Why such a focus of substances and no mention of the more common addictions such as video games, porn and social media?
Also, as others have said, the societal impact of substance abuse are often much more visible, directly measurable, and immediately felt.
Video game addiction often leads to children and adults completely destroying their professional or academic lives. In many cases, a child grows up to find a balance between working just enough to afford their videogame habbit.
I have read stories of an adult who was so addicted to a simple cellphone game that they were compulsively telling lies to create more game time and ultimately destroyed all of their social relationships and lost their job. All of that dysfunction stems from their brain's addiction to the rush of progress bars, levelling up, victory screens, and success chimes.
Not all people are wired the same. A lot of brains are hopelessly addicted to these two categories of stimuli and I feel you dismiss them a bit too carelessly.
I do not have a solution to this problem and it is a problem that I myself would contribute to if I was trying to design an app that people would use. Greater addiction mechanisms trend toward wider market adoption which leads to a higher value for shareholders. The current system of incentives to a company makes this focus inevitable.
The job-like feeling is real. Before they even realize it, people start organizing their own schedules around some stupid phone game. Setting alarms to wake up at 3 AM because that's when the timer resets and they can play again.
The thing is I've personally seen opioid addicts do literally anything for a drug. Not for pleasure, just to avoid the pain of abstinence. One guy killed his own mother because she tried to cut off his access to the drugs, he ended up homeless and reduced to crime and was eventually arrested and forced to undergo treatment. The power of these substances cannot be underestimated. As bad as predatory video games are, I'm convinced opioids are worse.
Benzodiazepines addiction is severe as well. Not as bad as opioids but still pretty bad. I've seen patients get violent because a doctor didn't want to renew their prescription for their own good.
Big disagree. I'm not going to say opioid addiction isn't a worse thing, but I watched a friend fail out of college because he played WoW all day every day. For a whole year he barely left his room. It definitely wasn't healthy.
I remember at one point I was playing Everquest all night in high school. My friend had an account and let me use it when he was sleeping, so I'd play from 9:00pm to 6:00am, then go to school, then repeat. I hardly ever slept, which was definitely not healthy. There's a reason they called it Evercrack.
One dorm-mate was kicked out of college because he spent ALL of his time playing WoW (World of Warcraft) and failed all of his classes. (Side note: I remember being scared to go near that game from hearing so many similar stories at the time.) I've known many people who remain unemployed and do nothing but play video games.
Getting blasted by/constantly engaging with tweets all day and endless scrolling on Instagram/TikTok/Facebook are just "things that people do" nowadays. I've seen countless couples on dates where they spend a great deal of their time using their phones instead of talking to each other, for example.
My inner curmudgeon remembers when my parents would scold me for spending all of my time on the computer when 56K was all the rage. I was mostly writing websites, looking at PC parts, and browsing Slashdot, mind, but spending all night after school doing it instead of hanging out with friends (that I didn't have or want; I was aggressively bullied back then) was abnormal and concerned them.
For example, consider the criteria used to describe the signs of addiction: "You need an increasing amount of alcohol or drugs to feel a buzz or high. You feel an urgency to get the first drink or drug of the day. You experience a loss of interest in other activities and an increased desire to get ‘high’ or ‘buzzed’. You try to quit or cut down on the use of alcohol or drugs but can’t. You will do almost anything to get the drug or alcohol."
You might feel an urge for these other addictive habits at the start of the day; experience a loss of interest in other activities; and try to cut down but can't. For the pull to experience an "increasing amount" of the activity for a high, that is plausible for porn (for some users, it's a want for more extreme content), but less so for video games and social media. It's also not immediately obvious—especially when compared to drugs and alcohol—that a user of video games, porn, or social media would "do almost anything" to satisfy the urge.
The bottom line is that these behaviours, while addicting, have significant differences when compared to alcohol and drugs. Speaking from past writing experience, these would require the article to significantly broaden its scope, which may not have been possible due to editorial constraints (e.g. word count). It's also plausible that the original article may have been, "The first steps to respond to a potential alcohol or drug addiction," but the editor shortened it to a catchier "How to know if you're addicted."