[dalbasal]

I haven't listened to the episode, so this may be off, but...

our broad use of the word “addiction” can cause real harm.

I would say that the opposite is (at least) as harmful. Quantifying and medically defining addiction narrowly has led to a lot of harm. Smoking is extremely hard to kick, with some first handers claiming that its worse than heroin. People rarely prostitute themselves (or others) for tobacco though. Which defines or quantifies addiction?

Withdrawal symptoms of severe alcoholism are among the most dangerous, and deadly, much worse than cocaine. That doesn't quite capture what addiction is though. Withdrawal symptoms are short lived, and addicts of many substances are extremely likely to regress well after this part. Cannabis can be habit forming. There are no withdrawal symptoms, and motivated quitters seem to have good success rates... even returning to moderate use. OTOH, it is a very common experience that someone decides not to consume... but does, repeatedly, with impacts on other areas of life.

We know that context and comorbidity is very important.

I think there's no doubt that technology creates impulsive & compulsive behaviours, that people want to stop, but fail to.

It's all complex. There aren't real dividing lines between procrastination, self discipline issues addiction and such. People call it addiction because it walks and quacks like addiction. I'm more inclined to say that research definitions are incorrect that layman ones. If a researcher narrows the definition to observable neurochemistry or withdrawal symptoms, excluding other addictions with similar behavioural effects... who is wrong here?

That said, I haven't listened. Adding depth and nuance to our understanding of different addiction (or addiction like) experiences may be useful.

[louis___]

Exactly this.

The "discover who really has the power to break these supposed “addictions.” (Hint: It’s you.)" rethoric is always pushed by lobbies for industries who do not want to be considered responsible for the harm their products cause.

For example, MacDonalds and other fast-food producers have been pushing that in order to fight rampant obesity, people should do more sport, rather than have limited access to deeply addictive, processed and sugary-filled foods.

[grenoire]

Seriously, this is about the equivalent of telling somebody with a substance dependence (I think weed is likely the best analogue, with a weaker physiological dependence, that is) to just quit it. These devices are not inhaled, injected, ingested, but they are very much a tool in releasing hormones.

[to11mtm]

You're absolutely correct.

A few years ago I went gluten free to see if it helped with some other health issues (it did, NCGS.)

So, between late 2016 and the end of 2020, I avoided gluten as best as I could. Which all but eliminates most fast food and the majority of prepackaged foods/snacks/etc.

Portion control became incredibly easy. I ate when I was hungry. Sometimes people would comment on how little I was eating, but I was still energetic and kicking ass at work/etc. My body also fairly quickly started to adjust to a more 'proper' weight. (As long as I wasn't drinking. There were parts of that time of my life where I sometimes did, never to where it interfered with work but definitely was hiding from my personal life circumstances.)

ANNNNYWAY. Late last year I decided to try gluten again to see whether I still had a bad reaction and/or if it was moreso specific types that caused me issues (They all kinda bother me, but barley makes me ragey....)

I remember the first thing I ate from McDonalds last year. It was a double cheeseburger.

I then spent the next 2 weeks straight getting at least one meal a day from McD's. It was an eye-opener on how addictive some of the components in a food can be to your neurons.

[bumby]

>Which all but eliminates most fast food and the majority of prepackaged foods/snacks/etc. Portion control became incredibly easy.

One prevalent theory about why just about elimination diet works is because of this effect of an easy decision heuristic to make smarter food choices. That seems more plausible to me than a single instance of the gluten in a 150 calorie bun being the culprit (unless you have something like celiacs disease, of course). Regardless, I’m glad you found a regimen that works for you.

[grenoire]

I think the same treatment is necessary for these sorts of foods. It's hard to regulate both in terms of classification (what're the thresholds?) and regulation (how to get politicians to take action?). It's going to take time, but I'm hopeful.

Happy to hear you managed to cut out the junk for a long time, I hope you haven't rebounded in full!

[thegrimmest]

What if the person doesn't want to quit? What to take into your body and how to regulate your health are deeply personal choices. Why not just let people make them?

[grenoire]

I didn't remark on that but I'll entertain your comment: I think it's about having the facilities to educate people about the effects, and help them in rehabilitation if they prefer to.

