by Adam Alter
. . . Coca is a most wonderful invigorator of the sexual organs and will cure seminal weakness, impotency, etc., when all other remedies fail . . .
To the unfortunate who are addicted to the morphine or opiate habit, or the excessive use of alcohol stimulants, the French Wine Coca has proven a great blessing, and thousands proclaim it the most remarkable invigorator that every sustained a wasting and sinking system.
Like Sigmund Freud, Pemberton believed that a combination of caffeine and coca leaves would conquer his morphine addiction without introducing a new one in its place. When the local government introduced prohibition laws in 1886, Pemberton removed the wine from his medicine, rechristening it Coca-Cola.
The story splits in two here. For the product, Coca-Cola, the sky was the limit. Coca-Cola went from strength to strength, sold first to business tycoon Asa Candler, and then to marketing geniuses Ernest Woodruff and W. C. Bradley. Woodruff and Bradley devised the brilliant idea of selling Coke in six-packs, to be carried more easily between the store and home, and both became immeasurably rich. For the man, John Pemberton, the opposite was true. Coca-Cola turned out not to be a viable replacement for morphine, and his addiction deepened. Instead of replacing morphine, cocaine compounded the problem, Pemberton’s health continued to decline, and in 1888, he died penniless.
It’s easy to look back at how little Freud and Pemberton understood of cocaine with a sense of superiority. We teach our children that cocaine is dangerous, and it’s hard to believe that experts considered the drug a panacea only a century ago. But perhaps our sense of superiority is misplaced. Just as cocaine charmed Freud and Pemberton, today we’re enamored of technology. We’re willing to overlook its costs for its many gleaming benefits: for on-demand entertainment portals, car services, and cleaning companies; Facebook and Twitter; Instagram and Snapchat; Reddit and Imgur; Buzzfeed and Mashable; Gawker and Gizmodo; online gambling sites, Internet video platforms, and streaming music hubs; hundred-hour work weeks, power naps, and four-minute gym workouts; and the rise of a new breed of obsessions, compulsions, and addictions that barely existed during the twentieth century.
And then there’s the social world of the modern teen.
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In 2013, a psychologist named Catherine Steiner-Adair explained that many American children first encounter the digital world when they notice that their parents are “missing in action.” “My mom is almost always on the iPad at dinner,” a seven-year-old named Colin told Steiner-Adair. “She’s always ‘just checking.’” Penny, also seven, said, “I always keep on asking her let’s play let’s play and she’s always texting on her phone.” At thirteen, Angela wished her parents understood “that technology isn’t the whole world . . . it’s annoying because it’s like you also have a family! How about we just spend some time together, and they’re like, ‘Wait, I just want to check something on my phone. I need to call work and see what’s going on.’ Parents with younger kids do even more damage when they constantly check their phones and tablets. Using head-mounted cameras, researchers have shown that infants instinctively follow their parents’ eyes. Distracted parents cultivate distracted children, because parents who can’t focus teach their children the same attentional patterns. According to the paper’s lead researcher, “The ability of children to sustain attention is known as a strong indicator for later success in areas such as language acquisition, problem-solving, and other key cognitive development milestones. Caregivers who appear distracted or whose eyes wander a lot while their children play appear to negatively impact infants’ burgeoning attention spans during a key stage of development.”
Kids aren’t born craving tech, but they come to see it as indispensable. By the time they enter middle school, their social lives migrate from the real world to the digital world. All day, every day, they share hundreds of millions of photos on Instagram and billions of text messages. They don’t have the option of taking a break, because this is where they come for validation and friendship.
Online interactions aren’t just different from real-world interactions; they’re measurably worse. Humans learn empathy and understanding by watching how their actions affect other people. Empathy can’t flourish without immediate feedback, and it’s a very slow-developing skill. One analysis of seventy-two studies found that empathy has declined among college students between 1979 and 2009. They’re less likely to take the perspective of other people, and show less concern for others. The problem is bad among boys, but it’s worse among girls. According to one study, one in three teenage girls say that people their age are mostly unkind to one another on social network sites. That’s true for one in eleven boys aged twelve to thirteen, and one in six boys aged fourteen to seventeen.
