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Transcript: Brian Smiga, TEDxAsburyPark Founder and Co-founder of Alpha Venture Partners, interviews Esther Dyson
Brian Smiga: Hi, this is Brian Smiga with TEDxAsburyPark, and the 1act.1idea interview. I’m here with my good friend, Esther Dyson, who I’ve known since 1998, and who spoke at our TED conference in 2015 on health. Welcome, Esther.
Esther Dyson: Glad to be here.
Brian Smiga: Great to see you. And you look very well as always. Are you swimming, running and staying fit during this pandemic?
Esther Dyson: I’m swimming and staying fit, and fortunately, I also bought “swimming insurance” for the few months that my YMCA was closed and that was a rowing machine. But swimming is much better.
Brian Smiga: Oh, great. I use a WaterRower. I’m very happy with it. What kind of rowing machine do you have?
Esther Dyson: I use a plain old Concept2 with air; I don’t want to deal with water leaks.
Brian Smiga: Yeah, it’s been great. And there’s a couple of bolt-on companies like Ergatta that do for rowers what Peloton does for cyclists.
Esther Dyson: I don’t really use that. I just listen to books or watch sped-up YouTube things.
Brian Smiga: Likewise, I just do a YouTube “watch later list” and it’s my education time on the rower or on the bike. It’s a shame I can’t do it when I’m out on the water in my kayak, because, no screen out in salt water.
Esther Dyson: You can listen to books. (Audible!)
Brian Smiga: That’s true. So we’re here today to talk about health, and specifically within health, mental and behavioral health, and specifically within that topic, addiction and new forms of addiction. This is really interesting. So what was the epiphany? What was the pinch that made you get interested anew in this topic, Esther?
Esther Dyson: Well, it takes several pinches. The first really was in Russia, realizing alcoholism was a big problem. This was in 1989. I was noticing that the men, in particular, felt useless. They had jobs that were useless. They got money that was also useless. Women would stand on line and convert the money into real things, like food and clothes. Because of pricing, things were rationed, so it was more valuable to have a thing than to have money. If you saw a line, you would just get on it and ask what they were selling. I had a friend who once bought 12 vegetable choppers, because they were selling vegetable choppers.
Anyway, Angus Deaton and Anne Case wrote about deaths of despair1. (Also, a book published this year – Deaths of Despair and the Future of Capitalism) And that, again, was the same sort of thing: people who feel useless, whose dignity has been taken. And then there was Sam Quinones’ wonderful book, Dreamland, which talks about the two business models of addiction.
One was the Sacklers and prescription opioids and so forth, and the other was basically the Mexican drug cartels, which used to be wholesale and sold mostly in urban Black neighborhoods. But they found a new business model, with no wholesale middlemen/dealers. They hired drivers to show up in suburban places outside pain clinics and sell heroin cheaper and faster than you could get the prescription opioids inside. This issue kept coming up, in the five Wellville communities and in other communities all over the U.S., addiction is a huge problem.
Brian Smiga: Yeah. It seems like it’s a trend that has been increasing steadily since the advent of Oxy.
Esther Dyson: Well, never forget alcohol. Back in the first half of the 19th century, alcohol was a huge problem…Many factory workers were just drinking beer all day and stuff like that.
Brian Smiga: Which is why we had Prohibition for a short time.
Esther Dyson: Right. Yeah, the temperance movement. In lots of cultures there are equivalents, say opium, and it’s universal, but in the U.S. more recently, it’s been a bigger and bigger problem I think because of a whole lot of things. Our culture has changed. It’s an instant gratification culture. There are many fewer happy two-parent families. You have a lot of children who grow up anxious and damaged. All the adverse childhood experiences are visibly correlated with addiction.
Brian Smiga: Mm-hmm.
Esther Dyson: And it’s not just poor people and Black people, though they have much higher rates of the *conditions* that foster addiction – starting with poverty and poor neighborhoods – and fewer resources and less support to fight back. It manifests in many different ways, but COVID-19 has also dramatically increased the rates of depression, anxiety, suicide – and overdoses, which I would call “negligent suicides.”
Brian Smiga: Indeed. Yes, and they’re so hard to get real help and real diagnostics, and we’re still doing the 12-step and the other types of programs, which don’t seem to quite work, but you’ve now dived into this.
Esther Dyson: And two more things. One is stigma. If your friend’s kid has cancer, the neighbors will come by with potluck. But addiction, not so much.
Brian Smiga: That’s right. It’s so stigmatized.
Esther Dyson: And the second thing: There’s Facebook and all these other online seductions… At first I thought, “What a clever metaphor, addiction, internet, whatever.” And then I started reading a lot more, In the Realm of Hungry Ghosts: Close Encounters with Addiction, by Gabor Maté, Unbroken brain by Maia Szalavitz, The biology of desire by Marc Lewis (who also has a wonderful blog, “Understanding Addiction” ) and Lost Connections by Johann Hari.
