Addiction
May 24, 2021 — March 14, 2024
I think there are many technical definitions of addiction. Informally, addictions are a conflict the desire to get a hit right now in a way that sabotages longer-term desires. Or maybe habits that seem worth continuing while we have them, but we are glad to avoid when we stop. That includes social media, of course: Allcott et al. (2019).
Not much to say here right now; Perhaps see weaponised addiction for some hot takes.
1 Neurobiological pathways
What does the role of opiate agonists say? Aboujaoude and Salame (2016):
Thirty-nine efficacy studies were retrieved, covering alcohol use disorder \(n=22\), opioid use disorder \(n=6\), nicotine use disorder \(n=5\), stimulant use disorder \(n=2\), gambling disorder \(n=2\), trichotillomania \(n=1\), and kleptomania \(n=1\). Despite the very different presentations within and between both addiction categories, the data, as a whole, show consistency in favor of naltrexone’s relative efficacy and safety. Given the potential benefit and good tolerability revealed in the studies, the high morbidity associated with addiction, and the dearth of alternate treatments, naltrexone would seem like an underutilized treatment option. Further, naltrexone’s seemingly broad anti-addiction efficacy supports a shared role for brain opioid pathways in the pathophysiology of addiction, broadly defined.
2 Superstimuli and adversarial attacks on our urges
Spencer Greenberg, On “superstimuli” and their dangers categorises some things superstimuli
- food: Cheetos / skittles / McDonalds
- goal achievement: video games
- visual arousal: porn
- pair bonding: romance novels
- affection: dogs
- cuteness: puppies & kittens
- stories: TV
- beauty: photoshopped models
- gossip: celebrity magazines
- social approval: Facebook
Consider also narrative and clickbait.
Should we include recorded music in that list?
Interesting that opiates and other fun drugs are not in there. But without that inclusion it is easier to make the argument that they are all examples of things which have been gradually refined over time to improve their effectiveness of getting our attention. Those danged puppies have co-evolved over millenia to give us that loving.
Ronald Dworkin, The New Prohibition
Addiction is defined as using a substance or engaging in behaviors in a compulsive manner despite harmful consequences. Opioid and alcohol addiction are classic examples. Over the years, the definition of addiction has expanded to include activities such as shopping and golf. But when one thinks about it, we all have compulsive behaviors that border on the harmful. Such behaviors are even central to our identities. We know people by what they love and what they hate, typically expressed in a sentence that begins with the word “I,” as in “I love this and I don’t love that.” This “I” of ours—including its peculiar property of loving one thing and not another with varying degrees of intensity, be it ice cream, work, or sexual partners—is how we distinguish one person from another in our minds.
Erik Hoel, Exit the supersensorium touches upon many themes; dreaming, addiction, myths and the entertainment-industrial complex. See also Living in the Supersensorium - by David Gasca.
3 Incoming
Could Ozempic Also Be an Anti-addiction Drug? - The Atlantic
Can we cure Alcoholism? - by Sam Atis notes that some pharmeceutical intervention effect sizes are not amazing:
It sounds odd, but the best advice to someone who is an alcoholic is probably: just try to give up, you’ve got a pretty good chance of succeeding. It sounds a bit shit, doesn’t it? I once made the case that good advice should be non-obvious, and the advice ‘you should just try to stop drinking, have you thought of that?’ fails the non-obvious test. So what about: try to give up drinking, take some Antabuse if you can get it because there’s a chance it’s actually pretty effective, and go to Alcoholics Anonymous too just for good measure.