Many teens refuse to communicate on the phone or face-to-face, and they conduct their fights by text. “It’s too awkward in person,” one girl told Steiner-Adair. “I was just in a fight with someone and I was texting them, and I asked, ‘Can I call you, or can we video-chat?’ and they were like, ‘No.’” Another girl said, “You can think it through more and plan out what you want to say, and you don’t have to deal with their face or see their reaction.” That’s obviously a terrible way to learn to communicate, because it discourages directness. As Steiner-Adair said, “Texting is the worst possible training ground for anyone aspiring to a mature, loving, sensitive relationship.” Meanwhile, teens are locked into this medium. They either latch onto the online world, or they choose not to “spend time” with their friends.
Like Steiner-Adair, journalist Nancy Jo Sales interviewed girls aged between thirteen and nineteen to understand how they interacted with social media. For two and a half years she traveled around the United States, visiting ten states and speaking to hundreds of girls. She, too, concluded that they were enmeshed in the online world, where they learned and encountered cruelty, oversexualization, and social turmoil. Sometimes social media was just another way to communicate—but for many of the girls, it was a direct route to heartache. As addictive contexts go, this was a perfect storm: almost every teenage girl was using one or more social media platforms, so they were forced to choose between social isolation and compulsive overuse. No wonder so many of them spent hours texting and uploading Instagram posts every day after school; by all accounts, that was the rational thing to do. Echoing Sales’ account, Jessica Contrera wrote a piece called “13, Right Now” for the Washington Post. Contrera chronicled several days in the life of a thirteen-year-old named Katherine Pommerening, a regular eighth grader who lumbered beneath the weight of so many “likes and lols.” The saddest quote from Pommerening herself comes near the end of the article: “I don’t feel like a child anymore,” Katherine says. “I’m not doing anything childish. At the end of sixth grade”—when all her friends got phones and downloaded Snapchat, Instagram, and Twitter—“I just stopped doing everything I normally did. Playing games at recess, playing with toys, all of it, done.”
Boys spend less time engaged in damaging online interactions, but many of them are hooked on games instead. The problem is so visible that some game developers are pulling their games from the market. They’ve begun to feel remorseful—not because their games feature sex or violence, but because they’re devilishly addictive. With just the right combination of anticipation and feedback, we’re encouraged to play for hours, days, weeks, months, and years at a time. In May 2013, a reclusive Vietnamese video game developer named Dong Nguyen released a game called Flappy Bird. The simple smartphone game asked players to guide a flying bird through obstacles by repeatedly tapping their phone screens. For a while, most gamers ignored Flappy Bird, and reviewers condemned the game because it was too difficult and seemed too similar to Nintendo’s Super Mario Bros. For eight months Flappy Bird languished at the bottom of the app download charts.
But Nguyen’s fortune changed in January 2014. Flappy Bird attracted thousands of downloads overnight, and by the end of the month, the game was the
most downloaded free app at Apple’s online store. At the game’s peak, Nguyen’s design studio was earning $50,000 a day from ad revenue alone.
For a small-time game designer, this was the Holy Grail. Nguyen should have been ecstatic, but he was torn. Dozens of reviewers and fans complained that they were hopelessly addicted to Flappy Bird. According to Jasoom 79 on the Apple store website, “It ruined my life . . . its side effects are worse than cocaine/meth.” Walter19230 titled his review “The Apocalypse,” and began “My life is over.” Mxndlsnsk warned prospective gamers not to download the game: “Flappy Bird will be the death of me. Let me start by saying DO NOT download Flappy Bird . . . People warned me, but I didn’t care . . . I don’t sleep, I don’t eat. I’m losing friends.”
Even if the reviews were exaggerated, the game seemed to be doing more harm than good. Hundreds of gamers made Nguyen sound like a drug dealer when they compared his product to meth and cocaine. What began as an idealistic labor of love appeared to be corrupting lives, and Nguyen’s conscience overshadowed his success. On February 8, 2014, he tweeted:
I am sorry ‘Flappy Bird’ users, 22 hours from now, I will take ‘Flappy Bird’ down. I cannot take this anymore.
