The Fix

This is a resilient craze, as Dana Cowin, Food & Wine magazine’s editor-in-chief told Reuters in 2011. ‘I have predicted the demise of the cupcake so many times that I’m actually going to go to the dark side now and say the cupcake trend is not going to abate,’ she said.8 When an earthquake struck Washington DC on 23 August 2011, someone tweeted that you could tell it had happened because there was suddenly no line outside Georgetown Cupcakes.

Could the ‘emptiness’ of the cupcakes to which Xanthe Clay refers be part of their appeal? Their overwhelming sugar hit fills the consumer with what nutritionists call ‘empty calories’, because they have no nutritional value. But that’s not to say they have no mood-altering value. Sugar triggers production of the brain’s natural opioids, according to Princeton neuroscientist Bart Hobel, who led a study into sugar dependence. He found that rats which binged on sugar went into withdrawal when the supply was cut off. ‘We think that is a key to the addiction process,’ he said. ‘The brain is getting addicted to its own opioids as it would to morphine or heroin. Drugs give a bigger effect, but it is essentially the same process.’9

Opioids are also implicated in bulimia, irrespective of whether sugar is involved. Have you ever experienced that feeling of glorious relief after you’ve just thrown up a dodgy curry? It’s not just getting rid of the food that makes you feel good; it’s a natural elation produced by chemicals in the brain. Bulimics get off on it, to put it crudely.

As Abigail Natenshon explains: ‘The bulimic cycle releases endorphins, [opioid] brain chemicals that infuse a person with a sense of numbness or euphoria. Ironically, the relief passes in short order, only to be replaced by anxiety and guilt for the bulimic behaviours.’ Again, we need to state the obvious fact that most people don’t throw up their food. But the sort of food associated with purging is also the sort of food that many of us have difficulty resisting, because its heavy concentrations of sugar, fat or salt can magnify euphoria and neediness.

It’s easy for urban sophisticates to mock American rednecks or British ‘chavs’ who stuff themselves with fast food, and easy to recognise that they’re in the grip of some sort of addiction. Just look at their waistlines. But the marketing executive who orders a cranberry muffin to go with her morning cup of coffee really ought to ask herself: why am I eating cake for breakfast?

So what about the iPhone? Isn’t it a bit much to call our love affair with this shiny gadget an ‘addiction’? Researchers at Stanford University aren’t so sure: in a survey of 200 Stanford students in 2010, 44 per cent of respondents said they were either very or completely addicted to their smartphones.10 Nine per cent admitted to ‘patting’ their iPhone. Eight per cent recalled thinking that their iPods were ‘jealous’ of their iPhones. These are strange things for students at one of America’s top universities to say about their phones, even in jest. They also reveal something about how completely the iPhone has become part of these students’ identities and social frameworks. They’re not just tools that allow us to connect instantaneously and prolifically with others: they’re also being afforded identities of their own – ‘patted’, protected and cherished.

Perhaps it has something to do with how these devices are engineered. They practically force you to perform repetitive rituals of the sort associated with obsessive-compulsive behaviour: from the initial activation of the iPhone to the weekly ‘syncing’ and nightly charging, your relationship to the phone is structured for you. And because the iPhone’s battery life isn’t quite enough to last a full day’s use – and certainly not long enough to withstand hours of constant fiddling and gaming – ‘pit stop’ charges become a regular feature of the day. iPhone users can often be seen checking for power sockets in coffee shops so that, while they get their own fix of caffeine, their phones can get juiced up as well.

‘iPhone owners live in a constant state of anxiety about their battery levels,’ says Milo Yiannopoulos, editor of The Kernel, an online culture magazine. ‘To some extent, the phone ends up structuring their day. For example, they tend not to plan to be out of the office for more than six hours at a time, in case they run out of battery and have to start knocking on doors, USB cable in hand, begging for a few minutes’ worth of charge to get them through the afternoon.’

Talk about the replacement of people by things. The 4S version of the iPhone, released in October 2011, includes a virtual assistant called Siri that responds to spoken instructions and speaks back to the user. This infant technology is already so complex that you can have entire conversations with Siri. She will then execute commands, in some cases fetching very specific data from the internet. ‘Intelligent personalised assistant software is going mainstream,’ says Yiannopoulos. ‘Never in the history of mass-market consumer electronics has the line between man and machine been so blurred.’

