“Problem Gambling” is Now a Recognized Addiction: Why it Matters!

 “Problem Gambling” is Now a Recognized Addiction: Why it Matters!

Bruce K. Alexander with Tom G. Holborn

Presentation to The Evergreen Council on Problem Gambling Conference at Swinomish Casino & Lodge, Anacortes, Washington

October 2, 2019

I will first express my gratitude to the people of the Swinomish tribe who have invited us all to their beautiful place by the sea and also to the Evergreen Council on Problem Gambling who invited me to address this conference. But, most of all, I am grateful to you in the audience. You are the people who deal with the grim tragedies of gambling addiction every day, and you help people at ground level. It is so very important that you succeed. I have personal as well as professional reasons for caring.

I have spent most of my professional life for the past half-century researching, teaching, and publishing about addiction to drugs, primarily heroin and other opioids, and none of my time, until very recently, on gambling addiction. But then, a couple of years ago, a young relative of mine gambled away a Vancouver condo that belonged to him and his wife. 

I found this family disaster very difficult to understand. I have no trouble understanding the strength of addiction to alcohol, drugs, work, sex, love, food, exercise, religious and ideological fanaticism. This is partly because I have personally experienced most of these activities, and some of my experience may have been borderline addictive. But I have not gambled since my teenage years.

So my first response was to spend some time in casinos and to bet some money there, in order to understand the attraction of gambling. After a few hours of wandering around a casino watching other people gamble, I lost $55 in 20 minutes at a roulette table. This might not seem like much money to a seasoned gambler, but it was too much for me. I needed a less expensive way to educate myself about gambling addiction! So I consulted colleagues who are experts on gambling, read what they suggested, and had long talks with a few people I know who are, or have been, addicted to gambling. And I have spent a lot more time wandering around casinos, but now I keep my wallet in my pocket.

I learned that, although gambling addiction has a huge amount in common with other kinds of addiction, the stories of people addicted to gambling also have a significantly different flavour from the stories of people addicted to drugs. I am not sure that I completely grasp the flavour difference yet. I also learned that problem gambling has only recently been regarded as an addiction. 

Half a century ago, when I started researching addiction, most authorities believed that although excessive gambling could be called “problem gambling,” or a  “compulsion,” a “bad habit,” or even a “psychological addiction”, it was not a “real, physical addiction.” However now, after extended debate, countless experiments, and innumerable brain scans, most professionals regard severe problem gambling as a “real” addiction that does not differ in any fundamental way from opioid or alcohol addiction. It’s official! (See American Psychiatric Association, 2013, pp. 481-589)  

My question for today is: Does the new consensus that problem gambling is a “real addiction” actually matter? ... Or do we researchers and theorists just mess around with our professional definitions when we have nothing more useful to do? I am hoping that you will all take a minute to seriously ask yourself that question, before I tell you my own answer.

……… 

I believe that recognizing problem gambling as a real addiction actually does matter, big time! I think that this new realization will help treatment professionals to more effectively help vulnerable individuals not to gamble their lives away. Even more importantly – and unexpectedly – I have come to believe that understanding gambling addiction can shed new light on some of the most daunting political and environmental problems of our era. 

I will explain today why I think that recognition that problem gambling is an addiction can be all that important. I will begin by reviewing two themes that have I have watched slowly establish themselves in the field of addiction over the past half century. 

 After I discuss both of these themes, I will show how they can help us to deal better with individuals with serious gambling problems, and how, I now believe, they can help us to collectively understand and cope with some political and environmental crises of modern society as well (Fig. 1).

  • 1. Broadened Definition of Addiction. People can get genuinely addicted to countless activities and pursuits, not just drinking or taking drugs. Gambling is one of a very large number of so-called “behavioural” or “process” addictions.
  • 2. Addiction as Adaptation.  Addiction is neither a sin nor a disease, but a way of adapting. Addictions can be minor and temporary, but they can become overwhelming when desperate people can find no better way to adapt to unbearable alienation. 

Fig. 1. Two Emerging Themes in the 21st Century Field of Addiction.

Emerging Theme #1: Broadened Definition of Addiction

By collectively realizing that gambling problems are “real” addictions in the last couple of decades, we are not discovering something new. Instead, we are gradually re-discovering a basic fact of cultural wisdom that was somehow lost in the late 19th and early 20th centuries. In our cultural classics, the word “addiction,” in both the English and Latin languages always included addictions to religion, power, social status, gambling, love, sex, fame, wealth, work, violence, political extremism, exercise, fashion, and countless other pursuits.

 This cultural history of the word “addiction” is not controversial. It is simply a fact that linguists have long known (see definition 1a of addiction in the Oxford English Dictionary; usages of “addiction” over the centuries in the Google ngram Viewer; Alexander and Shelton, 2014; pp. 76-79, 145-157; Roberts, 2015; Lemon, 2018). Although “addiction” has been very broadly defined throughout our cultural history, that history has mostly been forgotten. Beginning in the 19th century, addiction was radically narrowed and re-defined as a problem of excess drug or alcohol use caused either by weak character or by a medically treatable brain disease. 

  1. a. The state or condition of being dedicated or devoted to a thing, esp. an activity or occupation; adherence or attachment, esp. of an immoderate or compulsive kind.

In later use freq. influenced by sense 1b

See Also: Lemon, R. (2018). Addiction and devotion in early modern England. Philadelphia, Pennsylvania: University of Pennsylvania Press

Fig. 2a Traditional Oxford English Dictionary Definition of Addiction and a current linguistic reference.

  1. b. Immoderate or compulsive consumption of a drug or other substance; spec. a condition characterized by regular or poorly controlled use of a psychoactive substance despite adverse physical, psychological, or social consequences, often with the development of physiological tolerance and withdrawal symptoms

Fig. 2b. New Oxford English Dictionary Definition of Addiction (first appeared in 1933 in the OED Supplement.)

During the historical period of the late 19th and early 20th centuries, western society constricted, moralized, and medicalized the concept of addiction (Fig. 2b). Since then we have periodically gone into collective panics about addiction to one drug or another and sorely neglected the majority of human addictions. 

This cultural constriction persists in most accounts of the current “opioid crisis” in the US and Canada. The loss of life due to opioid overdoses is real and tragic, but the situation is often portrayed as if it were a stand-alone opioid problem (see U.S. Department of Health and Human Services, 2018), out of context of the much broader problem of addiction. However, despite this and previous single-drug-focussed panics, addiction to drugs has always been, and remains, only one relatively small – but highly visible – portion of a larger tapestry of addiction, dependence, and related human tragedies that appear to be becoming more and more prevalent in the modern era. 

This becomes clear in the context of the current opioid crisis if you contemplate what is meant by the phrase “loss of life”. If “loss of life” is restricted to sudden death from overdose, today’s opioid crisis is indeed overwhelming, but this is a very narrow way of looking at life. If “loss of life” means simply death, rather than being restricted to sudden overdose death, then there is, and has long been, way more loss of life due to long term effects of alcohol and tobacco than to opioids, and the amount of suicide due to gambling and many other process addictions is huge although impossible to count accurately. If “loss of life” is defined more broadly still, to include every person whose addiction prevents them from maintaining a fulfilling productive life, then addictive loss of life is less tied to all drugs, taken together, than it is to the full range of process addictions – including gambling as well as many, many others (Sussman, Lisha, and Griffiths, 2011; Courtwright, 2019).

If we look at this grim tapestry of addictive suffering in detail we will first notice the terrible addictions that usurp people’s lives and then see that there are also less severe addictions to the same habits that people tolerate for a while without too much individual harm. You can be severely or fatally addicted to many habits, or you can be only mildly addicted to those same things, or you can engage in most of those same pursuits without any addiction at all!

We also see that, although a majority of people in the modern world get through life without becoming dangerously addicted for any lengthy period, almost all of us in the modern era know addictions personally. Most of us sometimes use various minor or short-lived forms of addiction to cope with modern life and, at one time or another, feel the fatal attraction of more dangerous and long-duration forms of addiction personally or see their effects in our families. 

David Courtwright argues in his important new book that we now live in an “Age of Addiction” (2019) to countless habits and pursuits. I think Courtwright’s book title highlights an important truth, although it obviously does not mean that addiction is the only defining feature of our age, just one of the real stinkers.

Emerging Theme #2: Addiction as Adaptation to Dislocation

The second emerging theme is the growing understanding that contemporary addicted people are not out-of-control slaves to their addiction, but are using their addictions to adapt, as well as they can, to the painful realities of modern life. The primary reason that we live in an “Age of Addiction” is that many people use addiction as a substitute for a full life that they have not been able to achieve, or as a way of escaping from an unbearable emptiness, or both. For many people, addiction is the best solution to pain and desperation that they can find, so they cling tightly to their addictions, even those that may eventually kill them.  

Although this idea is still controversial today, many variations of it are becoming accepted in the addiction literature. If you search the web for the “dislocation theory of addiction” you will find a version of it that I introduced in my book, The Globalization of Addiction: A Study in Poverty of the Spirit (Alexander, 2008/2010). However, many other writers have been exploring other versions of this theme, in their own vocabularies, for a long time (e.g., Chein, Gerard, & Rosenfeld, 1964; Peele & Brodsky, 1975; Dodes, 2011, 7-21; Hart 2013, 74-95; Hari, 2015; Fetting, 2016; Dunnington, 2017; Spofford and Kaniuka, 2019; Patel, 2019; Morgan, 2019; Preyser, 2019). Like most of our ideas about addiction, this one is not new. It was well known in ancient times, particularly in Plato’s Republic (see Alexander, 2008/2010, chap. 13) 

I cannot prove it, but, in my old age, I believe I can feel the adaptive view emerging as a dominant causal theme in many corners of today’s field of addiction, much as the earlier definitional theme has finally become the dominant way of thinking during my long lifetime. 

