Vital Sings: Age of Addiction

Airdate: July 20, 2020.

Dr Sanjay Gupta: 00:23

Obsessive cravings and total loss of control, whether it’s from a substance or a behaviour, addiction is a disease. This is Vital Signs. I’m Dr. Sanjay Gupta.

Dr Sanjay Gupta: 00:34

Today, we’re going to focus on behavioural addictions. One of the most well known is gambling. It’s not necessarily the act of gambling that’s addictive, but the way that it feels. When the brain perceives a situation as stressful or exciting, like gambling, it sends a signal to the adrenal gland. The gland then releases adrenalin, a stress hormone, causing a s pike in blood pressure and a faster heart rate. Many addicted gamblers describe that adrenaline rush when they place a bet  or play a slot machine. When it comes to gambling, you might be surprised at the country that tops the list.

Dr Sanjay Gupta: 01:08

Meet Kate Seselja. She’s a loving wife and a devoted mother to her six children. Now, get ready to toss out any stereotypes you might have had about gambling addicts.

Kate Seselja: 01:20

People always say to me, “Well, you don’t look like a mother of six.” They were equally as shocked, when I came forward and said that I had a 12 year gambling problem.

Dr Sanjay Gupta: 01:30

Kate lives in Southeast Australia. It’s the country with the highest rate of gambling in the world. She started gambling when she was a teenager. By the time she was 18, Kate was spending her monthly wage in just one day.

Kate Seselja: 01:46

Once I had that first rush on a poker machine, it just did something to my brain. Looking back now, I was just pushing money into it like I was pushing paper through a shredder.

Sally Gainsbury: 02:00

Australians are actually the biggest gamblers in the world. We lose around $1,100 per person per year, compared to less than 600 in the US, and less than 500 in Canada and Britain.

Dr Sanjay Gupta: 02:14

Sally Gainsbury is a psychologist in Sydney, who studies gambling. She says in Australia, there are 197,000 electronic poker machines or pokies. You don’t need to go to a casino to find them either. Pokies are in neighbourhood bars and  clubs, making it harder to escape them.

Sally Gainsbury: 02:33

Very easy to play, which makes them very accessible. Just put money in and press a button. You’re unlikely to win the jackpot, but when you do play, you do get very quick reinforcement in terms of small wins along the way that encourage you to keep betting. Even though in the long run, you are losing.

Kate Seselja: 02:49

I connected with the machine.

Dr Sanjay Gupta: 02:53

Kate got married and started a family, all while hiding the seriousness of her gambling addiction.

Sally Gainsbury: 03:00

People often don’t seek any help for, say, seven to 15 years. They gamble, rather than spending time with their friends and family, and loses productivity at work. They may jeopardise their job, either by stealing or by not working as much, or being preoccupied with gambling, so always thinking about it.

Dr Sanjay Gupta: 03:17

12 years of her life controlled by this disease. During that time, Kate estimates she lost well over half a million dollars.

Kate Seselja: 03:25

There were several times during that 12 years that I  tried to get help. I guess not knowing who to turn to. Feeling like I was such a failure. I felt by the end that I was profoundly broken and I didn’t think there was any possible recovery. On the 20th of January, 2012, after I’d accessed the last money that  I could, I sat behind a machine for eight hours crying, not knowing what to do next.

Dr Sanjay Gupta: 04:12

In that moment, Kate says she strongly considered ending her life.

Kate Seselja: 04:17

I was three months pregnant with our last child and it was my love for her that stopped me making the biggest mistake of my  life.

Dr Sanjay Gupta: 04:33

Kate reached out for help with the support of her husband.

Kate Seselja: 04:36

I tried to get help before and it hadn’t worked. But this time, this counsellor, she saw straight away that my self esteem was destroyed. The counsellor said to me, “I want you to name 10 things that you like about yourself.”

Kate Seselja: 04:56

And I just burst into tears and said, “  Can I list my children into .”

Kate Seselja: 05:03

And she said, “No. You have to tell me 10 things that you like about you.”

Kate Seselja: 05:11

And it took me a week and I still have that list.

Kate Roberts: 05:15

One of the challenges with problem gambling is that unlike drug and alcohol addiction is you can’t see it, you can’t smell it.

Dr Sanjay Gupta: 05:22

Kate Roberts is the executive officer of the Gambling Impact Society. For the past year and a half, she’s also been helping  Kate share her story to help others.

