The store in the shopping mall has locked its doors. Outside, customers claw helplessly at the windows. Their faces are grey, their eyes dead, their movements jerky and robotic. ‘Why do they come here?’ one appalled onlooker asks her companion. ‘Some kind of instinct, memory – what they used to do,’ he replies. ‘This was an important place in their lives.’
It was an inspired move of George A. Romero to set his 1978 film Dawn of the Dead in the Monroeville Mall, Pennsylvania. The juxtaposition of zombies and a shopping mall captured the public imagination: it seemed such a good fit, somehow. Cinema audiences felt a tweak of recognition as they watched empty-headed people being drawn to the mall like filings to a magnet (especially if they were actually watching Dawn of the Dead inside a mall). The zombies criss-crossed the walkways in the aimless patterns of real shoppers, albeit more slowly. Sharp-eyed viewers quickly worked out the director’s subversive intentions: Dawn of the Dead is a satire on consumer capitalism.
But do shopping malls actually zombify us? And if so, how? There is a term in pop psychology called the ‘Gruen Transfer’, named after Victor Gruen, architect of some of America’s first malls. The theory goes that some shopping malls are laid out in such a way as to disorientate customers. Exits and routes are obfuscated so that people find themselves led back to stores they left earlier, where a mixture of ambient music, specific lighting and visual cues prompts them to make impulse purchases. According to one account, ‘the classic signs that someone is experiencing Gruen Transfer are a dropped jaw, slightly glazed eyes, and a hazy, confused feeling; many people also begin to walk more slowly as this peculiar mental state sets in’.1
Compared to the shopping mall of 1978, today’s mega-malls offer a near-psychedelic assault on the senses. Westfield Stratford City, a retail centre next to the London Olympic stadium that opened in 2011, contains 300 shops and 70 restaurants on a site the size of 25 football pitches; one bar stocks 50 different champagnes.
There’s another Westfield – smaller, but still the size of a dozen cathedrals bolted together – near my home in west London. Last time I visited, plenty of shoppers were displaying the lobotomised expression of the Gruen Transfer. Perhaps this was post-prandial lethargy: a sugar crash after lunchtime feasting on dim sum and Ben & Jerry’s.
But other shoppers seemed hyper-vigilant, their eyes darting from side to side, like nervous hunters; one woman looked terrified, as if she was expecting a Marks & Spencer sweater to leap off the counter and strangle her.
What is going on in the minds of these shoppers? You only have to look at them to see that they’re surrounded by more choice than their brains can easily handle. Hence the combination of confusion and over-stimulation. They are dazzled by a degree of availability that only the 21st-century retail environment can provide. We’ve already considered the theory that the more drugs that are available, the more people will run into trouble with them. But shopping malls suggest that the dangers of availability aren’t confined to drugs. Put simply, human beings haven’t evolved mental defences against the vast range of dangerous temptations they’ve created in such a short space of time.
In evolutionary terms, we essentially have the brains and bodies of hunter-gatherers. Our biochemistry has changed a bit in response to our dramatically altered surroundings, but not nearly enough for us to be able to adjust to them without damaging ourselves. Most people don’t reach the point of becoming addicts; but this mismatch between our bodies and our environment is the fundamental problem of addiction, and it is common to all humanity.
Why is shopping for something more fun than owning it? The process of buying that new suede jacket – the window shopping; the decision to try it on; the parading in front of the mirror; the deep breath before we fish out our credit card – leaves a more vivid memory trail than the experience of wearing it. ‘Pleasure appears to evaporate when we direct our attention to it,’ says the psychiatrist and brain researcher Morten Kringelbach. ‘The more we focus on the pleasure itself, the more it slips away.’2 In contrast, we can easily focus on the events leading to pleasure. To put it another way, it’s not the orgasm that lingers in the mind, it’s the foreplay.
To make sense of this, we have to keep reminding ourselves that ‘wanting’ and ‘liking’ activate different circuits in the brain. Of the two, the dopamine-driven ‘wanting’ experience is the more powerful and responsive to cues. It’s no accident that in everyday conversation we talk more often about seeking pleasure than finding it; looking for a fix than getting it. Sometimes the cue is a reward in itself – not least when we go shopping.
Melinda, a compulsive shopper I met in a 12-step meeting, told me: ‘It’s all about the thrill in the store. The purchase itself is far more fun than unpacking things when you get home. I barely look at half the shit at the bottom of my wardrobe.’
