Today's Most Common Addiction? Doomscrolling.

The origins of social media emphasized the social—connecting and chatting with friends, building online communities, maybe even promoting local small businesses. Today, however, social media has evolved to highlight the media. While maintaining relationships with friends remains a major function of social media, the space has evolved to present short-form, highly stimulating, often AI-generated content in algorithms specifically designed to maximize user engagement. These algorithms are designed to stimulate the brain’s dopamine receptors and to create addiction. As a result, this new sensationalist paradigm has sparked massive debate about the ethicality of social media, particularly because, upon exiting social media, dopamine dissipates and a cycle of compulsive use is reinforced [6].

Doomscrolling describes the common habit of spending excessive time “scrolling” through content on social media, a term that gained prominence during the lockdowns of the COVID-19 pandemic. Although generally understood to be a stress-coping mechanism, Harvard doctor Aditi Nerurkar claims that doomscrolling is rooted in the brain’s limbic system. The limbic system, or colloquially, the animal brain, produces signals for hunger, thirst, reproduction, caring for young, and, most relevant to this case, the fight-or-flight response [5, 7]. She argues that stress incites the urge to scroll and to seek information. Doomscrolling is also interpreted as an addiction to negative news specifically, which some argue stems from the brain’s negativity bias, “an evolutionary survival trait that drives more attention to threatening or bad information” [1]. In any case, nearly 1 in 3 US adults admit to doomscrolling to some extent, with Gen-Z and millennials citing even higher figures (~50%) [3].

While mental health research related to doomscrolling is still emerging, doomscrolling has been linked to several negative mental health outcomes. These include a heightened anxiety baseline associated with negative news [4], depression, sleep disturbances from an overstimulated brain at bedtime, and reinforcement of negative thought patterns [1]. Furthermore, as with other compulsive behaviors, doomscrolling can take time away from activities such as connecting with friends and family, schoolwork, and exercise, further compounding its harmful effects.

So, what are some ways to mitigate the effects of doomscrolling? The Mayo Clinic suggests asking oneself some self-reflective questions. How is time online affecting my social health? What am I missing out on because of my time spent scrolling? [2] Setting intentional time limits and using other de-stressors—such as socializing with friends and exercising—are also helpful. Other ways can be implemented directly at the source, such as using screen time apps and setting the screen to grayscale to reduce visual appeal. 

In conclusion, while algorithmic social media platforms are ethically questionable, individuals are not powerless. Many already recognize it as a personal problem, but understanding it more deeply—as both a neurological response and a habit enforced by social media platforms—permits more effective intervention. Through self-awareness and healthier coping mechanisms, the balance between the online and real worlds can be restored.

Designed by: Jennifer Liu

Reviewed by: Vedant Patel

References

[1] Bock, S. (2025). Doomscrolling Again? Expert Explains Why We’re Wired for Worry. Ucsd.edu. https://today.ucsd.edu/story/doomscrolling-again-expert-explains-why-were-wired-for-worry

[2] Bowman, A. (2024, April 18). Doomscrolling: Stop the scroll, protect your mental health. Mayo Clinic Press. https://mcpress.mayoclinic.org/mental-health/doom-scrolling-and-mental-health/

[3] Briggs, E. (2024, March 20). How Americans Feel About Doomscrolling. Morning Consult Pro. https://pro.morningconsult.com/analysis/doomscrolling-impact-users-mood-2024

[4] Cassidy, C. (2022, September 5). Doomscrolling linked to poor physical and mental health, study finds. The Guardian. https://www.theguardian.com/society/2022/sep/06/doomscrolling-linked-to-poor-physical-and-mental-health-study-finds

[5] Cleveland Clinic. (2024, April 6). What Is the Limbic System? Cleveland Clinic. https://my.clevelandclinic.org/health/body/limbic-system

[6] Goldman, B. (2021, October 29). Addictive potential of social media, explained. Stanford Medicine News Center. https://med.stanford.edu/news/insights/2021/10/addictive-potential-of-social-media-explained.html

[7] Salamon, M. (2024, September 1). Doomscrolling dangers. Harvard Health. https://www.health.harvard.edu/mind-and-mood/doomscrolling-dangers

Vaping: Harm Reduction Tool or a New Ethical Epidemic?