It’s significant that a quarter of respondents in the survey above said they found iPhones ‘dangerously alluring’. They are supposed to be. Absolutely nothing is left to chance in the design of these devices. If Apple customers have an embarrassing tendency to anthropomorphise their gadgets, that is because Apple has explored the possibilities of the human mind and body more thoroughly than any of its competitors.

For example, one of the most appealing features of the MacBook laptop line has been the status light, which pulsates gently when the computer is sleeping. Early reviewers cooed over the calming effect of the light, but couldn’t put their finger on why it felt so good to watch. Later, it was revealed that Apple had filed for a patent for a sleep-mode indicator that ‘mimics the rhythm of breathing’ and was therefore ‘psychologically appealing’. As the tech blogger Jesse Young noted, while Apple’s sleep light matched the pace of breathing while we sleep, Dell’s was closer to breathing during strenuous exercise. ‘It’s interesting how a lot of companies try to copy Apple but never seem to get it right. This is yet another example of Apple’s obsessive attention to detail,’ he wrote.11

Former Apple executives – who frequently brief American technology blogs off the record about the internal culture at Apple’s headquarters in Cupertino, California – describe the lengths the organisation goes to in order to create coveted products. There’s a design-dominated power structure that results in hushed reverence when Jonathan Ive, Senior Vice President of Industrial Design, walks into the boardroom. ‘Marketing and design have been fused into a single discipline at Apple,’ says Yiannopoulos. ‘Everything, from product strategy to research and development, is subordinate to making the products as beautiful and compulsive – that is, as addictive – as possible.’

It works. To quote an extreme example, in 2010 a schoolboy in Taiwan was diagnosed with IAD – iPhone Addiction Disorder. According to Dr Tsung-tsai Yang of the Cardinal Tien Hospital, his eyes were glued to his phone screen all day and all night. Eventually, ‘the boy had to be hospitalised in a mental ward after his daily life was thrown into complete disarray by his iPhone addiction’.12

Two days after it opened in 2010, I visited the Apple Store in Covent Garden – a magnificently restored Palladian building dominated by a glass-covered courtyard. The heady aroma of addiction was unmistakable. The misery in the queue for the Genius Bar, where broken computers are diagnosed, was painful to behold. Legs were crossed and uncrossed and eyebrows twitched every time a Genius read out a name. I couldn’t help thinking that these customers looked like addicts waiting for their daily dose of methadone.

I wanted to ask a Genius what it was like dealing with people who weren’t just asking what was wrong with their laptops but pleading for (literal) fixes. But finding someone who would talk was easier said than done.

First I went down the route of asking an Apple Store manager – a friend of a friend – whether he could chat off the record about the way the company seemed to encourage addiction to its products, or put me in touch with someone who would. His first response was encouraging, but then he changed his mind. He would be in big trouble if his bosses suspected he’d put me in touch with an indiscreet ex-employee, and he’d be fired on the spot if he got caught blabbing himself.

So I tried a different route. A start-up CEO friend of mine put out a message to one of his networks. Shortly afterwards, a young man called Ben Jackson, a social media entrepreneur, emailed to say he could meet me for coffee in Soho, London, a few streets from the Apple Store where he had spent two years as a Genius.

Ben, like many former Apple employees, inhabited the cooler end of the geek spectrum, with glasses offset by a gym-honed body. He didn’t need any prompting to talk about addiction to technology: the experience of seeing the addiction every day – deliberately stimulated by the company – was one of the reasons he left the store.

‘I saw a whole range of addictive behaviours. It’s one of the things that made the Apple Store such a surreal place to work. At one end of the scale you have the total Apple obsessives who exhibit a sort of religious fanaticism that the company does nothing to discourage – it encourages it, in fact. They’re the people who will book the same tutorial again and again, being shown how to do stuff they already know.

‘When a new product is launched, it’s the same faces at the front of the line every time. They treat the staff almost like celebrities, trying to ingratiate themselves. At the Genius Bar, they’ll show you Apple products from years ago, and you’ll have to pretend you haven’t seen them before, because they need their egos massaged. It’s kind of sad. Well, it is sad.’

