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Home » Smartphones: It’s Time to Confront Our Global Addiction: Dr. Justin Romano (Transcript)

Smartphones: It’s Time to Confront Our Global Addiction: Dr. Justin Romano (Transcript)

Here is the full text and summary of Dr. Justin Romano’s talk titled “Smartphones: It’s Time to Confront Our Global Addiction” at TEDxOmaha conference.

Listen to the audio version here:


Let’s start with a dirty word, shall we? Pandemic. As we transition out of the last pandemic, we’re entering a new pandemic of addiction that might be the most pervasive addiction in human history. Scary part is the world has yet to even acknowledge that this addiction exists, despite it being all around us and fueling our current mental health crisis.

But today, we turn the tide on this new addiction. What if I were to tell you that in 2007, a new addictive drug came out and it took the world by storm. In less than 15 years, over half of the world’s population was using this drug daily. It was causing a rise in depression, anxiety, and suicide in all age ranges, but especially in young girls.

And it was accounting for 3,000 traffic deaths per year in the United States from impaired driving. If this were happening, wouldn’t there be an outrage? Wouldn’t the government and society as a whole be trying to fix this? Wouldn’t we be drafting class action lawsuits and demanding justice?

Well, check your pockets, because I’m guessing you have this drug on you right now, and it’s your smartphone. When you think about addiction, what comes to mind? Substances like drugs and alcohol, maybe sex, gambling. You think about computer code, apps, algorithms?

As a child and adolescent psychiatry fellow, I am here to advocate for my patients, who are mostly kids aged five to 19, who I’m seeing become addicted to their phones en masse. And the purpose of this talk is to shift your perception of addiction, because we must start viewing smartphones, technology, and social media in the context of addiction if we want to reverse our current mental health crisis.

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What we know about addictions neurologically is that all addictive things, including your smartphone, increase dopamine in your brain at the levels of the ventral tegmental area and the nucleus accumbens. Dopamine makes you feel good, satisfied, but also increases your drive. That drive is important, because it’s the drive that makes you do things over and over again.

For example, in caveman times, if you were to find a new food source that helped you survive, say a big bush of wild blueberries, your brain would release a ton of dopamine to make you feel good about your find and increase that drive to do it again.

In today’s world, there are endless apps that are trying to trick your brain into releasing dopamine without being fundamentally good for you. App developers have found a way to hack a reward and addiction pathway, and they did it without a substance. They did it with computer code. Addiction in 2022 has become nothing more than zeros and ones.

Typically, we define addiction by these signs. Play along and see how many you have, like hazardous use, using while driving or when it’s dangerous, impaired social functioning, like isolating yourself or giving up on your social roles, having withdrawal from your phone, cravings for your phone, increased tolerance like your screen time creeping up, trying to cut down on your use and being unable to, spending more time using than you initially anticipated, and giving up your hobbies and interests to use.

How many of you have that, oh crap, that’s me, a feeling? And if you don’t see it in yourself, how many people around you do you see these signs in?

So if we’re seeing everyone become addicted to their phone, you’d think that the mental health community would be doing something about this, right? But this addiction came on so fast that academia has yet to catch up. And as of now, none of the top mental health associations in the world have even recognized this as a real diagnosis.

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The DSM-5, the Diagnostic and Statistical Manual, Psychiatry’s Bible, has no official diagnosis for phone addiction. The ICD-10 and 11, the international billing and coding system we use in America. Now there is a code for getting sucked up into a jet engine and requiring medical care, but there’s no code for phone addiction. And if there’s no code, it makes it incredibly difficult to diagnose, bill for, and track.

We have to come to a consensus on a diagnosis and a code, because right now, without an official diagnosis, the world has yet to even admit that this is a real problem. And you don’t have to be a psychiatrist to know that the first step in treating an addiction is admitting that you have a problem.

How pervasive is this issue? Well, to compare it to smoking, at the peak of the tobacco industry in 1954, only 45% of Americans smoked. Right now, 97% of Americans have a smartphone, and surveys indicate about half of them feel addicted to them already.

Here’s why your smartphone is a super addiction. It places multiple addictive elements into one device. Video games, pornography, sports gambling, shopping, social media, instant messaging. By placing these all into one device that lives in your pocket, you’re walking around with an addiction-ticking time bomb that you have unlimited access to.

Your phone is programmed to buzz and ding you at just the right rate to make sure that you’re constantly thinking about your phone and your screen time creeps up.

Now, the phones are specifically designed to be addictive, but there are so many other reasons why this is a super addiction, like rapid acceptance. Remember, smartphones have only been around for the past 15 years. The iPhone was released in 2007, and in 2022, 95% of American teens have a smartphone and use them, on average, up to nine hours per day.

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The original telephone took over 100 years to democratize, where everyone has access to it. The smartphone did it in less than a fifth of the time. Smartphones have revolutionized a very sexy topic in 2022, supply chains. Most addictions have to be planted, grown, processed, shipped, packaged, prepared, and consumed. Smartphones eliminate almost all of these steps and allow app developers to deliver free, legal, addictive content to anyone, anywhere, instantly.

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