by Matt Richtel
By fourteen, David was experimenting with drugs. Marijuana, barbiturates, LSD. Then he started taking and selling painkillers from his parents’ medicine cabinet.
“It was a cry for help,” he says, looking back. “My parents’ marriage was crumbling.”
He spent four and a half months at a place called Harold House, an inpatient rehab center in an old warehouse. He got clean. Still, he said, his high school guidance counselors had “thrown in the towel” on him.
They were wrong. David became a psychologist, earning a PhD in 1986 from Texas Tech University, and, eventually, becoming an assistant clinical professor of psychiatry at the University of Connecticut School of Medicine. He now brings a particularly personal perspective to the debate about addiction. He’s the director of the Center for Internet and Technology Addiction, one of the first places in the world to treat technology addiction as a medical disorder.
What’s happening today with technology, he argues, is comparable to what happened in the seventies with drugs. “It’s exactly the same, the pace of adoption of technology and cultural acceptance isn’t that much different than the pace of adoption and cultural acceptance of the drug culture, except that one is legal and one isn’t.”
HE GETS RAISED EYEBROWS. At conferences, people say: Gimme a break; technology’s not like cocaine or heroin or crack, where you can see the tissue damage in the brain. They say: There’s no proof of increasing tolerance levels to technology. And: People can walk away from their devices.
Dr. Atchley, while an admirer of Dr. Greenfield, isn’t convinced that technology is addictive, per se, though Dr. Atchley remains open to the debate.
The so-called bible on the question of psychological illnesses is the Diagnostic and Statistical Manual of Mental Disorders, the DSM. The disorders, and their classifications, change with each edition, reflecting new science and understanding. Its committees have grappled with the question of technology addiction but haven’t made it an official diagnosis. For now, it falls into a broader category, “Impulse Control Disorders Not Otherwise Classified.”
According to a 2012 article titled “Are Internet and Video-game-playing Addictive Behaviors?,” scholars from Yale and University College London concluded that the features of an impulse control disorder are “a failure to resist an impulse, drive or temptation to perform an act that is harmful to the person or others.” It goes on: “The individual feels an increasing sense of tension or arousal before committing the act and then experiences pleasure, gratification, or relief at the time of committing the act.”
To an extent this is a semantic conversation. The Yale paper notes that the word addiction derives from the Latin addicere, which translates to “enslaved to” or “bound by.” They are broad definitions. It was only in the last thirty or so years that the definition came to be narrowed to substance abuse, notes Marc Potenza, a psychologist at the Yale School of Medicine and an expert in addiction science who was one of the paper’s co-authors.
In short, most researchers don’t put texting, or video game playing or Internet use in the same category as addictive drugs. They might be compelling, say many researchers, but not addictive.
To Dr. Greenfield, it’s mere semantics. “Whether the word is ‘impulse,’ or ‘compulsion,’ or ‘addiction,’ clearly there is an overtaking of rational, logical processing of information and judgment like we see with other drugs,” he says.
He’s worth hearing out. For one, the way he describes and breaks down our day-to-day interaction with our devices is extremely resonant. His analysis rings true. Also, even though technology is not classified as “addictive,” some neuroscience points to stark similarities between how technology use and drug use trigger chemical release in the brain.
IN 1998, RIGHT ABOUT the time that Dr. Greenfield sensed the lure of computer technology, neuroscientists at the Imperial College School of Medicine in London observed the brains of eight male subjects playing a video game.
The game entailed using a computer mouse to direct a virtual tank through a battlefield. Subjects had to collect flags while avoiding and destroying enemy tanks. As subjects got more flags, they progressed to a new game level. And they got a reward of seven pounds for each new level achieved.
The players were injected with low levels of a chemical called raclopride. The significance of raclopride is that when it travels through the bloodstream into the brain—crossing the “blood-brain barrier”—it attaches to dopamine. The chemical is also a radioactive isotope, which means it can be visualized using a PET scan.
The technique allows researchers to take a picture of the inside of a body, sort of like an X-ray. But one key difference is that a PET scan lets researchers look at various neurotransmitters, and cellular activity—a power unimaginable just a few generations ago.
The results were interesting, if open-ended. Dopamine levels at least doubled. And not just that, the subjects who performed better at the game had greater increases in dopamine.
To Dr. Greenfield, the true believer, it is a crucial piece of baseline evidence. “When you’re playing a computer video game, the dopaminergic centers light up like a fucking Christmas tree.”
DOPAMINE CENTERS ARE CRITICAL. They are, in a basic sense, our reward centers. They help tell us when we’ve done a good thing. They light up when we eat, or have sex, when we accomplish something. They are part of what helps us survive.
But they also light up when the brain interprets something as pleasurable, even if the behavior doesn’t appear to have the survival value of, say, eating or procreating. They are activated in lots of circumstances, even when we’re doing something that can be destructive. For instance, the reward centers light up when someone takes drugs, like cocaine, or booze, depending on a person’s susceptibility.
Different drugs use different mechanisms to trigger increased levels of dopamine. Some addictive drugs, like cocaine, appear to prevent dopamine from being absorbed. That leaves more of the neurochemical in the synapses. Other drugs, like amphetamines, appear to induce a greater initial release of dopamine.
