The Addictive Products Myth: Who Is the Culprit Here?

• 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.

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.”¹⁴National Drug Threat Assessment Summary, eBook, (2015), https://www.dea.gov/sites/default/files/docs/2015%2520NDTA%2520Report.pdf. 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.¹⁵Maia Szalavitz, “Prescribed Painkillers Didn’t Cause the Opioid Crisis,” Tonic, (June 20, 2017), … Continue reading It 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.¹⁶Deni Carise et al., “Prescription OxyContin Abuse Among Patients Entering Addiction Treatment,” The American Journal of Psychiatry 164, no. 11 (November 2007), 1750–56. … Continue reading

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“Fear of Distress Signals Risk for Opioid Misuse in Chronic Pain Patients,” National Institute on Drug Abuse, (April 24, 2018), … Continue reading

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 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 C.M. Gillan et al., “Enhanced Avoidance Habits in Obsessive-Compulsive Disorder,” Biol Psychiatry, (March 16,2013), https://doi.org/10.1016/j.biopsych.2013.02.002. 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.¹⁹ Stanton Peele, Ph.D.,“The Surprising Truth About Addiction,” Psychology Today, (May 1, 2004), https://www.psychologytoday.com/articles/200405/the-surprising-truth-about-addiction-0. But how can that be, if addicted people are somehow wired differently? Once again, there must be more to the story.

• 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.

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.”²⁰Marc Lewis, Memoirs of an Addicted Brain: A Neuroscientist Examines his Former Life on Drugs, (Public Affairs, 2012), loc 26 of 4678, Kindle.

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.²¹Phone call with author, May 18, 2016. 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.”²²Marc Lewis, Memoirs of an Addicted Brain: A Neuroscientist Examines his Former Life on Drugs, (Public Affairs, 2012), loc 38 of 4678, Kindle.

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.²³Jeremy Kuzmarov, The Myth of the Addicted Army: Vietnam and the Modern War on Drugs, (University of Massachusetts Press, 2009), 51. 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“What Vietnam Taught Us About Breaking Bad Habits,” NPR’s Morning Edition, (January 2, 2012), … Continue reading

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.²⁵Jeremy Kuzmarov, The Myth of the Addicted Army: Vietnam and the Modern War on Drugs, 72. During their first year home, only 5 percent of vets were addicted to any sort of narcotic.²⁶L.N. Robins, “The Sixth Thomas James Okey Memorial Lecture. Vietnam Veterans’ Rapid Recovery from Heroin Addiction: A Fluke or Normal Expectation?” Addiction 88, no. 8 (1993): 1041–45.

The data was hard to believe. Whereas treatment programs in the United States reported heroin relapse rates at over 80 percent,²⁷W.A. Hunt, L W Barnett, and L G Branch, “Relapse Rates in Addiction Programs,” Journal of Clinical Psychology 27, no. 4 (October 1971): 455–56. 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“What Vietnam Taught Us About Breaking Bad Habits,” NPR’s Morning Edition. 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.

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.”²⁹ Robert West and Jamie Brown, “Theory of Addiction,” Second Edition, (Wiley-Blackwell, 2013) Furthermore, 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.³⁰Deborah A. Dawson et al., “Recovery From DSM-IV Alcohol Dependence, United States 2001-2002,” National Institute on Alcohol Abuse and Alcoholism, (Accessed May 8, 2018), … Continue reading

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.³¹National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration, Drugabuse.gov, (June 2015), … Continue reading However, 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 Stanton Peele, PhD, “The Surprising Truth About Addiction,” Psychology Today, (May 1, 2004), https://www.psychologytoday.com/articles/200405/the-surprising-truth-about-addiction-0. 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.

• 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.

Like trepanning, Svengalis, and zombies, mind control at the hands of some invasive mind virus isn’t real; it’s fiction. Similarly, blaming so-called “addictive” products as the cause of addiction is shortsighted. A more rational perspective reveals that no product, on its own, is the source of addiction. Blaming pushers or big business for causing addiction is a story we like to tell. It deflects responsibility from the individual, who may lack the ability to cope with their pain. It also shields society from its responsibility to help people escape seemingly hopeless circumstances.

However, just because a product isn’t the root cause of addiction, does not mean companies do not bear a moral responsibility to intervene. If a company knows people want to stop using their product, they have an ethical responsibility to not impede them from quitting. Moreover, companies who know how much people use their products should proactively reach out to those who may be abusing it and offer resources to help. A “use and abuse policy” could be implemented by social media and gaming companies to help those whose usage patterns indicate they may be struggling with an addiction. Companies should institute such policies immediately and failing to do so, it should be mandated by law.

But if we hold our breath waiting for companies to change their business practices and politicians to fix things, we’re going to suffocate. In the meantime, we too can change our ways.

First, let’s start using the term “addiction” correctly. Addiction is not liking something a lot, nor is it overusing something from time to time. Addiction is “a persistent, compulsive dependence on a behavior or substance” that harms the user.³³“Addiction.” Accessed May 29, 2019. https://medical-dictionary.thefreedictionary.com/addiction. Addiction is a pathology and it’s time we talk about it like one. Just as it is important for people who are truly struggling with addiction to come to terms with their disorder, it is equally important that those not actually suffering from it to stop labeling themselves, and everything like to indulge in, as addictive.

The words we use matter. If we toss around the word in relation to anything we find appealing, we water down the term and risk not giving it the weight it deserves. Furthermore, it pathologizes a normal part of being human, namely, struggling with temptations.

Why do we say we’re “addicted” to something, like a television show, an app, or chocolate, when we’re really not? Because it’s so much easier than having to resist. Blaming things for being “addictive” hands over control to a powerful force “hijacking” our brain. That’s self-defeating silliness.

Feeling in control is critical to changing our behavior and a sense of powerlessness makes us less likely to fix the problem. In fact, several studies have found beliefs of powerlessness determined whether someone would relapse after treatment as much as the level of physical dependency itself did. Consider that for a minute — mindset mattered as much as the physical dependency!

Addiction is widely misunderstood. It is hard to get one’s head around the fact that something can addict someone, and yet not addict everyone. That’s why we should study and provide extra care to vulnerable groups. This includes teens, the elderly, the economically disadvantaged, and the socially isolated. We must understand the pain they seek to escape. If we don’t tackle the underlying sources of the problem, banning one analgesic or another won’t get us anywhere. Vulnerable people will always find something to complete the addiction triangle.

And finally, we should understand ourselves. Instead of blaming something on the outside for making us give in to temptation, we can try and understand our own sources of discomfort that pushes us to seek relief in unhealthy ways. We can try tactics to control overuse, without labeling ourselves as powerless or saying a substance or behavior is addicting us, when it isn’t.

Today’s panic over technology addiction is the latest example of fear and misconceptions leading us astray. Let’s stop feeding into the moral panic around technology companies “hijacking” our brains. We need to understand what addiction really is. As the decades-old “war on drugs” has demonstrated, you can’t win a war when you don’t understand the enemy.