She’s one of those women who like to brag about their shoe and handbag collections to their friends. But secretly she’s ashamed about the amount of money she wastes, and she struggles to explain what goes on in her head between picking up the latest season’s slingbacks and walking out of the store with them lavishly gift-wrapped. Her ex-husband presumably finds it something of a mystery too.
‘I wouldn’t call it a black-out, exactly, but something just draws me towards the till. I often find my credit card is already in my hand by the time I get to the front of the queue. I can’t wait to jam it in the machine.’
Melinda is no stranger to other sorts of compulsions: she freely admits she drinks too much – punchbowl glasses of Pinot Grigio are an essential component of her Friday night – and she tells me, less enthusiastically, that she used to do a lot of cocaine in her early twenties. But the shopping is what’s ruining her life.
Mikey, a self-confessed shopping addict who works in a Manchester bookshop, also has a Pavlovian fixation on watching the plastic work its magic. (Only it’s a debit card these days: he’s had to cut up all his credit cards to stop him spending money he doesn’t have.) ‘The biggest kick comes from the little whirr of the card machine when your transaction goes through. It really gets the juices flowing. Honestly, I nearly get a hard-on when I hear it. The most embarrassing thing is that it even works on me when it’s someone else’s card. Say I’m looking at a sweater, and I hear the machine spitting out a receipt for another customer. At that point, I’m powerless: that sweater is ending up in my wardrobe. After my own receipt is handed over, though, everything is an anticlimax.’
Mikey’s reference to sexual arousal isn’t that outlandish, from a biological point of view. The anticipation of fulfilment, whether in the form of consumer goods or a sexual encounter, provokes similar neurochemical responses. The juice flowing through Mikey’s brain is, of course, dopamine.
Here’s where evolutionary theory becomes pertinent. Pleasure isn’t an end in itself: the goal of all organisms, not just humans, is to survive. Pleasure is a reward for behaviour – conscious or unconscious – that increases our chances of survival. The evolutionary purpose of sex and meals is obvious; but sports, country walks and playing the stock market are also more subtly aimed towards the physical health and material resources that protect us. So you would expect the body to reward people who indulge in them.
In fact, most enjoyable pursuits push us towards desirable evolutionary goals. The problem is, they keep pushing us towards them long after our biological needs have been satisfied. We have no way of switching off the hunter-gatherer instincts inherited from the mammals that preceded us, which have developed over hundreds of thousands of years. Most of the time we’re not even aware that they are at work. But, as the evolutionary psychologist Gad Saad argues, they shape even our most trivial consumer preferences.3
For example, we like fattening foods because our ancestors needed to store calories in order to ward off starvation. Nearly all human beings, irrespective of their background, prefer juicy burgers to raw broccoli because our taste buds have evolved that way. Women’s fashions in most cultures mimic signs of sexual arousal: red lipstick and clothes remind men of the reddening of erogenous zones, while cosmetics generally try to enhance facial symmetry, a genetic indication of good health.
Men buy flashy cars partly as a way of signalling to women their value as a mate: there’s more than a kernel of truth in the old joke about penis extensions. But note also that cars, like other status symbols, are objects deployed to bypass long and costly social processes. And the moment of taking possession of the car keys usually provides the new owner with a powerful fix. We’re not far removed here from the addict’s replacement of people by things.
Social networking websites, meanwhile, cater to our evolved need to connect to others and to draw attention to ourselves. That need is all the stronger because traditional ties of friendship that have glued together societies for thousands of years have been weakened by the very technology that makes Facebook possible. The new networks are fragile in comparison – but, as compensation, they offer a quick route to a fix: an exciting new friendship that stimulates dopamine and can be abandoned when the juice runs out. The ‘defriending’ and ‘blocking’ features of social networks are instant replacements for messy interpersonal meltdowns.
Technology and addiction exist in intricate symbiosis. The word ‘technology’ is shorthand for an infinite number of tools, crafts and techniques that, thanks to scientific discoveries, have the potential to make life more bearable for us – or to tantalise us with the prospect of cheap thrills.
The great rhetorical scholar Kenneth Burke wrote that man is ‘separated from his natural condition by instruments of his own making’.4 Our natural condition is one in which our survival is constantly threatened. Technology keeps those threats at bay, at least for a time, by housing, clothing, feeding and healing us as efficiently as possible. Indeed, the mark of a successful invention is that it allows us to achieve greater rewards for less effort.