In fact, the emerging causal theme follows logically from the fully-emerged definitional theme. During the relatively brief historical period when society restricted addiction to a way of responding to certain “addictive” drugs it was reasonable to look for a chemical “hook” that “flipped a switch in the brain.” But now that we recognize that people can be addicted to countless activities that involve no drug use at all, and that most people can enjoy “addictive” drugs safely, there needs to be a broader explanation. And there is no reason to think that the must useful explanation must be stated in the language of neuroscience. 

Outside of the addiction world, the new causal theme is part of a broader recognition that something has gone seriously wrong with modern society as a human habitat. This recognition is recognized in medical terms within the “Social Determinants of Health” movement. This movement within the health professions and the World Health Organization, provides evidence that a great many health problems are largely caused by the distortion of social relationships associated with the fragmentation of modern society (Jetten, Haslam, & Haslam, 2011; Holt-Lunstad, Smith, Baker, Harris, & Stephenson, 2015; Allen, 2016; Monbiot, 2016a; Davis & Gonzáles (2016, esp. pp. 11-12).

If the dislocation theory of addiction is correct, it ultimately points to the daunting conclusion that today’s steadily increasing addiction problem cannot be brought under control by heroic, individual will-power, or by punishment or by harm reduction, or by medical treatment, or by psychological treatment, or by all of these together, but that it can only be controlled by making epochal changes in society itself that make it easier for people to shape their lives without needing to use addictions to withstand their desperation and anxiety. Societal changes of this magnitude can only be achieved by engaged citizen participation in family, community, national, and global transformation projects over a long period of time. 

It will be a while before the second paradigm shift is completed, because dislocation theory contradicts the still powerful 19th century view of addiction as a character flaw or wilful evil, and it equally contradicts the highly promoted 20th century brain disease theories of addiction, which hold that gambling addiction and the other addictions are caused by the effects on the brain of irresistibly addictive things, like opioid molecules that flip a switch in the brain, highly engineered slot machines that feature losses disguised as wins, diabolical schedules of intermittent reinforcement, vaping technology, sugar, and so on. 

According to these two outmoded, but still dominating popular views we can control our addiction problems either by a “war on drugs” (if it is a character flaw or willful evil) or by providing much more money for addiction treatment (if it is a brain disease). Dislocation theory suggests that both of these doctrines are simplistic.

I have centered today’s summary of dislocation theory on a portrait of Christopher Columbus looking worried. I hope you will quickly see why Columbus is the central image, and why he was right to worry.

Fig.3. The Dislocation Theory of Addiction

Of course, the modern age has spawned more immediate dangers than the rising tide of addiction, including the possibilities of nuclear annihilation and of environmental collapse, as well as gruesome daily realities of mass starvation; obscene income inequality; economic volatility; political corruption; religious fanaticism; ubiquitous electronic surveillance, news and propaganda; huge refugee populations; and seething mass resentment and apathy. Although this presentation is about addiction, I hope that it will also show how addiction is inextricably interwoven with other dangers of the modern age.

 “The modern age” or “modernity” has long been a topic of concentrated attention among historians, social scientists, and literary writers. The modern age is generally understood by historians and social scientists as the five centuries since Columbus’ voyages, although some thinkers date its beginnings somewhat later. The first couple of centuries of modernity are conventionally known as the “early modern” period, and the last couple of centuries as “late modernity”. 

I will focus on three major aspects that have been gradually increasing throughout the whole period of modernity, as it is conventionally understood:

1. Globalized markets and commercial institutions, currently including multinational corporations; financial markets dominated by global banks and enormous hedge funds; the Internet, China’s Belt and Road Initiative, and international trade agreements. Late modern corporations and institutions, and the small number of people, corporations, and superpowers who control them, have wealth and powers over ordinary people’s lives of a magnitude that were associated with Kings, Emperors, and God in early modernity (Arendt, 1968, pp. 123-304; Galeano, 1973; Phillips, 2018; Foer, 2019). These entities relate to each other in a shifting network of alliances and rivalries that we who are outside the loop can only vaguely understand. The beginnings of today’s globalized network of massive economic and political power can be traced back to the conquest of the western hemisphere beginning with Columbus. 

2. Spectacular advances in science and technology, including the technology of surveillance and thought control. Like the commercial institutions, science is globalized. There is only one periodic table of the elements for the entire world, one theory of evolution, and one “big bang” theory. Modern technology increasingly dazzles us on a global scale with the prospect of the “Internet of everything,” with computers implanted in the human body and all our convenient “devices”. Technology appears on the verge of transforming world society into a man-machine system with “artificial intelligence” and unlimited capacities for surveillance and political control (Pentland, 2014; Zuboff, 2019; Wylie, 2019)

3. (Paradoxically)…Despite the awesome power of modern commercial institutions and technology over human beings, modernity also entails ever-increasing individual freedom from traditional norms and morality (MacIntyre, 1984). It relentlessly celebrates individual achievement and flamboyant personal style, including today’s rapidly multiplying gender variants. Like the first two aspects of modernism, the celebration of individualism is a global phenomenon, as seen in the ubiquitous images of global advertising and in the globally circulated videos and games that I watch on the Internet with my grandchildren. The paradox of modernity is the contradiction of celebrating individualism in an era of unprecedented surveillance and thought control.

The principal components of the dislocation theory of addiction in the modern age are summarized below (Fig. 4). 

1. The social fragmentation of the modern age mass-produces human dislocation.

2. Many dislocated people use addiction in their attempts to adapt to their fragmented world.

3. When desperately dislocated people have no better adaptive alternative than a destructive addiction, the results are disastrous.

4. Intractable addictions ultimately increase social fragmentation and individual dislocation, completing the vicious cycle.

5. Although compassionate treatment interventions can lessen the suffering and aid in individual recovery, they cannot stem the flood of addiction, because they do not address the social cause.

6. Only epochal social change can bring the current flood of addiction under control.

Fig. 4. Summary of the Dislocation Theory of Addiction

Fragmented Society

From the time of Christopher Columbus onward, Western European powers crushed pre-modern societies and aboriginal tribes around the globe by conquest, disease, enslavement, enticement, economic exploitation, forced religious conversion, and ecological devastation of their homelands. This societal fragmentation was initially enabled by early modern advances in science and technology, like the ship’s compass, heavy gunnery, and mass production of cheap trade goods. Equally important were powerful modern ideologies that eloquently justified subduing the entire planet to increase the wealth and power of the civilized nations and the great corporations of the world (Columbus, 1505/2004; Galeano, 1973; Kinzer, 2017; MacLean, 2017). 

As the colonizing European nations fragmented societies overseas to expand their national wealth and power, they also crushed and impoverished the subcultures of their own homelands, although with somewhat more restraint. Agricultural and industrial revolutions, which accompanied and enabled global colonization, devastated stable peasant farms and commons throughout Europe (Polanyi, 1944). Refugees from this domestic fragmentation were cruelly stigmatized and economically exploited in European slums or shipped abroad to populate the colonies (Isenberg, 2016).

Although it is sometimes overlooked now, European nations also fragmented their own upper crusts of wealth and power. Rich adventurers, manufacturers, and bankers competed relentlessly to maximize their individual wealth and glory and many wound up in ruins (Galeano, 1973, 22-28, 55-56). As Viennese scholar Karl Polanyi (1944, p. 128) described early modern England, “... the most obvious effect of the new institutional system was the destruction of the traditional character of settled populations and their transmutation into a new type of people, migratory, nomadic, lacking in self-respect and discipline—crude, callous beings of whom both labourer and capitalist were an example.” 

The world-wide fragmentation of society that began in the early modern era still escalates in the 21st century. People, both rich and poor, are engulfed by the great economic, political, and bureaucratic machinery of the modern age at the expense of once-sustaining relationships with families, communities, and religions. This fragmentation has been shaped by different economic and political regimes throughout the evolution of modernity, and has been extensively documented in diverse terms: free-market capitalism; totalitarian communism; superpower rivalry for world control; ecological devastation; military bombardment of helpless populations; extreme income inequality; kleptocracy and oligarchy; mining of personal information from social media; “smart” devices and cities; imposed third world “development;” financialization with its periodic fiscal crises; corporate culture; “metacolonialism;” meritocracy; surveillance capitalism; high speed technical change; real estate bubbles and crashes; relentlessly advancing efficiency in manufacturing and agribusiness; robotization; “ludocapitalism;” “limbic capitalism;” the Internet of Everything; and the continuing plunder of the few remaining aboriginal cultures. 

Today’s continuing global fragmentation is not exclusively propagated by the original European colonial nations, but by today’s major powers and multinational corporations, as they extrapolate the ruthless lines of development that originated in Western Europe five centuries ago (e.g., Norberg-Hodge, 2018).

