Addiction: From the Biochemical to the Behavioral

Technology is wacky. We carry powerful, sophisticated computers in our pockets and wear them on our wrists. With them, we access the Internet and the Cloud, computing everywhere we go. Then, there’s the plethora of apps and games that do things from teaching languages and scoring our real-life fitness habits to linking us to people around the globe while we show off our latest lunch or command digital armies. 

Tech pervades all aspects of our lives, for productivity and leisure, giving us the ability to accomplish tons in a small span of time, or, conversely, to kill a ton of time. Where tech continues to give us powers, it also enables new, dark pitfalls of behavior. Phone and game addictions are amongst the newest technology-related behavioral disorders, and the capability of future augmented reality applications may completely change or distort our reality. 

Our technology can be quite addictive, with the ability to destroy our lives as much as build them up. Is our understanding of addiction up to snuff to combat various types of behavioral technology addictions, and, if not, how is it changing to keep up with our rampant technology development?

Addiction is widely recognized as a behavior or set of behaviors that can cause serious detriment to a person’s life in the case of work, personal and professional relationships, and physical and mental health — and how we view addiction has changed over time. 

During the United Kingdom’s and USA’s industrial revolutions, the first concepts of addiction stemmed from alcoholism as a disease of character and biology. In the mid-20th century, the disease model was institutionalized in part by Alcoholics Anonymous and the Minnesota model of treatment and recovery — characterized by alcoholic abstinence, inpatient settings, and family involvement — and medicalized by experts like physiologist Elvin Morton Jellinek. At the same time, the physiological effects of withdrawal and increasing tolerance helped define addiction as a metabolic disease or reinforced behavior. Later, harm reduction models were created to reduce risk-associated behaviors, and in the 1990’s calls to take seriously the materiality, embodiment, and biology of addiction finally led to a neuroscience of addiction — the understanding that most of us are now familiar with: an addiction situated squarely in the space of the brain. 

This prevailing definition is known as chronic, relapsing brain disease (or CRBD for short). Drugs and pleasurable activities overwhelm and change systems in the brain associated with desire, reward, and pleasure. The disease rewires our brain through dopamine receptors and other means so that over time our brains need the specific drug or activity to replicate positive feelings.    

Recent research of the past decade argues that focusing solely on CRBD fails to take in the complex relationship between addiction’s biological processes and the surrounding or related social, cultural, physiological, and political elements. Dr. Scott Vrecko, professor at King’s College London and author of the article “‘Civilizing Technologies’ and the Control of Deviance” suggests we be ambivalent toward addiction as a disease and take into account its physiological, biological, and political elements simultaneously. Dr. Daniel H. Lende suggests in his research “Neuroanthropology and the Encultured Brain” that repetitive habits and intense desire (central to addiction) are neurocultural processes, or, are related both to neurological changes and cultural and sociological pressures that affect brain development. 

If we’re to take into account recent research like this, the truth of addiction lies in between familiar medicalized understandings and broader cultural considerations. We can look at gambling addiction, for instance. Cultural anthropologist Natasha Dow Shull analyzes gambling addiction in her book, Addiction by Design: Machine Gambling in Vegas. She suggests the addiction is reinforced by the environment in which it often takes place; the consuming experience of the video gambling machine works alongside architecture and the work of designers to encourage repetition and pleasurable mental states. Looked at through this lens, addiction is co-produced by the activity or behavior and its surrounding contexts. 

Video games and phone apps are often designed in the same way with the inclusion of digital points, medals, and customization options that illicit a repetitive feedback loop. The like, retweet, and follower count stands in as social currency inside this loop.

These experiences exist within the broader context of relationships and lifestyles outside of the device: the places we go, the people we want to connect with, the relationships we want to maintain, the expressions we want to share. They all co-mingle within our and designers’ or creators’ desires.

If we’re to understand that research points to wider socio-cultural understandings of addiction, what does that mean for the addict and treatment processes? Programs like reStart seek to treat patients with many types of behavioral addictions, but specifically focus on addictions related to technology like screen and game addiction. reStart does this by separating patients from society at large to implement personalized treatments in what they call naturopathic care involving psychopharmacology, nutrition, and psychotherapy. Therapy focuses on building new relationships and repairing old ones, as addiction has been proven to be a result of isolation. While it sounds familiar and though it may be effective, it doesn’t prevent addiction within broader contexts. 

As technologies like augmented reality begin to reshape our daily landscape in the same way that the smartphone has, separating ourselves from addictive environments generated by reward-centric applications will become more and more difficult.

Perhaps the best way to approach the complexities of behavioral addictions is for powerful agencies involved to take responsibility. When W.H.O. announced their classification of gaming disorder, the Entertainment Software Association encouraged them to rescind the announcement, declaring that games are not addictive and instead pointed to depression and social anxiety disorder as underlying causes of compulsive gaming. 

Perhaps the solution is social responsibility; can the games industry and other technology-related creators and developers take proper measures to encourage healthy lifestyles and prevent overuse? What would an effort like that look like?

Hopefully something better than a surgeon general’s warning.  

Jeremiah French spends most of his time dissecting and consuming human-built worlds in multimedia, from written fiction to simulated spaces. When he isn’t doing that, he’s making his own in podcast and print. Occasionally he remembers that he’s a musician, so he’ll do that, too. Check out his musings on interactive entertainment at drunkenmarmoset.com, and his primary action-fantasy podcast Gafgarn: The Eternally Unfurnished, anywhere podcasts are available.

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One response to Addiction: From the Biochemical to the Behavioral

Excellent review of the literature! Have you considered looking into the democratic presidential candidates’ surgeon general picks? Or their picks for the FCC? With the right people in those Executive and regulatory agencies, could we see the US leading the world in screen/game addiction recovery? I think of the way we regulate alcohol content, and nicotine consumption – usually through funded mandates that are tied to desperately needed federal dollars. I am especially interested to hear how the Sanders campaign is speaking to the issue. They brand their “revolution” as a lone driven by 30 and under’s. This will undoubtedly be the addiction of their time. I’d expect to see a candidate speak on a bold set of proposals to solve it.

Thought-provoking indeed!

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