The Progress of Addiction

Some of Silicon Valley’s most successful app designers are alumni of the Persuasive Technology Lab at Stanford, ... founded in 1998 by B.J. Fogg, whose graduate work “used methods from experimental psychology to demonstrate that computers can change people’s thoughts and behaviors in predictable ways,” according to the center’s website. ...

Fogg’s behavior model involves building habits through the use of what he calls “hot triggers,” like the links and photos in Facebook’s newsfeed, made up largely of posts by one’s Facebook friends.

One of Fogg’s students, Nir Eyal, offers a practical guide in his book Hooked: How to Build Habit-Forming Products. A former game designer and professor of “applied consumer psychology” at Stanford’s Graduate School of Business, Eyal explains why applications like Facebook are so effective. A successful app, he writes, creates a “persistent routine” or behavioral loop. The app both triggers a need and provides the momentary solution to it. “Feelings of boredom, loneliness, frustration, confusion, and indecisiveness often instigate a slight pain or irritation and prompt an almost instantaneous and often mindless action to quell the negative sensation,” he writes. “Gradually, these bonds cement into a habit as users turn to your product when experiencing certain internal triggers.” ...

On Facebook, one asserts one’s social status and quantifies its increase through numbers of likes, comments, and friends. According to Eyal, checking in delivers a hit of dopamine to the brain, along with the craving for another hit. The designers are applying basic slot machine psychology. The variability of the “reward”—what you get when you check in—is crucial to the enthrallment. ...

Facebook’s 2012 acquisition of Instagram, a startup with thirteen employees, for the bargain price of $1 billion, “demonstrates the increasing power of—and immense monetary value created by—habit-forming technology.” In other words, Instagram was so damned addictive that Facebook had to have it. ...

The toll of technology is emotional rather than physical. But the more you read about it, the more you may come to feel that we’re in the middle of a new Opium War, in which marketers have adopted addiction as an explicit commercial strategy. This time the pushers come bearing candy-colored apps. ...

Tech companies are engaged in “a race to the bottom of the brain stem,” in which rewards go not to those that help us spend our time wisely, but to those that keep us mindlessly pulling the lever at the casino. ...

In the last part of his book, Eyal raises ethical considerations and says developers ought to peddle only products that they believe in. But in the main, his book reads like one of those tobacco industry documents about manipulating nicotine levels in cigarettes. ...

As long as software engineers are able to deliver free, addictive products directly to children, parents who are themselves compulsive users have little hope of asserting control.

- Jacob Weisberg, We Are Hopelessly Hooked, NY Review of Books, Feb. 25, 2016 Issue

It appears that much as CNN tried to improve its ratings by following in the footsteps of Fox News, focusing increasingly on producing content entertaining enough to draw a larger audience, the New York Times plans to shift toward producing content that is more entertaining to attract more readers. The Times will increasingly focus not on reporting the most important news, but on "incorporating reader ideas" — in other words, tailoring the product to satisfy the tastes of a mass audience, producing content that large numbers of people will find so enticing that they come back for more, much as the food industry incorporates consumers' preferences, designing foods so as to maximize customers' urge to consume more:

More than most news organizations, The Times has hitched its future to building a loyal audience that will come back repeatedly and pay for the privilege of doing so. ...The Times hopes to make its content sufficiently unique and addictive that it turns frequent visitors into subscribers. ...

In May, Dean Baquet, the executive editor, told the staff that the way The Times tells stories would be changing. “Fewer stories will be done just ‘for the record,’ ” he said. “In fact, fewer traditional news stories will be done over all. Stories will relax in tone.” ...

Think of pioneering comedians like Jon Stewart.... He created a whole new genre of delivering the news. His incisive wit and brilliance enabled him to convey, in one entertaining spoof, what reams of reporters missed through more dutiful stories. ...

''I don’t worry that The Times will go too far in incorporating reader ideas.... I worry that it won’t go far enough.

