Dopey About Dopamine: Video Games, Drugs, & Addiction

Last week I was speaking to a colleague whose partner is a gamer. She was telling me about their visit to his mother. During the visit my colleague was speaking to his mother about how much he still enjoys playing video games. His mother expressed how concerned she had been about his playing when he was young. “It could have been worse though,” she’d said, “at least he wasn’t into drugs.”

This comparison is reminiscent of the homophobic one where the tolerant person says, “I don’t mind if you’re gay, as long as you don’t come home with a goat.” The “distinction” made actually implies that the two things are comparable. But in fact they are not.

Our culture uses the word addiction pretty frequently and casually. And gamers and opponents of gaming alike use it in reference to playing video games. Frequently we hear the comments “gaming is like a drug,” or “video games are addictive,” or “I’m addicted to Halo 3.” What muddies the waters further are the dozens of articles that talk about “proof” that video games are addictive, that they cause real changes in the brain, changes just like drugs.

We live in a positivistic age, where something is “real” if it can be shown to be biological in nature. I could argue that biology is only one way of looking at the world, but for a change I thought I’d encourage us to take a look at the idea of gaming as addictive from the point of view of biology, specifically dopamine levels in the brain.

Dopamine levels are associated with the reward center of the brain, and the heightened sense of pleasure that characterizes rewarding experiences. When we experience something pleasurable, our dopamine levels increase. It’s nature’s way of reinforcing behaviors that are often necessary for survival.

One of the frequent pieces of evidence to support video game addiction is studies like this one by Koepp et al, which was done in 1998. It monitored changes in dopamine levels from subjects who were playing a video game. The study noted that dopamine levels increased during game play “at least twofold.” Since then literature reviews and articles with an anti-gaming bias frequently and rightly state that video games can cause dopamine levels to “double” or significantly increase.

They’re absolutely right, video games have been shown to increase dopamine levels by 100% (aka doubling.)

Just like studies have shown that food and sex increase dopamine levels:

This graph shows that eating food often doubles the level of dopamine in the brain, ranging from a spike of 50% to a spike of 100% an hour after eating. Sex is even more noticeable, in that it increases dopamine levels in the brain by 200%.

So, yes, playing video games increases dopamine levels in your brain, just like eating and having sex do, albeit less. But just because something changes your dopamine levels doesn’t mean it is addictive. In fact, we’d be in big trouble if we never had increases in our dopamine levels. Why eat or reproduce when it is just as pleasurable to lie on the rock and bask in the sun?

But here’s the other thing that gets lost in the spin. Not all dopamine level increases are created equal. Let’s take a look at another chart, from the Meth Inside-Out Public Media Service Kit:

This is a case where a picture is worth a thousand words. When we read that something “doubles” it certainly sounds intense, or severe. But an increase of 100% seems rather paltry compare to 350% (cocaine) or 1200% (Meth)!

One last chart for you, again from the NIDA. This one shows the dopamine increases (the pink line) in amphetamine, cocaine, nicotine and morphine:

Of all of these, the drug morphine comes closest to a relatively “low” increase of 100%.

So my point here is twofold:

1. Lots of things, not all or most of them drugs, increase the levels of dopamine.

2. Drugs have a much more marked, sudden, and intense increase in dopamine level increase compared to video games.

Does this mean that people can’t have problem usage of video games? No. But what it does mean, in my opinion, is that we have to stop treating behaviors as if they were controlled substances. Playing video games, watching television, eating, and having sex are behaviors that can all be problematic in certain times and certain contexts. But they are not the same as ingesting drugs, they don’t cause the same level of chemical change in the brain.

And we need to acknowledge that there is a confusion of tongues where the word addiction is involved. Using it in a clinical sense is different than in a lay sense– saying “I’m hooked on meth” is not the same as saying “I’m hooked on phonics.” Therapists and gamers alike need to be more mindful of what they are saying and meaning when they say they are addicted to video games. Do they mean it is a psychological illness, a medical phenomenon? Do they mean they can’t get enough of them, or that they like them a whole lot? Do they mean it is a problem in their life, or are they parroting what someone else has said to them?

I don’t want to oversimplify addiction by reducing it to dopamine level increase. Even in the above discussion I have oversimplified these pieces of “data.” There are several factors, such as time after drug, that we didn’t compare. And there are several other changes in brain chemistry that contribute to rewarding behavior and where it goes awry. I just want to show an example of how research can be cited and misused to distort things. The study we started out with simply found that we can measure changes in brain chemistry which occur when we do certain activities. It was not designed or intended to be proof that video games are dangerous or addictive.

Saying that something changes your brain chemistry shouldn’t become the new morality. Lots of things change your brain chemistry. But as Loretta Laroche says, “a wet towel on the bed is not the same as a mugging.” We need to keep it complicated and not throw words around like “addiction” and “drug” because we want people to take us seriously or agree with us. That isn’t scientific inquiry. That’s hysteria.