To Dr. Greenfield, technology behaves more like the amphetamine model. The way he thinks about it is that even the smallest click of a device gives a little rush, a tiny dopamine squirt. Hit a key and something happens. You click and a letter appears on the screen, for instance, or a picture comes up, an email opens. Each of these, on some level, triggers tiny rewards.
“It’s in a sense a narcotic.”
After a while, he says, the mere presence of the device begins to offer the promise of tiny hits, and bigger ones. It’s what Dr. Greenfield calls “the anticipatory link.”
It’s a bit the way a smoker feels a little thrill when opening the pack, or lighting up, knowing the nicotine hit is coming. “You see the computer, it’s one trigger, then you sit at the keyboard, it’s another, you push the key, you get a result, then you get the big result. There’s a cascade of dopamine. It’s the big kahuna.”
This is, in essence, interactivity. Touch the key, get a response; touch the screen, get a burst of information, or a reward. That’s not inherently bad. But the way Dr. Greenfield sees it, people feed the need, click after click. And then, when the rush of excitement fades, he says, people feel rotten. “So they go try to get more.”
A DIFFERENT STUDY, REPORTED in a 2012 paper in the Journal of Biomedicine and Biotechnology, found a connection between Internet use (rather than video game playing) and dopamine.
The researchers used PET scans to examine the brains of five men, around the age of twenty, seeking treatment for Internet addiction (use of the Internet more than eight hours per day) from the Peking University Shenzhen Hospital. The men experienced reduction in the dopamine transporter, a protein, as compared to a control group of nine men who were not compulsive Internet users. What’s significant about the dopamine transporter, among other things, is that it also gets altered in people with chronic substance abuse. In other words: Some of the same pathways and resul
ts seen in the abuse of substances is happening in the brain of heavy Internet users.
The paper concluded: “These findings suggest that [Internet addiction] is associated with dysfunctions in the dopaminergic brain systems and are consistent with previous reports in various types of addictions either with or without substances.”
It is worth noting the significance of the phrasing “various types of addictions either with or without substances.” That word choice is crucial because, while there is interesting emerging science around Internet addiction, there is a predicate question being asked by many scientists: Can behaviors be addictive, or just substances? (At the center of the debate is a behavior like gambling; is it classically addictive, or does it belong in some other category of compulsion?)
Researchers point to a number of surveys of Internet users that suggest, at least, that their behavior can fairly be defined as “addictive.” The 2012 paper from Yale (“Are Internet Use and Video-game-playing Addictive Behaviors?”) summarized the findings of surveys and questionnaires. The surveys found a range of prevalence of “Internet addiction” among young people and adults across the globe. For instance, a 2011 survey of students in the United States found a 4 percent prevalence; a 2008 survey of elementary and high school students in Hong Kong found a 19.1 percent prevalence; others showed 10.7 percent among students in South Korea and 18.3 percent among college students in the United Kingdom.
There was a similar range in surveys exploring excessive video game use, or problematic video gaming (PVG).
The paper also found interesting evidence that people who identify as Internet addicts also tend to have personality traits, or psychological conditions consistent with substance abuse and “pathological gambling.” These so-called comorbidities—meaning the conditions co-occur with Internet addiction—include “attention-deficit hyperactivity, mood, anxiety and personality disorders.”
The paper says that, as with substance abusers, studies of people with Internet addiction have found “increased novelty seeking, low reward dependence, impulsivity, high risk taking, low self-esteem and disadvantageous decision making.”
What that implies, but does not prove, is that some individuals could be more susceptible to Internet addiction, just as some people are more susceptible to pathological gambling or substance abuse.
The paper also explores the neurological studies, including one that suggests the release of dopamine by players of a computer-based racing game is similar to that produced by amphetamines and crystal meth. The Yale paper strikingly concluded: “Taken together, these findings suggest that (Internet addiction) is associated with dopaminergic neural systems in a fashion similar to substance-related addictions.”
WHEN IT COMES TO the lure of technology and the way it stimulates people, there’s one more comparison that researchers widely cite. It’s not to drugs but to gambling, specifically, to slot machines. And the parallel stems from a concept that is quite counterintuitive: the Internet, smartphones, and other devices are addictive because they often deliver us worthless information.
Say what?
An American author named Frank Scoblete once wrote that slot machines “sit there like young courtesans, promising pleasures undreamed of, your deepest desires fulfilled, all lusts satiated.”
In fact, what makes slot machines so powerful, at least in part, is that they so often leave the player unsatisfied. And, even more to the point: The players never know when they will get a payoff, a feeling of satisfaction, a fulfilled desire. In a nutshell, slot machines work on a principal called variable or intermittent reinforcement. Take, for instance, several classic studies with animal models. A baboon, say, is shown that if it pushes a lever then some food will drop through a dispenser. But the animal doesn’t know which push of the lever will be the one that will deliver the food.
“The baboon will press the lever at a very steady rate. ‘Is the food there yet, is the food there yet?’ Each press is like a question,” explains Dan Bernstein, a professor of psychology at the University of Kansas, where he has an office down the hall from Dr. Atchley.