[thegrimmest]

> facilities to educate people about the effects

I think we already do a pretty good job at this, don't you? Drug awareness education in one form or another has been part of the curriculum since the 19th century.

> help them in rehabilitation if they prefer to

We have lots of NGOs that are setup to help drug addicts. Are they not doing a good job?

[grenoire]

You missed my point, sorry if it wasn't clear: These should exist for 'device addicts' and addiction.

[slibhb]

You're ligitating free will here and you've decided it doesn't exist. Well, right or wrong, people who believe in their own agency make better choices. It's somewhat bizarre to me to see you criticzing the idea that people should be held responsible for what they put in their mouths, chew, and swallow. You write like it's such an awful idea that people could choose to eat healthier foods or exercise more.

[thegrimmest]

> rather than have limited access to deeply addictive, processed and sugary-filled foods.

So individuals are not responsible for their decisions? I personally would rather not live in a world where my choices are artificially limited by someone's idea of what is "good for me". I'm perfectly capable of deciding for myself, and willing to accept consequences of my mistakes.

[hxtk]

Your choices are already being shaped in that way. That's why, for example, modern residential roads are designed with shorter sight distances, narrower lanes, speed bumps/humps, and more roadside shrubbery compared to their counterparts from a century ago. It turns out that the mere suggestion of a speed limit—albeit carrying force of law—does not make everyone choose to drive that speed. Instead, human factors are taken into account so that it "feels more natural" to drive the road at the speed the engineers intended. We try to make it easier to use the system in a way that is safe and accomplishes the user's goals than in a way that causes harm.

Human factors isn't a binary question of whether or not we influence the choices made by individuals. In the real world, individual choices are always influenced by a variety of factors. The question is that, when we are aware that a particular design decision will influence the choices of individuals, is it ethical to make that decision in whatever way maximizes the profitability of the product, without regard for any predictable impact it will have? Simply maintaining willful ignorance of human factors in engineering does not make the world functionally better or worse than if that same decision had been made from a position of understanding of those factors and an attitude of malice/benevolence/apathy.

I don't think it's contradictory to tell consumers to make their own choices while at the same time telling producers not to design products that needlessly influence consumers to make destructive choices.

[bumby]

FWIW, I agree with you but think it’s also important to recognize the devils advocate position.

>I'm perfectly capable of deciding for myself

I think there’s a decent amount of evidence that humans aren’t as capable of making rational decisions, or at least not nearly as rational as we’d like to think. In the context of systems like nationalized healthcare, this can become a negative externality. If I’m responsible (in part) of paying for your healthcare, there may be an argument that I (in part) have a say in the decisions you make that effect your health.

[thegrimmest]

> I (in part) have a say in the decisions you make that effect your health.

Well then you (in part) become my master. No person has the right to be master of another. One doesn't need to always make rational decisions in order to be entitled to make them. This is also why I'm against nationalized healthcare.

[bumby]

>One doesn't need to always make rational decisions in order to be entitled to make them.

Agreed. But regarding the “master” comment, I think that’s a bit hyperbolic. You give up certain decisions as part of the social contract. I can’t decide, for example, that I want to drive on the other side of the road. Giving up that choice also doesn’t make me subservient, especially in a representative democracy. It just means I know how to balance the rights of the individual with the overall welfare of society.

[thegrimmest]

I don't think it it's hyperbolic really. The only relevant question is where the line is and by what principle it is defined. Is the difference between freedom and slavery clear and well-drawn? or is it a spectrum? I'm inclined to the former view. The only legitimate social contract is the one keeps the peace and manages the commons (this is already quite a lot). Everything on top that tries to shape our behaviour or compel us to cooperate is a violation of a person's right to be their own master.

> I can’t decide, for example, that I want to drive on the other side of the road.

You can perfectly well drive on whatever side of whatever road you want assuming it's a private road. Public spaces have rules, and always have. What's not fine is managing the interactions of private people minding their own business.

[defaultname]

I've eaten at McDonalds. Yet I only eat there infrequently, usually when traveling and want something quick. I'm not obese.