This is a simple point, but worth spelling out. Technology pushes the work-to-reward ratio in the direction of rewards – and usually short-term rewards at that. All animals like short-term rewards. That’s because, as we’ve seen, the goal of all organisms is to survive and immediate rewards make that possible. But what other animals can’t do – and very few humans could do until recently – is reach out for a quick reward whenever they feel like it.
Unlimited availability can turn a blessing into a curse. Take the example of sugar. We have evolved to like sweet things. Our ancestors recognised fruit as a source of energy. Over countless generations, our internal organs have adjusted to the sort of sugar burst provided by, say, an orange. But what happens when we glug a can of orange soda containing ten times as much sugar as the fruit?
The answer is that our internal organs struggle to cope with this massive ingestion of sugar. But we can’t just turn off the brain’s ancient urge to gorge on sugar, even though it undermines the health of the rest of our body. The result? A biological-environmental mismatch that has created an epidemic of Type 2 diabetes, a disease which now affects over 300 million people worldwide.5
In short, changes in the work-to-reward ratio damage individuals while bringing benefits to society. Sometimes, though, it’s difficult to know where the benefits end and the damage begins. Either way, there is an economic incentive for manufacturers and retailers to keep pushing the ratio towards reward. That’s what ‘economy’ means, after all.
As rewards spread throughout society, so does biological maladaptation to our surroundings. In the ancient world, everyone benefited from the inventions of the wheel and the plough. Only privileged individuals, however, could amuse themselves with the fruit of others’ labours and fill their stomachs to the point of sickness.
That changed with urbanisation, which did more than satisfy the biological minimum in terms of shelter, clothing and food. Gradually more and more people could indulge themselves, either to the point of satiety – feeling stuffed after a heavy meal – or to the point where they felt a craving for repeated rewards. The towns and cities of the industrial revolution divided labour in a way that forced the poor to work punishingly long hours. But the overall effect of industrialisation was to increase the profitability and availability of short-term rewards. Even factory workers, living on top of each other in conditions of squalor, had access to quick ways of changing their moods.
Capitalism introduced cheap, strong and unhealthy fixes into the lives of all but the poorest citizens of western countries. As an illustration of that process, let’s consider the history of the world’s most popular psychoactive drug: alcohol.
It’s possible to become an alcoholic without developing a taste for spirits. I should know. Red wine was my drug of choice, closely followed by beer. Not that I turned my nose up at an offer of whisky, gin or vodka; but I didn’t think of spirits as enjoyable drinks so much as a quick route to intoxication. Too quick, really – unless it was a post-pub drinking session, by which time any instinct for self-preservation had long since disappeared.
Spirits can be blamed for proper mass drunkenness, which doesn’t seem to have existed before distillation came along. It’s true that the Dionysian revellers of ancient Greece drank themselves into a stupor, but only in the limited context of their quasi-religious rituals. No doubt some peasants 3,000 years ago were too fond of wine or beer and earned a reputation as village drunks, but alcoholic drinks weren’t regarded as a problem for society as a whole until more recently.
By the twelfth century, monks had learned how to distil grape alcohol, but it was used mainly for medical purposes, as was edible opium in China at the same time. It wasn’t until the invention of techniques for distilling cereal crops that the industrial production of very powerful beverages became possible.
Spirits took the relatively mild effects of wine and beer – which helped people to conquer anxiety, strengthen communal bonds and find sexual partners – and refined them into a hit. Their high concentration of ethanol produced faster changes to brain chemistry than any previous beverage. The result was a quicker fix and a greater risk of physical dependence.
That was good news for the people who made and distributed the stuff. It’s not just consumers who get more bang for their buck when the work-to-reward ratio of a drug changes like this: so do manufacturers, especially if an addictive spiral is created in which the stronger the commodity, the more insistently customers return for more.
The first recorded epidemic of drunkenness in history – the Gin Craze that hit London in the eighteenth century – followed a dramatic upheaval in the marketplace. In 1690 Parliament blocked imports of French brandy with an Act ‘for the encouraging of the Distilling of Brandy and Spirits from Corn’. The monopoly of the London Guild of Distillers was broken; in 1713 Parliament passed another Act allowing anyone to distil spirits without fear of prosecution.