In late modernity, countless works of philosophy, fiction, poetry, and song lament the fragmented cultures of the poor and exploited (e.g., Charles Dickens) – but also the fragmented lives of the affluent and privileged. Think, for example, of the fiction of Dostoevsky or Kafka, or the poetry of T.S. Elliot and Allen Ginsberg as they have dissected middle and upper class life. Recent American research documents the agonizingly fragmented and bewildered lives of affluent children and young adults (Douthat, 2018; Luthar, Barkin, and Crossman, 2013; Luthar, Small, and Cicolla, 2018; Aviv, 2019; Packer, 2019) 

Modernity creates highly visible economic inequality and environmental devastation, but the focus of my presentation is social fragmentation, at all levels of society. Beneath the steamroller of modernity, nuclear families become dysfunctional; extended families and communities are scattered; local cultures, economies, and nations are pulverized; legitimate authority is toppled, religious and moral traditions are flattened; and traditional arts are reduced to mass-production of trinkets from the cultural rubble for the tourist shops. People and social groups that do not contribute to the advance of modernity are marginalized, excluded, or exterminated (Norberg-Hodge, 2018; Guilluy, 2019). 

Societal fragmentation may have once seemed a necessary economic foundation for the modern miracles that have enabled the earth to support eight billion people and five billion cell phones. But this miraculously modern world society is in deep – possibly terminal – trouble. This trouble comes, in large part, from the diverse side effects of fragmentation. For today’s presentation, the most important of these side effects is the mass dislocation of individual human beings and, in its trail, mass addiction.

Mass Dislocation of Individuals

I use the word “dislocation” to designate the psychological malaise that follows from societal fragmentation. Fragmentation destroys the traditions, certainties, and institutions that have supported people’s peace of mind and have helped children to mature into confident, secure, and compassionate adults. The genius of well-functioning societies in the past has been to produce people who have an encompassing sense of belonging and morality, yet still feel free and powerful (Erikson, 1963). However, that psychosocial integration has become ever more difficult to achieve. As fragmentation spreads globally, dislocation afflicts people everywhere. 

Dislocation is so now so widely recognized that it has inspired a profuse vocabulary. For example, psychologists speak of lack of attachment, belonging, identity, meaning, and purpose leading to disorders such as depression, anxiety, and loneliness. Sociologists speak of the alienation, atomization, disempowerment, and resentment of individuals facing the hegemony of large bureaucratized societies. Political scientists speak of the economic poverty, unrealized expectations, powerlessness, and exclusion experienced by marginalized segments of the population that find no place in the high tech modern world. Christians speak of the poor in spirit and lament the decline of faith and morality the modern world. Existentialists describe feelings of anxiety, dread, absurdity, helplessness, despair, loneliness, existential void, and nothingness in meaningless societies. Evolutionary biologists speak of failure to satisfy the innate social needs of the human species in modern times. Dislocation has not yet been adequately described in the language of neuroscience – but it surely will be as the current official view of addiction as a behavioural brain disease gradually loses its paralyzing grip on neuroscientists (see Heilig, Epstein, Nader, & Shaham, 2016; Venniro et al., 2018). 

Dislocation is painfully obvious in the poor, the homeless, the wandering refugees of today’s world, and in working people who are exploited or marginalized for economic reasons (Case & Deaton, 2017, 429-434; Guilluy, 2019; Bowles, 2019; Orford, 2019) – but dislocation is not confined to them. It afflicts every stratum of world society. Dislocation devastates the affluent and powerful, as well as the poor (e.g., Kozol, 1985, pp. 40-43; James, 2007; Luthar, Barkin, & Crossman, 2013; Powell, 2016; Mayer, 2017, esp. chap. 2; Curran and Hill, 2017; Han, 2015; 2017; Brand, 2017, pp. 13-41; Luthar, Small, & Cicolla, 2018; Solnit, 2018; Douthat, 2018; Zuboff, 2019; Rushkoff, 2019; Packer, 2019).

One touching story about mass dislocation describes affluent Japanese people sometimes hire actors to stand-in for long lost spouses, friends, and relatives in everyday family events and in important rituals like weddings, funerals, and welcoming new babies into the world. These practices are documented in a recently published article (Morin, 2017). The man fondling his new baby in Fig. 5 is an actor. The illusion is illustrated by picturing him in black-and-white.

Fig. 5. “Renting Friends and Family in Japan” (Morin, 2017) Photo credit: Atlantic Magazine

Mass dislocation has come to seem inevitable. The modern market system and superpower rivalry requires that individuals must perform ever more efficiently, unimpeded by sentimental ties to families, friends, religious values, or norms of compassion. Children must be prepared for a life of cutthroat competition. Since they are too young to comprehend this, their parents must push them relentlessly to acquire competitive skills, presumably for their own good (Packer, 2019). We expect our politicians to produce “economic growth” and to “create jobs” at all costs. Stringent economic rationality is said to make the law of supply and demand function efficiently, and thus to “clear the markets” each day. China, India, Brazil and other nations that have joined the global market economy of the superpowers are paying the price in surging dislocation – and addiction. 

Dislocation can be rightly understood in a positive light, as providing a space for creative freedom for people who have felt stifled or oppressed by traditional, close-knit societies (Han, 2017, chap 13; Bruder, 2017). However, prolonged, radical dislocation ultimately generates misery in most people. In fact, prolonged dislocation is so unbearable for most people that it has been imposed as an extreme punishment from ancient times to the present. Punishments like ostracism, shunning, and excommunication, are, in essence, imposed dislocation. Radical social isolation, including solitary confinement, is an indispensable part of today’s terrifyingly scientific technology of torture (Klein, 2007, chap. 1).

 Dislocation” resists quantitative measurement. For example, psychologists like myself may speak of dislocation as lack of attachment, connection, identity, meaning, and purpose. But can a strong identity make up for a weak sense of purpose? Can a strong sense of attachment and belonging make up for other lacks? How are dislocation, attachment, belonging, identity, meaning, and purpose measured? I cannot answer these questions very well. Nonetheless, dislocation – under its various names – has long been recognized by the most renowned observers of the modern era. When I speak about dislocation to audiences in various parts of the world, people know what I am talking about. Many tell me their own dislocation stories after the presentation is over.

Flood of Addictions: Addiction as an Adaptation to Dislocation

Just as individual dislocation historically follows fragmentation of a society’s traditions and institutions, a flood of addiction problems historically follows dislocation. Extensive historical, anthropological, and clinical evidence documents this predictable sequence (Dodds, 1965; Hughes, 1987; Samson, 2003; Bayly, 2004; Case & Deaton, 2017, pp. 429-434; see review in Alexander, 2008/2010, chap. 5).

Addiction follows dislocation because addictions can bring dislocated people some relief and compensation for bleak, empty lives, when nothing else is working for them. Addictions can be adaptive in a fragmented, modern world because – in psychological terms – severely dislocated people can use addictions to obtain some morsels of attachment, belonging, identity, meaning, and purpose, at least in the short term (Alexander 2008/2010: chaps. 6-8; Dodes, 2011; Hart 2013: 74-95; Hari, 2015; Fetting 2016; Dunnington, 2017; Spofford & Kaniuka, 2019; Morgan, 2019). Without their addictive identities and their connections in the addict subculture, many dislocated people would have terrifyingly little reason to live, and would risk incapacitating anxiety, depression, or be drawn towards suicide. Addictions of all sorts threaten to become universal because they help masses of dislocated people to survive in a fragmented world.

 For example, opioid drugs, including heroin as well as prescription drugs, provide real relief for the physical and psychological pain of dislocated people. It is not hard to understand why many people depend on opioids for relief in the modern, dislocated, stressed-out world. The great majority of opioid users do not become addicted (Alexander, 2008/2010, chap. 8; Satel, 2018) and if they do, they do not become severely addicted or remain addicted for very long (Heyman, 2009; 2019; Morgan, 2019).

However, there are many people who endure intractable, crushing dislocation for extended periods, no matter how they try to overcome it. For them, opioid addiction – not just opioid use or even opioid dependence – can provide a desperately needed, irreplaceable, substitute for what is missing.  

When people who are severely addicted to opiate drugs wake up each day, at least they know who they are and what they must accomplish that day. Rather than being devastated by unbearable emptiness, they keep frantically busy chasing drugs and interacting with other drug chasers within a loose community of drug addicted people. At the same time that opioid addiction gives people a purpose, it can enhance their identity and self-esteem by symbolically linking their forlorn lives with fascinating stories of opioid-addicted celebrities like William S. Burroughs, Sid Vicious, Curt Cobain, Phillip Seymour Hoffman, Amy Winehouse, Michael Jackson, Robin Williams, Prince, or Carrie Fisher (Pryor, 2003; O’Donnell, 2018). The enhancement of self-esteem is not entirely unwarranted: Heroin addicts know that it truly takes courage to become a regular, injecting user of the world’s most feared drug. Fentanyl users know this even better (see Willie, 2018)

With the assistance of indigenous colleagues, I have personally studied the deadly outbreak in harmful addictions to alcohol, opioids, and other drugs in the native people in my area of Western Canada that followed the fragmentation of their tribal cultures and consequent mass dislocation imposed by British colonization (Alexander, 2008/2010, chaps. 5, 6). Unfortunately, the tragedy of the modern colonial fragmentation and dislocation of aboriginal people, followed by mass addiction, is not restricted to Canada, but has been repeated on every continent (Bayly, 2004; Mann, 2011).

The historical relationship between loss of employment, dislocation, and the current “opioid crisis” has been well documented among the descendants of the white colonizers of North America as well as the colonized natives (e.g., Quinones, 2015; Case & Deaton, 2017), but the opioid crisis is only one aspect of a more encompassing addictive response to modern dislocation, that does not spare the employed and affluent. 