- Liz Spayd, Want to Attract More Readers? Try Listening to Them, NYT, July 9, 2016

Scientists across the globe have demonstrated that shifting the internet from our computers to our phones has created an epidemic worse than the one created by smoking, albeit attacking our minds instead of our lungs.

60 Minutes recently ran a piece showing how Silicon Valley engineers are using what they know about the brain to manipulate us into staying perpetually addicted to our smartphones. Their investigation caught numerous firms red-handed as they used knowledge of brain science to increase the addictive natures of their apps. ...
It’s a simple fact that the purpose of a company is to generate revenue, and that companies do what they can—often through clever marketing—to make you purchase more of their products. Many of these techniques manipulate our minds....
- Jeff Stibel, Has the Internet become an Epidemic?, LinkedIn, July 10, 2017Featured in: Millennials, Productivity, Social Media, Technology

Fogg called for a new field, sitting at the intersection of computer science and psychology, and proposed a name for it: “captology” (Computers as Persuasive Technologies). Captology later became behaviour design, which is now embedded into the invisible operating system of our everyday lives. The emails that induce you to buy right away, the apps and games that rivet your attention, the online forms that nudge you towards one decision over another: all are designed to hack the human brain and capitalise on its instincts, quirks and flaws. The techniques they use are often crude and blatantly manipulative, but they are getting steadily more refined, and, as they do so, less noticeable.

It's a case study in how designers use technology to create habit-forming products by marrying the principles of consumer psychology with the latest in big data analytics. Indeed, it is just one of many products and services we use habitually that alter our everyday behavior — just as their designers intended.

How does it work? After years of distilled research and real-world experience, I call it the Hook Model: a four-phase process companies use to form habits. Through consecutive hook cycles — of trigger, action, variable reward, and investment — successful products reach their ultimate goal of unprompted user engagement, bringing users back repeatedly without depending on costly advertising or aggressive messaging. To illustrate this, it's helpful to look at the early days of Gruenewald's Bible app.''
- Nir Eyal, Nir Eyal: What Makes Some Products Indispensable?, Insights, Stanford Graduate School of Business, April 30, 2014

Fear that new internet technologies are doing more to waste time and brainpower than to increase productivity has already provoked a backlash in China, where officials recently criticized online gaming as “electronic heroin.”
- Ruchir Sharma, When Will the Tech Bubble Burst?, NYT, AUG. 5, 2017

We now know that those iPads, smartphones and Xboxes are a form of digital drug. Recent brain imaging research is showing that they affect the brain’s frontal cortex — which controls executive functioning, including impulse control — in exactly the same way that cocaine does. Technology is so hyper-arousing that it raises dopamine levels — the feel-good neurotransmitter most involved in the addiction dynamic — as much as sex.

This addictive effect is why Dr. Peter Whybrow, director of neuroscience at UCLA, calls screens “electronic cocaine” and Chinese researchers call them “digital heroin.” ...
Once a kid has crossed the line into true tech addiction, treatment can be very difficult. Indeed, I have found it easier to treat heroin and crystal meth addicts than lost-in-the-matrix video gamers or Facebook-dependent social media addicts.

According to a 2013 Policy Statement by the American Academy of Pediatrics, 8- to 10 year-olds spend 8 hours a day with various digital media while teenagers spend 11 hours in front of screens.
- Dr. Nicholas Kardaras, It’s ‘digital heroin’: How screens turn kids into psychotic junkies, New York Post, August 27, 2016

The video poker machines that Stephen Paddock liked were the ones that did not draw attention. They had few look-at-me flashing lights or listen-to-me bells.