Some Twitter users believed Nguyen was responding to intellectual property claims, but he quickly dismissed that assumption:
It is not anything related to legal issues. I just cannot keep it anymore.
The game disappeared on cue and Nguyen evaded the limelight. Hundreds of Flappy Bird imitations popped up online, but Nguyen was already focused on his next project—a more complex game that was specifically designed not to be addictive.
Flappy Bird was addictive in part because everything about the game moved fast: the finger taps, the time between games, the onslaught of new obstacles. The world beyond Flappy Bird also moves faster than it used to. Sluggishness is the enemy of addiction, because people respond more sharply to rapid links between action and outcome. Very little about our world today—from technology to transport to commerce—happens slowly, and so our brains respond more feverishly.
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Addiction is today better understood than in the nineteenth century, but it has also morphed and changed over time. Chemists have concocted dangerously addictive substances, and the entrepreneurs who design experiences have concocted similarly addictive behaviors. This evolution has only accelerated over the past two or three decades, and shows no signs of slowing. Just recently a doctor identified the first Google Glass addict—an enlisted naval officer who developed withdrawal symptoms when he tried to wean himself off the gadget. He’d been using it for eighteen hours a day, and he began to experience his dreams as though he were looking through the device. He’d managed to overcome alcohol addiction, he told doctors, but this was much worse. At night, when he relaxed, his right index finger would repeatedly float up to the side of his face. It was searching for the Glass power button, which was no longer there.
2.
The Addict in All of Us
Most war films ignore the boredom that sets in between bouts of action. In Vietnam, thousands of American G.I.s spent weeks, months, or even years just waiting. Some waited for instructions from their superiors, others for the action to arrive. Hugh Penn, a Vietnam vet, recalled that G.I.s passed the time by playing touch football and drinking beer at $1.85 per case. But boredom is the natural enemy of good behavior, and not everyone took to wholesome, all-American pastimes.
Vietnam lies just outside a region of Southeast Asia known as the Golden Triangle. This region encompasses Myanmar, Laos, and Thailand, and was responsible for most of the world’s heroin supply during the Vietnam War. Heroin comes in different grades, and most Golden Triangle labs at the time were producing a chunky, low-grade product known as no. 3 heroin. In 1971, that all changed. The labs invited a series of master chemists from Hong Kong who had perfected a dangerous process known as ether precipitation. They started turning out no. 4 heroin, which was up to 99 percent pure. As the price of heroin rose from $1,240 to $1,780 per kilo, it began to find its way to South Vietnam, where bored G.I.s were just waiting to be entertained.
Suddenly, no. 4 heroin was everywhere. Teenage girls sold vials from roadside stands along the highway between Saigon and the Long Binh U.S. army base. In Saigon, street merchants crammed sample vials into the pockets of passing G.I.s, hoping they would return later for a second dose. The maids who cleaned the army barracks sold vials as they worked. In interviews, 85 percent of the returning G.I.s said they had been offered heroin. One soldier was offered heroin as he disembarked from the plane that brought him to Vietnam. The salesman, a heroin-addled soldier returning home from the war, asked only for a sample of urine so he could convince the U.S. authorities that he was clean.
Few of these soldiers had been within a mile of heroin before joining the army. They arrived healthy and determined to fight, but now they were developing addictions to some of the strongest stuff on the planet. By the war’s end, 35 percent of the enlisted men said they had tried heroin, and 19 percent said they were addicted. The heroin was so pure that 54 percent of all users became addicted—many more than the 5–10 percent of amphetamine and barbiturate users who developed addictions in Vietnam.
Word of the epidemic filtered back to Washington, where government bureaucrats were forced to act. In early 1971, President Richard Nixon sent two U.S. congressmen to Vietnam to gauge the epidemic’s severity. The congressmen, Republican Robert Steele and Democrat Morgan Murphy, rarely saw eye to eye, but they agreed it was a catastrophe. They discovered that ninety enlisted men had died from heroin overdoses in 1970, and expected the numbers to rise by the close of 1971. Both men were approached by heroin vendors during their short stay in Saigon, and they were convinced the drug would find its way back to the United States. “The Vietnam War is truly coming home to haunt us,” Steele and Morgan said in a report. “The first wave of heroin is already on its way to our children in high school.” The New York Times printed an enlarged photo of Steele with a vial of heroin in his hand to show how easy it was for G.I.s to access the drug. A Times editorial piece argued for the withdrawal of all U.S. troops from Vietnam “to save the country from a debilitating drug epidemic.”