Methamphetamine addiction provides another contemporary American example of the effects of fragmentation and dislocation on addiction. An American methamphetamine panic broke out at the end of the 20th century in the US.  The surge in methamphetamine use and addiction was explained as the work of an irresistibly addictive drug. Some champions of the familiar story announced at the time that methamphetamine was “more addictive than crack cocaine” – at a time when crack was thought to be “instantly addictive.” 

Then, deeper thinkers showed why methamphetamine was spreading so fast and why the spread was concentrated in the farming states. Mass dislocation had emerged in the American farming states following legislation and immigration practices that destroyed what had remained of the traditional American family farm culture (Berry, 2002, p. 40-44). Large numbers of dislocated former farmers and dislocated workers from meatpacking and other agricultural industries had appeared in a region with abundant farm chemicals that could be converted into methamphetamine. Dislocated people could use methamphetamine as a “party” drug in a way that raised their spirits and gave them some friends. This unfortunate combination of events produced a devastating increase in methamphetamine use and addiction in the American farm belt, a region that was later nicknamed “Methland” by one investigative journalist (Reding, 2009; see also Alexander, 2011).

Similarly, addiction to fanatical political movements and religious cults can provide alternative lives of ritualized virtue and spirituality for people who suffer from prolonged dislocation (Arendt, 1968, 312-324; 474-479; Mishra, 2017; Helmore, 2019). Addictive use of social media can provide compensation for people who are experiencing exclusion or marginalization from society (Zuboff, 2019, pp. 30-37, chap. 16). 

I now see that dislocation theory applies equally well to gambling addiction. Many dislocated people use horserace gambling addictively to colourize their otherwise bleak lives.  They exchange information and hunches at the track with a subculture of track habitués, and share a mythology of famous gamblers and legendary horses (Ryan, 2014a, b). 

Stories about casino and on-line gambling addiction have a slightly different flavour than stories about drug addiction. People who gamble addictively on slot machines, roulette tables, or the Internet do not seem to seek human social interaction so as much as a “zone” of intense engagement with dazzling gambling machines that have been ingeniously designed to be interactive and seductive, without having the annoying qualities of actual human beings (Ross, 1987, pp. 232, 234; Schüll, 2012; 2015; Dixon et al., 2017). Many people addicted to gambling, whether at the track, the casino, or online, are too under-confident to achieve real political or economic power but crave the excitement and “action” that comes with handling large sums of money. They can feel creative, important, and powerful – like movers and shakers – even as they are losing everything (Dostoevsky, 1866; Ross, 1987, pp. 196-199, 295; Larcombe, 2017). These addicted people cannot be helped by lectures on the odds against winning money in the casino: Winning money is not the most important reason why they are there. 

Here is my personal uncertainty of today. Is there a difference between the adaptive value of addictive drug use and the adaptive value of addictive gambling? Johann Hari, in his global best seller, Chasing the Scream (2015), was speaking primarily of drug addiction when he coined his famous phrase that “the opposite of addiction is connection.” But is that exactly true of gambling addiction, or is its function slightly different from the function of drug addiction? Perhaps the opposite of gambling addiction is more like a feeling of importance, excitement, bravery, or power. These essential feelings, like the feeling of social connection, are also undermined by fragmentation of society and dislocation before a person becomes addicted to gambling. 

I am intrigued by a story that I heard from a long time gambling addict. The story concerns two men who were addicted to both alcohol and to gambling. Both found devoted wives and both gave up alcoholism very quickly after marriage. But both continued addictive gambling. One of the two is still addicted to gambling, although he has found an ingenious way to gamble every day without disastrous financial losses. Did their marriages provide some kind of “connection” that made alcohol addiction unnecessary, while leaving a hole in their sense of  “importance” that gambling addiction partly fills?   

People who are not too seriously dislocated can use drugs, associate with cults, gamble, or engage in other potentially addictive practices without serious risk. They have reasonably full lives already, and they can safely use such practices for adventure, recreation, and escape. Even if they become addicted for a time, they leave their addictions behind when it is time to get serious (see arrow #2, Fig. 3). However, there are millions of people whose dislocation is so desperate that they build their lives addictively around drugs, gambling, cults, or other potentially dangerous pursuits, because they have no more effective foundation for a full life (see arrow #3, Fig. 3). 

When severely dislocated people find that an addictive lifestyle provides their best hope for enduring and colourizing their existence, they hold onto it with the same iron grip with which they would seize a piece of floating junk in a stormy sea. Quite often, they seize more than one piece of junk and have multiple addictions that I call an “addictive complex” (Alexander, 2008/2010, chap. 9; Sussman, Lisha, and Griffiths, 2011).

Saying that harmful addictions are adaptive, does not entail denying that severe addictions can have horrible consequences. But it does entail denying both the moral and medical theories of addiction – the story that addicted people are willfully wicked and the story that addicted people have lost their will power and are acting maladaptively because of a brain disease. Adaptation is neither a sin nor a disease.

All of our human ancestors successfully adapted to their environments behaviourally, as well as anatomically and physiologically. We have inherited our adaptive capacities from them. The ability to become intensely devoted or dedicated to a particular habit is one of these adaptive capacities.

To speak of addiction as adaptive is also to deny that there is a categorical distinction between those who are addicted and those who are not. Like many familiar adaptations, there are degrees of addiction, and all of them can help people to endure, at least for a time. When addictions are mild or short-lived, as they most often are (Lopez-Quintero et al., 2010; Heyman, 2009, chap. 4; 2019;), they can help people to get by until they can move on to more socially integrated lives. 

Merchants understand that great numbers of dislocated people are drawn to addictive experiences precisely because they are addictive. Why else do they proclaim the alleged addictive qualities of their wares in their advertising? Self-proclaimed “addictive” products can include videogames with millions of players (Fig. 6), a highly popular sitcom on British television (Fig. 7), diet cookies (Fig. 8), hair salons (Fig. 9), and practically anything else.

Fig. 6. Addictive Games

Fig 7. A Popular British Sitcom

Fig. 8. Nonni’s Cookies

Fig. 9. “Chemically Addicted Hair” Vancouver, BC

Addictions, in the traditional Oxford English Dictionary definition (1a), can be also utilized adaptively for purposes unrelated to dislocation. Many students and academics, for example, know about the binges of overwork that are sometimes required to complete assignments, term papers, theses, dissertations, research projects, and books. These minor episodes of addiction often temporarily disrupt other important aspects of the person’s life, such as their family, their health, and their economic security, but this is a price that it can make sense to pay. 

Although addiction can be adaptive and sometimes even essential, it is also like many other forms of adaptation that can become harmful or fatal if overworked by individuals who have no better way of adapting to a long-term stressor. In the so-called “diseases of adaptation,” physiological or behavioural adaptive systems become dangerous when they are either worked to exhaustion (Selye, 1950) or when they overreact to threats (Angeli, Minetto, Dovio, and Paccotti, 2004).

Consequences of Severe Addiction: The Cycle Continues 

Up to this point, I have emphasized that people cling too long to their addictions when they are the best adaptations to dislocation that they can find. People also may cling to addictions like work and achievement that are actively encouraged by modern society (Weber, 1920/1958). Consumer products that lend themselves easily to addictions are also actively marketed by corporations in the interest of profits (Courtwright, 2019). 

There is, however, yet another important reason why the tide of severe addiction continues to rise in the modern era. Many long-term addictions not only harm the addicted person, but also further fragment an already fragmented modern society, thereby increasing the mass dislocation. Increased mass dislocation then makes more people vulnerable to addiction. The fatal feedback loop takes yet another turn (See arrow #3 in Fig. 3). 

Some fragmenting societal consequences of addiction include: 

1. Environmental and social destruction mandated by wealth and power addicts pursuing profits in multinational corporations, investment banks, hedge funds, and organized crime (Slater, 1980;  James , 2007, pp. 3-12; Polk, 2014). Wealth and power addicts deliberately subvert governments through their lobbyists, lackey politicians, think tanks, and “economic hitmen” (Perkins, 2016; Mayer, 2017; MacLean, 2017). Some rich addicted people appear to be addicted not only to wealth and power, but also to gambling in a global casino in which the “chips” include human lives and irreparable planetary damage as well as money. For example, Donald Trump has been described as a “gambler” by some close observers (Crowley, 2016; Benko, 2017; Khrusheva, 2018; NJ Online Gambling, undated), although derogatory labels applied in the current overheated political climate must of course be carefully checked. 

2. Environmental destruction caused by shopping addiction, hoarding, overeating, and wasteful consumption by hundreds of millions of more-and-less severely addicted consumers (James, 2007; Courtwright, 2019); 

3. Family and community fragmentation produced by all the talented people who die or are lost to healthy family functioning and productive work because of severe addictions, incomplete recoveries, suicides or overdose deaths (Woolf & Shoomaker, 2019); 

4. Social insecurity in local communities produced by the overt criminal acts by addicted people supporting their drug or gambling habits and violent gangs supplying the drugs;

5. Mass distraction from civil responsibilities in people addicted to social media, exacerbated by their manipulation by targeted fake news and advanced behaviour modification technology delivered on their cell phones to manipulate elections (see Zuboff, 2019; Wylie, 2019);

6. The loss of the wisdom of elders who cannot contribute stabilizing wisdom to succeeding generations because they are too addicted to television, bingo, slot machines, home remodelling, Sudoku, prescription drugs, or whatever.