Did they forget to put the "addictive" additive in mine?

Misusing the word addictive to mean "things that aren't beneficial, and can be detrimental in excess" is not helpful to anyone.

People who are depressed self-sabotage in a wide variety of ways. They sleep all day. Maybe overeat. Maybe sit flicking through TikTok all day. Some even clean endlessly. That doesn't mean any of those things are "addictive".

This whole discussion borders on parody. People with zero responsibility or self-control screaming that they have no self direction and need their world corralled and constrained for them. Beyond bizarre. And apparently these amazingly addictive ingredients only work on Americans, who seem to lack any self-reflection or inquisitiveness as to why that is.

I read a Robertson Davies trilogy for hours last night. Probably stayed up a little late. Blame it on Big Books and the Book Cartel for Addicting me like this.

[lolinder]

There are also hundreds of millions of people who drink socially and never become alcoholics. Are the hundred million alcoholics "people with zero responsibility or control", or is it more likely that some bodies react differently to certain addictive substances than other bodies?

If you allow for different reactions to alcohol, why could the same not be true for sugar and fat?

[defaultname]

While alcohol addiction usually does begin with depression or lack of self control, the physiological effect of ongoing abuse is seen worldwide. This isn't at all true for whatever NOT MY FAULT BLAME [INSERT TARGET HERE] easy solution Americans are pitching today.

Are the Japanese addicted to McDonalds? Are the French? Are Mexicans? Are the British? Are Chileans?

The tale in another comment that someone had McDonalds and then they went back every day for two weeks straight literally reads like parody. If someone were mocking that sort of lazy, not-my-faultism they'd author a comment precisely like that, thinking they were exaggerating and making it sound absurd.

Is it American Exceptionalism that makes for this remarkable, magical dietary addiction? Or is it a market that is particularly susceptible for easy victims and easy "not my fault" answers. Blame it on Big McDonalds. Make a documentary (usually cartoonishly full of misstatements and lies) and it gets Eaten Up, pardon the pun, because it's an easy, incredibly lazy thing to blame.

Obesity is a problem around the globe, and in every country it's different causes. Calories became a lot cheaper, and people like eating. If you think one magical ingredient is the cause, get a grip. It isn't so simple. And eventually it 100% comes down to self control.

If someone spends 9 hours scrolling through TikToks, that isn't TikTok's fault. It really isn't. It is remarkable reading people imagine up the nefarious ingredient that puts the responsibility on someone other than themselves.

[TimPC]

He doesn’t argue that the behaviours aren’t harmful at all but rather often manifest as a coping mechanism for another condition. He thinks it’s a dangerous idea to treat social media addiction as something to treat directly rather than something that likely indicates another problem. I don’t think it’s perfect because actual addictions are often caused by other problems (ex. Depression). I really wish the expert was forced to answer questions like whether it’s worthwhile to treat alcohol addiction directly without treating an underlying depression. It seems like this definition may not quite work the way he wants it to. The distinction may be if you treat the depression directly the social media addiction disappears but if you treat the depression directly the alcoholism still needs to be dealt with.

[dalbasal]

Yeah... maybe (obviously) I shouldn't have commented without listening, caveats or no.

That said, this is also true of heroin addiction. It is highly related to other, often social, malaises. This has been experimentally proven in rodents. Lonely, unhappy rodents are far more addiction prone. It has been observed in people too, notably the vietnam war example.

I don't even think there is a common treatment for alcoholism anymore that doesn't relate to "underlying" issues. AA, and related group therapies are all about creating a supportive community. Social isolation is a major factor in addiction.

That's kind of what I meant. These hard lines don't exist, and I think many that do exist for research purposes. Hard to study something that isn't discreetly defined. Physical withdrawal symptoms were once a primary researchers' definition of addiction, even though addicts rarely think of it that way.

[ghodith]

“This has been experimentally proven in rodents”

If you are talking about the rat park[0] series of experiments, that conclusion has hardly been “experimentally proven.” There are many replication issues and the authors themselves don’t support the popular conclusion often taken from their research.

