not combust. Fentanyl, Fortnite, and Facebook, are potentially addictive, but they don’t become addictions without other factors present. Thus, it is not accurate to say addictive products are the cause of addiction. Nor is it true that people’s personal tendencies necessarily define their destiny.
Addiction only occurs at the unfortunate collision of three factors:
- a product that relieves discomfort
- a person otherwise unable to cope, and
- a source of pain they are ill-equipped to handle.
Addiction is not mind-control. It is a confluence of factors. Take out any of the elements at the root of addiction and the product can be used in moderation. However, when all three conditions are present, the addiction can rage like lit gasoline.
It’s important to use the term “addiction” when we really mean it. Addiction is a pathology. Today, however, many people use the term to slough off blame for their overuse of one thing or another. All sorts of things are called “addictive.”
For instance, many people say they or their children are “addicted” to their digital devices. But blaming our smartphones for “addicting” us, without taking steps to change our behavior, only justifies and perpetuates unhealthy use. Believing that a product is “hijacking” our minds teaches learned helplessness instead of inspiring action.
However, when the addiction is real and causes harm despite our best efforts, we must take it seriously. What is an addiction, really? In this article, we’ll cover the following topics in three sections:
- No One Is Addicting You (i.e., the Product)
- The Product Isn’t the Cause of the Problem
- Anything That Stops Discomfort Is Potentially Addictive
2. How the Inability to Cope with Discomfort Drives Addiction (i.e., the Person)
- Who Gets Addicted
- The Flywheel of Infatuation
3. Addiction Isn’t About Feeling Good, It’s About Not Feeling Bad (i.e., the Pain)
- Escaping Pain
- The Opposite of Addiction Isn’t Always Abstinence
Conclusion: Who’s to Blame and What Do We Do?
No One is Addicting You
The fear of malicious mind control is older than recorded history. Ancient human skulls show clear evidence of trepanning, the practice of cutting a hole in the head to release a demon.1 Forms of exorcisms, intended to free the “possessed,” have had a place in nearly every major religion.2Tales of hypnotic seduction by shady Svengalis horrified readers, and later moviegoers, since the late 1800s.3
Today, an entire entertainment genre is devoted to this sort of horror: zombies. According to one 2011 estimate, zombie-themed entertainment is valued at well over $5 billion annually.4 In a sense, zombies are worth more dead than alive.
Zombie stories tend to follow a similar format. The most fundamental element is the mind virus that infects the victims’ brains and makes them act against their will. Though zombie stories are pulp fiction, there’s something about the nightmare of mind control we can’t seem to wake up from. Perhaps our fears stem from an inborn revulsion to pathogens that may infect the body and cause disease? Maybe it’s the realization that at times, we all act in ways we don’t fully understand? Or, perhaps it’s the real-life cases of people acting in strange ways? Maybe it’s the zombies we see all around us?
Just have a look around. On public transport, people stare blankly into their screens. Families mindlessly chew their food while watching television. And coworkers can’t sit down for a meeting without someone impulsively checking their email. Our use of digital devices can sure look zombie-like.
Today, we have a new word for our fear of mind control: addiction. Addiction is the zombie mind virus reincarnate. The word encapsulates the dread that a demon force will enter our heads and drive our behavior against our will. In the zombie story, the source of the terror is a voodoo spell or laboratory experiment that creates the virus. But what is the source of our zombie-like fixations in our real world? What causes addiction, and can it be manufactured?
It’s been said, “There are only two industries that call their customers ‘users’: illegal drugs and software.”5 Like drug dealers, software companies have a profit motive. They power our technological distractions and want to keep people using. Manufacturing addiction would seem to benefit their bottom lines by keeping us checking, clicking, and scrolling.
Some critics claim that tech is manipulating us in ways we can’t control, just like a drug. Books with titles like Irresistible: The Rise of Addictive Technology and the Business of Keeping Us Hooked and The Hacking of the American Mind: The Science Behind the Corporate Takeover of Our Bodies and Brains warn readers about the mind-controlling nature of our technologies. An article titled How Technology is Hijacking Your Mind enumerates the ways online products are built to addict us, just like hard drugs. (Ironically, the article went viral.)
If addiction is a virus-like disease, and these companies are making us sick by spreading it, then they deserve to be regulated or shut down. But is that what’s really happening? As H.L. Mencken writes, “There is always a well-known solution to every human problem — neat, plausible, and wrong.”6
At first, I wanted to believe the mind-virus narrative as the source of addictions and distractions. My first inclination was to follow the same zombie narrative and look for the source of the problem in some secret lab. The closely guarded campuses of Facebook, Google, and the other Silicon Valley behemoths seemed to fit the archetype. Big corporations like these, I thought, were clearly the source of our addictions and distractions.