He would sit in front of them for hours, often wagering more than $100 a hand. The way he played — instinctually, decisively, calculatingly, silently, with little movement beyond his shifting eyes and nimble fingers — meant he could play several hundred hands an hour. Casino hosts knew him well. ...
“Video poker is the crack cocaine of gambling,” Mr. Curtis ["a former professional gambler and currently the owner and publisher of Las Vegas Advisor, a website covering the casino business"] said.
- JOHN BRANCH, SERGE F. KOVALESKI and SABRINA TAVERNISE, Las Vegas Gunman Chased Gambling’s Payouts and Perks, NYT, OCT. 4, 2017

Alter teaches marketing and psychology at New York University and wants to show us how smartphones, Netflix, and online games such as World of Warcraft are exquisitely and expensively engineered to hook us in. “As a kid I was terrified of drugs,” he writes. “I had a recurring nightmare that someone would force me to take heroin and that I’d become addicted.” It’s unsurprising he’s become a psychologist of addiction, and his intoxicant of choice is the internet. In a chapter subtitled “Never Get High on Your Own Supply” he makes the observation that neither Steve Jobs of Apple nor Evan Williams of Twitter have allowed their children to play with touch screens.
A couple of years ago a programmer called Kevin Holesh, worried that his own screen time was getting out of control, wrote an app called Moment, which tracks how long a user is interacting with a screen (it doesn’t count time on phone calls). The results were startling, even among those concerned enough to download the app: for 88% it was more than an hour a day, with the average being three hours. The typical user checked their phone 39 times in 24 hours. By comparison, in 2008, before smartphones became widespread, adults spent just 18 minutes a day on their phone. ...
The middle part of Alter’s book is illuminating on the ways that designers engineer behavioural addiction. ...
These neuropsychology experiments are well known, but Alter retells them to illustrate how the latest technology traps us in a lab cage of connectivity. For an addict, there’s little opportunity to escape.

Some will find this shrill and alarmist – new technology has always had its catastrophisers. It may have been that the girl who killed herself would have done so without the public shaming that followed her post; there have always been neglectful parents; my teenage patient might have struggled to concentrate without being woken by his phone. Socrates said that writing would make us all forgetful; Caxton’s printing press destroyed the economy of scribes; television was condemned for vulgarising and trivialising entertainment. Connectivity is here to stay....
- Gavin Francis, Irresistible: Why We Can’t Stop Checking, Scrolling, Clicking and Watching - review, The Guardian, Sunday 26 February 2017

Half the developed world is addicted to something, and Alter, a professor at New York University, informs us that, increasingly, that something isn’t drugs or alcohol, but behaviour. Recent studies suggest the most compulsive behaviour we engage in has to do with cyber connectivity; 40% of us have some sort of internet-based addiction – whether it’s checking your email (on average workers check it 36 times an hour), mindlessly scrolling through other people’s breakfasts on Instagram or gambling online.

Facebook was fun three years ago, Alter warns. Now it’s addictive. This tech zombie epidemic is not entirely our fault. Technology is designed to hook us, and to keep us locked in a refresh/reload cycle....
- Fatima Bhutto, Irresistible by Adam Alter review – an entertaining look at technology addiction, The Guardian, Friday 21 April 2017

If you talk to experts in the industry they'll say something like, say, between two and four years from now just as most of us own smartphones, we will pretty much all own these virtual reality goggles. ... What that will mean is that at any moment in time you'll have a device that will allow you to escape the imperfect real world, and you'll be able to go to a perfect virtual world.
- Fresh Air, 'Irresistible' By Design: It's No Accident You Can't Stop Looking At The Screen, March 13, 2017

Adam Alter, a professor of psychology and marketing at NYU, is at the cutting edge of research into what makes these products so compulsive, and he documents the hefty price we're likely to pay if we continue blindly down our current path. People have been addicted to substances for thousands of years, but for the past two decades, we've also been hooked on technologies, such as Instagram, Netflix, and Facebook—inventions that we've adopted because we assume they'll make our lives better. These inventions have profound upsides, but their extraordinary appeal isn't an accident. Technology companies and marketers have teams of engineers and researchers devoted to keeping us engaged. They know how to push our buttons, and how to coax us into using their products for hours, days, and weeks on end.
- ADAM ALTER, Irresistible: The Rise Of Addictive Technology And The Business Of Keeping Us Hooked, NPR Books

Today, roughly 90 percent of smokers say they regret having started, and about 80 percent express a desire to quit. Some 40 to 50 percent of smokers try to quit each year, but fewer than 5 percent of them succeed.
- ROBERT H. FRANK, Why Even Tougher Regulations on Smoking Are Justified, NYT, JAN. 5, 2018

Facebook and Google have become “obstacles to innovation” and are a “menace” to society whose “days are numbered”, said billionaire investor and philanthropist George Soros at the World Economic Forum in Davos on Thursday. ...