Kate Roberts: 05:33

The whole concept is the time on machine, there’s a lot of design features now to envelope you into the world. And people are not aware of that and more importantly there’s a massive industry that is depending and building itself around that. We need to get away from the idea that these are flawed people. What we actually have is a flawed product and a case of regulatory failure.

Dr Sanjay Gupta: 06:02

The Australian government estimates the cost of problem gambling to the country’s public is $4.7 billion a year. The government has pledge $25 million to support programmes for addicted gamblers. But they also collect roughly 10% of their tax revenue from gambling.

Kate Roberts: 06:21

If it’s going to be recreational, let’s make it recreational. I don’t believe a product that takes $1,200 an hour off you is a recreational product.

Dr Sanjay Gupta: 06:30

As part of her own recovery, Kate Seselja has started the hope project and she still has the original list of 10 things she’s proud of about herself. It’s a reminder of just how far she’s come and what she’s doing now to help millions of others just like her around the world.

Kate Seselja: 06:51

I want people to understand that we’re human beings and when did we lose sight  of that? I really never thought I’d get to the point where I’d be thankful for the journey, but I am. I wouldn’t stop it.

Dr Sanjay Gupta: 07:12

Kate gambled on the electronic poker machines. But online gambling is now posing a new challenge for programmes like the Gambling Impact Society. And as technology increases in all aspect of our lives, it’s becoming a behavioural addiction all on its own.

Dr Sanjay Gupta: 07:28

Think of all the technology advances just  in the last decade. Our phones and our tablets are powerful computers. They’re almost always with us. Kids know how to use tablets from a very young age. And video games are now more mobile than ever. SO maybe it’s no surprise technology and gaming addiction are combining to form a serious problem. Some researchers have shown that here in the United States, as any as three million children are addicted to video games. The manual on mental health disorders in America now included internet gaming disorder as  a condition warranting more clinical research. It’s an important first step when it comes to taking gaming addiction seriously.

Douglas Gentile: 08:08

Scientifically documented real effects. So if they’re on this side of the zero, it means doing a few less of them, and if you’re doing-

Dr Sanjay Gupta: 08:15

It’s a chilly day on the campus of Iowa State University. In room 225, Professor Douglas Gentile addresses his graduate students.

Douglas Gentile: 08:23

And that has led people to believe that maybe only certain types of people are vulnerable to this effect.

Dr Sanjay Gupta: 08:29

They are here to study  how media affects behaviour and the impact of technology and video games. Gentile is one of the world’s leading researchers on video games and all that can come with them. Including addiction.

Douglas Gentile: 08:44

Even back in the 1990s, parents were talking about their kids being addicted to games and I thought, “That can’t be true.” I thought, “All they mean is my kid spends a lot of time playing and I don’t understand why.” And it turns out I was wrong.

Dr Sanjay Gupta: 08:59

Gentile’s  research shows roughly 8.5% of kids gaming in the United States show signs of addiction. Across the world, he found similar numbers.

Douglas Gentile: 09:10

One of the things we know that is a risk factor for addiction is access. So with greater access, we’re gonna see the problem probably increasing. How do we deal with that?

Dr Sanjay Gupta: 09:28

In southern California, addiction  to this virtual world is a reality for Noelle Mathieu’s family. Her 16-year-old son, Griffin, was in treatment for internet gaming disorder. He didn’t want to be interviewed on camera, but told his mother she could speak to us about their experience.

Noelle Mathieu: 09:44

Griffin is a very sweet, very sweet boy. He’s quite introverted. He is quiet. He is on the shy side.

Dr Sanjay Gupta: 09:52

When he was still a child, Griffin’s parents divorced. His mom says he suffered from depression and anxiety. Around age 10,  he started playing video games.

Noelle Mathieu: 10:01

Gryphon is bright. He’s quick to learn things so he did take quickly to it and he became good. He’s good at it. He’s good at the gaming.

Douglas Gentile: 10:11

Sometimes parents want to know why are games so compelling to kids? What is it that is drawing them? Well, there’s a theory of intrinsic motivation. What is it that makes us excited to do something on our own? Called self determination theory. Basically, it’s an A, B, C of human needs. The A is autonomy.  So we like to feel like we’re in control. The B is belongingness. We like to feel like we’re connected to other people. And the C is competence. We like to feel that we’re good at what we do. Well, games are fantastic at all three of these. There’s nothing wrong with that initially, but over time it can start to get out of balance.

