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Understanding the Means and Objects of Addiction:
Technology, the Internet, and Gambling
Howard J. Shaffer, Ph.D., C.A.S.
Harvard Medical Schoo~ Division on Addictions
This article describes how using new computer technology and the Internet for
gambling can represent both the means and object of addiction. However, these tech-
nological factors do not represent the cause of addictive behavior. Given the wide-
spread availability of computer technology and the remarkable expansion of the In-
ternet, it is not surprising, however, that these technological advances have become
associated with intemperate gambling activities. By discussing the concept of addiction
and its associated social setting, neurochemistry, and gaming characteristics, this m-ti-
de suggests that addiction is the result of shifts in subjective experience and that new
technology and the Intemet can provide relatively reliable and potent contemporary
vehicles for changing emotional states.
New computer technology is the means by which gambling is de-
livered to homes, businesses, and airplanes. Computer users require
this new technology to access and maintain the Internet, which is a vast
network that serves as both a communication system and a repository
of information. During 1995, the Internet came to be regarded as a new
"mainstream" communication vehicle for the general public (Chapman,
1996). Researchers estimate that there are 13 to 15 million Internet
users in North America and 20 to 25 million users around the world
Special thanks are extended to Joni Vander Bih, Matthew Hall, and Gregory O'Donohue for
their helpful comments on earlier versions of this article.
Send reprint requests and correspondence to Dr. Howard J. Shaffer, Division on Addictions,
Harvard Medical School, 220 Longwood Avenue, Boston, MA 02115.
Journal of Gambling Studies Vol 12(4), Winter 1996
9 1996 Human Sciences Press, Inc. 461
462
JOURNAL OF GAMBLING STUDIES
(Chapman, 1996). By combining an expansive number of Internet
users, credit cards, and new computer technology, access to gambling
has become easy. The Internet permits casino type gambling to become
ubiquitous.
Without a specific jurisdiction responsible for its activities, Inter-
net gambling is difficult to regulate (National Association of Attorneys
General, 1996). "Gambling once involved clandestine dealing with un-
savory bookmakers .... Innovators are using technology to extend the
frontiers of gambling-often to the frustration of regulators" (Bulkeley,
1995, p. 1). In addition to regulatory problems, there is a growing pub-
lic concern (e.g., Jabs, 1996; O'Neill, 1995) that new technology may in-
crease gambling addiction. Murray (1996) described the general prob-
lems of computer addiction for students. This article will explore the
relationship between technology and addiction by using the Internet
and gambling as contemporary examples of the means and the object,
respectively, of potentially self-destructive, repetitive behaviors.
UNDERSTANDING THE CONCEPT OF ADDICTION
To begin this exploration, we must first take a digression and come
to some agreement about what is meant by addiction. This is a daunt-
ing task, however, since there is considerable confusion about the na-
ture of addiction (e.g., Shaffer, 1986; Shaffer, in press). Most theoreti-
cal explanations of addiction are provincial, attending only to the
unique characteristics associated with specific objects (e.g., alcohol,
heroin, cocaine, lottery) and a narrow pattern of behavior (e.g., alco-
holism, heroin dependence, cocaine dependence, pathological gam-
bling). As the opportunities to engage in potentially addicting activities
(e.g., gambling) become more prevalent because of widespread access,
a more cosmopolitan model of addiction will be necessary to help us un-
derstand the role that new and emerging technology plays in initiating,
expediting and sustaining addictive patterns.
Currently, there is conceptual chaos surrounding the notion of ad-
diction (e.g., Shaffer, 1986; Shaffer, in press). Clinicians, researchers,
and social policy makers are without a shared definition of addiction.
For example, addiction does not appear as a concept in any contempo-
rary diagnostic manuals. Absent a mutually agreed upon definition of
addiction, clinicians and social policy makers often are left to debate
whether patients who use drugs also "abuse" drugs. Similarly, "heavy"
HOWARD J. SHAFFER 463
gamblers remain difficult to distinguish from "pathological gamblers."