This deregulation had some ugly consequences. Even rotten corn could be turned into gin, producing potent but foul-tasting liquor. As Jessica Warner writes in Craze, her study of the epidemic, ‘aside from its name, this beverage bore little resemblance to what now passes for gin. It was made from the worst possible ingredients, and because of this it was flavoured with fruits and other additives in an attempt to mask its harsh and musty taste.’ Gin was ‘the punch of the poor’. The taxes it raised financed the building of an empire while lining the pockets of landowners and the merchant classes.6
This morality tale was played out against a background of rapid, disorientating urbanisation. England’s capital city was expanding too fast for its own good. To quote the historian Elise Skinner, ‘gin sellers thrived in the sprawling suburbs of London because the local authorities were either too weak, corrupt or simply overwhelmed by the number of problems to deal with to adequately respond to the increased consumption. This situation was exacerbated by the absence of magistrates willing or qualified to police these neighbourhoods. Consequently, thousands of women and men were able to sell gin openly and without a licence.’7
Many of the gin drinkers were women. The old ale houses were all-male environments, but in the unruly new gin shops of London women were allowed to drink alongside men. This horrified social reformers, who depicted these women as drunken prostitutes who spread syphilis and abandoned their children. The gin-sodden harridan became the focus of respectable anxiety about the craze, rather as vomiting ‘ladettes’ dominated media depictions of binge drinking in late 1990s Britain.
I’ve already mentioned Hogarth’s engraving Gin Lane, set in the London district of St Giles. No one who has seen it can forget the hideous sight of a woman casually dropping her baby to its death. She is half naked, allowing us to see the sores from the syphilis that she has picked up as a prostitute. In the background, another mother tips gin down her infant’s throat. A lunatic dances in the street bearing a dead baby impaled on a spike. Drunks fight and stagger outside the busy distiller’s shop, which bears the apt name of Kilman. Also thriving is Mr Gripe the pawnbroker, to whom the gin-addicted carpenter is offering his saw and the housewife her cooking utensils. In contrast, the barber is ruined because nobody can afford a haircut or shave. His body dangles from a rope in the attic of his shop.
Gin Lane exaggerated the crisis, as cartoons do, but not by much. One in four houses in St Giles sold gin, which cost only one and a half pennies per cup. Hawkers toured the streets with wheelbarrows of gin, some of it poisonous. In total, five million gallons of spirit were being distilled in London every year. Most gin drinkers got through two pints of it a week.
By the time Hogarth’s cartoon appeared in 1751, Parliament was finally ready to take drastic action. In that year, it passed a Gin Act that banned distillers from selling to unlicensed merchants. This, coupled with a rise in grain prices, began to put smaller gin shops out of business. The craze petered out.
Were the gin-sodden victims of the craze ‘proper’ alcoholics? That’s like asking whether the heroin-smoking soldiers in Vietnam were proper addicts. The 12-step fellowships would probably say no, but their understanding of addiction isn’t sufficiently flexible to encompass addicted people who return to normal. For a time, the Georgian drinkers were trapped by a dopamine-fuelled desire for repeated doses of a highly refined drug. They consumed it addictively. Then, thanks to circumstances beyond their control, the supply of their drug dried up, as it did for the Vietnam GIs flown home. The amount of gin being produced halved in the decade after the Gin Act. Many people simply abandoned the suicidal drinking habits of the craze.
Common sense tells us that some eighteenth-century gin drinkers were more prone to alcoholism than others, but we don’t have the data. Nor do we know much about Vietnam soldiers’ individual susceptibility to addiction.
Such is the paucity of information available to us about addictive epidemics that it is not possible to establish causation with certainty – but in both cases we can trace a correlation between addictive behaviour and availability, the factor so often overlooked in studies of addiction.
To repeat Michael Gossop’s argument, people are most likely to run into trouble with a drug if it is economically, socially and psychologically available to them. If all these boxes are ticked, then the scene is set for an epidemic of addiction among people who would not otherwise become addicts. If Parliament had voted differently in 1692, the terrifying crone dropping her baby down the stairwell might have been a happy housewife and a loving mother.
Anyone who has read Malcolm Gladwell’s The Tipping Point will remember how the book opens, with a description of how Hush Puppies went almost overnight from being horribly drab footwear to must-have hipster accessory. Later chapters offer an anatomy of word-of-mouth ecosystems, in which tiny tweaks to the environment can produce dramatic changes in popular behaviour.