Vaping has become one of the most controversial public health issues of the last decade. For some, e-cigarettes represent a powerful harm reduction tool capable of reducing cigarette-related disease. For others, they signal the emergence of a new nicotine epidemic, particularly among adolescents. How do we weigh reduced harm for adult smokers against rising addiction in youth? And how do we confront addiction without reinforcing stigma?

Nicotine is the central issue. Regardless of delivery system, nicotine activates reward pathways in the brain by stimulating dopamine release, which reinforces repeated use and can lead to dependence [1]. Over time, users develop tolerance and experience withdrawal symptoms when nicotine levels drop: irritability, cravings, and difficulty concentrating [1]. Modern e-cigarettes, particularly pod-based devices, can deliver nicotine in concentrations comparable to or exceeding traditional cigarettes [2]. The use of nicotine salts also makes inhalation smoother, increasing the likelihood of sustained use [2].

From a harm-reduction standpoint, vaping differs meaningfully from smoking. Combustible cigarettes produce thousands of chemicals through burning tobacco, including tar and numerous carcinogens. E-cigarettes do not rely on combustion and therefore expose users to fewer of these toxic byproducts [3]. For adults who completely switch from smoking to regulated e-cigarette use, exposure to certain harmful substances is likely reduced [3]. In this context, vaping may serve as a transitional tool away from more dangerous tobacco products. 

However, reduced harm does not equal harmlessness. E-cigarette aerosols contain ultrafine particles, volatile compounds, heavy metals, and flavoring chemicals that may irritate or damage lung tissue [4]. Long-term health outcomes remain uncertain, particularly for individuals who begin using nicotine through vaping rather than switching from cigarettes. This uncertainty becomes especially concerning when considering adolescents.

Youth vaping surged dramatically in the late 2010s, prompting the U.S. Surgeon General to label it an epidemic [5]. Adolescence represents a critical period of brain development, especially in regions involved in impulse control and decision-making. Nicotine exposure during this period may alter neural pathways and increase susceptibility to long-term addiction [5]. Many adolescents who vape report they had not previously smoked cigarettes, suggesting vaping may not function as harm reduction but as a form of harm introduction [6].

The tension lies here: vaping may reduce harm for one population while increasing harm for another. Public health policy must grapple with this dual reality. Blanket condemnation may push adult smokers away from a potentially less harmful alternative. Unregulated promotion, however, risks normalizing nicotine dependence among youth.

Complicating the issue further is stigma. Addiction is frequently framed as a moral failure rather than a neurobiological process. Such framing discourages individuals from seeking help and undermines public health efforts [7]. Adolescents who vape are often portrayed as reckless or irresponsible, ignoring the engineered addictiveness of high-nicotine products and the role of targeted marketing. Effective solutions must address behavior without shaming individuals.

Evidence-based approaches offer a path forward. Restricting youth-targeted advertising, limiting flavors that appeal primarily to minors, and regulating nicotine concentrations may reduce adolescent uptake [6]. At the same time, adult smoking cessation programs should remain accessible and emphasize complete switching rather than dual use [3]. Clear communication is also essential to maintain public trust.

Vaping is not a simple story of good versus bad. It exists within the broader context of addiction science, regulatory ethics, and social responsibility. Whether it becomes a lasting harm reduction strategy or a new public health burden depends on how carefully society navigates this balance in the years to come.

Designed by: Jiyu Hong

Reviewed by: Ayan Jung

References

[1] Benowitz, N. L. (2010). Nicotine addiction. New England Journal of Medicine, 362(24), 2295–2303. https://doi.org/10.1056/NEJMra0809890

[2] Goniewicz, M. L., et al. (2018). Nicotine levels in electronic cigarette refill solutions: A comparative analysis. Tobacco Control, 27(5), 538–544. https://doi.org/10.1136/tobaccocontrol-2017-053601

[3] National Academies of Sciences, Engineering, and Medicine. (2018). Public health consequences of e-cigarettes. National Academies Press. https://doi.org/10.17226/24952

[4] Allen, J. G., et al. (2016). Flavoring chemicals in e-cigarettes. Environmental Health Perspectives, 124(6), 733–739. https://doi.org/10.1289/ehp.1510185

[5] U.S. Department of Health and Human Services. (2016). E-cigarette use among youth and young adults: A report of the Surgeon General.