“This is particularly nefarious because social media companies influence how people think and behave without them even being aware of it. This has far-reaching adverse consequences on the functioning of democracy, particularly on the integrity of elections.”

In addition to skewing democracy, social media companies “deceive their users by manipulating their attention and directing it towards their own commercial purposes” and “deliberately engineer addiction to the services they provide”. The latter, he said, “can be very harmful, particularly for adolescents”.
- Olivia Solon, George Soros: Facebook and Google a menace to society, The Guardian, 26 Jan 2018 [for full transcript, see Remarks delivered at the World Economic Forum]

The company says it uses artificial intelligence technology to figure out what users like, then makes sure they are fed more and more of it. ...
“It’s like having a chef in your house who knows what kind of food you like,” said Xu Qinglu, a 22-year-old student and Toutiao user in Beijing.

“I think the app is not harmful,” she added. “The people who use it should be responsible for their own behavior.” ...
Bytedance’s detractors say that salty, unwholesome material — the sort that has the Chinese government on edge these days — is exactly what the company’s apps have specialized in, and is a major reason for its popularity. ...
Even Bytedance’s news app, Toutiao, featured plenty of edgy material that kept users coming back, sometimes reluctantly, for more. Xiao Lin, a 29-year-old programmer in Beijing, called the app “spiritual opium.”

“On a typical night, I would keep clicking on news items the app recommended to me while telling myself, ‘After this, I will sleep,’ ” Mr. Xiao said. “But I ended up reading more and more, for hours. I couldn’t stop.”
- RAYMOND ZHONG, It Built an Empire of GIFs, Buzzy News and Jokes. China Isn’t Amused., NYT, APRIL 11, 2018

Mr. Chaslot worked on the recommender algorithm while at YouTube. He grew alarmed at the tactics used to increase the time people spent on the site. ...
What we are witnessing is the computational exploitation of a natural human desire: to look “behind the curtain,” to dig deeper into something that engages us. As we click and click, we are carried along by the exciting sensation of uncovering more secrets and deeper truths. YouTube leads viewers down a rabbit hole of extremism, while Google racks up the ad sales.

Human beings have many natural tendencies that need to be vigilantly monitored in the context of modern life. For example, our craving for fat, salt and sugar, which served us well when food was scarce, can lead us astray in an environment in which fat, salt and sugar are all too plentiful and heavily marketed to us. So too our natural curiosity about the unknown can lead us astray on a website that leads us too much in the direction of lies, hoaxes and misinformation.

In effect, YouTube has created a restaurant that serves us increasingly sugary, fatty foods, loading up our plates as soon as we are finished with the last meal. Over time, our tastes adjust, and we seek even more sugary, fatty foods, which the restaurant dutifully provides. When confronted about this by the health department and concerned citizens, the restaurant managers reply that they are merely serving us what we want.

This situation is especially dangerous given how many people — especially young people — turn to YouTube for information.
- Zeynep Tufekci, YouTube, the Great Radicalizer, March 10, 2018

Almost 100 people are dying every day across America from opioid overdoses – more than car crashes and shootings combined. The majority of these fatalities reveal widespread addiction to powerful prescription painkillers. The crisis unfolded in the mid-90s when the US pharmaceutical industry began marketing legal narcotics, particularly OxyContin, to treat everyday pain. This slow-release opioid was vigorously promoted to doctors and, amid lax regulation and slick sales tactics, people were assured it was safe. But the drug was akin to luxury morphine, doled out like super aspirin, and highly addictive. What resulted was a commercial triumph and a public health tragedy. Belated efforts to rein in distribution fueled a resurgence of heroin and the emergence of a deadly, black market version of the synthetic opioid fentanyl.
- Sarah Boseley, Why is there an opioid crisis in America?, the Guardian, 13 Feb 2018

Video games work hard to hook players. Designers use predictive algorithms and principles of behavioral economics to keep fans engaged. When new games are reviewed, the most flattering accolade might be “I can’t put it down.”

