I saw a patient recently who I suspected had issues with alcohol abuse. A standard questionnaire we learned from medical training to identify alcohol addiction is known as the CAGE Criteria where “CAGE” is an acronym for the following:
C Have you ever felt you should Cut down on your drinking?
A Have people Annoyed you by criticizing your drinking?
G Have you ever felt bad or Guilty about your drinking?
E Eye opener: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?
Two affirmative responses are considered a positive test and indicate a high likelihood of alcoholism and the need for further evaluation. As I was reflecting on this patient's case and thinking about the CAGE criteria, I started substituting drinking with my more recently increased internet use resulting from my book release. If you swap the glass of alcohol with a smartphone, you can see that many of us, including myself are addicted to some degree. I asked myself these same questions and answered yes to all of them. The “eye opener” in particular is a good sign of intense addiction. A casual, social drinker doesn't normally crave alcohol when they wake up first thing in the morning. An addict however craves stimulation after being deprived of their drug during sleep. How many of you have an intense urge to check messages when you first wake up in the morning? That's because your brain has missed that steady dose of digital stimulation which triggers the release of dopamine, the pleasure chemical in our brain that's also released by drugs like heroin. You wake up craving that nice pulse of dopamine when that screen lights up your face and you see those new message notifications.
Now I added one more letter to the criteria to make it “CAGED.” The “D” stands for driving. Most alcoholics are able to hold back on drinking and driving being well aware of its risks. However despite most of us knowing the clear risks of texting and driving or being engaged with our devices in any way, so many of us are guilty of mixing our device with our driving in some way. There are nearly 500,000 reported crashes and 4,000 lives lost annually to distracted driving. In fact, April is officially Distracted Driving Awareness Month. Until we have legislation and a built-in solution to this problem, we may need to turn to other forms of technology as an interim solution. A patient of mine whose teenage son had a car accident from texting and driving downloaded an App called LifeSaver which uses innovative technology to disable his smartphone when his car is in motion and provides digital rewards like iTunes, Amazon and Starbucks cards.
So ask yourself, are you “CAGED” into your digital world? And if so, recognize that it is likely contributing to issues like high levels of stress, insomnia, obesity, musculoskeletal issues from poor posture and prolonged sitting, and risky driving, in addition to disconnecting us from nature and direct personal relationships. Set boundaries by downloading downtime apps, turning on timers, or just scheduling digitally-free time so you can escape every now and then and connect to people and nature without being tethered to a device. Make it a priority to unplug regularly throughout the day to improve your physical and mental health.