[6] Centers for Disease Control and Prevention. (2023). Youth and tobacco use. https://www.cdc.gov/tobacco

[7] Livingston, J. D., et al. (2012). Reducing stigma related to substance use disorders. Addiction, 107(1), 39–50. https://doi.org/10.1111/j.1360-0443.2011.03601.x

Methadone Treatment for Opioid Use Disorder: Benefits, Barriers, and Solutions

In 2022, more than 9 million adults in the United States needed treatment for opioid use disorder (OUD) [1]. OUD is diagnosed when an individual meets at least two guidelines listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) [2]. These criteria include, but are not limited to, persistent cravings, continued use despite social or interpersonal consequences, unsuccessful attempts to cut down or stop using, and experiencing withdrawal symptoms [3]. Withdrawal can affect nearly every system in the body, producing symptoms such as nausea, vomiting, dilated pupils, teary eyes, runny nose, anxiety, tachycardia, and cravings [4]. The combination of severe physical discomfort and psychological cravings often results in return to opioid use [5]. Because withdrawal symptoms can make abstinence incredibly difficult, medications have been developed to alleviate these effects and support long-term recovery [6].

Methadone is a full opioid agonist that has been used to treat OUD for more than 40 years [7]. It is a synthetic opioid which reduces withdrawal symptoms by activating the same receptors as addictive opioids [8]. However, unlike short-acting opioids, methadone has a long half-life, allowing it to bind to receptors slowly and steadily without producing the euphoria associated with misuse [9, 10]. The benefits of methadone treatment are well documented. Methadone clinics boast long-term abstinence rates ranging from 60–90% [11]. Individuals receiving methadone are significantly less likely to experience an overdose compared with those attempting abstinence without medication [12]. Additionally, methadone treatment is associated with reduced hospitalizations related to substance abuse [13].

Despite its efficacy, access to methadone remains limited. To receive treatment, patients must present to federally regulated opioid treatment programs (OTPs), also known as methadone clinics, where medication is dispensed on a near-daily basis [14]. While this structure may support accountability for some, it creates barriers for others. In 2022, only 25% of adults who needed treatment for OUD received medication [15]. Barriers occur both before and after patient interaction with providers. Historically, patients had to be examined in-person prior to methadone induction, which excluded individuals without reliable transportation or access to healthcare [16]. Even when patients obtain a prescription, financial barriers may persist. Insurance coverage is inconsistent, and uninsured individuals often face significant out-of-pocket costs [17]. Geographic disparities further compound the issue: only approximately 18% of Americans are within a reasonable distance of a methadone clinic [18].

Recognizing these challenges, policymakers and healthcare leaders have introduced reforms to expand treatment access. As of 2023, federal policy changes eliminated the waiver requirement for prescribing certain medications for OUD, increasing the number of providers eligible to offer medication-assisted treatment [19]. In 2024, the U.S. Department of Health and Human Services further expanded access by allowing physicians to initiate methadone treatment via telehealth, removing the requirement for an in-person evaluation [20]. Additionally, the National Methadone Access and Quality Commission was established to identify and address systemic barriers to methadone care [21]. Innovative models are also emerging, including integrating methadone services into existing substance use treatment centers to reduce geographic barriers [22]. Methadone is a life-saving, evidence-backed treatment for individuals with OUD. Improving availability, affordability, and accessibility has the potential to transform lives.

Designed by: Sonali Patel

Reviewed by: Wendy House

References

[1] Dowell, D., et al. (2024). Treatment for opioid use disorder: Population estimates — United States, 2022. MMWR. Morbidity and Mortality Weekly Report, 73. https://doi.org/10.15585/mmwr.mm7325a1

[2] Strang, J., Volkow, N. D., Degenhardt, L., et al. (2020). Opioid use disorder. Nature Reviews Disease Primers, 6(1), 3. https://doi.org/10.1038/s41572-019-0137-5

[3] Strang, J., Volkow, N. D., Degenhardt, L., et al. (2020). Opioid use disorder. Nature Reviews Disease Primers, 6(1), 3. https://doi.org/10.1038/s41572-019-0137-5

[4] Torres-Lockhart, K. E., et al. (2022). Clinical management of opioid withdrawal. Addiction, 117(9), 2540–2550. https://doi.org/10.1111/add.15818