Now, the World Health Organization is saying players can actually become addicted.

On Monday, “gaming disorder” will appear in a new draft of the organization’s International Classification of Diseases, the highly regarded compendium of medical conditions. ...
Now, mental health professionals say they increasingly see players who have lost control.

“I have patients who come in suffering from an addiction to Candy Crush Saga, and they’re substantially similar to people who come in with a cocaine disorder,” Dr. Levounis said. “Their lives are ruined, their interpersonal relationships suffer, their physical condition suffers.”
- Tiffany Hsu, Video Game Addiction Tries to Move From Basement to Doctor’s Office, NYT, June 17, 2018

Playing video games is not addictive in any meaningful sense. It is normal behavior that, while perhaps in many cases a waste of time, is not damaging or disruptive of lives in the way drug or alcohol use can be.
- Christopher J. Ferguson and Patrick Markey, Video Games Aren’t Addictive, NYT, April 1, 2017

The opioid epidemic didn’t have to happen. It was a human-made disaster, predictable and tremendously lucrative. At every stage, powerful figures permitted its progress, waving off warnings from people like Van Zee, participating in what would become, in essence, a for-profit slaughter. Or as Macy puts it: “From a distance of almost two decades, it was easier now to see that we had invited into our country our own demise.”

Particularly grotesque is the enthusiasm with which Purdue peddled its pills. In the first five years OxyContin was on the market, total bonuses for the company’s sales staff grew from $1 million to $40 million. Zealous reps could earn quarterly bonuses as high as $100,000, one former salesperson told Macy, adding, “It behooved them to have the pill mills writing high doses.” Doctors were plied with all-expense-paid resort trips, free tanks of gas and deliveries of Christmas trees and Thanksgiving turkeys. There were even “starter coupons” offering new patients a free 30-day supply.
- Jessica Bruder, The Worst Drug Crisis in American History, NYT, July 31, 2018

Schools across the country are grappling with teenage e-cigarette use, to the point that the Food and Drug Administration (FDA) declared last month that it has reached "an epidemic proportion": more than 2 million middle and high school students were regular users of e-cigarettes last year. E-cigarette use skyrocketed between 2011 to 2017, going from 1.5 percent to 11.7 percent among high school students and from 0.6 percent to 3.3 percent among middle school students, according to the FDA.

The FDA told the companies that make some of the most popular devices — including Juul, co-founded by two Stanford University graduate students — that they had 60 days to prove they can keep the products away from minors. Federal law prohibits selling e-cigarettes to anyone under 18. Juul is meant for adult smokers and requires customers to be 21 years or older to purchase products online, but the company has faced sharp criticism for targeting teenagers, particularly through the marketing of flavors like mango and mint.
- Elena Kadvany, High schools confront vaping 'epidemic', Palo Alto Weekly, Oct 5, 2018

This January, Gov. Tom Wolf signed a statewide disaster declaration, the first of its kind for a public-health emergency in Pennsylvania. There had been more than 1,200 overdose deaths in Philadelphia in 2017 — a 34 percent rise from 2016. Wolf pushed the state to roll back regulations that might be stopping users from getting help, like ID and sobriety requirements for shelters and treatment facilities. ... It sent a van into the neighborhood to offer recovery services. It gave residents blue light bulbs for their porches, because the light seemed to make it harder for heroin users to find a vein.
- Jennifer Percy, Trapped by the ‘Walmart of Heroin’, NYT, Oct. 10, 2018