At a press conference on June 17, 1971, President Nixon announced a war on drugs. He looked into the cameras with grave determination, and said, “Public enemy number one in the United States is drug abuse.”
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Nixon and his aides were worried, not just because the soldiers were addicted to heroin in Vietnam, but about what would happen when they returned home. How do you deal with a sudden influx of 100,000 heroin addicts? The problem was all the worse because heroin was the most insidious drug on the market.
When British researchers assessed the harm of various drugs, heroin was the worst by a big margin. On three scales measuring the likelihood that a drug would inflict physical harm, induce addiction, and cause social harm, heroin scored the highest rating—three out of three. It was by far the most dangerous and addictive drug in the world.
It was hard enough to wean heroin addicts off the drug, but 95 percent relapsed at least once even after they’d detoxed. Few ever completely kicked the habit. Nixon was right to worry. He put together a team of experts who spent every waking hour planning for the onslaught of 100,000 new rehab patients. Nixon’s team decided that the addicted G.I.s should stay in Vietnam until they were clean.
The government settled on a two-pronged attack, bolstering resources in Vietnam and at home. In Vietnam, Major General John Cushman was charged with cracking down on heroin use, which was so widespread that Cushman could see the problem by walking through camp. Doctors confirmed that hundreds if not thousands of men were addicted to the drug. Shocked by the extent of the problem, Cushman pursued a crackdown. At 5:30 one morning, he surprised his troops by confining them to base for twenty-four hours. Everyone was searched, and emergency medical clinics were s
et up to treat users as they detoxed. Heroin was so hard to come by that desperate users were forced to pay forty dollars per vial—up from three dollars per vial just a day earlier. At first Cushman seemed to have the upper hand, as three hundred men turned themselves in for treatment. But days later, as soon as he relaxed the travel ban, usage rates spiked again. Within a week heroin was selling for four dollars per vial, and more than half of the men who tried to detox were back on the drug.
At home, the government appointed a researcher named Lee Robins to monitor the progress of returning soldiers. Robins was a professor of psychiatry and sociology at Washington University, in St. Louis, where she studied the root causes of psychiatric epidemics. Robins was known for her uncanny ability to ask the right interview questions at just the right time. People trusted her, and she seemed to uncover sensitive information that interview subjects usually preferred not to share. The government decided that Robins was the perfect person to interview and track the recovery of thousands of addicted G.I.s as they returned home.
For Robins this was an extraordinary opportunity. “[Studying] heroin use in a highly exposed normal population was unique,” she reflected in 2010, “because there is nowhere else in the world where heroin is commonly used.”
In the United States itself, heroin use is so rare that [a national survey] of 2,400 adults obtained only about 12 people who had used heroin in the last year. Because heroin users are scarce both worldwide and in the United States, most of our information about heroin comes from treated criminal samples.
But when Robins began following the returning vets, she was confused. What she found made no sense at all.
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Normally just 5 percent of all heroin addicts stay clean, but Robins found that only 5 percent of the recovering G.I.s relapsed. Somehow, 95 percent managed to stay clean. The public, waiting for a calamity after Nixon’s high-profile press conference, was naturally convinced that Robins was hiding the truth. Robins spent years defending the study. She wrote papers with headings like “Why the study was a technical success,” and “The study’s assets.” Her detractors asked her, over and over, how she could be sure her results were accurate, and, if they were accurate, why so few of the G.I.s used the drug after they had returned home. It’s easy to understand their skepticism. She had been appointed by a beleaguered president who declared a war on drugs, and Robins’ report suggested he was gaining the upper hand. Even if she had been above politics, her results were simply too good to be true. In the world of public health, victories take the form of incremental reductions—a 3 percent drop here or a 5 percent drop there. A 90 percent drop in relapse rates was outlandish. But Robins had done everything right. Her experiment was sound and the results were real. The problem was explaining why only 5 percent of her G.I. subjects had relapsed.