[5] Torres-Lockhart, K. E., et al. (2022). Clinical management of opioid withdrawal. Addiction, 117(9), 2540–2550. https://doi.org/10.1111/add.15818

[6] National Institute on Drug Abuse. (2018). Medications to treat opioid use disorder. U.S. National Institute of Health. https://nida.nih.gov/sites/default/files/21349-medications-to- treat-opioid-use-disorder.pdf

[7] National Institute on Drug Abuse. (2018). Medications to treat opioid use disorder. U.S. National Institute of Health. https://nida.nih.gov/sites/default/files/21349-medications-to-treat-opioid-use-disorder.pdf

[8] National Institute on Drug Abuse. (2018). Medications to treat opioid use disorder. U.S. National Institute of Health. https://nida.nih.gov/sites/default/files/21349-medications-to-treat-opioid-use-disorder.pdf

[9] Durrani, M., & Bansal, K. (2024). Methadone. StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/sites/books/NBK562216/

[10] National Institute on Drug Abuse. (2018). Medications to treat opioid use disorder. U.S. National Institute of Health. https://nida.nih.gov/sites/default/files/21349-medications-to-treat-opioid-use-disorder.pdf

[11] Canadian Addiction Treatment Centres. (2017, May 8). Methadone treatment program success rate. CATC. https://canatc.ca/methadone-treatment-program-success-rate/

[12] Wakeman, S. E., Larochelle, M. R., Ameli, O., et al. (2020). Comparative effectiveness of different treatment pathways for opioid use disorder. JAMA Network Open, 3(2), e1920622. https://doi.org/10.1001/jamanetworkopen.2019.20622

[13] Wakeman, S. E., Larochelle, M. R., Ameli, O., et al. (2020). Comparative effectiveness of different treatment pathways for opioid use disorder. JAMA Network Open, 3(2), e1920622. https://doi.org/10.1001/jamanetworkopen.2019.20622

[14] Mosel, S. (2026, February 23). Opioid rehabilitation clinic – How does a methadone clinic work? American Addiction Centers. https://americanaddictioncenters.org/rehab-guide/methadone-clinics

[15] Dowell, D., et al. (2024). Treatment for opioid use disorder: Population estimates — United States, 2022. MMWR. Morbidity and Mortality Weekly Report, 73. https://doi.org/10.15585/mmwr.mm7325a1

[16] Coulson, M. (2023, September 26). Barriers to methadone access | Johns Hopkins | Bloomberg School of Public Health. https://publichealth.jhu.edu/2023/barriers-to-methadone-access

[17] Bremer, W., et al. (2023). Barriers to opioid use disorder treatment: A comparison of self-reported information from social media with barriers found in literature. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1141093

[18] Bonifonte, A., & Garcia, E. (2022, October). Improving geographic access to methadone clinics – ClinicalKey. Journal of Substance Abuse Treatment, 141. https://www.clinicalkey.com/?adobe_mc=MCMID%3D85088167743361025363580734186766386745%7CMCORGID%3D4D6368F454EC41940A4C98A6%2540AdobeOrg%7CTS%3D1771875217#!/content/journal/1-s2.0-S0740547222001180

[19] Substance Abuse and Mental Health Services Administration. (2024, November 6). Waiver elimination (MAT Act). https://www.samhsa.gov/substance-use/treatment/resources/mat-act

[20] Federal Register. (2024, February 2). Medications for the treatment of opioid use disorder. https://www.federalregister.gov/documents/2024/02/02/2024-01693/medications-for-the-treatment-of-opioid-use-disorder

[21] Foundation for Opioid Response Efforts (2026, January 28). National methadone access and quality commission established to improve access to high-quality, patient-centered, evidence-based treatment for OUD. FORE. https://forefdn.org/national-methadone-access- and-quality-commission-established-to-improve-access-to-high-quality-patient-centered-evidence-based-treatment-for-oud/

[22] Bachhuber, M. A., Cunningham, C. O., & Jordan, A. E. (2025). Potential improvement in spatial accessibility of methadone treatment with integration into other outpatient substance use disorder treatment programs, New York City, 2024. PLOS ONE, 20(2), e0317967. https://doi.org/10.1371/journal.pone.0317967