Games of Abuse: The Neuroethical Issues of Gaming Addiction

Michael Bai


We live in an era where scientific innovation is no longer a generational event; rather, it recurs time and again within a single lifetime. Technological marvels such as automobiles, telephones, and electricity took decades to gain the same popularity that “Pokemon Go'' was able to achieve in three weeks. This is in large part due to the widespread use of internet technology [1]. Our ability to stimulate our reward system so quickly and frequently may be harmful for our health, but seeking immediate satisfaction through unhealthy means is not something new. Historically, the most pertinent example of such exploitation is substance abuse, and understandably, it has led to strict legislative control measures. Today, we face novel means through which people are obtaining a rapid sense of reward, but without associated controls, in the form of “reward-based gaming.” [2]. Gaming addiction has been a known behavioral problem for over two decades now [3]. While recent neuroscientific evidence strongly analogizes this with substance addiction. This essay aims to compare gaming addiction to other forms of substance abuse while highlighting ethical concerns of the gaming industry’s impacts. If the psychological basis of gaming is indeed similar to other forms of addiction, then regulation is indeed necessary. Without any restrictions, the exploitation of gaming companies, and their subsequent impact on society may run rampant.

Neurological Basis

As a species, human beings are incredibly versatile. Intelligence, spatial memory, and analytical ability are all capabilities that make humans highly adaptable to technological advancements. However, despite this façade, the core essence of human biology remains mostly unchanged, and to a certain extent, abides by the laws of evolution [4]. After all, it took millions of years for the human brain to develop the synaptic connections that drive its ultimate survival.

At the cornerstone of these connections is the dopaminergic system, which mediates the most basic reward pathways of the brain [5]. Dopamine is released from the mesencephalic neurons, and modulates the striatal, cortical, hypothalamic, and limbic neuronal pathways. These neural circuits constitute the basic framework of motivational and reward pathways in the brain (10.3389/fncir.2013.00152). While these systems have evolved to reward constructive behavior, they can also be abused once they get “hijacked” by those seeking to exploit human nature for financial gains. Research exploring the function of the brain has shown that addictive drugs like cocaine, for example, can trigger these reward mechanisms and tap into compulsion [6]. Gambling also influences reward behaviors by triggering dopaminergic release, which then reinforces pathological behaviors [7,8]. Thankfully, such sources of addiction have been under stringent governmental control with laws and public awareness, which mitigates their harmful effects.

In line with substance abuse disorder, the neuropathogenesis of gaming addiction has also been traced to the same neural circuits that govern reward behavior and compulsion [9–12]. Recent evidence suggests that the ventral tegmental area-nucleus accumbens (VTA-NAc) pathway, a major component of the drug addiction-associated pathways, is strongly implicated in gaming addiction as well, while dopamine plays its role as a key neurotransmitter in these neuronal circuits [13]. Much similar to substance abuse, individuals who report persistent cravings for online gaming, tend to have poor functional connectivity between their VTA and NAc [14]. In addition, the prefrontal cortex (PFC) is also believed to become dysregulated as a direct result of gaming abuse [15]. However, unlike drugs and gambling, gaming is currently not subject to stringent controls, and companies can freely exploit their users for profit.


Psychiatric Basis

Whether purposefully or naturally following market success, gaming companies have clearly been investing in this, with all of the top grossing games having based their income on micro-transactions. They focus on creating and growing a specific collection or in-game aspect, such as evolving a character, thus appealing to the human sense of creation or evolution [16]. The majority of these games also involve multiplayer options, thereby appealing to the human sense of community. In a study of attitude towards video games, 30,000 players indicated that “achievement,” “socializing,” and “immersion” were the factors that motivated them most [17, 18]. Add to that the appeal of exploring one’s identity without real-life ramifications, and the gaming companies have created the perfect simulation of human life. This may very well exploit the human psyche while providing virtual rewards that reinforce the same habits. 

Psychiatric studies have suggested that gaming addicts are highly likely to possess an antisocial personality [19]. A trait which is also commonly associated with drug addicts [20]. Moreover, both groups of individuals are also prone to developing a neurotic personality [21]. These characteristic similarities suggest a significant comparability between the victims of internet gaming disorder and substance abuse. In line, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has already included game addiction in their list of mental disorders [22]. Gaming addicts exhibit the same impulsive behavior as drug abusers, with the only difference being that the substance is replaced by an uncontrolled interaction between the person and machine [23-27]. Individuals who are addicted to gaming squander their valuable time and finances on their gaming console, and display signs of serious social dysfunction and withdrawal [28]. Moreover, gaming addiction has even been cited as an indirect cause of death [29].

The human mind evolved to reward beneficial behavior, but with the gaming addiction, it has now been tricked into satisfaction with no foreseen evolutionary benefit. Perhaps it is time that behavior-based dependencies, traditionally comprising of eating, gambling, sex, etc., should be redefined to include technological dependencies involving human-machine interaction as suggested by Griffith et al. [30].


Legislative Obligations 

The human dependence on technology is undeniable. Technological advances have allowed us to continue functioning even under quarantine situations like the recent COVID-19 lockdown. It also allows for new entertainment and socialization activities. Online gaming has become a $1.1 billion industry through e-sport events alone, and a $139 billion industry overall [27-29]. However, similar to how drugs—which revolutionized medicine—can be abused, so too can reward-based gaming. In this sense, gaming companies could have inevitably become the drug-dealers as they exploit a basic human need. As an ethical issue, legislators should intervene, and set limits to at least some, if not all aspects of this industry. These could encompass restrictions involving age and overall timing of gameplay. Moreover, financial transactions can also be regulated in the online gaming industry.

Recognizing gaming as a potentially harmful activity and restraining its use could help millions of young people in need [29]. Some countries around the world have already set forth plans to counteract its impact on public health [30]. One such example is China where the officials have limited the use of online gaming in minors by imposing a restriction over the time spent on playing computer games. However, efforts should be intensified both nationally, and internationally due to the multinational nature of various gaming powerhouses.


Gaming addiction and drug addiction share similar neurochemical bases, psychiatric profiles, and social burdens. Therefore, it is society’s ethical obligation to set laws that regulate the gaming industry such that its adverse sequelae are minimized. From the outset, gaming may not seem as harmful as alcohol or narcotics, but only time will tell how damaging gaming addiction can be to future generations.


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Michael Bai

Michael Bai

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