7. The rise of dangerous political and religious mass movements among addicted zealots who have been excluded from civil society. Hannah Arendt analysed this tendency among fascist and totalitarian zealots in her classic Origins of Totalitarianism (1968, pp. 312-324; 474-479). Pankaj Mishra analysed the zealots of murderous political and religious revolutionary movements in late modernity his Age of Anger (2017, pp. 75-79). In the case of the United States, an extreme “populist” movement has helped to transform what was once a beacon of democracy into a laughingstock of corruption and incoherence within my lifetime. How can the collapse of American political integrity not mass-produce dislocation among Americans and their allies in other countries? (Goldberg, 2019; Siegel, 2020) 

Because severe addiction, including gambling addiction, exacerbates societal fragmentation, it is much more than just one of a few hundred disorders that the latest DSM warns could afflict us, and more than just one of dozens of “process addictions” to watch out for in our own lives. Addiction is a major social challenge to modern civilization itself because it is not only a downstream adaptation to societal fragmentation but also an upstream cause of fragmentation. Addiction is built into modern, global society structurally. It is self-propagating and socially destructive. 

Do you think I am exaggerating the danger of addiction? If so, I hope you are right. When you think this over, however, please bear in mind I am not arguing that addiction is the sole cause of the structural weakness of modern civilization, because there are many other problems as well. But I am arguing that understanding addiction is an important analytical tool for understanding what is going wrong.

Can We Better Control the Problem of Gambling Addiction in View of The Two Emerging Themes?

1. Individual Treatment. Addiction therapy is hard, labour-intensive work and it is being undertaken everywhere with devotion and good will. Many diverse kinds of therapy have proven successful with some people who are addicted to just about everything, but all of them together are not bringing the problem under control. If the dislocation theory of addiction is correct, there is hope for doing therapy more effectively, but no realistic hope that therapy will ever bring the problem under control until fragmentation and dislocation can be reduced.

The broadened definition of addiction and the dislocation theory of addiction lead to a clearer view of how therapy works. For example, nothing that a professional counsellor can tell a gambler about financial risks is likely to help. In fact, most gambling addicted people understand the odds of winning far more realistically than the people who lecture them about it. They are not gambling to win, but for the “action” or to get into “the zone,” and feel a sense of power, as a compensation for the full lives they desperately need, but do not have.  They do not need to be told that they can’t win an obviously unwinnable game in the long run.

But people addicted to gambling (or to anything else) desperately do need to find a less destructive form of “action,” because the opportunities for “action” and participation in “the zone” of important civic and economic matters in society is normally reserved for people who have more confidence and specialized education than they do. Recovery requires finding a way of meeting this challenge that is more engaging and less destructive than gambling addiction. Helping gamblers to “get a life” that will be a satisfying alternative to their addiction is possible, but extremely difficult. 

Addicted people can be helped to acquire functional and engaging lifestyles by family, friends, and professionals who support them and give them good advice, if the advice-givers understand that their good ideas might not be acted upon right away. New lifestyles can be nourished in recovery houses where people are encouraged to develop connections and social skills in cooperation with other recovering people. More and more treatment of this beneficial sort is going on within the burgeoning “recovery movement.” Gamblers Anonymous and other twelve-step groups have long served a similar function.

But, notwithstanding the dedication of the people and groups who do the arduous work of addiction treatment, and notwithstanding the many genuine success stories that can be recounted, addicted gambling addiction cannot be brought under control by treatment alone. In my opinion, individual treatment is not the most important contribution that professionals can provide to relieve the terrible problem of gambling addiction. 

We who do treatment work are uniquely placed to make an important contribution. We need to become humble enough to tell the world that there is no treatment for addiction that succeeds more often than it fails and that many addicted people refuse to accept our treatment offerings, even when they are free of charge. No matter how much money you give us counsellors and therapists, we cannot control the scourge of addiction on a societal level. We have long hoped that this situation would change as medical and neuroscience research on addiction progressed, but it has not, even though there has been a steady stream of loudly proclaimed miracle cures, from the 19th century to the present day (White, 1998; Leung, 2019). 

As the new themes emerge in the field of addiction, we are gradually coming to see why addiction treatment can never be more than marginally effective. It is because there is no “brain disease” or “disorder” of addiction to be cured! There are just desperate people struggling to adapt to a fragmented society in the best ways they can find. Adaptation is neither a disease nor a disorder.

When we do not succeed as therapists, there remains the alternative of supporting people who are willing to define themselves as victims of a chronic, relapsing disease and willing to remain in treatment or a self-help group indefinitely. Whether they really have a disease or not does not matter too much in such cases, because sometimes this belief is a helpful fiction for managing a severely addicted person when nothing else works. In the case of many medical treatments and 12-step groups, many people able to retain the adaptive benefits of the addict identity as long as–ironically–they are willing to give up drinking or gambling! They can also maintain a place in the culture of other “recovering” people. But, however many individual lives it saves, even this last-ditch strategy can never solve the growing addiction problem in the modern world.   

2. Gambling Regulation. Addiction professionals can help to make gambling addiction less accessible to dislocated people. I think we should actively advocate for gambling policy changes, in our roles as experts. Speaking as experts, we can influence enlightened politicians to ban seductive advertising for gambling, to keep money machines out of casinos, to prevent credit card use for on-line gambling, and to effectively keep people from casinos after they have requested “banning.” 

More fundamentally, if we can find the courage, we can advocate banning casino and online gambling altogether! There is nothing at all wrong with gambling as a form of recreation, but who actually benefits from gambling machines and table games that are available all night long on-line and in casinos?  The devices are designed by expert psycho-engineers and computer experts to suck as much money as possible out of vulnerable people (Schüll, 2012, 2015; Courtwright, 2019). There is no real hope that people who make their living running casinos will not eventually try to bleed their addicted customers dry. After all, running a casino is a competitive business and the iron laws of the competitive market apply. Profits must be maximized. Shareholder value must be increased. 

Can casino and on-line gambling serve any important function that cannot be served by all the forms of recreational gambling? The answer seems a perfectly obvious to me: Of Course Not! I am convinced that commercial gambling should be prohibited entirely. But, maybe I am missing something here. I dearly hope you who understand gambling better than I do will tell me if I am overlooking something, before I publish this speech and become a laughing-stock. 

I do not see how commercial gambling can be defended by saying that it keeps taxes down. Surely, people who are economically secure – including retired people like myself with a decent pension – do not need to keep our tax rate a few percentage points lower by sucking the money out of desperately dislocated people at government-licenced casinos. We know that most of the profits from gambling come from a very small number of players. How can we maintain our own self-respect when we allow our governments to enrich us by exploiting desperate human beings?

Unfortunately, laws restricting or prohibiting commercial gambling have only a limited potential to control the addiction problem. Many dislocated people will find high stakes non-commercial gambling possibilities that will feed their addictive needs. Moreover, less addiction to commercial gambling could well mean more addiction to other kinds of addiction that are almost as dangerous to individual and family survival. Like treatment, prohibiting commercial gambling can help a bit, but it can never bring the problem of addiction under control, because it does not address the root cause.

3. Psychosocial Integration. The real necessity, in view of the two emerging themes in the field of addiction, is to transform society so that it nurtures psychosocial integration for many more people. Society cannot thrive if it causes an ever-rising flood of dislocation that makes huge numbers of us vulnerable to addiction to countless habits and pursuits that are accessible to us – especially those that have been designed by experts to addict us. As I have tried to show earlier, the spread of addictions is not only undermining us individually, but also contributing to the destruction of our societies!

I am not presumptuous enough to believe that I have a ready formula for making world society more engaging and nurturing, even though I am convinced that it is one of the essential tasks of our day. I do know for sure, however, that it is essential to disagree loudly with one dogma of pop morality that has been championed by many people recently, including world-famous psychologist, Jordan Peterson. Peterson’s best selling book, 12 Rules for Life, states that achieving well-being in the modern world requires that you “Set your house in perfect order before you criticize the world” (Peterson, 2018, rule #6, p. 147).  But achieving “perfect order” in life is too hard for mortal human beings, especially if they live in a fragmented world. The menacing problems of the world will not wait until we solve the impossible challenge of putting our individual lives in perfect order. We must confront the problems of our lives and of our societies at the same time.

I am also convinced that it is absolutely necessary to accept that the Cold War is over. During the long Cold War decades it was possible to believe that global well being depended primarily on accepting capitalism (and destroying socialism) or accepting socialism (and annihilating capitalism). Many people are still proclaiming versions of these simplistic battle cries (see Mayer, 2017, 446-448). But it is now perfectly obvious that all countries are mixed economies and that the most flourishing countries have pragmatically adopted institutions of both capitalist and socialist types (Børge, 2020). Successful social transformations often require fresh innovations and artful reconciliation of capitalism and socialism (Diamond, 2019). 

Although I have no final plan for re-organizing society to submit to you today, I do have sources of inspiration to share. First, I am inspired by Gregory Baum (2006). He might seem an unlikely source of inspiration for me, because he is a Catholic theologian. I am neither a religious person nor about to become one. Nonetheless, I found wisdom in Baum’s theology as well as his secular scholarship.

Beneficial social change cannot be achieved if we think like gamblers who predicts football games, or like underwriter who predict accidents. Sports gamblers and underwriters make their livings by anticipating that unchanging human motivations and abilities will lead to roughly the same outcomes in the future that they did in the past. However, Gregory Baum (2006) points out that the human capacity for unforeseeable kinds of creative thinking expands at times when everything seems hopeless. Baum used the history of the prophet Isaiah to illustrate his point.

