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Doped-Up Nation: How America Became a Country of Addicts

The external fixes to our internal problems are readily available, and every addiction fuels somebody else's craving—for cash.


We’re a nation of addicts. Would you care to dispute it?

Recent studies confirm an alarming reality: As a country, when it comes to dealing with personal problems, we use an external fix. Whether it's routine disruptions we face at work, the common crises at home, or our children trying to parse the maelstrom of media overload—the fact is that it's increasingly rare that Americans turn to internal or interpersonal resources to establish equilibrium. Instead, our first impulse is to seek out a quick and external source, which becomes both the cause of our problems, and the solution.

The first place people look is the simple dopamine spike. Most people have reliable techniques to make themselves feel better—or, as I like to say, to give themselves a little “dopamine spike.” Dopamine, as you probably know, is the neurotransmitter triggered by “rewarding events.” These pleasurable moments may occur naturally, but they are also the  direct result of specific drugs, such as cocaine, methamphetamine or nicotine. 

While we may admire the American impulse to applaud hard work, innovation, and daring, the rewards of these labors aren't immediate. We’re an impatient nation; we seek more immediate gratification. We’ve come to accept an approach of “why wait?”, so we grab ahold of whatever it takes to feel better, to keep feeling better, to make it through the day.

In our addicted culture, we go for the artificially-induced dopamine spike—and not just one, but one right after the next. Consider the following: Roughly one in ten Americans is currently an illicit drug user; nearly one quarter of American adults engage in binge drinking, many on a regular basis; and the  majority of those with problem drug or alcohol use do not seek treatment for their problems. 

Now, if we broaden the criteria that we use in thinking about addiction to include unhealthy coping mechanisms and other “ways-to-get-through-the-day”—we face staggering results. For one, most Americans have lost their ability to eat normally, with two-thirds of the nation’s adults meeting the definition of obese. As another example, approximately  one out of every five American women is on an anti-depressant. I recently signed up with a new primary care physician. When she found out that I’m a psychologist, she asked me “Why is every kid in New York on Ritalin, and every adult taking Ambien?”

It’s an excellent question.

How is it that we’ve wrapped ourselves in the fuzzy dopamine blanket of substance misuse, prescription medication, compulsive eating, celebrity worship, compulsive shopping, internet addiction, video gaming, and compulsive sexual behavior?

Here’s one reason: these external fixes are readily available, and every addiction fuels somebody else's craving—for cash. The alcohol industry takes in over $100 billion a year; Big Tobacco earns $35 billion. Gambling, pornography, prostitution, and texting all add fuel to our country's dopamine fire. 

The root issue is that direct, undiluted, authentic engagement with the world and others is a challenge, and the strategy of occasional mood alteration that many employ to "take the edge off" can slide into something more dangerous. Others end up in another kind of distorted dependence, finding that it's easier to move your onscreen avatar through the world than to actually navigate it on your own. What about the  tragic case of the Korean couple who found it easier to raise a “virtual” baby in a popular internet cafe than to take care of their child who died while they were busy online?

The couple’s three-month old starved to death. She was only fed between sessions of the game. According to police, these parents “indulged themselves in the online game raising a virtual character so as to escape from reality, which led to the death of their real baby. Here in Dopamine Nation, internet and video game addiction are  real concerns.

Those of us who work in the addiction treatment community find our most critical task—helping clients find an authentic path to recovery—more challenging than ever. In part, this is due to a culture that seems engineered to foster dependence on artificially induced means to “feel OK.”

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