Unfortunately, the more I learned about the science of addiction, the more difficult it became to believe the comic book depiction I had bought into. It turns out drug addiction is an excellent way to explain technology addiction — but not for the reasons most people think.
The Product Isn’t the Cause of the Problem
If using a drug were enough to addict people, then we should expect most, if not all, people to get addicted to the drug. Take heroin, for example, which is widely considered among the most addictive substances on earth. Counterintuitively, you may be surprised to learn that many people who use heroin never get hooked. Author Johann Hari points out in an article for the Huffington Post:7
If you get run over today and you break your hip, you will probably be given diamorphine, the medical name for heroin. In the hospital around you, there will be plenty of people also given heroin for long periods, for pain relief. The heroin you will get from the doctor will have a much higher purity and potency than the heroin being used by street-addicts, who have to buy from criminals who adulterate it. So if the old theory of addiction is right — it’s the drugs that cause it; they make your body need them — then it’s obvious what should happen. Loads of people should leave the hospital and try to score smack on the streets to meet their habit. But here’s the strange thing: It virtually never happens . . . The same drug, used for the same length of time, turns street-users into desperate addicts and leaves medical patients unaffected. If you still believe — as I used to — that addiction is caused by chemical hooks, this makes no sense.
“Some 70 percent of the population is exposed to medical opioids during their lifetime,” Maia Szalavitz, the author of Unbroken Brain: A Revolutionary New Way of Understanding Addiction, writes in Vice. Yet, in America, the “addiction figure is roughly 2.5 million, or about 1 percent of the adult population.”8
The overwhelming majority of people who try heroin never get addicted. In fact, most who try the drug don’t even like it. Dan Rather, the former CBS anchorman, famously shot up heroin in the 1950s for a news story. Yet despite taking the drug, the reporter says heroin only gave him a “hell of a headache.”9 Rather’s reaction is not unique.
A 2012 study on healthy volunteers found that some 15 percent of people given an opioid reported a strong dislike of it.10 50 percent of test subjects reported mixed results, neither strongly liking or disliking the sensation. Only 30 percent of people in the study found the sensation to be pleasant. Of those reporting that the drug made them feel good, only half said they would want to experience it again.11 That’s a pretty poor showing for the world’s most addictive substance.
Anything That Stops Discomfort Is Potentially Addictive
These numbers may be surprising to someone who’s been sold a story about the mind-controlling power of drugs. But we’ve all safely used a substance or done a behavior others find addictive. Many people experiment with cannabis, but only 9 percent become dependent.12 Drinking wine never becomes alcoholism for the overwhelming majority of people who enjoy it. Gambling doesn’t make you a gambling addict and having sex certainly doesn’t make someone a sex addict. The same goes for our use of digital devices.
In contrast, many completely benign things are addictive to some people. In 2010, the cable television channel TLC launched a program the New York Daily News panned as the “most disgusting reality show on television.”13 The show, called My Strange Addiction, follows the lives of people compelled to do very unusual things. The first episode of the series documents a few days in the life of Kesha. Despite her best attempts, Kesha finds herself unable to quit eating toilet paper, over half a roll per day. In another episode, a woman named Maureen reveals her compulsion to buy and use makeup, applying gobs of the stuff incessantly. In yet another episode, we meet Theresa, a woman who is addicted to sniffing gasoline out of a water bottle she carries with her at all times.
Most of us think about hard drugs when we hear the word “addiction.” But nearly all of the compulsive behaviors in the show involve everyday items. Yet the people profiled on the show formed destructive compulsions just as powerful as those of hard-core drug users. Watching My Strange Addiction, I noticed how miserable the people on the show appeared to be. Similarly, drug users and other addicts are notorious for the anguish they endure. This conflicted with the idea that drugs hook people by making them feel good.
Technology critics today echo this ideology. They claim that video games, smartphone apps, and social media sites keep people engaged by providing irresistible enjoyment. But if people get addicted because they seek pleasure, why do addicts seem to experience no joy? Why do so many wish they could stop using something they supposedly find so pleasurable?
It’s a fact that some people get addicted to benign household items like makeup and toilet paper. Only a single-digit percentage of people who take an opioid ever get hooked. This should cast doubt on the idea that the product itself or, more specifically, the pleasure derived from using it, is the source of the addiction. The fact is, nothing on a screen or, for that matter, put inside the body, is addictive by itself.