Gregory Baum’s writing has inspired me to take notice of the many indications that modernity is now rapidly losing its once unassailable credibility even among those who have benefitted from it economically.  The dominant form of globalized, contemporary modernity is not the “end of history” (cf. Fukuyama, 1992). On the contrary, history may soon record the end of a stifling commitment to the worn out ideas of modernity and the emergence of a new creativity that may confront some of the worst problems of the late modern era in new ways. A transformation in creativity of this sort apparently occurred following the fall of the Roman Empire (Fallows, 2019).

I am particularly inspired by 16-year-old Greta Thunberg, as well as a whole string of other brilliant twenty-first century ecological thinkers (e.g., Klein, 2014, 2017) who recognize that society must be reorganized fundamentally if it is going to survive ecologically. I think the social re-organization that will be needed to reduce addiction will be intertwined with the economic re-organization that can, and must, avert ecological catastrophe. The necessity of social reorganization is not yet as obvious as the need for economic reorganization, however. 

The social re-organization that may quell the rising flood of addiction cannot focus exclusively on disadvantaged and marginalized people. The problem is much bigger than that. The desperate dislocation that leads poor people to ruin their lives and blow up their family’s future with alcohol, drug, and gambling addictions (e.g., Case & Deaton, 2017) also plagues the boardrooms of great corporations and the war rooms of nuclear superpowers where some of the participants pursue wealth and power addictively. For high stakes wealth, power, and gambling addicts, the “action” is not just reckless risk-taking with their own lives but reckless risk-taking with the survival of the planet and the people on it (see Slater, 1980; Mayer, 2017; Spalding, 2019, esp. 201-202). These same dislocation-fuelled addictive passions are also at work in the shopping malls where some of the affluent consumers frantically buy up the latest plastic consumer goods, even thought they know that each will produce a trillion micro-shards of plastic to pollute our oceans and grind away our collective self-respect as responsible human beings.

But how can we organize a modern society that will not generate the dislocation – among the rich as well as the poor – that feeds the addictive passions that are causing so much harm? How can we make a world that is fit for habitation by non-addicted people? Obviously, the answer must start with devoted care of our own families and neighbourhoods. I am approaching 80 years of age, but I am not yet old and wise enough to go much beyond that answer yet.

However, I am further inspired by recent writings of a British-Swedish author, Helena Norberg-Hodge (2018). The key word in her paper is “Localization”. She shows that local control by relatively small groups of people over many aspects of economy and culture can and must be restored. Localization is a formula for overcoming dislocation – i.e., for nurturing both “connection” and “importance,” – as well as achieving economic justice, democratic government, and ecological restoration. The challenge of restoring local control in a globalized world is enormous, but millions of people, grass roots organizations, local governments, and businesses are boldly accepting this challenge even in the current atmosphere of despair. Countless other current thinkers are making similar arguments (e.g., Bollier, 2014; Boyd, 2015; Fallows & Fallows, 2018) and I see energetic localization all around me, even on the little island where I live. However, I think Norberg-Hodge is expressing this principle with the greatest scope and clarity. I hope you will take a look at the short article of hers that I have cited. 

The counterforce against localization comes from the ever-expanding political power of large corporations, and the national governments that they have captured. The solution is that local action groups must coalesce into international educational and political groups that are large enough to change the political system.

 Norberg-Hodge introduces the paradoxical idea that might be called the “globalization of localism.” This empowerment of the local on a global scale is happening everywhere, and we are all invited to participate. We cannot say in advance exactly what we will be doing. There is no algorithm for the coalescence of thriving local groups into a viable global community; it has to evolve from the bottom up. 

The people who are working everywhere to localize need our help, even if the end point is unclear. And they most definitely need the help and energy of the people who are busily losing their economic security and self respect right now, in the casino down the hall from this meeting room. Participating in social change can give people meaning in their lives that makes addiction unnecessary. Saving the world can be therapeutic! Can we imagine a new generation of addiction counsellors whose primary task is making people aware that the real “action” of the twenty first century is saving modern civilization from catastrophic excesses by greater engagement with their own families and local communities?

In my mind, this idea has everything to do with helping my relative who gambled away his condo. Do you think I can help him recover from his gambling addiction by somehow helping him to see where the real “action” is?

But the dream of localization has its limitations too. Some problems cannot be controlled by small communities, no matter how many of them come into being, and no matter how enlightened they are and how they strive to link up. Bringing addiction under control requires, in addition to local initiatives, a coordinated and clearly-stated plan to control the globalized entities that mass-produce fragmentation, dislocation, and addiction. The missing link in controlling problems like these is not technological. The knowledge of how to organizing a less fragmenting society lies closer to the heart than the brain. The problem is the absence of moral structures and plans that can and will control the corporations and superpower rivalries that stand in the way of a massive social effort. History shows that the “free market” and its “libertarian” supporters are not about to provide the solution any better than governments (Mayer, 2017; MacLean, 2017). 

The crisis of addiction, including gambling addiction, requires an unprecedented global political transformation of similar scope to the one that is required to overcome the climate crisis. This global transformation must overcome the fragmentation, dislocation, and addiction that have proven to be intrinsic to the modern age. Where will this global transformation come from? What will it look like? How will it be interwoven with the solution to the climate crisis? What will be its moral foundation? How can this kind of a transformation be achieved in a world currently dominated and distracted by superpower rivalry, insatiable corporations, billionaire oligarchs, and cybermanipulation of our minds? How can we not tremble in terror of the totally unknown future? The final answers must come from people far wiser than me, and many are hard at work, as we speak, seeking them. But, so far, they continue to disagree, often diametrically, on which direction we should take to search for the solution. And some of them are still fighting the Cold War! So I cannot finish this presentation completely without yet another inspiration. I will keep searching for it. I hope you will too.

Alexander, B.K. (2008/2010). The globalization of addiction: A study in poverty of the spirit. Oxford, UK: Oxford University Press.

Alexander, B.K. (2011). A Train trip through Methland. Retrieved Sept 28 2019 from brucekalexander.com.

Allen, L. (2016, August 4) Beyond drugs: the war on lifestyle disease needs new tactics. The New Scientist, 231, 3085. Retrieved August 5 2016 from https://www.newscientist.com/article/2099950-beyond-drugs-the-war-on-lifestyle-disease-needs-new-tactics/?utm_medium=Social

American Psychiatric Association. (2013). DSM-5: Diagnostic and Statistical Manual of Mental Disorders (5th Edition). Washington, DC: American Psychiatric Association. 

Angeli, A., Minetto, M., Dovio, A., and Paccotti, P. (2004). The overtraining syndrome in athletes: A stress related disorder. Journal of Endocrinological Investigations, 27, 603-612.

Arendt, H. (1968). The origins of totalitarianism (2nd Ed.). New York, New York: Harcourt. (Original Work published in 1951).

Aviv, R. (2019, April 8). Are psychiatric drugs given out too freely? The New Yorker, 40-51.

Baum, G. (2006). Religion and alienation: A theological reading of sociology (2nd Ed.). Ottawa, Ontario: Novalis.

Bayly, C.A. (2004, April 4). The Birth of the Modern World, 1780 - 1914. Oxford, UK: Blackwell.

Benko,   (2017). Meet Donald Trump, Riverboat Gambler. Forbes. Retrieved 2 December 2019 from https://www.forbes.com/sites/ralphbenko/2017/04/04/meet-donald-trump-riverboat-gambler/#473e815954c1

Berry, W. (2002). The art of the commonplace: The agrarian essays of Wendell Berry. Berkeley, California: Counterpoint. 

Bollier, D. (2014). Think like a commoner: A short introduction to the life of the commons. Gabriola Island, BC: New Society Publishers.

Bowles, N. (2019, March 23). Human Contact is now a Luxury Good. The New York Times. Retrieved March 24 2019 from https://www.nytimes.com/2019/03/23/sunday-review/human-contact-luxury-screens.html 

Børge, B. (2020). This European country is a model for all the world. World Economic Forum. Retrieved 16 January from https://www.weforum.org/agenda/2020/01/the-new-nordic-model/

Boyd, D.R. (2015). The optimistic environmentalist: Progressing towards a greener future. Toronto, Ontario: ECW Press.  

Brand, R. (2017). Recovery: Freedom from our addictions. New York, NY: Henry Holt.

Bruder, J. (2017). Nomadland: Surviving America in the Twenty-First Century. New York, NY: Norton. 

Case, A. & Deaton, A. (2017, Spring). Mortality and morbidity in the 21st century. Brookings Papers on Economic Activity. 397-476.

Chein, I., Gerard, D.L., Lee, R.S., & Rosenfeld, E. (1964). The road to H: Narcotics, delinquency, and social policy. New York: Basic Books.

Columbus, C. (1505/2004). The book of prophecy edited by Christopher Columbus. (Roberto Rusconi Editor, Blair Sullivan Translator). Vol. 3 of Reportorium Columbianum (Geoffrey Symcox, General Editor). Eugene, Oregon: Wipf & Stock.

Courtwright, D.T. (2019). The Age of Addiction: How bad habits became big business. Cambridge, Massachusetts: Harvard University Press.