Addictive behaviour is fuelled in the same way. The most stupidly self-destructive habits, such as round-the-clock drinking or eating a 3,000-calorie fried chicken breakfast, are typically the product of social epidemics. They are ‘sticky’, to use Gladwell’s terminology. As Nicholas Christakis and James Fowler say in their book Connected, never underestimate the tendency of human beings to influence and copy one another. ‘Students with studious roommates become more studious. Diners sitting next to heavy eaters eat more food. Homeowners with neighbours who garden wind up with manicured lawns.’8
There’s a chilling passage in The Tipping Point in which Gladwell relates how a horrible example of ‘sticky’ behaviour, suicide, began spreading among teenage boys in the Micronesian islands. The boys who killed themselves were not obvious candidates for suicide, unlike Hogarth’s bankrupt barber. But, somehow, ending their own lives had become an appropriate response to minor setbacks for these young men.
Gladwell says that when we interpret other people’s behaviour, we invariably overestimate the importance of character traits and underestimate the importance of situation and context.9 He’s right – and epidemics of addictive behaviour support his argument.
Such epidemics were rare in the past because only occasionally was an addictive substance comprehensively available. But when they did strike, they weren’t confined to eccentrics, vagabonds or individuals who were already going off the rails. In the cases of the Gin Craze and the Vietnam heroin epidemic, it was precisely the ordinariness of the addicts that scared the authorities. They couldn’t tell who would succumb because everybody was at risk in such a dangerous environment. In Georgian London, it no doubt reawakened dreadful folk memories of the plague.
In the back streets of St Giles and the US barracks in South Vietnam, people found themselves herded together in the middle of an unregulated market in mind-bending intoxicants. Gin and heroin weren’t new substances, but in both cases there had been a leap forward in production techniques. In eighteenth-century London there weren’t enough magistrates to punish drunks; in Vietnam, the US authorities – who had managed to stamp out marijuana smoking – couldn’t detect odourless heroin-laced cigarettes. Also, both populations were disorientated by change. London was expanding at a bewildering pace; the GIs had been transplanted to a battlefield on the other side of the world.
These environmental changes produced a particular variety of social epidemic, the sort that saturates a high-density population. Even people who didn’t resort to drugs – and there are always people for whom intoxication has no appeal – found their lives altered by them. In the cases we’ve considered, if just one of the ingredients in the mixture had been different, those epidemics might not have materialised. But we can say that only with hindsight. The one thing we know for certain about social epidemics is that they can’t be predicted. No one knows exactly which environmental tweaks will lead to sudden change, or what form that change will take.
We see a different pattern of social epidemic, for example, in the case of opium smoking in eighteenth-century China – the world’s first truly catastrophic drug (as opposed to alcohol) epidemic. The habit spread too slowly to be described as a ‘craze’ this time, because the supply lines were diffuse, tangled and difficult to eradicate.
The opium epidemic began, as the others had, with a scientific discovery. Europeans picked up the habit of smoking tobacco from American Indians. But it didn’t occur to them to smoke opium, even though the drug had been widely used as a mild tranquilliser and aphrodisiac for thousands of years. Smoking it was a Chinese innovation: one that was to prove devastating.
Smoking did for opium what distillation did for alcoholic drinks, because the lungs deliver opium’s active ingredients, morphine and codeine, to the brain far more efficiently than the stomach. Users become almost literally high on happiness, since along with dopamine the drug releases the endorphins that soothe emotional pain.
In the nineteenth century Britain notoriously went to war to protect the supply of smuggled opium from British India. The trade was possible only because it was protected by Chinese bureaucrats and warlords who were themselves addicts. This reveals a common feature of addictive epidemics: 150 years later, rogue elements in the Vietnamese government protected the heroin trade, despite the damage it was doing to their country.
Successive Chinese emperors were horrified by the damage done to society. Opium addicts were useless to everyone and prone to persuade other bored people to try smoking the drug. The imperial court tried everything to banish it, including the most barbaric executions of opium dealers in front of Western merchants. But nothing worked. As an edict of 1799 noted, opium smoking had spread from ‘vagrants and disreputable people’ to ‘respectable families, students and officers of the government. When this habit becomes established by frequent repetition, it gains an entire ascendence, and the consumer of opium is not only unable to forbear from its daily use, but on passing the accustomed hour, cannot refrain from tears or command himself in any degree.’
When I read that, I asked an ex-heroin addict friend of mine if it rang true. ‘Definitely,’ he said. ‘Opiate addicts are a lachrymose bunch, emotionally shattered by the thought of going into withdrawal. You see them in the waiting rooms of clinics, comparing notes with desperate self-pity, terrified that they’re about to start “clucking”.’ (That’s an in-joke about going cold turkey.)