It doesn’t matter how high the high or how enjoyable the experience might be. Addiction is not about how good something makes people feel, but rather what happens after the initial sensation fades. It’s not pleasure per se that drives us, but rather the desire to escape discomfort. No matter what it is, if a substance or behavior helps us escape pain, someone is going to overuse and abuse it.
Anything that stops discomfort is potentially addictive. But if everything that quells pain is potentially addictive to someone, then the root cause and the blame can’t fall only on the product.
Then who is to blame? Where does the mind virus come from? There must be more going on.
Here’s a quick recap of what we’ve learned so far:
- From evil spirits to zombie stories, people have always feared mind-controlling forces. Today, many people blame technology companies for making their products “addictive.”
- To some people, addiction is caused by a substance or behavior that takes over the users’ brain.
- However, this model of addiction does not stand up to observational and scientific evidence. It is a simplistic view of how addiction works.
- Substances and behaviors don’t affect people in the same way.
- Millions of people receive opioids when they go to the hospital and never become addicted. Many people drink alcohol but never suffer from alcoholism. We have sex or gamble from time-to-time but aren’t all sex addicts or problem gamblers. Meanwhile, some people become addicted to the abusing mundane household items.
- Clearly, there is more going on than an addictive product controlling peoples’ minds.
- Anything that stops discomfort is potentially addictive. Addiction is not just about the product that is being abused.
- Addiction requires three factors: the product, the person, and the pain.
How the Inability to Cope with Discomfort Drives Addiction
In a 2015 report, the US Drug Enforcement Administration’s acting administrator writes that “overdose deaths, particularly from prescription drugs and heroin, have reached epidemic levels.” Additionally, “drug overdose deaths have become the leading cause of injury death in the United States, surpassing the number of deaths by motor vehicles and by firearms every year since 2008.”14 The appalling rise in addiction and overdose deaths seems to finger the drugs as the culprit. More drugs prescribed meant more patients became addicted. But if stats show few people given these drugs by doctors become addicted, where are all the addicts coming from? Turns out that those who abuse the drugs are often not the ones who received the drug prescription.
“The research actually shows that people who developed new addictions in recent years were overwhelmingly not pain patients,” Maia Szalavitz writes in Vice. “Instead, they were mainly friends, relatives, and others to whom those pills were diverted — typically young people.” Szalavitz cites several studies, which paint a clearer picture of the real cause of the current opioid crisis.15It wasn’t the case that anyone who took these pain killers subsequently developed an addiction. Rather, the drugs found their way into the hands of people who were most susceptible to addiction. For example, a study of, “people being treated for Oxycontin addiction found that 77 percent of them had also taken cocaine — and it’s hard to imagine that this was supplied medically,” Szalavitz writes.16
Who Gets Addicted?
Many people struggling with opioid addiction today were never prescribed the drugs. However, a tiny percentage of those given the medication from a doctor did get addicted. But why? In a 2018 study, researchers sought to answer that question. They wanted to understand more about the relatively small number of people who become addicted to opioids after medical treatment and recruited patients “who were receiving prescription opioid treatment for chronic neck or back pain.”17
Before reading the study, I would have guessed the people most likely to become addicted would be those who suffered the worst physical pain and therefore took the most drugs. But that’s not what the researchers found. The study concludes that “neither pain severity nor pain sensitivity was associated with the risk of opioid misuse.” What, then, drove their abuse?
What mattered more than how the patients felt physically was their level of what the researchers call “distress intolerance,” a measure of how much “fear and anxiety at the prospect of physical or emotional distress” the patients felt. Their inability to handle their fear of pain was a greater factor correlating with drug addiction than the pain they actually experienced.
Medical science still does not fully understand why addicted people have a higher distress intolerance. Something makes it more difficult for some people to cope. What might contribute to this inability to deal with discomfort?
The Flywheel of Infatuation
The answer may have been revealed by a brilliant experiment conducted by Naomi Fineberg at the University of Cambridge, who tested how discomfort drives compulsive behavior in certain people.18 In her study, Fineberg wired participants to a device that caused a tiny but uncomfortable electrical shock. Then, she gave test subjects a button to press to turn off the current. As expected, people learned that pressing the button would stop the painful sensation.
Once people had learned this behavior, Fineberg turned off the current so that whether they pressed the button or not, test subjects no longer experienced the shock. The learned behavior suddenly became futile; there was no longer an electric shock and thus no longer any need to press the button. Most people, as you’d expect, adjusted their behavior and unlearned the pattern. But some people did not stop. They could not stop even in the absence of a connection between pressing the button and stopping the shock. Certain test subjects continued to press and press, even when they themselves did not want to.