[0] https://en.m.wikipedia.org/wiki/Rat_Park

[dalbasal]

My apologies. "Replication crisis" (or Ted Talks, really) strikes again. I should have said "demonstrated," though that's probably a cop out.

From the wiki article and its meta research source, it seems that researchers do support the general idea that housing, enrichment and social conditions affect addiction. Popular science has just overstated the results.

"While the Rat Park studies did not use methods that are reliable by current standards, enrichment has been shown to reliably reduce opioid consumption and this effect can generalise to other drugs of abuse."

https://journals.helsinki.fi/jrn/article/view/10.31885.jrn.1...

Incidentally, I don't understand why stuff like this is still ambiguous. This is a classroom experiment, resource-wise. Why hasn't it been refined, replicated and conducted at scale sufficient to be reliable?

[jrochkind1]

Hm, in my observations and reflections, most addictions are in part coping mechanisms for something else.

So I think what he's saying about treating the gaming "addiction" without attention to the underlying trauma being coped with -- probably applies to actual/other addiction too, rather than being a distinction?

[possibleworlds]

“Actual addictions” are caused by actually addictive substances or patterns of behaviour. Genetic predisposition is also a significant and often misunderstood factor. Yes there can be links to underlying mental health issues, but addictions are primarily cause by things that are actually addictive. Nicotine, for example, causes immediate withdrawals and cravings in the short term, and basically rewires your brain chemistry with sustained long term use. Addiction to nicotine is not caused by depression, it is caused by nicotine.

[slibhb]

> People rarely prostitute themselves (or others) for tobacco though

I'm sure they would if tobacco was as hard to get as heroin.

We often find ourselves in this position where we have to choose between a broad and a narrow defintion (for addiction in this case). Maybe there is no right way to decide but I'd say we've been too often going with the broad definition. We tell ourselves "there aren't real dividing lines" and this becomes an excuse to expand definitions. One problem with this is that broad definitions are often less useful. In the worst case, expanding a definition results in meaningless (consider words like fascism and terrorism).

If addiction is "impulsive & compulsive behaviours, that people want to stop, but fail to" then anything can be addiction. Is that useful? I don't think so, I think it trivializes the concept and if that definition sticks, we'll have to come up with a new word. That's fine, I guess, but do we gain anything in that process?

[dalbasal]

There's a difference between meaningless an imprecise. Words like fascism, species, decency, beauty, and such do have meaning. They just don't have precise, F=ma like meaning.

There's also no problem defining and measuring addiction using discrete definitions such as withdrawal symptom severity, rehabilitation success rates or neurochemical signature. The problem arises when researchers (or anyone) then believes that this is the definition of addiction, when in reality it is a definition contrived for the purpose os (valid and useful) research. In a different context, it might be useful to think of these as indicators of... Usefulness is contextual.

Discrete language is fine. It just isn't the way we communicate normally, and it's impossible to use only discrete language to describe things we don't understand fully.

[slibhb]

Obviously natural language is never absolutely discrete. Let's say there's a spectrum between fairly discrete and fairly meaningless. I'm saying we should move toward the discrete side of things.

If we need to invent a new word to describe something, we can, we don't need to repurpose an old word and in doing so rob it of its meaning.

[amelius]

> People rarely prostitute themselves (or others) for tobacco though.

Because it's easier to get tobacco. Just ask someone, or pick up left-over pieces from the streets and build a new cigarette out of it. It's what I see certain homeless people doing all the time.

[ethbr0]

Broadly speaking, I tend to think of "addiction" (rightly or wrongly) as the errosion of free will.

If someone wilfully chooses to take a substance / perform an action that has subsequent negative effects (potentially including detoxing), then that seems a fair individual decision.

If someone takes a substance that destroys or decreases their future ability to choose not to take that substance in the future... that's a completely different level of danger.

... I'm not sure which categories social media and mobile gaming fall into.

My gut says if it's not the latter yet, then that's only because we / they haven't gotten there yet. Because the latter is obviously a more lucrative business to be in.

[dalbasal]

Both, I suppose.

Once you start seeing people locking away their smartphone, because they don't trust themselves to abstain or moderate... that's very clearly an attempt to impose their own will on themselves. Call it whatever you want, but it's a lot like a scene from trainspotting.