We think of any danger as coming from misuse — scammers, hackers, state-sponsored misinformation — but we’re starting to understand the risks that come from these platforms working exactly as designed. Facebook, YouTube and others use algorithms to identify and promote content that will keep us engaged, which turns out to amplify some of our worst impulses. ...
Whether they set out to or not, these companies are conducting the largest social re-engineering experiment in human history, and no one has the slightest clue what the consequences are. ...
It’s not that I fear some devastating privacy breach or misuse of my data. Rather, these platforms are incredibly sophisticated at learning our habits and keeping us engaged in ways that are not necessarily healthy for us or our communities. Most days, it’s unhealthy only on the scale of a candy bar or secondhand smoke, but who needs it? ...
To give social media some credit, some of my favorite serialized entertainment of any kind is the Twitter feed of Nicole Cliffe, a writer for various publications, which could exist and feel so personal only on a platform like Twitter.
- Max Fisher, Social Media’s Re-engineering Effect, From Myanmar to Germany, NYT, Nov. 7, 2018

The opioid epidemic didn’t have to happen. It was a human-made disaster, predictable and tremendously lucrative. ...
Particularly grotesque is the enthusiasm with which Purdue peddled its pills. ... Doctors were plied with all-expense-paid resort trips.... There were even “starter coupons” offering new patients a free 30-day supply.''
- Jessica Bruder, The Worst Drug Crisis in American History, NYT, July 31, 2018\

In Lawrence, Mass., a former mill town at the heart of New England’s opioid crisis, the police chief released a particularly gut-wrenching video. It showed a mother who had collapsed from a fentanyl overdose sprawled out in the toy aisle of a Family Dollar while her sobbing 2-year-old daughter tugged at her arm. ...

Mandy McGowan, 38, knows that. She was the mother unconscious in that video, the woman who became known as the “Dollar Store Junkie.” But she said the video showed only a few terrible frames of a complicated life.''

As a child, she said, she was sexually molested. She survived relationships with men who beat her. She barely graduated from high school.

She said her addiction to opioids began after she had neck surgery in 2006 for a condition that causes spasms and intense pain. Her neurologist prescribed a menu of strong painkillers including OxyContin, Percocet and fentanyl patches. ...
Medics revived her and took her to the hospital, where child welfare officials took custody of her daughter, and the police charged Ms. McGowan with child neglect and endangerment. ...
After Ms. McGowan was released from treatment, the father of her daughter died of an overdose. Two months later, that man’s 19-year-old son also died of an overdose.

Reeling, Ms. McGowan had a night of relapse with alcohol. She checked herself into treatment the next day. But at the same time, she had stopped reporting to her probation officer, a violation of parole that led to 64 days in jail. She was kicked out of a halfway house and stayed briefly at a shelter. She said she was raped this year. She checked herself into a hospital psychiatric ward for five weeks.

Ms. McGowan finally felt ready to start actively rebuilding her life. This spring, she moved to a halfway house in Boston, where her days were packed with appointments with counselors and clinicians, and meetings of Narcotics Anonymous and Alcoholics Anonymous. She had weighed just 90 pounds when she overdosed; now she was happily above 140.

Just after Thanksgiving she moved in with relatives, and now hopes to find a place of her own. Her treatment continues. If she stays sober and shows progress, the charges against her will be dropped in April.

She spends part of her day doing volunteer outreach along the open-air drug market in Boston known as Methadone Mile.

- Katharine Q. Seelye, Julie Turkewitz, Jack Healy and Alan Blinder, How Do You Recover After Millions Have Watched You Overdose?, NYT, Dec. 11, 2018

I’ve been a heavy phone user for my entire adult life. But sometime last year, I crossed the invisible line into problem territory. My symptoms were all the typical ones: I found myself incapable of reading books, watching full-length movies or having long uninterrupted conversations.
- Kevin Roose, Do Not Disturb: How I Ditched My Phone and Unbroke My Brain, NYT, Feb. 23, 2019

Recent data from the analytics company Flurry found that people in the US use their mobile devices for five hours a day, while a study from the tech-support firm Asurion found that Americans check their phones 80 times a day on average.