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Mike Langlois, LICSW

Mike consults, writes and teaches about online technologies, video games & psychotherapy. He provides private supervision for psychotherapists who seek to start, grow, & market their private practice.
About Mike Langlois, LICSW

Mike consults, writes and teaches about online technologies, video games & psychotherapy. He provides private supervision for psychotherapists who seek to start, grow, & market their private practice.

Comments

  1. Deborah Greene Bershatsky, PhD says:

    The highest praise you can give in reviewing an iPhone game in the App Store is to say that it’s addictive…

    And furthermore, everything IS biological. What of it? Mind=brain=body. So what? I was trained by a man who invented a talking cure for schizophrenia; and when I asked him in an interview 40 years later, what he made of it now being viewed as an hereditary organic brain disease it didn’t faze him in the least. He said, “What if it is? I don’t have a gene to speak French, but with good instruction I can learn French. A schizophrenic can learn ‘normal.’”

  2. Dennis Myers says:

    Excellent Report – The unfortunate result is not learning the long-term effects until a few generations

  3. I love this blog entry – well thought out with excellent references to back it up. My dissertation was essentially a lit review of video game research compiled into a small volume so other therapists can get up to speed with what the research says and what it doesn’t say. Sadly, too many therapists rely on media reports of studies to form their own “professional” opinion on video game use (especially violent video game use) without actually doing the work to research anything.

    When I talk to parents about excessive video game play, I liken it to getting pleasure from rewards out of sync – basically, someone has found solace in the predictable and frequently rewarding nature of video games and have gradually placed those experiences above the unpredictable and infrequently rewarding nature of real life.

    Are you familiar with Chris Ferguson’s research? He has some killer findings, especially with regard to a publication bias in violent video game research.

    • Mike Langlois, LICSW says:

      Thanks Patrick, and great blog! I also think your group practice’s website is one of the most innovative I’ve seen in a long time! Grats. I haven’t read Chris’s work, adding it to reading list… :-)

  4. “This graph shows that eating food more than doubles the level of dopamine in the brain, from 100% to a spike of 150% an hour after eating. Sex is even more noticeable, in that it increases dopamine levels in the brain by 200%, or quadruples the amount of dopamine.”

    I’m pretty sure that “more than doubles” for food is incorrect. It looks like it’s just a jump from a 100% to 150. The y label declaring it in terms of basal level supports this interpreting. On the other hand the part showing box feed which is at 50 supports your interpretation.

  5. Addiction isn’t quantified by dopamine levels, although what you have demonstrated is that there is potential for video game addiction to roughly the same degree as food or sex addiction (your numbers are off though, an increase from 100 to 150 for food is less than doubling, an increase from 100 to 200 for sex is doubling and not quadrupling).

    The criteria for addiction include craving, need for more of the substance to achieve the same results (i.e. playing for longer times, or playing more intense games), interference with normal functioning (do you lose sleep, play when you should be doing work, forego social interaction in lieu of playing), and whether it is maladaptive (are you in poor health due to sedentary lifestyle, or have you gotten in trouble at work for playing, etc), and withdrawal (do you feel angry or irritable if you cannot play). If none of those things are true, then dopamine doesn’t matter–for you gaming is not an addiction. If one or more of them is true, and for a lot of people they are, then gaming can be considered an addiction, and the best way to deal with it is to both reduce gaming time AND increase other pleasurable activities.

    Video games are addictive for the same reason that drugs are addictive–because they increase dopamine levels–but not to the same degree. You can’t be as addicted to video games as you are to meth, but you could be as addicted to video games as sex (and that in itself seems a little scary) or morphine.

    The difference between the reward from food and sex vs. gaming is that eating food and having sex are, as you point out, they are necessary for survival–for the individual in the case of food, and for the species in the case of sex. Gaming is falsely rewarding (like drugs) because it tricks the body into thinking you are doing something adaptive, “good for you” or necessary for survival, when it isn’t. There’s no real harm in feeling unproductive pleasure (aka, sex with a condom) so long as you are still able to receive pleasure in other ways, so that you have not “tricked” your brain into thinking that you need it. If you’re still not convinced of the potential for gaming to be addictive and maladaptive, do an internet search for “kid kills because of video game” and see how many stories there are out there.

    • Mike Langlois, LICSW says:

      Essa, thanks for your comment. I think it is worth editing the post a bit, because there is something inaccurate about I interpreted the first graph. First, I think it is fair to suggest that we start off with the basal level of 50% as the baseline. In other words, if your brain is at 0% dopamine you’re probably dead. So given that adjustment I think the first graph more accurately could be interpreted as s that eating food often doubles the level of dopamine in the brain, ranging from a spike of 50% (up from 50 to 100) to a spike of 100% (up from 50 to 150) an hour after eating. Sex is even more noticeable, in that it increases dopamine levels in the brain by 200%, which up from the 50% baseline would be 150% hence “more than doubles.”

      That said, I disagree that a video game is a substance. Like sex, playing a game does not involve ingesting a substance. Yesa it does something to your brain, so does playing hopscotch. But the current medically accepted diagnosis of substance dependence requires a substance that the body takes in, not an activity. The definition is from the DSM-IV and ICD, not me.