Fineberg observed that people suffering from obsessive-compulsive disorder (OCD) continued the behavior despite knowing full well it accomplished nothing. OCD sufferers reported an urge they simply could not resist. Somehow their brains were unable to break the association that pressing the button stopped the pain. Once they became fixated on pressing the button, the temptation only grew and grew until it became unbearable — they felt they had to press. The physical pain of the uncomfortable shock was replaced with the psychological pain of wanting to press the button so badly it hurt. Fineberg believes the incessant pressing relieved the build-up from the anxiety of resisting. The flywheel of the infatuation itself became the escape.
Most people can cope with discomfort in less harmful ways. However, people with characteristic distress intolerance are highly averse to pain. Ironically, the pain they seek to escape may be the discomfort of having to resist the urge itself.
While certain people appear to have a propensity toward addiction, a propensity need not be permanent. Moreover, people recover from addictions all the time. Statistically, the most common way people recover from addiction is through the elimination of the need for the substance.19But how can that be, if addicted people are somehow wired differently? Once again, there must be more to the story.
To recap what we’ve learned from this section:
- In contradiction to the belief that the opioid epidemic was a result of people prescribed the drugs, studies have found the overwhelming number of people suffering from opioid addiction had previously tried other illicit substances, like cocaine.
- The opioid addict archetype isn’t grandma getting addicted to fentanyl after she breaks her hip. It is her nephew who raided grandma’s medicine cabinet.
- People susceptible to addiction have a high “distress intolerance.” They have above average “fear and anxiety at the prospect of physical or emotional distress.”
- The fear of pain can itself be extremely painful for some people. Addiction may be a disorder of how the brains of some people process the discomfort of an unfulfilled urge. Ironically, the pain they seek to escape may be the discomfort of having to resist the urge itself.
- Yet, people recover from addictions all the time. How some people slip in and out of addiction during certain periods of their lives is the next question we’ll tackle.
Addiction Isn’t About Feeling Good, It’s About Not Feeling Bad
Few people understand addictive behaviors better than Professor Marc Lewis, a developmental neuroscientist at Radboud University in the Netherlands. A far cry from the staid, grey-bearded academic I spoke with, Lewis regularly broke into clinics to steal drugs in his youth. He was all too familiar with narcotics — heroin on the streets, powerful psychedelics at parties, and opium in the dens of Calcutta.
Lewis was arrested multiple times before finally recuperating and starting his life anew. “I’m an expert on the matter, from inside out and outside in,” he writes in his book Memoirs of an Addicted Brain, “because I’m a drug addict turned neuroscientist.”20
Lewis went from despondent druggie to admired academic. His journey is living proof that for many people, addiction is not a curse of a broken brain. The tendency may be temporary and appears to be conditional on one last factor.
Addiction is a form of learning, according to Lewis. “It’s the brain taking the shortest route to get what it wants, repercussions be damned,” he tells me.21 Lewis believes that how our brains form addictions follows a predictable pattern, regardless of what it is we become addicted to. The brain’s biochemical process for forming dependencies is shockingly similar, be it Friday night drug benders or the compulsive checking of email on Monday morning.
Lewis believes addiction is the brain’s rewards system channeling attention to just one pursuit above everything else. “Then what accounts for the difference?” I ask Lewis. “Why do some people get addicted while others never use again? Why do some people abuse for years, then suddenly quit?”
“It could be that what feels good is what you’ve been missing,” Lewis tells me. In other words, the addictive behavior has to scratch a particular kind of itch for the user to pursue it.
For the compulsive gambler or video game player, for example, it may be the escape from the uncomfortable realities of life; for the opiate addict, perhaps it’s the relief from emotional hurt; for the sex addict or workaholic, it may be the missing feeling of control. “Whether they are junkies or executives, people take drugs because they’re not feeling right,” he writes, “which is extremely convenient when the world is not a nice place to be.”22
Vietnam, 1971. That year, two congressmen returned with shocking news from an official trip to the war-torn country. In their report titled “The World Heroin Problem,” Representatives Morgan Murphy from Illinois and Robert Steele of Connecticut estimated that between twenty-five thousand to thirty-seven thousand soldiers were addicted to heroin — some 10 to 15 percent of deployed servicemen.23 Fearing a wave of drug-dependent soldiers returning to US shores, Murphy and Steel remarked, “The Vietnam War is truly coming home to haunt us.”