But it’s not only the true obsessives who are touched by addiction, according to Ben. ‘There’s a general perception that Apple is awesome in a way that other companies aren’t – a perception that’s quite at odds with the way it operates behind the scenes. Even the products are considered awesome, which is why otherwise normal people would get quite disproportionately angry and upset if anything went wrong with them. And it’s also why there’s such unease if people think they’ve fallen behind, that their stuff is out of date. But the point is that you can’t keep up to date without spending a lot of money on things you don’t need, because the products are just coming out too fast.

‘I’ve seen people burst into tears because a credit check wouldn’t allow them to stretch to the latest upgrade. That’s when I started thinking: I need to get the hell out of here.’

Admittedly, many psychiatrists don’t believe in ‘internet addiction’ as a medical condition, let alone addiction to a specific model of smartphone. They argue that obsessive users aren’t addicted to the internet so much as to the experiences it provides, such as digital porn and computer games. But few experts would deny that gadgets such as iPhones can produce behaviour that bears the hallmarks of addiction. And it’s becoming increasingly clear that the ability of manufacturers to stimulate this behaviour is racing far ahead of our ability to cope with the psychological and social problems that are created as a result.

The science of pleasure is playing a greater role in the marketing strategies of all sorts of companies: the people who waft the smell of freshly baked doughnuts at you in the shopping mall have fine-tuned their recipes in the laboratory, not the kitchen. But Apple is in a class of its own. No other company has managed to mix such a finely balanced cocktail of desire, in which the crude flavour of compulsion is disguised by a deliciously minimalist aesthetic.

‘More than any other product, the iPhone has encouraged the tech industry to concentrate on getting people hooked on things,’ says Yiannopoulos. ‘Apple’s marketing genius, and the incredible attention to detail paid to the design of their devices, filters down into the iPhone developer ecosystem.’

He cites the example of Angry Birds, a simple computer game app that, by May 2011, had been downloaded 200 million times.13 The premise of Angry Birds is simple: players launch birds across the screen with a slingshot, judging the trajectory of flight and altering the force and initial direction accordingly. It sounds harmless enough. But type ‘Angry Birds addiction’ into Google and you’re presented with 3.24 million results. So many people complain about being addicted to the game that it has spawned self-help pages all over the internet. Some of these pages ask whether Angry Birds addictions are changing people’s brains. Self-described addicts say they don’t know why they can’t put the game down, and talk about compulsively tracing their fingers on tables as they subconsciously recall the catapult action of the game. These sound suspiciously like the little rituals associated with alcoholism and drug abuse.

Again, perhaps a degree of scepticism is called for: it can only be a matter of time before some opportunistic researcher diagnoses ABAD – Angry Birds Addiction Disorder (which would presumably be a particular strain of IAD, since the game is played mostly on iPhones). No doubt the Angry Birds craze will fade, as these crazes always do. But it may well leave behind a residue, in the form of the compulsive instinct to perform repetitive actions.

It’s not a conspiracy theory to suggest that the primary task of iPhone game developers is learning how to manipulate our brains’ reward circuits. They cheerfully admit as much. At the 2010 Virtual Goods Summit in London, Peter Vesterbacka, lead developer for Rovio, the company behind Angry Birds, described how they make the game so addictive. ‘We use simple A/B testing to work out what keeps people coming back,’ he said. ‘We don’t have to guess any more. With so many users, we can just run the numbers.’14

We can just run the numbers. Remember those words. Where previously advertising and marketing were more creative disciplines that involved a huge element of risk, a new generation of manufacturers doesn’t need to guess what will keep us coming back for our fix: they already know.

Viewers of House, America’s most popular medical drama – and at one time the most watched television programme in the world – are familiar with the sight of Dr Gregory House, the snide, sexy, crippled antihero, tipping back his head and tossing a couple of Vicodin into his mouth. He’s even been known to throw a pill into the air and catch it like a performing seal. The screenplays go out of their way to portray House as an addict: several times we’re shown him shivering and sweating his way through opiate withdrawal. But, in the end, the Vicodin is as integral to his charm as his twisted humour. The one fuels the other.