[drooogs]

> Broadly speaking, I tend to think of "addiction" (rightly or wrongly) as the errosion of free will.

I don't claim to speak for all addicts, but this is not how I would describe my experiences, at least not under my conception of "free will".

I "wanted" to stop doing drugs in the same way a lazy person "wants" to go to the gym more. whenever the moment came to actually do it, I had to admit that I didn't want it nearly as much as I said I did. sure, I wanted the "outcome" of quitting, but in the meantime, I really wanted to keep doing drugs. so I did.

every day I had a clear goal in mind: getting money and acquiring drugs. I was fairly strategic in pursuing this goal; I was even capable of abstaining for a while (eg, to pass a drug test) if it increased the security of my future supply.

I was in and out of treatment for a while (primarily to appease others), but I ultimately stopped doing drugs because I didn't want to anymore. this happened rather suddenly, over the course of just a few months. a few areas of my life improved simultaneously, partially through my own efforts, but partially just luck. I now lead a fairly normal life.

anyways, the reason I type all this out is because I really don't like it when people describe addition this way, especially if they aren't/weren't addicts themselves (not assuming anything about you in particular). depending on what you think "free will" is, it may be more or less accurate. but it is usually a prelude to an argument about how addicts aren't competent to make choices for themselves and how society should Do Something About It, usually involving curtailing the freedoms of people unfortunate enough to be identified as addicts. addicts don't need to be controlled or disciplined (unless they are hurting others, of course). they just need to reach that tipping point in quality of life where drugs don't seem so appealing. at least that is my belief, based on my own experience and observations of others going through it.

[ethbr0]

Thanks for taking the time to write all that out and share your experience!!

I'd say my definition of "free will" is this context is more a hill's slope than a traffic light.

In that the slope is the difficulty of making (or not making) a decision. Where addiction doesn't preclude "not", but makes it harder / less likely.

I.e. the internalization of the external "10/100 non-addicts would choose to do X" vs "60/100 addicts would choose to do X"

Or to put it another way, whereas someone might be able to avoid doing something on everything except their 10% worse days, an addict might except on their 50% worse days.

Would be very curious with how that jives with your lived experience? When you made decisions (positive or negative), did it feel like the odds were tilted? Or did it feel exactly like it did before you started using?

[jl6]

Feels like you are drawing a distinction between harms, and recursive harms.

Harmful things can be analyzed; the risks can be quantified and weighed up against the benefits; the downside can be limited.

Recursively harmful things - which not only cause harm but precipitate further rounds of harm - are harder to analyze and have potentially infinite downside.

[ethbr0]

That's a good, simpler way of putting it: summing over all harms, including future ones.

For single act harms, future terms don't exist.

And for recursive, add in a probability weighting, if one wants to be pedantic about modeling.

[approxim8ion]

The problem is it's hard to classify decisions as willful if your judgement is impaired, don't you think? I might think I'm doing this consciously, but I could well be brainwashed/conditioned into making the choice.

[scottrogowski]

I really like the duck-typing analogy for addiction. Addiction is a complex set of causes, symptoms, and consequences and every addiction is different.

[jrochkind1]

> Smoking is extremely hard to kick, with some first handers claiming that its worse than heroin. People rarely prostitute themselves (or others) for tobacco though.

I suspect if we continue on the path of criminalizing tobacco use, this could change... That isn't a difference between the two drugs chemically, I think, but between their social contexts (specifically criminalization/expense).

[codeulike]

Really interesting take. Is there a 'more' missing from second-last para?

[dalbasal]

yep, fixed.

[bellazeus]

>> People rarely prostitute themselves (or others) for tobacco though.

Not really a fair comparison of addictive qualities. If heroin were legal, regulated, and priced accordingly, no-one would prostitute themselves (or others) for it.

[anotha1]

> People rarely prostitute themselves (or others) for tobacco though. Which defines or quantifies addiction?

Because you can walk to an ashtray and pick out cigarette butts, which is about as dirty as the prostitution.

[scandox]

It is not what we put into ourselves that is dirty, but what comes out of us.