Much of that time is spent in apps. Several of the most popular smartphone apps — like Instagram, Facebook, Twitter, and Snapchat — have been designed to use psychological tricks to grab your attention.

At this point, even Silicon Valley parents — some of the same ones responsible for building these addictive apps and devices — are raising their kids to be tech-free.
- Avery Hartmans, This beautifully designed 'dumb phone' can only make calls and send texts — and it might be the key to curing our addiction to apps, Business Insider, Mar. 1, 2018

Thousands, perhaps millions, of people who try to quit antidepressant drugs experience stinging withdrawal symptoms that last for months to years: insomnia, surges of anxiety, even so-called brain zaps, sensations of electric shock in the brain.

But doctors have dismissed or downplayed such symptoms, often attributing them to the recurrence of underlying mood problems.

The striking contrast between the patients’ experience and their doctors’ judgment has stirred heated debate in Britain, where last year the president of the Royal College of Psychiatrists publicly denied claims of lasting withdrawal in “the vast majority of patients.”

Patient-advocacy groups demanded a public retraction.... ...
The field of psychiatry has conducted few rigorous studies of antidepressant withdrawal, despite the fact that long-term prescription rates in the United States and Britain have doubled over the past decade, with similar trends in other Western countries.

More than 15 million Americans have taken the medications for at least five years, a rate that has almost more than tripled since 2000, according to a New York Times analysis of federal data.
- Benedict Carey, How to Quit Antidepressants: Very Slowly, Doctors Say, NYT, March 5, 2019

The effectiveness of the previous class of antidepressants such as Prozac and Paxil was vastly exaggerated when they came on the market. And the results of esketamine trials, which were paid for and carried out by Janssen, were mixed. ...
In one monthlong study, those on esketamine performed better statistically than those on placebo, reducing scores on a standard, 60-point depression scale by 21 points, compared to 17 points for placebo. But in two others trials, the drug did not statistically outperform placebo treatment. Historically, the F.D.A. has required that a drug succeed in two short-term trials before it is approved; the agency loosened its criteria for esketamine....
- Benedict Carey, Fast-Acting Depression Drug, Newly Approved, Could Help Millions, NYT, March 5, 2019

Tristan Harris, a former Google executive... compared phones and apps to slot machines that command attention and endlessly distract.

...Mr. Harris discussed electronic addiction....
When Mr. Harris worked at Google in 2013, he created a 141-page slide show that acted as a reckoning for the internet giant. ...
Seven years later, worries about the addictive nature of technology have multiplied. Apple and Google have introduced tools to try to help people better understand, and curb, their technology use.
Top executives in Silicon Valley are increasingly voicing their concerns about technology’s influence on young minds. Apple’s Timothy D. Cook told The Guardian he didn’t want his nephew on any social platforms. Steve Jobs didn’t want his children near iPads. Some parents are asking nannies to shield children from their phones.
- Talya Minsberg, Read This. Then Put Away Your Phone., NYT, March 1, 2019

Tim Cook, the C.E.O. of Apple, said earlier this year that he would not let his nephew join social networks. Bill Gates banned cellphones until his children were teenagers, and Melinda Gates wrote that she wished they had waited even longer. Steve Jobs would not let his young children near iPads.

But in the last year, a fleet of high-profile Silicon Valley defectors have been sounding alarms in increasingly dire terms about what these gadgets do to the human brain. Suddenly rank-and-file Silicon Valley workers are obsessed. No-tech homes are cropping up across the region. Nannies are being asked to sign no-phone contracts.