      Also, I disagree with the survival argument. I’m not a Puritan, I believe that pleasure is necessary for survival. If pleasure wasn’t necessary, we wouldn’t have the ability to have a neurological reward system in the first place.

      Finally, the existence of a prevalent topic on the internet does not indicate its validity of factual nature, just google “Maya 2012 end of the world” if you don’t believe that. And the prevalence of media stories you allude to is more attributable to media hype than frequency. The example I’ll leave you with is the percentage of World of Warcraft players who the media reported attributed their game playing to their infant death in 2008: 0.000019999999999999996%

      • Thanks for putting up the interesting graphs and stoking some conversation on this topic. I can totally see how it can be frustrating for two groups to understand each other when they use different definitions for the word “addiction”. Apart from the semantics though, it is fascinating that there are people who devote so much time to video games that they neglect their work, relationships, hygiene, nutrition, or even their 3 month old child (http://www.cnn.com/2010/WORLD/asiapcf/04/01/korea.parents.starved.baby/index.html?_s=PM:WORLD).

        First let’s clear up some confusing language. Basal means normal or base level. “x% of basal” means take the normal level and multiply it by x/100. Something at it’s normal baseline level is at 100% of basal. For example look at the graph of dopamine release for food in the blog above: it starts at 100% before the subject eats, increases to 150% of normal or 1.5 times normal, and ends back at 100% long after the subject ate.

        From the graph above, food elevates dopamine by 50% above baseline for a few minutes, but the excess falls off exponentially until levels are back to baseline within an hour. Average exposure above baseline looks like 20 or 30% for the hour where the effect is noticeable.

        If the peak dopamine exposure from video games is indeed roughly a 100% increase above baseline or normal level while playing, then the cumulative exposure above baseline over several hours daily (as is common for kids playing video games) rivals the cumulative extra exposure from some of the drugs in the charts above. For example from the charts above, 10 mg/kg morphine causes release 100% above baseline for 2 hrs and 50% above for ~1 hr while cocaine averages ~150% above baseline for 4 hrs. If we compare this to video gaming at 100% above baseline, then the exposure above baseline from 2 to 3 hours of video games is similar to the 10 mg/kg of morphine and 4 to 6 hours is comparable to cocaine. And while one might deplete cash fast with daily hits of morphine or cocaine, video games are cheap and easily accessible enough to be used daily.

        Interesting article here http://www.nature.com/tp/journal/v1/n11/full/tp201153a.html states “…dopaminergic medication in Parkinson’s patients can lead to pathological gambling and other addictive behaviour such as binge eating and hypersexuality. Greater dopamine release in the ventral striatum has been shown in Parkinson’s patients with addiction, obsession and gambling compared with Parkinson’s patients without these symptoms. These findings identify striatal function driven by dopamine as a core candidate promoting addictive behaviour.”

        Another interesting article http://www.ncbi.nlm.nih.gov/pubmed/20545602 states “Computer game playing may lead to long-term changes in the reward circuitry that resemble the effects of substance dependence.”

        I’d be interested to hear some of the generic consequences of chronic elevated dopamine exposure; have you heard of anything interesting?

  6. Kiran Lang Milunsky says:

    The interesting thing to consider is that individuals often come upon their “drug of choice” as a way to “self medicate.” Might we think that of a chicken and egg situation where individuals who are playing more games than others actually have lower dopamine levels and are benefiting from the play. I acknowledge that I, myself have not looked at the statistics or any existing research on this, but I am certainly curious to see if gamers are actually creating situations wherein there bodies are capable of producing necessary neurotransmitters.??

  7. If we could steer young people’s attentions to creative thinking games and away from the repetitive pattern games this might help but how we do that is beyond me. Seems as if the genie is already out of the bottle.

Trackbacks

  1. [...] There was a lot of reactionary scuttlebutt to Koepp’s article claiming that since video games double the brain’s production of dopamine, they’re therefore clinically addictive and comparable to other things that release high levels of the chemical, such as drugs and sexual activity. It was falsely purported for a number of years that “game addiction,” as a result, was a real and dangerous thing that stemmed from the brain’s acquired dependence on increased levels of dopamine, which simply isn’t true. [...]

  2. [...] Mike Langlois, who maintains an excellent blog “gamer-therapist” said “The stereotype presents the gamer as apathetic and avoidant of any work or investment. One thing we know about stereotypes is that they can be internalized and lead to self-fulfilling negativism, and I’ve come to hear gamers refer to themselves as lazy slackers.” [...]

  3. [...] Dopey About Dopamine: Video Games, Drugs, & Addiction [...]

  4. [...] While girls average a healthy five hours a week on video games, boys average 13. The problem? The brain chemistry of video games stimulates feel-good dopamine that builds motivation to win in a fantasy while starving the parts [...]

  5. [...] Ask yourself – Are you sure that a child playing a challenging and creative video game is comparable to an alcoholic or drug addict? Think hard before you label a child an addict. [...]

  6. […] aside, this is probably the real, root reason. Most games are basically dopamine dispensers. Here’s a primer on dopamine’s relation to video games. Anyways, trophies and achievements are like a […]

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