Crowley, M. (2016, February 14). The ‘Whale’ that nearly drowned the Donald. Political Magazine. Retrieved Dec. 10 2019 from https://www.politico.com/magazine/story/2016/02/japanese-gambler-donald-trump-213635

Curran, T., & Hill, A. P. (2017, December 28). Perfectionism is increasing over time: A meta-analysis of birth cohort differences from 1989 to 2016. Psychological Bulletin. Advance online publication. http://dx.doi.org/10.1037/bul0000138

Davis, J.E. & Gonzáles, M. (2016). To Fix or to Heal: Patient care, public health, and the limits of biomedicine. New York: New York University Press.

DeLisi, M. & Wright, J.P. (2019, Summer). Behavior matters: Why some people spend their lives in poverty and social dysfunction.  City Journal. Retrieved September 30 2019 from  https://www.city-journal.org/behavioral-poverty?utm_source=City+Journal+Update&utm_campaign=80ba8ae6d7-EMAIL_CAMPAIGN_2019_09_27_07_32&utm_medium=email&utm_term=0_6c08930f2b-80ba8ae6d7-109361453

Diamond, J. (2019). Upheaval: Turning points for nations in crisis. New York, New York: Little, Brown.

Dixon, M.J., Stange, M., Larche, C.J. Graydon, C., Fugelsang, J.A., & Harrigan, K.A. (2017). Dark flow, depression, and multiline slot machine play. Journal of Gambling Studies, 34, 73-84. 

Dodds, E.R. (1965). Pagan and Christian in an age of anxiety: Some aspects of religious experience from Marcus Aurelius to Constantine. Cambridge, UK: Cambridge University Press.

Dodes, L.M. (2011). Breaking Addiction: A 7-Step Handbook for Ending Any Addiction. New York, NY: Harper Perennial. 

Dostoyevsky, F. (1867). The Gambler (Translated by C.J. Hogarth). Project Gutenberg. Downloaded September 17 2019 from http://www.gutenberg.org/files/2197/2197-h/2197-h.htm

Douthat, R. (2018, October 3). How Ivy-League resentments took over the Kavanaugh debate. The New York Times.

Dunnington, K. (2017). Addiction: The perilous choice (part 1). Public lecture at Biola College. https://www.youtube.com/watch?v=cGW35iAiXCE

Editors of The Atlantic (2019, December). Special Issue of The Atlantic (324, 6): How to Stop a Civil War. 

Erikson, E.H. (1963). Childhood and society (2nd ed.). New York: Norton.

Fallows, J. (2019). The End of the Roman Empire Wasn’t That Bad: Maybe the end of the American one won’t be either. The Atlantic.  Retrieved 10 December 2019 friom https://www.theatlantic.com/magazine/archive/2019/10/in-the-fall-of-rome-good-news-for-america/596638/

Fallows, J. & Fallows, D. (2018). Our Towns: A 100,000-Mile Journey Into the Heart of America. New York, New York: Pantheon. 

Fetting, M. (2016).
Perspectives on substance use, disorders, and addiction: with clinical cases (Second edition). London, UK: Sage.

Foer, F. (2019, March). How kleptocracy came to America. The Atlantic. Retrieved November 21 2019 from https://www.theatlantic.com/magazine/archive/2019/03/how-kleptocracy-came-to-america/580471/

Fukuyama, F. (1992). The end of history and the last man. New York, NY: Avon.

Galeano, E., (1973). The open veins of Latin America: Five centuries of the pillage of a continent. New York, NY: Monthly Review Press.

Goldberg, M. (2019, 13 December). Democracy grief is real: Seeing what Trump is doing to America, many find it hard to fight off despair. The New York Times, 

Guilluy, C. (2019). Twilight of the elites: Prosperity, the periphery, and the future of France. New Haven, Connecticut: Yale University Press.

Han, B.-C. (2015). The burnout society. Stanford, California: Stanford University Press. 

Han, B.-C. (2017). Psychopolitics: Neoliberalism and new technologies of power. Brooklyn, New York: Verso.

Hande, M.J. (2019). Disability consciousness on the frontlines of urban struggle. Antipode: A journal of radical geography, 51(2), 558-578.

Harari, Y.N. (2018). 21 Lessons for the 21st Century. London, UK: Jonathan Cape.

Hari, J. (2015). Chasing the scream: The first and last days of the war on drugs. London, UK: Bloomsbury.

Hart, C. (2013). High price: A neuroscientist’s voyage of self-discovery that challenges everything you know about drugs and society. New York, NY: HarperCollins.

Heilig, M., Epstein, D.H., Nader, M.A., & Shaham, Y. (2016, June 9 advance online publication) “Time to connect: bringing social context into addiction neuroscience.” Nature Reviews Neuroscience.  doi:10.1038/nrn.2016.6 

Heyman, G.M.  (2009). Addiction: A disorder of choice. Cambridge, Massachusetts: Harvard University Press.

Heyman, G.M. (2019). Deriving addiction: An analysis based on three elementary features of making choices. In H. Pickard and S.H. Ahmed (Eds.) The Routledge Handbook of Philosophy and Science of Addiction. Oxford, UK: Routledge, pp. 23-33.

Holt-Lunstad, J., Smith, T.B., Baker, M., Harris, T. & Stephenson, D. (2015). Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review. Perspectives on Psychological Science, 10, 227-237. 

Isenberg, N. (2016). White Trash: The 400-Year Untold History of Class in America. New York: Viking.

James, O. (2007). Affluenza: How to be successful and stay sane. London, UK: Vermillion.

Jetten, Y., Haslam, C, & Haslam, A. (2011). The social cure: Identity, health, and well-being. Psychology Press.

Kinzer, S. (2017). The true flag: Theodore Roosevelt, Mark Twain, and the birth of the American Empire. New York: Henry Holt.

Klein, N. (2007). The Shock Doctrine: The Rise of Disaster Capitalism. Toronto, Ontario: Knopf, Canada.

Klein, N. (2014). This Changes Everything: Capitalism Vs. the Climate. Toronto, Ontario: Knopf, Canada

Klein, N. (2017).  No is Not Enough: Resisting Trump’s Shock Politics and Winning the World We Need. Toronto, Ontario: Knopf, Canada.  

Khrusheva, N. (2018, August 3). Trump’s gambling problem. Japan Times. Retrieved 2 December 2018 from https://www.japantimes.co.jp/opinion/2018/08/03/commentary/world-commentary/trumps-gambling-problem/#.XeV2rq2ZP2Q

Larcombe, J.R. (2017, July 17). The fall and rise of a gambling addict. TedxRoyalTunbridgeWells. Retrieved October 5 2017 from https://www.youtube.com/watch?v=7AN3VLLlkdI

Lemon, R. (2018). Addiction and devotion in early modern England. Philadelphia, Pennsylvania: University of Pennsylvania Press.

Leung, W. (2019, 16 December).  How deep-brain stimulation treats disorders: ‘It’s given me my life back.’The Globe and Mail (BC Edition), pp. 1,15.

Lewis, Marc. (2015). The biology of desire. Why addiction is not a disease. New York: Public Affairs.

Lofgren, M. (2014, February 21). Essay: Anatomy of the Deep State. “Moyers and Company” website. Retrieved March 9 2017 from http://billmoyers.com/2014/02/21/anatomy-of-the-deep-state/

Lofgren, M. (2017, March 2). The deep state 2.0. Moyers and Company. Retrieved April 4, 2017 from http://billmoyers.com/story/the-deep-state-2-0/

Lopez-Quintero, C., Hasin, D.S., Pérez de los Cobos, J., Pines, A., Wang, S., Grant, P.F. & Blanco, C. (2010). Probability and predictors of remission from lifetime nicotine, alcohol, cannabis or cocaine dependence: results from the National Epidemiologic Survey on Alcohol and Related Conditions, Addiction, 106, 657-669. 

Luthar, S.S., Barkin, S.H., & Crossman, E.J. (2013). “I can, therefore I must”: Fragility in the upper-middle classes. Developmental Psychopathology, 25, 1529-1549.

Luthar, S.S., Small, P.J., and Cicolla, L. (2018). Adolescents from upper middle class communities: Substance misuse and addiction across early adulthood. Development and Psychopathology, 30, 315-335.

Mann, C.C. (2011). 1493: Uncovering the New World Columbus created. New York, NY: Vintage Books. 

MacIntyre, A. (1984). After Virtue: A Study in Moral Theory (2nd Ed.). Notre Dame, Indiana: University of Notre Dame Press.

Mayer, J. (2017). Dark Money: The hidden history of the billionaires behind the rise of the radical right. New York, New York: Anchor Books. 

Milman, O. (2019, September 23). Greta Thunberg condemns world leaders in emotional speech at UN. The Guardian. Retrieved September 24 2019 from https://www.theguardian.com/environment/2019/sep/23/greta-thunberg-speech-un-2019-address

Mishra, P. (2017). Age of anger: A history of the present. New York: Farrar, Straus, & Giroux.

Monbiot, G. (2016, October 12). There Is Such a Thing As Society. The Guardian. Retrieved December 5 2016 from www.monbiot.com/2016/10/12/there-is-such-a-thing-as-society/

Morgan, O.J. (2019). Addiction, Attachment, Trauma, and Recovery: The Power of Connection. New York, NY: Norton.