Those who have exposed their children to screens try to talk them out of addiction by explaining how the tech works.
- Nellie Bowles, A Dark Consensus About Screens and Kids Begins to Emerge in Silicon Valley, NYT, Oct. 26, 2018

Janet Michael, Silver Spring Maryland, Nov. 8, 2018
Screen time is a genie already out of the bottle.Silicon Valley may not want it for their children but they are working overtime to make it not only attractive but addictive to your children.I am one of those really old, really quaint people who grew up before the age of television.Our books were precious to us - we read and reread them.We spent hours playing outdoors and doing craft projects indoors.
- Janet Michael, Comment on Nellie Bowles, A Dark Consensus About Screens and Kids Begins to Emerge in Silicon Valley, NYT, Oct. 26, 2018

KMD, Denver, Nov. 8, 2018
I am a teacher in a high school whose students are mainly low-income students of color. It’s impossible to overstate how damaging cell phones are to their lives. Students routinely fail all classes while spending hours into the night on phones or playing video games. They attempt to text through all classes, all day, and a teacher who attempts to stop it will have a day full of conflict as students angrily curse about having to put phones away. Many cannot sustain 5 minutes of focus on a printed page, let alone ask questions or think deeply about meaning.
- KMD, Comment on Nellie Bowles, A Dark Consensus About Screens and Kids Begins to Emerge in Silicon Valley, NYT, Oct. 26, 2018

A growing body of research has linked social media to religious and racial violence.

Social media platforms build their businesses on sophisticated algorithms that serve up content that will keep users engaged. This favors posts that tap into negative, primal emotions like anger and fear, studies suggest.

Misinformation is rampant....
Last year, United Nations officials said Facebook had played a “determining role” in Myanmar in whipping up genocide; thousands were killed.
- Max Fisher, Fearing More Violence, Sri Lanka Silences Social Media, NYT, April 21, 2019

Algorithms reward content that keeps users engaged, which means posts that stir anger spread and get clicks.
- Matt Apuzzo and Adam Satariano, Russia Is Targeting Europe’s Elections. So Are Far-Right Copycats., NYT, May 12, 2019

The new A.I., known as Reinforce, was a kind of long-term addiction machine. It was designed to maximize users’ engagement over time by predicting which recommendations would expand their tastes and get them to watch not just one more video but many more.

Reinforce was a huge success.
- Kevin Roose, The Making of a YouTube Radical, NYT, June 8, 2019

The mission is to get more people to read more of The Times. To get addicted to our journalism.
- ‘Oversharing’ on Google Calendar, and Making Sure Readers Come Back for More, Featuring Jodi Rudoren, NYT, June 12, 2019

I was amazed to learn that Juul Labs is now worth more than the Ford Motor Company.

We once had a manufacturing economy, then a service economy and now, it seems, an addiction economy. The big winners are those who can get consumers hooked on their products (opiates, video games, e-cigarettes), never mind the personal and social costs.
- Laurie Mazur, Takoma Park, Md., Juul and the New Economy, NYT, 12/4/2019

Added sugar lurks in nearly 70 percent of packaged foods and is found in breads, health foods, snacks, yogurts, most breakfast foods and sauces. The average American eats about 17 teaspoons of added sugar a day (not counting the sugars that occur naturally in foods like fruit or dairy products). That’s about double the recommended limit for men (nine teaspoons) and triple the limit for women (six teaspoons). ...
And increasingly, the scientific community is acknowledging the addictive nature of the fructose in processed foods and beverages. Brain scan studies show that fructose affects the dopamine system, a messenger center in the brain that controls how we experience pleasure. Eating lots of added sugar can create changes in the brain similar to those found in people who are addicted to cocaine and alcohol, and it’s one reason so many of us find ourselves craving sweets.
- Tara Parker-Pope, Make 2020 the Year of Less Sugar, NYT, Dec. 30, 2019

Social media. The time wasting, addictive drugs that let us subliminally express our deepest narcissistic thoughts. ...
Let me tell you this, social media is a whole different monster for a 17-year-old. Everyone my age is spending hours every day snapchatting, instagraming, facebooking — and whatever else.
If you’re not involved — you’re an outsider. You’re looked at as weird and stupid. A loser.
- Corey Simon, I’m 17 And I Deleted All My Social Media. Here’s What Happened., Medium, Apr 29, 2017 (accessed 1/8/20)

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