In response to rising public fears, President Nixon created the Special Action Office of Drug Abuse Prevention and appointed Dr. Jerome Jaffe to head the division. One of Jaffe’s first actions was to commission a study to track veterans as they returned stateside. Jaffe called on Dr. Lee Robins, a well-regarded psychiatric researcher, to collect data on every enlisted man leaving Vietnam. The news was even worse than expected. Robins found that “around 20 percent of the soldiers self-identified as addicts.”24
However, something unexpected occurred when these soldiers returned home. The vast majority of soldiers lost their addictions when they left the war. “The legend has always been that if you get hooked on heroin you never get off. The exception is supposed to be a miracle or mistake. The Vietnam veterans have proven otherwise,” Jaffe was quoted.25 During their first year home, only 5 percent of vets were addicted to any sort of narcotic.26
The data was hard to believe. Whereas treatment programs in the United States reported heroin relapse rates at over 80 percent,27 Robins’ study turned the numbers upside down.
Instead of relapsing, nearly all the soldiers stayed clean. Jaffe says of Robins, “Everyone thought [that] there was somehow she was lying, or [that] she did something wrong, or [that] she was politically influenced. . . . She spent months, if not years, trying to defend the integrity of the study.”28 Forty years later, Robins’ research is no longer controversial or disputed.
When the soldiers were taken out of the stressful environment of war, the vast majority stopped using. But how can that be? The veterans wouldn’t have had much trouble finding heroin (the product). It’s also unlikely they had all undergone a sudden change in the way they handled their pain (the person). What then explained the massive discrepancy in relapse rates between the returning soldiers and civilians addicted to heroin?
The answer lies in the problems the veterans left behind in Vietnam. For young soldiers looking for a way out, heroin provided an escape from the nightmare of war. Who could blame them? Drafted into a war you didn’t want to fight, killing at the request of often incompetent officers, the war left many young men with few options to ease their minds. But when their environment changed, so did their addictions.
Meanwhile, civilian addicts, then and now, can’t be helicoptered out of their problems. The pain of childhood trauma, poverty, racism, homelessness, or other serious hardships can’t be left behind. Whether soldier or civilian, circumstances can inflict people with problems, and therefore pain, that they can’t always handle on their own.
The Opposite of Addiction Isn’t Always Abstinence
Thankfully, circumstances in people’s lives can change with time. Since Robins’ seminal work, several studies have concluded, as one example study did, that “a large proportion of individuals addicted to alcohol, heroin, cocaine, nicotine and gambling appear eventually to stop engaging in the activity. In many cases, this seems to occur without formal treatment.”29Furthermore, many addicted people are able to moderate their use, such as in the case of drinking alcohol. The National Institute on Alcohol Abuse and Alcoholism has found that just as many alcoholics recover while drinking moderately as do from abstaining completely.30
Dr. Lewis says he is living proof that people often recover when their circumstances change. Lewis began using at fifteen when he was sent to a hard-nosed naval boarding academy by his parents. He didn’t want to be there, and to the bullies in his class, he was fresh meat. Anti-Semitic attacks by other students left Lewis feeling weak and hopeless. He took refuge by staying in bed, hiding in the library, or wherever else he could find shelter. That search led him to drink and eventually to harder drugs.
Lewis’ young adult experience with drugs is unfortunately not unique. According to the United States National Institute on Drug Abuse, people in their late teens and twenties are most likely to use illegal substances.31However, usage declines with age, from 20 percent of 18- to 25-year-olds reporting use in the past month, to only 15.1 percent of 25- to 34-year-olds, and finally to just 6.7 percent among those aged 35 and up.
Addiction, for most sufferers, appears to be a temporary condition.32 The truth is that without a source of discomfort the sufferer can’t otherwise handle, there can be no addiction. For many people, when the pain in their lives dissipates, so does their addiction.
To recap this third and final section:
- Addiction is not about the pleasure of getting high, it’s about escaping the pain of feeling low.
- As was the case with soldiers returning from the Vietnam War, when people’s circumstances change, their addictions often do too.
- Just as many alcoholics recover while drinking moderately as do from abstaining completely. This is further evidence that the product itself isn’t the root cause of addiction.
- When painful life circumstances change and people no longer seek to escape reality, or they learn better ways to cope with pain, many people moderate harmful behaviors and lose their addictions.
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Nir Eyal is the author of Hooked: How to Build Habit-Forming Products and blogs at NirAndFar.com. For more insights on using psychology to change behavior, join his newsletter and receive Nir’s free list of research-backed tips and tricks to increase your personal productivity.