Morin, R. (2017, November 7). How to hire fake friends and family. The Atlantic. Retrieved November 15 2017 from https://www.theatlantic.com/health/archive/2017/11/paying-for-fake-friends-and-family/545060/

Nonni’s Foods, 2019. Real Good. 100 Calories. Retrieved March 28 2019 from http://nonnis.com/products/thinaddictives/

Norberg-Hodge, H. (2018, May 12). Localization: A strategic alternative to globalized authoritarianism. Retrieved September 7 2019 from Local future: Economics of Happiness. Retrieved September 23 2019 from https://www.localfutures.org/localization-a-strategic-alternative-to-globalized-authoritarianism/

NJ Online Gambling. (undated). New Jersey’s Most Notorious Gamblers: Donald Trump. Retrieved 10 December 2019 from https://www.njonlinegambling.com/new-jerseys-most-notorious-gamblers-donald-trump/

O’Donnell, M. (2018, January). Losing Phil: When Phillip Seymour Hoffman succumbed to a drug overdose in 2014, his death was one of thousands sweeping the country. His partner, Mimi O’Donnell, reflects on the difficulties – and devastation – of addiction. Vogue, 56-59, 98-99.

Orford, J. (2013). Gambling is addictive. Gambling Watch UK. Retrieved August 7 2019 from https://www.gamblingwatchuk.org/research-new/105-gambling-is-addictive

Orford, J. (2019). Power and addiction. In H. Picard and S.H. Ahmed (Eds.), The Routledge Handbook of Philosophy and Science of Addiction. Oxford, UK: Routledge, pp. 209-219.

Packer, G. (2019, October). When the culture war comes for the kids. The Atlantic, 324, 56-71.

Peele, S., & Brodsky, A. (1975). Love and addiction. New York: Taplinger.

Patel, K. (2019). Book Review: The Globalization Of Addiction: A Study In Poverty Of The Spirit. Journal of Interprofessional Care. Retrieved September 28 2019 from http://jicareblog.org/book-review-the-globalization-of-addiction-a-atudy-in-poverty-of-the-spirit/

Pentland, A. (2014). Social physics: How social networks can make us smarter. New York, NY: Penguin. 

Perkins, J. (2016). The New Confessions of an Economic Hit Man, 2nd Ed. Oakland, California: Berrett-Koehler 

Peterson, J.B. (2018). 12 Rules for Life: An antidote for chaos. Toronto, Ontario, Canada: Penguin Random House Canada. 

Phillips, P. (2018). Giants: The global power elite. New York, NY: Seven Stories.

Pinker, S. (2018). Enlightenment now: The case for reason, science, humanism, and progress. New York, New York: Viking. 

Polk, S. (2014, January 18). For the Love of Money. The New York Times. Retrieved 2 December 2019 from https://www.nytimes.com/2014/01/19/opinion/sunday/for-the-love-of-money.html

Powell, K (2016, October 26). Young, talented, and fed up: Young scientists tell their stories. Nature, 538, 446-449. Retrieved January 2 2018 from https://www.nature.com/news/young-talented-and-fed-up-scientists-tell-their-stories-1.20872

Pryor, W. (2003) The Survival of the Coolest: an Addiction Memoir. Bath, UK: Clear Press.

Preyser, E. (2019, August 30). When you’ve been drunk your whole life who are you when you get sober? CBC Radio, https://www.cbc.ca/radio/tapestry/weekend-flow-1.5262870/when-you-ve-been-drunk-your-whole-life-who-are-you-when-you-get-sober-1.5263138

Quinones, S. (2015). Dreamland: The true tale of America’s opiate epidemic. New York, NY: Bloomsbury.

Reding, N. (2009). Methland: The death and life of an American small town. New York, NY: Bloomsbury.

Roberts, E.F.S. (2015). Food is Love: And so, What Then? . BioSocieties, 10, 247-252.

Ross, G. (1987). Stung: The incredible obsession of Brian Molony. Toronto, Ontario: Stoddard. 

Rushkoff, D. (2019). Team Human. New York: W.W. Norton & Co. 

Ryan, D. (2014a, April 26). Hastings Park gallops on: The glory days are gone but Vancouver’s racetrack still has its own unique community. The Vancouver Sun, pp. B11-B12.

Ryan, D. (2014b, April 26). Living the life: The mystical beauty of horses and family of racetrack personalities captivate Vancouver author Kevin Chong. The Vancouver Sun, p. B12.

Samson, C. (2003). A way of life that does not exist: Canada and the extinguishment of the Innu. London, UK: Verso.

Satel, S. (2018, February 21). The myth of what’s driving the opioid crisis: Doctor prescribed painkillers are not the biggest threat. Politico Magazine. Retrieved February 28 2018 from https://www.politico.com/magazine/story/2018/02/21/the-myth-of-the-roots-of-the-opioid-crisis-217034

Schüll, N.D. (2012). Addiction by design: Machine gambling in Las Vegas. Princeton, NJ: Princeton University Press.

Schüll, N.D. (2015, December 16). Addiction by Design: From slot machines to candy crush. Addictions Old and New. Conference at University of Richmond. Retrieved 11 January 2016 from https://www.youtube.com/watch?v=TazssD6L7wc

Selye, H. (1950, June 17). Stress and the general adaptation syndrome. The British Medical Journal, 1, 1383-1392. Retrieved January 2 2017 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2038162/pdf/brmedj03603-0003.pdfork 

Shane, S. (2019, 30 November). Prime Mover: How Amazon Wove Itself into the Life of an American City. The New York Times. Retrieved 1 December 2019 from; https://www.nytimes.com/2019/11/30/business/amazon-baltimore.html

Siegel (2020, Jan. 20). Why is America so depressed? The New York Times. Retrieved January 9 2020 from https://www.nytimes.com/2020/01/02/opinion/depression-america-trump.html

Slater, P. (1980). Wealth Addiction. New York, NY: Dutton.

Slutske, W.S. (2006). Natural Recovery and Treatment-Seeking in Pathological Gambling: Results of Two U.S. National Surveys. American Journal of Psychiatry, 163, 297-302.

Slutske, W.S., Blaszczynski, A., and Martin, N.G. (2009). Sex Differences in the Rates of Recovery, Treatment-Seeking, and Natural Recovery in Pathological Gambling: Results From an Australian Community-Based Twin Survey. Twin Research and Human Genetics, 12, 425-432.

Solnit, R. (2018, May 7) Easy Chair: Driven to Distraction. Harpers, 336, 7-9.

Spofford, E. & Kaniuka, P. (2019). Real people, real recovery: Overcoming addiction in modern America. Plantation, Florida: J. Ross.

Stiglitz, J.E. (2019, Nov. 26). The end of neoliberalism and the rebirth of history. Social Europe. Retrieved November 30, 2019 from https://www.socialeurope.eu/the-end-of-neoliberalism-and-the-rebirth-of-history

Sussman, S., Lisha, N., & Griffiths, M. (2011). Prevalence of the Addictions: A Problem of the Majority or the Minority? Evaluation and the Health Professions, 34, 3-56.

Taylor, C. (1991). The malaise of modernity. Toronto, Ontario: House of Anansi.

Toynbee, A.J. (1948). Civilisation on trial: New York: Oxford University Press.

Trump, D. cited by McCord, M.B. (2019). Armed Militias are Taking Trump's Civil War Tweets Seriously.  Lawfare. Retrieved 1 December 2019 from https://www.lawfareblog.com/armed-militias-are-taking-trumps-civil-war-tweets-seriously

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General. (2018). Facing Addiction in America: The Surgeon General’s Spotlight on Opioids. Washington, DC: HHS.

Venniro, M., Zhang, M., Caprioli, D., Hoots, J.K., Golden, S.A., Heins, C., Morales, M., Epstein, D.H and Shaham, Y. (2018). Volitional social interaction prevents drug addiction in rat models. Nature Neuroscience, 21, 1520-1529

Weber, M. (1958). The protestant ethic and the spirit of capitalism. New York: Scribner. (Original work published 1920).

White, W.L. (1998). Slaying the Dragon: The history of alcoholism treatment and recovery in America. Bloomington, IL: Chestnut Health Systems.

Willie, C. (2018, August 27). My life and death on opioids. The Walrus online. Downloaded August 29 2018 from https://thewalrus.ca/my-life-and-death-on-opioids/

Woolf, S.H. & Shoomaker, H. (2019, November 26). Life Expectancy and Mortality Rates in the United States, 1959-2017. Journal of the American Medical Association, 322, 1996-2016.  

Wylie, C. (2019). Mindf*ck: Cambridge Analytica and the Plot to Break America. New York, New York: Random House.

Zuboff, S. (2019). The age of surveillance capitalism: The fight for a human future at the frontier of power. New York, New York: Public Affairs.

 Newest Article:

"My Final Academic Article on Addiction"

 
Read Now

“Problem Gambling” is Now a Recognized Addiction: Why it Matters!"

 
Read Now

"Creating Healing Communities in a Toxic Society: Viktor Frankl and Jordan Peterson"

 
Read Now
"Treatment for Addiction: Why Aren’t We Doing Better?"
 
Read Now

Addiction: A Hopeful Prophecy From a Time of Despair

Read Here

 "What Shakespeare Knew About Addiction, But We Have Forgotten"
 
Read Now

Healing Addiction Through Community: A Much Longer Road Than it Seems?

Read Here

Rat Park vs. The NY Times

Read Here

New Revision of "The Rise and Fall of the Official View of Addiction"

Read Here

Addiction, Environmental Crisis, and Global Capitalism

Read Here

Listen to Bruce Alexander
speak with David Crowe on
"The Infectious Myth" 

Dealing with Addiction