Vivek MurthyAP

“I think that—and I should be careful about how I say this, but—I do think using Facebook sometimes feels like using heroin,” Vivek Murthy, the recent-past U.S. Surgeon General, said yesterday.

The comment came at the Aspen Ideas Festival, in a room with green tape on the floor in the shape of a rectangular box, along with about 100 people who came to participate in a sort of experiment about social isolation and ideological polarization. The session was called “Creating Connections in a Divided World.”

At the start, Murthy noted that Americans report being twice as lonely today as compared to the 1980s, and that this is a serious health concern. The question before us was, why the loneliness? Why do we divide and isolate ourselves? The setup was simple. A moderator posed a series of questions to the group. For example, if you could be a fabric, would you be silk or corduroy? Everyone was then supposed to choose a side, and then physically move toward one side of the big green box or the other, depending on how strongly they identify with a given answer. One of the more interesting prompts was: Do you identify more as a hand-shaker, or a hugger? It turns out almost everyone is a hugger. At least, they say they are—the handshake is still the default. It turns out that our former surgeon general is also a hugger, I note.

I actually wrote down his position on every answer. He was somewhere between silk and corduroy. On the question of whether he would choose friends over health, he would choose friends. Though, he noted, “If I didn’t have any friends, that would influence my health.” The fair point here was that some of the questions are more a matter of semantics—as they are in real life, and the point was to see how the crowd divided itself, and then try to reconcile why divides exist in real life. A recurring answer was that people just interpreted the question itself differently.

Among the most contentious prompts: “To up my emotional well-being, I would spend time with others” versus “To up my emotional well-being, I would spend time with myself.” (“Up” is here used, chalkboard-scratchingly, as a verb.) The prompt created much chatter among the crowd about introverts and extroverts. Murthy lands a little with myself of middle. When called to comment, he added a caveat: “Though I know if I went weeks and weeks without social connection, I would not do well.”

Although people love to talk about their introversion or extroversion, he clarified, “We all need some level of social connection.” The room nodded collectively. A participant next to Murthy noted that even at Walden Pond, Thoreau used to host “ragers.”*

Professor of psychology at Brigham Young University Julianne Holt-Lunstad, also among the participants, explained that introversion and extroversion are tied to vigilance levels, so some people’s bodies are more in fight-or-flight mode when they’re in social situations; others are more vigilant when they’re alone. Over time, these stress levels manifest as health problems. After the word vigilance had been said several times, a doctor in the room raised his hand to corroborate the physiology. He said we should trust him because his name was Pierre Vigilance. The room laughed.

Now to the heroin bit. The prompt was “Social media is making us more lonely,” versus, “Social media is making us less lonely.” An older gentlemen asked if his email chains with his friends counted as social media. The crowd leaned heavily toward social media is making us more lonely. Murthy again landed just that side of center. He took the microphone and made the heroin comparison, explaining that he knows he’s using social media wrong when it becomes more of a destination than a weigh station.

Heroin is, of course, concentrated morphine designed to create euphoria. Facebook is a platform that’s designed to keep users engaged. Part of that involves red notifications that give users a burst of euphoria. This invites a comparison. Though it’s simplistic and problematic in ways, the comparison made more sense in the context of Murthy’s overall philosophy of health, which became clear over the course of the day. Later he was part of a panel on what to do about the opioid epidemic. This one wasn’t interactive, and the audience was rapt and overflowing, and the whole vibe was much sadder, and Murthy’s tack was back to characteristically staid. A point he kept emphasizing was this: The medical community needs to regard addiction as a disease of the brain—not as some failing of will power. A disease to be diagnosed and treated.

The less-accepted corollary to this is that treatment will need to be largely extra-medicinal. It will involve cognitive behavioral therapy, social support, and investment in social determinants of health. So in a very real way, social connection is key to treating the opioid epidemic. Actually in two real ways: Social connection is also the way to bridge the political divides that lead to partisanship that keeps people out of the healthcare system. The opioid epidemic will continue as long as people don’t have access to addiction treatment and comprehensive medical care, of the sort that takes more time and resources than writing a prescription for an opiate.

The Facebook-opiate metaphor seems to hold in that both are tools that can be used productively and destructively. The only place to land on the “Is social media making us lonely?” question is in the middle of the room. The challenge posed to the crowd by Murthy was to use social media to bridge divides by understanding them, and not to isolate, divide, and avoid. Because the ultimate goal, the panacea for human health, is to build and maintain diverse, strong communities. Nothing improves until that happens.


*This article originally attributed this comment to Professor Holt-Lunstad. We regret the error.

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