Although Dr House, played brilliantly by Hugh Laurie, is prescribed the drug to dull the pain of a leg injury, he also uses it to stave off boredom and stimulate his work as a diagnostic detective. Any similarity to the cocaine-injecting Sherlock Holmes is surely intentional. But only the very earliest Holmes stories actually depict drug abuse: Arthur Conan Doyle, worried that he might encourage addiction, quickly made his hero abandon the vice. Not so the makers of House, who have sustained the central character’s dependence on Vicodin despite criticism from some medical professionals (and, reportedly, the Drug Enforcement Agency).

‘Since the first episode I have been concerned with the show’s message and have attempted several times to educate the writers and producers regarding the danger of Vicodin abuse,’ wrote one physician, coincidentally named Dr John House, who specialises in hearing loss, a devastating side effect of Vicodin.15 He lobbied long and hard for this symptom to be recognised in House and eventually it was, albeit in a throwaway line. (As I write, the series is coming to an end, and so far one symptom that hasn’t been mentioned, so far as I can tell, is the awful constipation it causes: a truly realistic scenario would force the good doctor to spend most of the season straining on the lavatory.) The fictional House does succeed in giving up Vicodin after suffering rather implausible hallucinations caused by the drug and completing a period of rehab, but after a couple of seasons he is shown relapsing.

Vicodin was already a fashionable recreational drug when the show first aired in 2004. It was passed around like after-dinner mints at Manhattan dinner parties. In 2001, USA Today described Vicodin as ‘the new celebrity drug of choice’. Matthew Perry, one of the stars of Friends, had already gone into rehab for his addiction to it – twice. Eminem had a Vicodin tattoo on his arm. David Spade joked about it at the Golden Globes. ‘Who isn’t doing them?’ asked Courtney Love. ‘Everyone who makes it starts popping them.’16 Celebrities favoured it for the same reason other users did: it was (and is) relatively easy to persuade doctors to prescribe it. In the US, Vicodin falls into the Schedule III category, less tightly controlled than stronger opiate painkillers such as Oxycontin, classified as Schedule II. You can phone in a prescription for Vicodin to a pharmacy; for Oxycontin, you have to hand over a physical script.

So by the time the first House screenplays were being written in 2003, Vicodin was already as famous for its recreational buzz as for its painkilling properties. When the show became a hit, Associated Press writer Frazier Moore suggested that its success was thanks to the way it ‘fetishises pain’. In other words, millions of Americans on painkillers could identify with Dr House’s suffering.17 If true, that’s only part of the story. The scripts often refer to Greg House’s pain, caused by the removal of leg muscles after a thigh aneurysm. But much of the sharpest humour centres around House’s schoolboy naughtiness in trying to score more pills than he has been prescribed. That isn’t the fetishisation of pain: it’s the fetishisation of Vicodin. An unofficial range of House T-shirts, still on sale in 2011, includes one that reads: ‘Wake up and smell the Vicodin’. The same logo, accompanied by a photo of Hugh Laurie looking spaced out, is also available as desktop wallpaper for your computer.

Meanwhile, the embedding of the drug in other parts of popular culture continues apace.

‘The Vicodin Song’, by singer-songwriter Terra Naomi, has been watched on YouTube more than half a million times. It’s an appropriately sleepy ballad which begins: And I’ve got Vicodin, do you wanna come over?

The most popular comment on the thread underneath the YouTube video reads: ‘When I listen to this I think of Dr House :)) This song is really cool.’18 Many of the 2,000-plus comments, however, aren’t about the song or the show. They’re about how much Vicodin you can take recreationally without hurting your liver. It’s a vigorous debate:

FreeWhoopin1390: Well vicodin (aka hydrocodone) gives you a good calm high. It’s a super chill high to be honest. Now some people might try and tell you that 20–25 mg gets you high, let me start by saying those people are idiots. 20–25 mg will give you a relaxed small buzz for the first time. If you want a really good calm high that lasts for a while take 35–40 mg. I say 40 for the first time but that’s just me. Word of caution tho, do not exceed 4000 mg of tylenol [paracetamol] which is in vicodin, in 24 hours.