Treatment programs regularly mistake drug users and "abusers" for
those who are drug dependent. Similarly, bad luck "heavy" gamblers can
be mistaken too easily for pathological gamblers. Too often the result
of this confusion is unnecessary hospitalization, increased medical
costs, and patients who learn to distrust health care providers. Alterna-
tively, absent a precise definition of addiction, some people fail to re-
ceive the care they require. As a result of these complex conceptual con-
ditions, practice guidelines in the addictions are equivocal and health
care systems experience management and reimbursement chaos.
Addiction with Dependence and Without Dependence: Substances and
Processes.
Even under most established constructions of addiction, not
all drug dependent patients evidence addictive behavior. 1,2 For exam-
ple, in most civilized countries, under nearly all traditional circum-
stances, people who are nicotine dependent do not evidence addiction.
In spite of nicotine dependence, when cigarettes are readily available,
smokers rarely express themselves with anti-social behavior patterns or
resort to illicit activities. However, when tobacco is recast as a socially
unsavory or legally illicit substance, addictive behavior patterns have
emerged (e.g., Reuters News Service, 1992). Similarly, many post-oper-
ative patients receive sufficient quantities of narcotics as analgesic med-
ications to produce some level of physical dependence. However, in
spite of their neuroadaptive experiences (i.e., tolerance and with-
drawal), the overwhelming majority of these patients never display ad-
dictive behavior toward narcotics.
Complicating matters, physical dependence is not necessary for the
notion of addiction to apply. For example, upon stopping, pathological
gamblers who do not use alcohol or other psychoactive drugs can reveal
physical symptoms that appear to be very similar to either narcotics,
stimulants, or poly-substance withdrawal (e.g,, Shaffer, Hall, Walsh, &
Vander Bilt, 1995; Wray & Dickerson, 1981). Perhaps the patterns and
frequency of excessive behaviors are more important than the objects
of these acts.
1Although a full discussion of this matter is beyond the scope of this article, it also is important
to note that not all people with addiction are impaired in every aspect of their daily life. Despite some
exceptions, substance addictions tend to be more broad spectrum disorders while pathological gam-
bling tends to be a more narrow spectrum disorder.
'~'his notion of addiction includes a shifting priority of behaviors so that those once having pri-
ority lose value while others gain ascendancy;, in addition, since these new patterns include anti-social
behaviors, illicit activity is present on occasion.
464 JOURNAL
OF
GAMBLING STUDIES
If addiction can exist both with and without ingesting exogenous
drugs--as is the case with gambling-then the concept of addiction must
be sufficiently broad to include human predicaments that are related to
either substances or activities (i.e., process addiction). Although it is
possible to debate whether we should include both excessive substance
or process disorders within the conceptual domain of addiction, tech-
nically there is little choice.Just as exogenous substances precipitate im-
postor molecules vying for receptor sites within the brain, other activi-
ties (i.e., not related to drug taking) can also stimulate naturally
occurring neurotransmitters (e.g., Hyman, 1994; Hyman & Nestler,
1993; Milkman & Sunderwirth, 1987). The effects of these naturally oc-
curring psychoactive substances likely will be determined as the medi-
ating cause of many process addictions as neuroscience researchers in-
vestigate the biochemistry of the brain.
THE NEUROCHEMISTRY OF ADDICTION:
SHIFTING SUBJECTIVE STATES
If addiction can exist both with and without physical dependence,
then we can advance addiction theory by considering the objects of ad-
diction to be those things or activities that reliably and robustly shift
subjective experience. The most reliable and robust "shifters" hold the
greatest potential to stimulate the development of addictive disorders.
Psychoactive drugs, gambling, and certain other activities will correlate
highly with shifting subjective states because these activities reliably shift
subjective states. The strength and consistency of any activity to shift
subjective states will vary across individuals. In spite of this variation,
psychoactive drug use and gambling are sufficiently reliable shifters of
subjective states that this model will continue to rank these experiences
high among the array of activities that can become the objects of ad-
dictive behavior.