Dr Sanjay Gupta: 10:49

Over time, Griffin’s parents noted a shift in that balance and changes in his behaviour.

Noelle Mathieu: 10:55

The isolation, the wanting to be with  playing more, so then that takes away from family time. It takes away from socialising with his friends. I think it really started escalating more in middle school and then we noticed there was a change, a real change, in Griffin around eighth grade. I remember going, “Okay, you know what? I think he could have a tech addiction here.”

Douglas Gentile: 11:21

If we want to know what makes an addiction, there’s not one definition that everyone agrees with. But they do share a lot of basic characteristics. First of all, it has to be something  that’s actually damaging your life, and damaging multiple areas of your life.

Dr Sanjay Gupta: 11:35

This past summer, Griffin’s parents sent him for treatment. They found a programme called Outback Therapeutic Expeditions in Utah. Griffin would spend time outdoors, unplugged from technology, and away from his games.

Noelle Mathieu: 11:49

I felt very strongly about him going that we had no other options, our hands were tied. So I was like, “You know what? We’re doing this for you because we love you and we care about you and we  recognise you need some help.”

Dr Sanjay Gupta: 12:02

Griffin spent six weeks in treatment and returned home. His mom says he still has challenges with his tech use and his depression.

Noelle Mathieu: 12:11

It is a battle. It is so hard because when I look back with Griffin, I was the dealer. “Mom, there’s this new game came out. My friends all have it.”

Noelle Mathieu: 12:21

And I was like, “Sure,” because he is a good kid.

Dr Sanjay Gupta: 12:24

Shortly after our interview with Noelle, Griffin sent us an email. He wanted to share  his message for anyone struggling like him. Griffin wrote, “I want other kids to realise that the problems they are facing aren’t because of what’s going on around them, but also due to the fact that they stay inside and won’t speak to anyone about them. Sitting inside and staring at a screen won’t make it disappear.”

Dr Sanjay Gupta: 12:49

Griffin’s treatment was essentially a digital detox. That method has been adopted elsewhere in the world to treat technology addition. In London, Dr. Richard Graham started the United Kingdom’s  first rehab programme for tech addicts.

Richard Graham: 13:03

Gamers will vividly tell you that when they’re gaming, they are so immersed that they don’t see the screen, the don’t feel the controller. And I think we’re seeing similar issues with smart phones. People incorporate it into their sense of body, into their image of themselves, and in a sense don’t even know they’re doing it at times.

Dr Sanjay Gupta: 13:21

Dr. Graham started the programme in 2010. The clinic operates out of Nightingale Mental Hospital, a private institution.

Richard Graham: 13:29

And we know, for example,  from our media regulator in the UK that young people between 16 and 24 are going to spend pretty much 10 hours at least each day on screens. So we’ll be talking with parents about ensuring there’s a curfew, that there is no screen time an hour before bedtime is an absolute basic essential.

Dr Sanjay Gupta: 13:50

Controlling that screen time is what Douglas Gentile recommends too.

Douglas Gentile: 13:56

Parents often feel powerless. But the reality is when  you set your limits on how much time and what types of media your children can use. It actually has a powerful ripple effect out into the future across a wide range of health and wellness benefits.

Dr Sanjay Gupta: 14:14

Setting limits can work if you know what you’re looking for. But what happens when the source of the addiction is hiding where you least expect it? Next, what we can all learn to protect ourselves from food.

Dr Sanjay Gupta: 14:28

It is hard to combat an addiction  when the temptations are all around you. Like technology, food addicts struggle with overwhelming access. And as more and more processed foods enter our diets, sugar consumption is on the rise. While we might not think of it on the same level as addictive substances like drugs, research has shown that sugar fires off the same reward centres in the brain as cocaine. Unlike cocaine, we actually do need some sugar in our bodies. It’s broken down into energy for ourselves. The issue is that we’re eating too  much of it and it can be hard to cut back. Especially when it’s hiding in foods you’d never think of.

Dr Sanjay Gupta: 15:10

So this is a pretty standard grocery aisle. Tell me where your eyes go. Where do you …

Dr Sanjay Gupta: 15:15

Lisa Drayer is a nutritionist and a best selling author. We’ve come to the best place we could think of to talk about sugar, a typical American grocery store.