Basically, people take drugs because they feel bad and want to feel better( though they may start just to experiment). The drugs provide self-medication…. But it’s not just drugs, which can create a physical dependence (or “substance abuse”), but also other things, which create an emotional dependence; *that*’s addiction. As well as drugs and alcohol, the focus of addiction can be food, or Facebook, or influence points, and now also RobinHood, which is the newest, socially sanctioned form of addiction-slash-gambling. They call it “democratizing investing,” but for many people it’s providing broader access to gambling – and the business model likely won’t work without that population; they;re the active traders (so-called “investors”) . In the end, it’s just like alcohol and painkillers and everything else. They have their place. Sometimes they’re useful. Some people use them wisely, or at least have a fun time getting high on Friday night but don’t get sucked in. But for people who are vulnerable to addiction, they can be dangerous and ultimately lethal.
Brian Smiga: Yes.
Esther Dyson: The fundamental pattern of addiction is that you get focused on this thing that is going to relieve your anxiety or your pain. Ironically, it’s the title of Mary Trump’s book about her uncle: “Too Much and Never Enough.” You want that release and you can’t think of anything else other than that thing, whether it’s gambling or the drug or the experience, and you forget about your family and the people you have responsibility to. You also don’t see a future and you don’t see a past. You have no agency; you’re not trying to change things except for satisfying this one need, right now. You seek the immediacy of relief. You’re not seeking pleasure; you’re looking for comfort and release. The pleasure has gone away. You just want to avoid the pain. You’re in this tight box in space and time.
Brian Smiga: Right. You must be thinking about some of the counters to this behavior that’s happening everywhere, including in addictive Robinhood investing. Have you discovered some efficacy, some ways to counter it?
Esther Dyson: The basic point is that the opposite of doing drugs or succumbing to any addiction is not…not doing it. It’s doing something else with meaning and purpose. It’s connecting with people you love and shaping your own future.
Brian Smiga: Right.
Esther Dyson: And that, of course, is easier said than done. Addiction is a very deep hole to climb out of, because recovering just one thing – eliminating the physical dependency with suboxone, for example, or connecting with your mother – still leaves the others out of reach. You’ve lost so many of the affordances of an addiction-free life.
There are many ways and different kinds of programs to help, but they often fail… When you ask a person to stop taking drugs, you need to give them something else that is more meaningful and purposeful, which is why counseling and community support and all those things are so important. However, if you stop taking drugs, but you don’t have a job and your family won’t talk to you, hey, why stop taking drugs? At least you get some relief.
The best thing is to raise children in a happy, secure environment so they don’t succumb to it in the first place. They have resilience. They’re not looking for relief. They’re looking longer-term for meaning and purpose; they need to matter to someone else. They’re looking to be part of a community and to maintain those connections that Johann Hari writes about. But we can’t roll back the clock, and it’s worth it to try to make the recovery programs and the re-entry schemes more robust and successful.
Brian Smiga: Yeah. So I think you and I practice this a little bit through the positive addictions of physical exercise and maybe in human conversations. But I know without any doubt that my daily dose of physical exercise, which is almost required, is a shot of endorphins, not Oxycodone, of the right brain chemistry to make me feel happy and fulfilled. Are there solutions that lie in that direction?
Esther Dyson: Well, exercise is one really good thing to do. I mean, it makes you physically healthier and also mentally healthier, but not just by giving you relief, but by actually giving you, it improves your metabolism, and all these things interact to affect your mood and your anxiety and so forth. It doesn’t take away your hope for the future; it actually gives you agency and improves your future. By contrast, drugs are inherently physically bad for you in excess; they cause physical dependence so that you need more and more. Exercise is physically good for you. An addiction is just doing something that is destructive and you keep doing it anyway. Generally, exercise is not an addiction, unless you have an eating or weight disorder where you do that to the point that it’s harmful. For example, if you went out running every night, even when your kid was sick and said, “Daddy, please stay home and take care of me,” then it would have become an addiction. Again, it’s your relationship to the substance or activity; it’s not the thing itself.
Brian Smiga: Yes. Well, I’ve always called cycling my positive addiction, but it’s just really my good habit. So now, you’re a technologist, you’re one of the leading technologist pundits that I know. What is technology doing to counter this? In some ways, technology is exacerbating it. Are there any counter trends in technology?
Esther Dyson: There’s technology that helps people communicate with one another, tele-mental-health counseling, finding a therapist… Those are all useful. I’m an investor in a bunch of companies that do this and related things…. . Foresight mental health, Humanest, Hurdle, MindRight, Supportiv. Mostly, they deal with the mental strains that can underlie addiction. Then there’s MedicaSafe, which will soon enable you to get your maintenance drugs like Suboxone in a secure box that unlocks one dose at a time. And Pocket Naloxone will provide an over-the-counter overdose remedy, cheaper and more available than Narcan. But both of those are still pre-market though they are already in testing.
Brian Smiga: Interesting.
Esther Dyson: But the real solution is not technology. It’s other people; it’s the human connections. It’s the feeling of being needed and purposeful. Technology cannot provide that. It can be a medium through which that is provided, a medium through which you find the support you need and provide support to others . But technology does not replace the two-way human connections that are the foundation of human happiness.
Brian Smiga: Agreed. Agreed. Well, we’ve got to end here, Esther. It’s been really great talking with you. Esther was one of our speakers at TEDxAsburyPark 2015. We hope to welcome her back to our stage when we come back live. Our next event is on May 7th, 2022 at the Two River Theater in Red Bank. It’ll be sold out. It’s an all day idea conference. We hope you’ll book your tickets in advance. But thanks for listening. This has been the 1act.1idea Interview with Esther Dyson. Thanks, Esther.
Learn more about Esther Dyson