Takeaway: Traditional substances remain a concern but have clearer boundaries and established prevention frameworks. The digital challenge is teaching moderation of otherwise useful tools that are deeply embedded in modern life. - Modern digital behaviors show high compulsion development and lower barriers to moderation - The engagement cycle has generally shortened over time, with modern digital behaviors offering much more rapid reward cycles than traditional media. Harming attention spans. - Modern digital behaviors often combine multiple historical addiction mechanisms: - Social validation (like gambling's social aspect) - Narrative engagement (like radio/TV) - Variable rewards (like gambling) - Identity expression (like fashion/cultural addictions) - Digital behaviors have created unprecedented combinations of: - Nearly zero access barrier - High social acceptance - Extremely short reward cycles - Multiple simultaneous engagement mechanisms (dopamine stacking) #### Addiction Development & Patterns | Behavior/Substance | % Users Developing Problematic Use | Compulsion Development Speed | Tolerance Development | Return to Moderate Use Difficulty | |-------------------|-------------------------------------|----------------------------|---------------------|----------------------------------| | Short-form Video | 17% | 5 (Very Fast) | 4 (Rapid) | 2 (Often Possible) | | Social Media | 14% | 3 (Moderate) | 3 (Moderate) | 3 (Sometimes Possible) | | Video Games (Modern) | 6% | 3 (Moderate) | 4 (Rapid) | 2 (Often Possible) | | Streaming TV | 2% | 2 (Slow) | 2 (Slow) | 1 (Usually Possible) | | Gambling | 2% | 4 (Fast) | 5 (Very Rapid) | 4 (Rarely Possible) | | Alcohol | 6% | 2 (Slow) | 4 (Rapid) | 4 (Rarely Possible) | | Nicotine | 32% | 5 (Very Fast) | 4 (Rapid) | 5 (Almost Never Possible) | | Opioids | 23% | 5 (Very Fast) | 5 (Very Rapid) | 5 (Almost Never Possible) | | Caffeine | 10% | 3 (Moderate) | 3 (Moderate) | 2 (Often Possible) | - **% Users Developing Problematic Use** - Defined as: Percentage of regular users who develop patterns meeting clinical criteria for addiction/dependency - Scale: Actual percentage ranges (e.g., 5-10%, 20-30%, etc.) - Measurement: Based on clinical studies and population health data where available - **Compulsion Development Speed** - Defined as: How quickly casual use typically transitions to compulsive behavior - Scale: 1 - Years (Very Slow) 2 - Months to a Year (Slow) 3 - Weeks to Months (Moderate) 4 - Days to Weeks (Fast) 5 - Hours to Days (Very Fast) - **Tolerance Development** - Defined as: How quickly users need to increase usage to achieve same effect - Scale: 1 - Minimal (maintains same level of engagement) 2 - Slow (gradual increase over years) 3 - Moderate (noticeable increase over months) 4 - Rapid (significant increase over weeks) 5 - Very Rapid (dramatic increase over days) - **Return to Moderate Use Difficulty** - Defined as: How challenging it is to return to casual/controlled use after problematic use - Scale: 1 - Usually Possible 2 - Often Possible 3 - Sometimes Possible 4 - Rarely Possible 5 - Almost Never Possible #### Impact & Consequences | Behavior/Substance | Impact on Daily Function | Individual Development Impact | Withdrawal Severity | Time to Notice Life Consequences | | -------------------- | ------------------------ | ----------------------------- | ------------------- | -------------------------------- | | Short-form Video | 4 (Severe) | 3 (Moderate Delays) | 2 (Mild) | 3 (Weeks to Months) | | Social Media | 3 (Moderate) | 3 (Moderate Delays) | 2 (Mild) | 3 (Weeks to Months) | | Video Games (Modern) | 3 (Moderate) | 3 (Moderate Delays) | 2 (Mild) | 3 (Weeks to Months) | | Streaming TV | 2 (Slight) | 2 (Minor Setbacks) | 1 (Minimal) | 2 (Months to Years) | | Gambling | 5 (Extreme) | 5 (Major Life Derailment) | 3 (Moderate) | 4 (Days to Weeks) | | Alcohol | 4 (Severe) | 4 (Significant Disruption) | 5 (Extreme) | 3 (Weeks to Months) | | Nicotine | 2 (Slight) | 2 (Minor Setbacks) | 4 (Severe) | 2 (Months to Years) | | Opioids | 5 (Extreme) | 5 (Major Life Derailment) | 5 (Extreme) | 4 (Days to Weeks) | | Caffeine | 1 (Minimal) | 1 (Minimal Interference) | 2 (Mild) | 1 (Years) | - **Impact on Daily Function** - Defined as: Degree of interference with work, school, relationships, and basic responsibilities - Scale: 1 - Minimal Impact 2 - Slight Impact 3 - Moderate Impact 4 - Severe Impact 5 - Extreme Impact - **Individual Development Impact** - Defined as: Effect on personal growth, skill development, and life progression - Scale: 1 - Minimal Interference 2 - Minor Setbacks 3 - Moderate Delays 4 - Significant Disruption 5 - Major Life Derailment - **Withdrawal Severity** - Defined as: Physical and psychological symptoms when stopping use - Scale: 1 - Minimal (mild irritability) 2 - Mild (noticeable discomfort) 3 - Moderate (significant discomfort) 4 - Severe (intense distress) 5 - Extreme (medical intervention needed) - **Time to Notice Life Consequences** - Defined as: How long before negative life impacts typically become apparent - Scale: 1 - Years 2 - Months to Years 3 - Weeks to Months 4 - Days to Weeks 5 - Hours to Days