Thebluefus: If you get 40 mg of hydrocodone by taking vicodin you have reached the max for tylenol. You don’t need that much to get high, especially as a first time. Just two vicodin will get you the feeling. Don’t be stupid.

FreeWhoopin1390: Are you fucking stupid? The max for tylenol is 4000 mg a day. I take 50 mg of hydrocodone at once (they are 10/500). Which means they have 10 mg hydrocodone and 500 mg tylenol. Which means I am taking 2500 mg of tylenol. Which is nowhere near the max daily dosage. But thank you for sharing what you don’t know.

There are also catfights about the respective virtues of Vicodin and Oxycontin and a discussion of the regional variations in street prices. From time to time someone interrupts to say that they take Vicodin for real pain and that these junkies should be ashamed of themselves. But there are also commenters who were legitimately prescribed the drug who are now junkies themselves. They may resent being a slave to Vicodin or they may enjoy the high; perhaps a bit of both. What should we make of a comment like this?

1awareness: Bragging about pills is lame. I’m using them to make fibromyalgia feel less intense. I also have seizures which cause a lot of pain. I enjoy Vicodin.

These are commenters who describe themselves as Vicodin ‘users/abusers’, a term that neatly captures the ambiguity of prescription drug abuse. All mood-altering drugs, from Scotch whisky to crack cocaine, can be abused: you can harm yourself by taking too much of them. But the vast majority are supposed to intoxicate, even when consumed in ‘safe’ quantities. The Vicodin abuser, on the other hand, is hooked on a drug that the manufacturers insist isn’t designed to alter moods. To further complicate matters, if the abuser is in real pain, it can be hard to tell whether he or she is merely over-medicating or enjoying an extra recreational buzz on top of the pain relief – Dr Gregory House likes to keep his colleagues guessing on this point. But that sort of confusion doesn’t make Vicodin dependence any less difficult to manage; it just means that, like so many 21st-century addictions, it is difficult to categorise and therefore difficult to treat.

As if these problems weren’t bad enough, it was revealed at the beginning of 2012 that several drug companies were working on hydrocodone pills that were potentially ten times as strong as Vicodin. The new pills would be ‘safer’ than Vicodin, according to Roger Hawley, chief executive of Zogenix, because they wouldn’t contain the paracetamol that harms the liver. Maybe so; but their time-release formula would also allow abusers to crunch them up for one hell of a hit. Zohydro, as Zogenix plans to call the drug, is scheduled for release in 2013.

This is just a guess, but it wouldn’t surprise me if, all over America, clued-up Vicodin users are already telling their doctors that their pain is getting worse and maybe they could use something a little stronger …

The addictive qualities of cupcakes, iPhones and Vicodin aren’t immediately obvious. Someone encountering a cupcake for the first time since childhood doesn’t think: uh-oh, I’d better be careful not to develop a sugar addition that triggers an eating disorder and end up washing the sick out of my hair. Likewise, people buying their first smartphone don’t worry about developing an obsessive-compulsive relationship with a computer game, and until recently the recreational use of painkillers was almost unheard of. In other words, as unqualified consumers we’re increasingly tempted by products about whose effect on our brain we know virtually nothing. We may not even notice the burst of tension-relieving pleasure they provide – at least, not until we realise that we can’t live without them.

Using substances and manipulating situations to fix your mood isn’t new. It’s the pace, intensity, range and scale of this mood-fixing that is unprecedented, irrespective of whether it involves drugs, alcohol, food or sex.

Put simply, both our need and our ability to manipulate our feelings are growing. We’re always searching for new ways to change the way we feel because, to state the obvious, we’re not at ease with ourselves. That’s a very broad-brush statement, so let me try to be more specific. Our ancestors were unable to insulate themselves from fear and despair in the way that we try to: certain forms of unhappiness, such as grief at the death of children, were more familiar to them than they are to us. Nor did they possess many fixes to address those feelings – and, in any case, experiences of such intensity aren’t easily fixed, even in the short term. We, on the other hand, struggle with small but inexorable and cumulative pressures in our daily lives. These produce a free-floating anxiety that is susceptible to short-term fixes.