It may not be a comfortable comparison for some. But the image of a baboon pulling a lever for food is not all that dissimilar from a person obsessively pecking at their phone waiting for the next email to appear.
And it can almost be assumed that much of the stuff that comes into our devices is not particularly useful. It is, in a word, spam. A 2012 report from Symantec, a company that builds software to block computer viruses, found that around 67 percent of email is spam. The big number probably comes as no surprise and, doubtless, much of those unwanted missives are blocked. But even if only a fraction get through to the end user, it puts a fine point on just how hard it is to know what you’re going to get when the computer—or phone—pings with incoming information. Classic variable reinforcement.
And, setting aside the question of raw spam, the plain fact is that some information is simply more interesting than others. Some texts, calls, email, and Facebook status updates are really informative or entertaining. But you can’t really discern who or what quality information is coming your way without diverting attention. Every time a text comes in, “You don’t know what it’s going to be, who it’s from, and, hence, how valuable it is,” says Dr. Greenfield. “What’s happening, in essence, is that you’re constantly scanning your texts and email because every once in a while you are going to get a good one and you can’t predict when that is.
“The Internet is replete with novelty and variability,” he contends. “That’s why Facebook is so popular. It’s the fact that it’s dynamic, and novel, and constantly changing.”
CHAPTER 25
REGGIE
IN MID-JUNE 2007, REGGIE was at the Missionary Training Center in Provo. It was a place filled with excitement and some nerves; young adults amassed, in shirts and ties, taking in long hours in the classroom, preparing for a two-year voyage of maturity and zeal, the culmination for many of a lifelong dream, but also two years away from family. No cell phones. No visits home, no TV or radio. The focal point was the gospel. Full stop.
Everyone got a name tag, on which the most prominent words were CHURCH OF JESUS CHRIST OF LATTER-DAY SAINTS. Then there was your own name, slightly smaller, denoting that this was not about the individual, but the larger quest.
ELDER SHAW.
Reggie was thrilled when he put it on. Then more good news. The district president named him district leader, in charge of leading ten other kids in activities. He wasn’t sure why but assumed it was because he’d been to the center before, albeit briefly, and because he was a little older. On the very first day, he lead his group into the cafeteria for lunch and sagely directed them to the shortest line.
He said his group members just loved it. They had no idea he’d been there before. They were impressed. “I remember knowing the kids in my district loved being with me.”
At night, it was four to a room, sharing two bunk beds. Reggie was sleeping great. Peaceful.
A week in, he was sitting in class when there was a knock on the door just before lunch. A man who helped run the program poked in his head. “I need to speak with Elder Shaw, please.”
Reggie felt a surge of panic, “a pit in my stomach.”
In the hallway, the man told Reggie there was a phone call for him. “It’s a lawyer named Mr. Bunderson.”
They took an agonizing walk to the main office. Reggie well knew he wasn’t supposed to use the phone, and that it must be important if he was being asked to take a call, and, no less, from his lawyer.
“Hello,” Reggie said.
“Hi, Reggie,” Bunderson began, and immediately headed off the terror. “Everything is still going well.”
Reggie just listened.
“I’m calling because I need you to sign some papers. They’re called power-of-attorney.”
Bunderson explained that he needed the papers “just in case” he would need to deal with something while Reggie was away
on his upcoming mission. “If we did this, we won’t need to call you every time I need something,” Bunderson said.
Reggie felt more than a sense of relief. It was as if Bunderson was saying: Go on, nothing’s really happening, and I don’t much expect it to. That’s what Reggie heard, at least.
“After the conversation, that’s when I felt safe.”
TONY BAIRD WAS STRUGGLING. Finally, he was in a position to truly confront the issues in the Shaw accident. Yes, of course, the accident was a tragedy. But accidents happen. What were the facts? What was the law? And what was the responsibility of a responsible prosecutor?
It was not uncommon for Baird to answer someone who asked about his job, “By the stroke of my pen, I can ruin a life.
“Just because you can do something as a prosecutor, doesn’t mean you should do something,” he says. “Plenty of things go wrong in society. There are plenty of things that are troubling to society, but you have to take your power seriously.”
As Singleton began to amass evidence, and Baird saw that a potential case was coalescing, he let these thoughts percolate. He had a good familiarity with the driving laws, the reckless driving laws, the negligent homicide laws. And in the previous few years, he’d had cause to make hard decisions about how to use his prosecutorial powers in difficult cases. In one case, about six years earlier, Baird had prosecuted a twenty-one-year-old man who had been driving a small Toyota pickup through Logan Canyon, along a narrow, sometimes dangerous road. Earlier in the day, the man had told friends that his brakes were bad, Baird said. He was driving eighty miles an hour when he drove head-on into a family, killing the mother and grandmother.
The driver’s grandfather had recently retired as a district court judge, which gave the accident an extra public layer. In the jury trial, Baird argued that the defendant drove recklessly even after knowing his brakes were bad. The conduct, no question in Baird’s mind, rose to the level of “criminal negligence.” In Utah, as generally elsewhere, the meaning of that standard is that the defendant shows a “gross deviation” from the standard of care.