But, he added, that was more a function of the drug than of their personalities. Websites for relatives trying to wean their loved ones off opiates (usually heroin) are warned to expect tears and tantrums at the mere suggestion of going into treatment. Opiates mimic the endorphin release associated with maternal love: no wonder the prospect of losing the supply induces tears.
However, the Chinese addicts are unlikely to have taken up smoking opium because they desperately needed to experience its soothing euphoria; that came later, when they were dependent on it. There is no point in speculating about their psychological needs – well-documented social factors are far more relevant. It’s more likely that they chose opium because it was fashionable, because they were genetically intolerant to alcohol and this was their only available intoxicant, or because they were bored. Opium smoking is a languid, protracted process – it’s at the opposite end of the scale from coke-snorting in this respect. It has a special appeal for underemployed rich people, of whom there were an unusual number in imperial China.10
The Chinese opium epidemic was shaped by an environmental ‘fit’ between a particular narcotic and a particular segment of society. You could say the same about the other drug networks we’ve discussed. The two million Chinese addicts were not concentrated in one place, like the Vietnam GIs and, to a lesser extent, the London gin drinkers. Nonetheless, there is a common denominator: availability.
When we think of addiction, the first word that comes to mind is ‘drugs’. But perhaps it shouldn’t be. According to the sociologist Jacob Avery, our ideas are too heavily influenced by medical research, which concentrates on drugs and their effect on neurotransmitters. He argues that addiction is virtually uncharted territory for sociologists. As a result, not enough attention is paid to ‘micro-situations’, the small dilemmas of everyday life that ultimately lead people to take what are objectively very bad decisions, but provide them with a comforting emotional pay-off.11
Drugs need not come into the picture at all. Let’s consider two places that are specifically designed to arouse addictive urges – casinos and strip clubs. They both serve alcohol, but only as an accompaniment to the rituals that lead customers into costly but not substance-based self-indulgence.
The rites of the blackjack table, for example, are as meticulous as any religious rubric. Like a Catholic priest celebrating an elaborate Latin Mass, the dealer is following a far more detailed script than most members of his congregation realise. The laying out of the wagered bills, the stacking, the dealing of cards, the particular variety of shuffle, the rotation of dealers – all these are intended not just to guarantee the security of the game but also, with their hypnotic formality, to create a state of mind that channels the players’ compulsive urges.12
Likewise, strip clubs cynically exploit the sexual desire of middle-aged men with calculated theatrical spectacles. You see it so often on screen: a beautiful young woman making exaggerated flirting gestures as she loosens the tie of a sweaty businessman. In the strip club, for a few expensive moments, a man is at the centre of the sexual universe – and, as Avery points out, it’s all on display for other males to see. The scene is a grotesque parody of a mating ritual with roots so deep that they stretch across the animal kingdom. Yet the basic rule of strip clubs is that actual mating is forbidden: when the man’s hand reaches up, it is slapped down. He may even be thrown out.
Casinos and strip clubs crank up their customers’ ‘wanting’ instincts to a sadistic degree and keep them there. The thrill-seeker is endlessly teased with cues that signify sudden wealth or a glorious sexual encounter. Deep down, he knows that these cues are deliberately misleading – but such is the short-term buzz of excitement that he’s prepared to ignore the long-term consequences.
The owners of casinos and strip clubs endlessly tweak their products in order to make them as addictive as possible – but there’s no clear dividing line between customers with a ‘problem’ and recreational visitors. No one is really sure where the dividing line is, including the government, the casinos, the dealers and the patrons themselves.
No explanation of why people succumb to self-destructive temptations is going to be a tidy one. Although social context is important, that context may be too complicated to allow us to place people on a spectrum of addictive behaviour.
What we can do, however, is keep stepping back to remind ourselves of the big picture. The only things limiting our ability to stimulate ourselves to the point of frenzy are our fragile biology and our common sense. Western society has moved beyond the point where addictive epidemics can easily be distinguished from everyday behaviour; the dynamics of addiction and the dynamics of the free market simply have too much in common.
The modern marketplace depends for its smooth functioning on a supply of novel goods that automatically refreshes itself. Dopamine is excited by novelty; so are social networks. It’s hard for us, as consumers, to know whether we are paying too much attention to the lovely things dangled in front of us – and whether our desire for them is provoked by peer pressure or brain chemistry. But we usually end up buying them anyway.
‘My catarrh has disappeared!’ declares a chubby little schoolboy, holding up a long, thin bottle of medicinal syrup. He looks happy. Perhaps he’s high. He has, after all, been taking heroin.