Dr Sanjay Gupta: 15:25

Everywhere you look, I mean, there’s sugars. And, again, not in the places you’d necessarily expect  it. Spaghetti sauce. What do we find here?

Lisa Drayer: 15:33

Exactly right. So here we’re looking at tomato sauce and we see that a half a cup, which is one serving, has 12 grams of sugar.

Dr Sanjay Gupta: 15:41

This isn’t even sweet.

Dr Sanjay Gupta: 15:44

The American Heart Association has set daily recommendations for sugar consumption. For women, no more than six teaspoons a day. One teaspoon is four grams of sugar, so that means roughly 24 grams of sugar in a day. Men get a bit more, nine  teaspoons, or 36 gram s. But on average, we’re exceeding those numbers big time. Here in the United States, the average adult eats 22 teaspoons of sugar a day.

Dr Sanjay Gupta: 16:13

I think it’s really striking given that a lot of people think they’re doing the right thing. They’re led to believe that I’m eating healthy, but in fact they’re not. What are some of those misconceptions?

Lisa Drayer: 16:23

I think a lot of people think that just because something is natural, it’s healthy. So, for example, honey  is natural, but it’s very caloric and many people might not even know that a teaspoon of honey, or agave for that matter, has more calories than a teaspoon of sugar or sucrose.

Dr Sanjay Gupta: 16:40

All right. Speaking of misconceptions, it is remarkable and even I am stunned and I studied this. I’m stunned at what you think you’re eating and what you’re really eating. Talk me through some of this.

Lisa Drayer: 16:51

Sure. So here we have a quarter of a cup of dried cranberries.

Dr Sanjay Gupta: 16:55

Perfectly healthy and good for you.

Lisa Drayer: 16:56

Exactly. You toss it on your salad, you combine it with some nuts. But,  in fact, it contains the same amount of sugar as a quarter cup of candy. Who would think that a quarter cup of each would have the same amounts?

Dr Sanjay Gupta: 17:09

I mean, again, that is remarkable. To take it a step further, you’d put that on a salad.

Lisa Drayer: 17:13

Right.

A healthy salad.

Dr Sanjay Gupta: 17:14

You wouldn’t put these on a salad, but you’re essentially doing the same thing.

Lisa Drayer: 17:18

Essentially. When you think about sugar being sugar. That being said, dried cranberries do offer antioxidants which candy does not. I just want to show you. This is actually the amount of sugar  in one can of soda. That’s one 12 ounce can. You’ve pretty much maxed out on your sugar intake for the entire day.

Dr Sanjay Gupta: 17:52

Sugar is hiding in many of our foods and there’s both natural and added sugar. Natural sugars are found in foods like fruit and milk  in the form of fructose and lactose. Added sugars are included during processing or preparation but are really empty calories that don’t offer any nutritional benefits. There’s also artificial sweeteners. Decoding the nutrition label can help identify the different types, but that’s easier said than done. The label doesn’t distinguish between added and natural sugars, but the FDA is currently considering a proposal to change that. However, the Sugar Association in the US disagrees with the proposal saying the FDA has not quote, “Provided evidence that added sugars labeling is necessary to assist consumers in maintaining healthy dietary practices.”

Dr Sanjay Gupta: 18:45

According to the Sugar Association, sugar, as in sucrose not high fructose corn syrup or other sweeteners, is part of a healthy diet when consumed in moderation.

Lisa Drayer: 18:56

Barbecue sauce, one of the biggest offenders when it comes to added sugars  in foods. That is hidden sugar. I want you to take a look at that barbecue sauce, flip it around. What do you see as the first ingredient?

Dr Sanjay Gupta: 19:08

High fructose corn syrup. Bad sign. Big red flag.

Lisa Drayer: 19:12

And how many grams of sugar are we talking?

Dr Sanjay Gupta: 19:15

16 grams of sugar per serving.

Lisa Drayer: 19:19

How many servings was it per …

Dr Sanjay Gupta: 19:20

14 servings.

Lisa Drayer: 19:21

14 times four.

Dr Sanjay Gupta: 19:24

Yeah. 56.

Lisa Drayer: 19:26

56 teaspoons of sugar.