OBJECTS OF ADDICTION:
CAUSE, CONSEQUENCE, OR RELATIONSHIP
To this point, I have implied tacitly that simply using drugs or
gambling does not cause addiction. Now let me be explicit: from a
HOWARD J. SHAFFER 465
logical perspective, the objects of addiction cannot cause addictive be-
havior patterns. The teleological aspects of the current conventional
wisdom about addiction theory and practice contribute much to con-
temporary conceptual chaos. To illustrate, if using a drug was a nec-
essary and sufficient cause for addiction, then addiction would occur
every time this drug using pattern was present. Similarly, if drug using
was the
only
necessary and sufficient cause for addiction, addictive be-
haviors would be absent every time drug using was missing. Neverthe-
less, as I described before, both neuroadaptation and pathological
gambling are often present when drug using is absent. Therefore, drug
using is neither a necessary nor a sufficient cause to produce addic-
tion. Furthermore, it may not even be the primary cause of addiction.
Even though drug using is highly correlated with addiction, because
psychoactive substances reliably shift subjective experience, drug tak-
ing does not
cause
addiction. As in the case of pathological gambling
and excessive sexual behaviors that do not fall within the domain of
obsessive compulsive disorders, addiction can exist without taking
drugs. This observation provides insight into the necessity for consid-
ering a more complex relationship between a person who might de-
velop addiction and the object of their dependence.
It is the
relationship
of the addicted person with the object of their
excessive behavior that defines addiction. It is the confluence of psy-
chological, social and biological forces that determines addiction. No
single set of factors can define addiction precisely (e.g., Shaffer, 1987,
1992; Zinberg, 1984). Unfortunately, the concept of relationship is dif-
ficult to define. Therefore, until experience provides more insight into
the synergistic nature of these factors and helps us to determine the in-
teractive threshold(s) that may apply, we operationally define addiction
so that researchers, clinicians and policy makers can share a common
perspective (Shaffer, 1992; Shaffer & Robbins, 1991; 1995).
THE SUBJECTIVE EFFECTS OF GAMBLING:
GAME, SET, SETTING
The most common conceptual error committed by clinicians, re-
searchers and social policy makers is to think that addiction resides as
a latent property of an object (e.g., a drug or game of chance). Con-
ventional wisdom refers to "addictive drugs" or "addictive gambling."
466 JOURNAL OF GAMBLING STUDIES
However, addiction is not the product of a substance, game or tech-
nology, though each of these things has the capacity to influence human
experience. Experience is the currency of addiction. Addiction is the de-
scription of a relationship between organisms and objects within their
environment. Consequently, the causes of addiction are multifactorial
(e.g., Zinberg, 1984).
The experience of gambling--whether buying lottery tickets at a
convenience store, placing a bet on the floor of a casino, placing a wager
on the next race, or using credit cards to gamble at a web site on the In-
temet--is a function of the psychological "set" of the gambler, the "set-
ting" within which the gambling occurs and the "game" that is played. In
this case, set refers to the psychological expectations of the gambler, in-
cluding their personality and cognitive style. The setting refers to the
immediate social environment within which one gambles as well as the
influences exerted by the more distant social mores, folkways and cul-
tural context. The game refers to the specific activities involved in play-
ing a particular game (e.g., the speed, rules of play, articles, risk reward
ratio, player demands, etc.). These three interactive factors determine
the subjective experience of every gambling activity. There is consider-
able subjective variation among gamblers. For example, some people
only like table games and others only sports betting. Perhaps more in-
teresting is the variation that occurs within an individual: the same per-
son, playing the same game, will experience different subjective states
on various occasions because their set and setting vary. This circum-
stance makes it difficult to predict with precision who will develop ad-
dictive disorders.