The boy appears in an advertisement that ran in a Spanish newspaper in 1912; it’s for the heroin syrup that Bayer, a German pharmaceutical company, made for coughs, colds and ‘irritation’. In another ad, an elegantly dressed housewife is shown lovingly spooning heroin into her little girl’s mouth. La tos desaparece, it says – ‘the cough disappears’. The campaign had been completely forgotten until critics of Big Pharma dug it up and posted it online in 2011. Most of the ads were targeted at children, but one of them shows the same housewife feeding syrup to her bronchial husband, who has come home wrapped in a heavy scarf. Someone has added the line: ‘Hi, honey, here’s your smack!’13
I’m pretty sure Bayer would have preferred these advertisements to remain forgotten. If you enter the word ‘heroin’ into the search box on the multinational corporation’s website, you will find three brief references to the dangers of heroin abuse but no reference to the fact that Bayer invented the drug diamorphine in 1898 and trademarked it as Heroin, to indicate its ‘heroic’ properties.
Bayer had been looking for a less addictive alternative to morphine, which had become dangerously popular even in the most respectable circles. In his cultural history of intoxication, Out of It, Stuart Walton describes the late Victorian fad for morphine tea parties: ‘A society hostess would invite acquaintances around for tea at 4 p.m., after the service of which the ladies would be invited to draw up their sleeves and receive an adorably divine injection from their hostess who – one may assume – was scrupulous to a nicety in observing the hygienic imperatives demanded by needle-sharing.’ (One can’t help pitying the poor servants, since the side-effects of morphine include dizziness, light-headedness and vomiting.) Some women, Walton reports, even had customised syringes made so they could shoot themselves up during intervals at the ballet.14
You might ask what on earth was Bayer thinking – manufacturing a more refined version of morphine and imagining that it would be less addictive than the original? Certainly, within a couple of years of its introduction, the medical community knew that heroin was habit-forming. But, even now, it’s not clear that it really is more addictive than morphine. It is faster-acting, because it crosses the blood-brain barrier more quickly. Because of its strength, it costs less to inject. The high is basically the same, though, and far less intense for a first-time user than that produced by, say, crack cocaine.
What turned heroin into an infamous ‘demon drug’ is that it became readily available on the streets. It didn’t occur to anyone that the magic ingredient in a cough syrup would end up being injected by inner-city junkies – but perhaps it should have. History suggests that anyone who develops a powerful psychoactive substance, whether for medical or recreational purposes, is likely to create large-scale addiction – or, to put it another way, a hugely profitable surge in demand.
It’s not easy for manufacturers to know how to respond in those circumstances. People like the experience of an instant and painless chemical reward – and I’m using the word ‘reward’ loosely here, to include marvellously effective painkillers. Even when that reward ceases to be painless and they no longer get much pleasure out of the substance, the ‘wanting’ persists: as Gene Heyman emphasises, the non-reasoning parts of our brains don’t distinguish between the use and abuse of drugs. They don’t distinguish between legal and illegal drugs, either – or cheap and expensive ones.
This is where biology and supply-and-demand economics collide. The ‘wanting’ urge is so strong that demand for illegal drugs is inelastic, which means that, when police seize enough quantities of a drug to increase its street price – usually only temporarily – the market for it doesn’t shrink proportionately. People value their fix so much that they go to extra efforts to obtain it. Although decreased supplies provoke turf wars among drug dealers, addicts still clamour for their wares.15
If the supply of a drug could be permanently restricted and there were no alternatives, then demand for it would fall, albeit slowly. But these days there are always alternatives, even for the most desperate addicts. Health professionals who work in highly addicted communities report that if there is a sudden shortage of a particular drug in a city, users will switch to something else – from heroin to cocaine, for example, even though the effect of these two drugs on the brain is very different.
Also, it’s becoming clearer to scientists that non-substance addictions can perform many of the same functions, and do much of the same damage, as drugs or alcohol. We touched briefly on the puzzle of comorbidity in the previous chapter. People who give up a mind-altering drug often develop obsessive relationships with other things. Ex-drunks will start binge eating, for example. I remember being at an AA meeting at which a borderline obese Catholic priest announced: ‘I gave up the bottle only to fall headfirst into a tub of Häagen-Dazs.’
The notion that human beings have addictive urges which can be transferred from one object or substance to another has incredibly far-reaching implications. Science has a long way to go before it pieces together the jigsaw. But it only takes a visit to a major retail centre to realise that brands and businesses are learning more and more about our addictive vulnerabilities – and how to exploit them. And can we really blame them? It’s called making a profit.
