Internet addiction should be treated as seriously as substance use disorders | Opinion

The devastating effects of addiction — to alcohol, tobacco, cocaine, opioids — are well documented.

But video and computer games, cybersex and online porn, Internet gambling and surfing, texting and emailing, social media platforms, online auctions, and shopping can be every bit as addictive as substances.

In our practice at the Department of Psychiatry at Rutgers New Jersey Medical School (NJMS), we’ve seen numerous lives destroyed or derailed by technological addictions.

People have gotten so caught up in virtual worlds that they’ve lost jobs, money, and loved ones in the real world. Reports from South Korea and Alabama tell stories of parents so engrossed in gaming that they neglected and even starved their own children.

One of our patients, a 25-year-old man, could not date offline because he couldn’t find anyone as attractive as his virtual mates. Another, a 20-something war veteran suffering from schizoaffective disorder, ended up homeless because he racked up $10,000 in credit-card debt buying virtual accessories to enhance his status in a massive multiplayer online game that he couldn’t tear himself away from. Yet another 20-something veteran suffering from post-traumatic stress disorder spent so much time playing an online shooting game that he started reliving the horrors of his war years. He withdrew from his family and ended up hospitalized.

Although these cases involve young, tech-savvy people, the older population is just as susceptible to spending endless hours on Facebook feeds and cyber-shopping sites. Older internet users, who did not grow up with such technologies, are in fact particularly vulnerable to scams like the “wealthy prince” who happened to leave millions of dollars for them in his London bank account. More broadly, technological addiction is nondiscriminatory — anyone is susceptible. No preexisting psychological or physical conditions are required.

It’s not surprising that society seems resigned to the risk of technological addiction. The digital games we play and the sites we surf are, by design, addictive. They are made to mine our “likes” and “dislikes” and keep us clicking and tapping for more, more, more.

We, of course, do not advocate rolling back or restricting technology, which can be enormously beneficial and fun to use and will continue to be a major force in our lives. There is, after all, little empirical data on this emerging problem — yet — and the number of those technologically addicted is a significantly small subset of the general population. But we do want to call attention to the issue before it becomes pervasive.

Defining technological addiction is a slippery slope, though we can all appreciate the difference between surfing the Internet for two hours a day versus 16 hours. How can you tell whether you or someone you know has a technological addiction? As with other types of addiction, there are four main symptoms:

Help is available for people who develop technological addictions, even if they don’t see the problems with or costs of their behavior.

A consultation with a psychiatrist or a psychologist, preferably one who specializes in addiction, will establish a diagnosis and identify any co-occurring medical issues, such as depression, anxiety, and post-traumatic stress or eating disorders, that contribute to, result from, or even cause the addiction. There are no specificmedications for treating technological addictions. Medications for co-occurring conditions, however, may help. Psychotherapy, motivational enhancement therapy, or cognitive behavioral therapy can reinforce healthy behaviors.

The American Academy of Addiction Society is a wonderful resource, as is, locally, our Department of Psychiatry at Rutgers New Jersey Medical School. This fall, the department will raise awareness about technology addiction by devoting its Seventh Annual Conference on Urban Mental Health to the subject.

Other organizations and leaders have drawn awareness to this issue. In 2018, the World Health Organization added gaming disorder to its International Classification of Diseases. This year U.S. Sen. Josh Hawley, a Missouri Republican, introduced the Social Media Addiction Reduction Technology Act (SMART), which aims to curb social media addiction.

But acknowledging the issue is not enough.

It is time for society to take technological addictions seriously and for the medical community to recognize them as legitimate conditions and treat them as vigorously as substance use disorders.

Petros Levounis, MD, MA, is professor and chair of the Department of Psychiatry at Rutgers New Jersey Medical School. He has published 13 books on addiction, coauthoring the book “Sober Siblings: How to Help Your Alcoholic Brother or Sister — and Not Lose Yourself.” James Sherer, MD, is a third-year psychiatry resident at Rutgers NJMS. He is the coeditor of the textbook “Ward Wisdom: Psychiatry Questions for Medical Students” and a chapter author in the forthcoming textbook “Absolute Addiction” from Springer Publishing.