Who's Addicted to Addiction? Sally Satel on the Social Media Trials & America's Therapeutic Culture

“You can do as many brain scans as you want, but you’ll never be able to distinguish an impulse that wasn’t resisted from one that’s irresistible.” — Sally Satel on why social media addiction can’t be proven in court

When Meta and YouTube lost the so-called landmark social media addiction trial back in March, there was jubilation inside and outside the courtroom. Finally, Big Tech seemed a bit less big. Justice, it seemed, had finally been done.

Or maybe not. (Full disclosure: my wife is head of litigation at Google, so I might be a bit biased). But today’s guest, the psychiatrist Sally Satel, doesn’t have a dog (or husband) in the fight, and she’s a skeptic of the trial’s outcome. A senior fellow at the American Enterprise Institute and the medical director of a Washington methadone clinic, Satel argues that the concept of addiction — her clinical specialty — was distorted in the trial to serve a $1.4 trillion litigation pipeline. The plaintiffs’ theory reifies addiction as behavior beyond control. If that were true, Satel argues, none of her patients would ever get better.

Satel comes at this as a doctor rather than a moralist. Clinically, she acknowledges, social media addiction exists — excessive use, loss of control, continued harm — and the treatments are the same behavioral strategies she uses at her clinic. But legally, where causation is everything, the plaintiff argument collapses. No brain scan can ever distinguish an impulse that wasn’t resisted from one that’s irresistible. The mechanism of harm is unprovable — a ludicrously brittle foundation, Satel argues, for a trillion dollars of lawsuits against social media companies.

So when is “addiction” really addiction? Satel’s upcoming book Not a Disease: Rethinking Addiction in the Heart of America’s Overdose Crisis, which will be out in early 2027, addresses this awkward truth. And we’ll certainly have her back on the show to discuss.

Five Takeaways

•       The $1.4 Trillion Distortion of Addiction. The March bellwether verdict awarded “Kaley” $6 million from Meta and YouTube, but the real story is the litigation pipeline behind it — four states suing Meta in a single day, with total claims reaching $1.4 trillion. Satel’s objection is professional: the lawsuits invoke brain science at the most superficial level and reify addiction as behavior beyond control. If addiction truly extinguished self-control, her methadone patients would never get better — and they do. Kaley herself had fragilities that long predated the platforms, one therapist testified social media barely came up in her sessions, and her stated career plan is to become an influencer.

•       Clinically Real, Legally Incoherent. Satel’s central distinction: in a clinic, social media addiction is a recognizable condition — excessive use, loss of control, continued harm — treatable with the same strategies she uses for drugs, from identifying idiosyncratic cues to self-binding tactics like grayscale screens and switched-off notifications. In a courtroom, where causation is everything, the concept falls apart. No brain scan can distinguish an impulse that wasn’t resisted from one that’s irresistible; the technology simply doesn’t exist. The mechanism of harm at the center of the litigation is not just unproven but unprovable.

•       Demoralization Is Not Depression. At her methadone clinic, nine patients out of ten arrive reciting diagnoses — bipolar, PTSD, depression — that closer examination reveals they don’t have. What’s medicated as depression is often demoralization: the entirely understandable response to crumbli