Addictive behaviours aren’t necessarily locked on to specific things: in a world where there are practically limitless pleasurable experiences on offer, obsessive behaviour becomes promiscuous: it can grab hold of any object or activity that promises us a hit.
These days, I still spend up to £100 a week on my own fix. I visit my dealer whenever I can, desperately hoping that he has something that will make my dopamine levels jump. Such as, for example, a recording of the little-known Russian pianist Dmitri Bashkirov playing a Schubert piano sonata.
I know how pretentious this sounds, but I’m addicted to buying CDs of classical music. I’m not addicted to listening to them. I do listen to lots of classical music, and derive intense pleasure from it, but I’m quite capable of buying a CD and leaving it for weeks in its shrink-wrap. You see, it’s already done its job: it was the experience of finding it that excited my dopamine pathway.
There are more than 3,000 classical CDs on my shelves. Many of them contain pieces of music that move and fascinate me so intensely that I’ve spent decades thinking about them and comparing recordings. Beethoven’s Hammerklavier Sonata, for example. I have 25 versions and even that’s not enough: every reading brings me closer to grasping the mysterious symmetry of its slow movement, or the crazed mathematics of the final fugue.
I don’t listen to it as a fix. But I buy CDs of it as a fix, along with innumerable discs of music that mean far less to me and that I want in my collection because I’m what critics refer to as a ‘completist’. This is the obsessive-compulsive side of addiction, as yet little understood by scientists. Connoisseurs of internet pornography collect thousands of images because it gives them a similar kick, as we’ll see later. Thankfully, I’ve settled on something more harmless.
My obsession is supply-driven by digital technology: I couldn’t have done the same thing when there were only five available recordings of the Hammerklavier, which was the case in the 1960s. To look at it another way, digitalisation has had the same explosive effect on the supply of classical recordings as it has on the supply of porn.
I thought this particular addiction of mine was unusual, until my oldest schoolfriend told me that, during the collapse of his first marriage, he was buying hundreds of CDs of classical music, many of which he still hadn’t unwrapped. ‘To be honest, I think it was one of the reasons we split up,’ he added.
Then I read a book called In the Realm of Hungry Ghosts by Dr Gabor Maté, a physician who treats homeless addicts in downtown Vancouver. It’s full of extraordinary insights into the lives of people tortured by every form of substance abuse and violence. But, for me, by far the most memorable passage is the one in which Maté – who has never struggled with substance addictions – describes his particular problem.
‘Hello, my name is Gabor, and I’m a compulsive classical music shopper,’ he says.
When things were at their worst, Maté was visiting Sikora’s, the classical music store in Vancouver, several times a week. He would spend more than a thousand dollars a month on his splurges. And when he wasn’t in Sikora’s, he was at home poring over online music reviews, something I do myself for hours at a time.
‘As soon as the reviewer says something like “no self-respecting lover of symphonic/choral/piano music should be without this set”, I’m done for,’ he writes.16 Suddenly he cannot imagine life without this new set of period-instrument Haydn symphonies, or his third version of Mozart’s complete violin concertos or yet another 14-CD cycle – his fifth – of Wagner’s Ring cycle.
I’ve just counted my own Wagner cycles: Bodansky/Leinsdorf, Keilberth, Solti, Böhm, Goodall, plus Levine and Boulez on DVD and Furtwängler’s incomplete set. Of these, my favourite is probably the Keilberth, because it’s the one the critics have praised most extravagantly (when I’m outside my area of musical speciality, I have a lazy habit of allowing critics to dictate my judgements) and, shamingly, because it has the nicest packaging.
CD boxes are not things of beauty, as some LPs were, but the neatness and smartness of the package influences the way I think about the music. It’s why I can’t get excited about downloading – though, like a true obsessive, I organise my iTunes library fastidiously. Yesterday I went hunting for a CD that I can download much more cheaply from the eMusic website. When I didn’t find it, my joyful anticipation seeped away and I could restore my spirits only by buying five discs of music that I didn’t want nearly as much. Which reminds me: I must play them some time.
Visitors to my flat look in amazement at the thousands of CDs in purpose-built bookcases and say they admire my absorption in the world of music. They’d be surprised if they knew how few concerts I can be bothered to drag myself to. What they’re really looking at is a middle-aged man who has found a socially respectable way of replacing people by things. In slightly different circumstances, it could have been stamps. But thank God it wasn’t.