The New Addictions


Our Brave New World is full of surveillance (George Orwell got that one right). But more invidious are our designer addictions, sold to us as ‘empowering’ consumer choices. The most ubiquitous of these is convenience data, or big data for small minds which, like convenience food, is very tempting, but it’s not actually good for you. (Short-cuts often end up selling you short).
(And the new Gulliver fable will be about us tying ourselves down with thousands of pieces of - convenient - string, we won't need someone else to do it for us).

Introduction

Work happens in the space that opens up when appetite is held in check - for yourself, &/or for a wider community, to get what you/we need.

Addictions, on the contrary, are exactly the opposite, they are never held in check – the more you have, the less you're satisfied; the more you ‘eat’, the more you want - which you soon convince yourself is what you really need. And they generally also include a temporary 'high' of some kind.

Virtual and Synthetics Addictions


... and the de-articulation of experience: on-line, in drone-attack command centres (see abstraction #11, here), etc.

Ironically, this is the inverse of the realignment of the 'firm' in the 1980's and 1990's when dis-intermediation was first fashionable. Dis-intermediation cut out the intermediaries, and linked ordering straight through from the customer to the firm, or even to the production line. Dell computers adopted this quite early. Amazon, today, is a more complicated derivative.

So adding additional layers (and technologies) between people and their materially shared experience, which we might call
re-intermediation, or diversionary intermediation [there must be a simpler way of putting this, no?] seems to be an odd thing to do in a world of 'connectivity'. On the other hand, it could be seen quite differently as multi-intermediation, or diversification - adding more and more ways to connect one person's presence to another's, over and above face-2-face, snail mail, telephones and telegraphs. The question is, do you get hooked, addicted, lost or distracted, or just learn to multi-task and multi-mode?

Which leads us back towards the question of our addictions.

In addition to our traditional, material, addictions, we now also live in a world of virtual and synthetic addictions – addictions that are manufactured as malevolently magical commodities, or designer addictions (to go with our designer shoes, clothes, cuisine, etc) … i.e. goods, services and activities that 'magically' increase your desire for them, rather than satisfying you. The more you consume, whether it’s 'food' for the mind, body or soul, the hungrier you get for more. Our addictions now include a whole range of virtual and material synthetics: things which have been specifically designed, engineered, manufactured, and marketed to hook you in, as a never-ending, perpetually unsatisfied, ideal consumer.

The perfect 'magic' commodities, in a perfectly distorted market, with numerous dangerous side effects, from obesity to mental health onwards. These markets have not reached their apogee, but rather their initial point of perfection - a never-ending machine to extract surplus value.

Many of these designer addictions are frighteningly 'normal' now: nicotine, sucrose, salt, diuretic soft 'drinks’, etc. Added to these are a range of specifically virtual activities that consume our attention, which, like convenience foods, can make us mal-informed, just as high sucrose / high salt food ‘stuffs’ can make us mal-nourished and/or obese. And virtual addictions can even end up making us alone-together (Shirley Turkle).

For instance …

Convenience Data


1. Statins

A recent report in The Guardian, warmly endorsed its sound byte/ headline: “Statins prevent 80,000 heart attacks and strokes a year”. And it quoted Richard Horton, editor of The Lancet who brazenly “likened the harm done to public confidence by the critics of statins to that caused by the paper his journal published on the MMR (measles, mumps and rubella) vaccine in 1998”. A colleague pointed out that Horton said he was taking a stand “because of [The Lancet’s] experience of MMR. "We saw in a very painful way the consequences of publishing a paper which had a huge impact on confidence in a safe and effective vaccine. We learned lessons from that episode and those lessons need to be widely promulgated. They are lessons for all journals and all scientists”.

However, what Horton failed to say was that Wakefield was a personal friend of his, three of the putative authors withdrew their names in protest, Wakefield was about to market three separate MMR vaccines which would have competed with the single MMR vaccine and, worst of all, it took him, as editor, 12 years to get the Lancet to retract the paper.

The Guardian report also quoted NICE (The National Institute for Clinical Excellence)’s guidance, “in 2013, to prescribe statins for patients with a low, 10% risk of [developing] heart disease in the next 10 years, which was half the previous level of a 20% risk. It made 4.5 million more people, who were fundamentally healthy, eligible for statins”.

Just one, simple, conclusive figure, no?

No. “80,000 heart attacks and strokes a year” sounds like a no-brainer. But the bottom line is that statins are effective for only 10% of high risk people, and for only 5% of low risk people, and only if they take the statins for five years. And when you join all the dots, and find out that the actual cost for each event avoided is something like half a million dollars, per person, you start wondering why NICE has lost the plot. There are many other ways to spend half a million dollars (each) to help people improve their health and life-style, and it is probably a safe bet that many of the alternatives would be more than 5% effective - for all those low risk millions. NICE seems to have completely lost sight of its mandate, i.e. to regulate the cost-effectiveness of health interventions, and is exclusively focusing on medication-interventions instead.

The bottom line: Why would anyone try to convince 95% of the low risk, "fundamentally healthy" millions to waste their time, and our - and the NHS's - scarce resources, taking statins for five years that have no benefits, and carry the risk of substantially damaging side-effects?

However, ‘saving 80,000 people’ works wonderfully as convenience data. It makes the bottom line (or headline in this case) simple and easy to understand, and with the Guardian’s own endorsement, it apparently clinches the argument. It’s also a sophisticated strategy to provide simple – or in fact simplistic – ways to use ‘big’ data to provide misleading 'knowledge' for small, lazy &/or confused minds.

More broadly, this supports the widespread addiction to convenience data of the media (including the supposedly critical Guardian), one of the top medical journals (and its editors), the politicians, one of the top universities’ researchers (at Oxford), and even the ‘objective’, arms-length regulator, NICE. The addiction to this kind of convenience data unfortunately resonates with many other modern addictions. And as a ‘virtual’ addiction, it's that much more difficult to pin down. It’s a no-brainer – in more than one sense.


2. (to follow: convenience data in higher education, educational testing, pre-schools, immigration, Brexit, and many more ... )