Dr Sanjay Gupta: 19:30

So salads, what could be wrong with salads and salad dressing?

Lisa Drayer: 19:34

Right. We think of salads as healthy and we certainly think of a fat free salad dressing-

Dr Sanjay Gupta: 19:39

Right.

Lisa Drayer: 19:39

… as very healthy. Right?

Dr Sanjay Gupta: 19:39

Yep.

Lisa Drayer: 19:41

So here.

Dr Sanjay Gupta: 19:42

You want us to help take care of your body, take care of your heart.

Lisa Drayer: 19:44

Exactly. We’re gonna save calories and fat. But, in fact, when we look here, we see that one serving or two tablespoons has 10 grams of sugar. So that’s for two tablespoons. If we’re talking about a ladle, that would be double the amount or-

Dr Sanjay Gupta: 19:44

20.

Lisa Drayer: 19:58

… 20 grams of sugar.

Dr Sanjay Gupta: 20:00

So 20 grams of fat free salad dressing, in two servings you’re gonna get 20 grams-

Lisa Drayer: 20:08

That’s right. 20 grammes. So that’s actually-

Dr Sanjay Gupta: 20:11

Brought my donuts.

Lisa Drayer: 20:12

… more sugar, that’s right, than four mini donuts. Four mini donuts have 17 grammes of sugar.

Dr Sanjay Gupta: 20:19

You’re supposed to be doing the right thing here. Fat free salad dressing. People might think that doesn’t even taste good, I’m punishing myself-

Lisa Drayer: 20:26

Right.

Dr Sanjay Gupta: 20:26

… by eating this, but I’m doing something good for myself. But they’re not.

Lisa Drayer: 20:29

This  we expect.

Dr Sanjay Gupta: 20:31

Right. Right.

Lisa Drayer: 20:32

This we don’t.

Dr Sanjay Gupta: 20:33

That’s the crucial point. Yeah.

Dr Sanjay Gupta: 20:36

Too many sugar calories lead to weight gain and obesity, straining your heart, and raising your risk for a stroke or an illness like diabetes. But there’s more at play here than just your sweet tooth. You might be craving sugar because it’s been shown to be addictive.

Lisa Drayer: 20:52

It seems to induce cravings and hunger that are comparable in magnitude to those induced by addictive drugs.  Does that mean it’s addictive? Maybe. I think one of the tell tale signs is a loss of control. So if you feel like you can’t stop eating the cookies, you have to finish the whole box, you can’t stop at one or two, you’re obsessing about how you’re gonna get your sugar fix, and you simply can’t focus on anything else. You have that psychological dependence. Then I think you’re probably talking about a food addiction.

Dr Sanjay Gupta: 21:23

Are there other little tips to sort of cut down on your sugar consumption?

Lisa Drayer: 21:26

You want to look at the ingredient list. If sugar of  any one of a bunch of terms are listed high on the label, you want to avoid that food. So we’re talking about corn syrup, high fructose corn syrup, agave, honey, molasses, and anything ending in “ose.” O-S-E.

Dr Sanjay Gupta: 21:42

Right.

Lisa Drayer: 21:42

Dextrose, fructose, sucrose. So these are the code words for sugar.

Dr Sanjay Gupta: 21:48

All right. Here is something that I think will astonish. I can barely lift this.

Lisa Drayer: 21:56

25 pounds of sugar.

Dr Sanjay Gupta: 21:58

25 pounds of sugar.

Lisa Drayer: 21:58

Right.

Dr Sanjay Gupta: 21:59

And now I would  tell you and would be still alarming if I told you, you ate this much in a year, but that’s not even the case.

Lisa Drayer: 22:06

That’s not even the case. Not only are we eating this much, but we’re eating a lot more. We’re eating five times this amount of sugar. So that’s more than some people’s body weight that I know. That’s a lot of sugar.

Dr Sanjay Gupta: 22:21

Whether it’s food, gambling, technology, or any other behavioural addiction, it’s more than just will. It’s a medical diagnosis. And there is a thin  line between doing something a lot and being addicted. A line even psychologists don’t have a consensus on just yet. But the keys are awareness of the warning signs and acceptance of the possibility it’s an addiction. Don’t let the stigma of the word addiction hold you back from getting help. For Vital Signs, I’m Dr. Sanjay Gupta.

END