What Makes the Addiction

Addiction is such an ugly word. It conjures images of squalid back alleys populated by people in a state of physical and mental decay. However, some recent articles draw attention to addictive responses to mobile communications technologies such as smart phones and PDAs.

The discussion in the press concerns itself with the “I can’t imagine life without it” response as a consequence of individual psychology. In that respect, it’s simply one of a long line of concerns about how using new technologies gets adopted and then becomes the norm. So smart phones and such like join the Internet and before that personal computers and before that automobiles and the telephone as an addictive technology.

The concern expressed by researchers is that new communication technologies threaten to displace relationships among flesh-and-blood human beings with disembodied relationships among user names. Some sociologists have reported a decline in the “connectedness” of Americans over the last several decades, a decline they attribute to the rise of disembodied communication technologies that put distance between people, making it more difficult to establish intimate relationships. Lack of such relationships is claimed to be at the root of a wide variety of health problems, both direct and indirect. Depression is an example of a direct effect of social isolation. Risk of heart attack is an example of an indirect effect.

Recently, the Pew Charitable Trust called this view into question. Their study found that people who had more connections through texting, tweeting, and so on also had more face-to-face connections. I think this actually begs the question. The real question is: in the absence of new technologies, would the number of intimate connections increase among heavy users of new technology? That is, does new communication technology displace embodied relationships. And, most importantly, would their health be better and risks reduced?

I have an abbreviated answer based on our evolutionary inheritance. Language, after all, is a fairly recent development. In one theory, the spoken word developed from sign and body language. Even today, humans are extremely gifted at reading body language and facial expressions—most of it unconscious. That means that we communicate most effectively when we are in each other’s presence. Call it hunter-gatherer communication. Like the diet, it’s what our bodies are built for. Straying too far threatens impaired health. But I digress.

The physiology of addiction is part of this discussion—for example, the squirt of dopamine that comes from the “fun” of using new technology. This represents smart phone addiction as equivalent to gambling addition: it’s psychological. But what if the addiction is like tobacco? In this view, the radiation from smart phones, PDAs, and the like have a direct effect on users and bystanders in a way analogous to how nicotine affects smokers and bystanders.

Although this is not a matter of polite conversation now, it’s likely to become one soon enough. After all, recognition of tobacco as chemically addictive, dangerous to the user, and dangerous to bystanders grew from its being a nuisance and behavioral addiction—“can’t imagine a cup of coffee without a smoke.”

Unfortunately, I fear that the social evolution of wireless technologies will be more like the addiction to the automobile. Smoking never had an effect on the infrastructure of our lives. Wireless technologies, on the other hand, are becoming an integral part of how we communicate in private and, more importantly, in commerce. As a consequence, it’s the worst of two addictive worlds: a technology we’re forced to use or at the very least exposed to without our consent and that is biologically active in a way that reinforces the addiction.

This last week saw a discussion of another kind of technology addiction: the recommendation by the Preventive Services Task Force to change guidelines for mammograms. The mantra for breast cancer screening using mammograms has been “mammograms save lives.” Some pretty good sciences says they don’t. That this government advisory body took the contrary science seriously is heartening. That many, up to and including the Secretary of Health and Human Services, vocally protested the panel’s conclusions and advocated instead continuing with the current standards is testimony to a technology addiction that is embedded commercially, professionally, and institutionally.

With the first wave of anger in response to the Task Force’s recommendations came reports from women who believed their lives were saved by early detection through mammography. It was days later that we saw any stories in the media about the risks of mammograms, risks that we discuss in Too Much Medicine, Not Enough Health and that we see too often in our practice. This is an example of technology as having only an up side; benefits without costs.

And that is what joins mammogram addiction to smart phone addiction: the belief that there’s only an up side. And we all know that that is almost never true.