In every instance of shifting technology, people require the op-
portunity to adapt to the unexpected subjective states associated with
using the new technology. The invention of the hypodermic syringe dur-
ing the middle 19 ta century ushered in an era of narcotics addiction
(Courtwright, 1982); when users developed the technology that permit-
ted smoking instead of chewing cocaine, they increased the potency of
this stimulant and started an era of cocaine abuse. When tobacco be-
came available in pre-rolled cigarettes and no longer required ritualis-
tic preparation, excessive smoking patterns increased (e.g., Zinberg &
Fraser, 1989; Zinberg, 1984). Now, as computers attract more people to
the Internet for collecting information or gambling, this technology is
changing how people learn and play; these new activities mark the be-
ginning of unaccustomed experiences. These new experiences are dif-
HOWARD J. SHAFFER 467
ficult to regulate precisely because the subjective state is novel. New op-
portunities to gamble using the Internet, computer technology and
other electronic means require people to adapt to these unprecedented
experiences. Adaptation to Promethean events requires time. Just as it
has taken decades to begin adjusting to the adverse consequences of
post-prohibition alcohol use, it will take time to learn how to relate to
computer technology with temperance. In spite of the inevitable prob-
lems associated with the use of new technology, we should not mistake
the technological means of gambling with the objects of addiction. We
also should not think that addiction is a property of computers, tech-
nology, or electronics.
The final pathway for all of the addictions is not the object of ad-
diction (e.g., as many believe drugs are "addictive"). The final common
pathway for addiction is always subjective experience. The organ of sub-
jective experience is the brain with all of its associated neurochemistry.
Activities that reliably shift human experience hold addictive potential.
This will vary from person to person and from moment to moment for
the same person. Epstein (1989)described the subjective experience of
shifting brain neurochemicals (e.g., increased dopamine) by gambling.
"Gambling is personal. It is associated with our status in life. No activity
has been more rationalized than gambling--odds figured, probabilities
worked out, point spreads meticulously established--and no activity,
surely, is finally more irrational. In this essentially irrational activity, the
first item that must be fixed, and with some precision, is the stake.
Above all, it cannot be too little; it must be enough to stimulate what-
ever those spiritual glands are that gambling calls into action. The pun-
ishment must fit the crime; the agony of losing must be roughly equiv-
alent to the ecstasy of winning. In this sense, it becomes clear that no
bet can ever be too large; and herein lies the madness inherent in gam-
bling, for the more you have, the more you need to risk" (Epstein, 1989,
p. 100).
Human vulnerabilities for consciousness shifting have been identi-
fied. For example, chronic and acute emotional pain enhances factors
that encourage the dissociative, pain relieving, characteristics of gam-
bling. In addition, exciting new findings reveal a genetic propensity for
novelty-seeking personality traits (Benjamin et al., 1996; Ebstein et al.,
1996). The interactive characteristics of novelty seeking as an analgesic
consciousness changing activity increase the potency and reliability of
the Internet as a shifter of subjective experience.
468
JOURNAL OF GAMBLING STUDIES
HOW DOES GAMBLING, COMPUTER TECHNOLOGY, AND THE
INTERNET INFLUENCE SUBJECTIVE EXPERIENCE
One of the great allures of gambling is its capacity to excite, en-
tertain, and help people forget their everyday problems. In this capac-
ity, Jacobs (1989) considered gambling to be a dissociative experience.
Computers have the capacity to stimulate the intellect and excite the
spirit. The Internet is a connecting web of computer sites. It is a system
of technological bridges woven together electronically to provide an
enormous repository of information. The Internet is a vehicle for gath-
ering resources and communicating with others. Using a computer, like
narcotics, often accelerates the subjective passage of time. Many begin-
ning users find themselves spending more time than anticipated in
front of a keyboard and monitor. Technological neophytes and experi-
enced users alike know the feeling of getting lost in the intellectual sub-
stance of cyberspace. Accessed by computer, the Internet provides users
with the opportunity to escape from one state of consciousness and visit
different worlds of information with all the euphoric mind-bending
properties associated with new adventures and problem solving.
Accessing and navigating the Internet provides users with a sense
of competency and control as they explore new worlds of information.
With remarkable swiftness, visitors to the Internet can take on them-
selves the roles of explorers who sail ("surf") the high seas in search of
new territories. The Internet has no inherent addictive properties; how-
ever, it does have the capacity to stimulate our senses and shift our sub-
jective state. The results of these experiential shifts can be positive (e.g.,
education) or negative (e.g., addiction).
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