The forager on Sulawesi, 6,300 to 7,600 years ago, with their teeth worn to the root, continuing to use the substance that had damaged those teeth because the substance temporarily numbed the resulting pain — this is a description of addiction in everything but the modern clinical terminology.

How Betel Nut Was Being Used Then Versus Now

One of the most important distinctions in the Sulawesi study is the difference between how the ancient foragers were using betel nut and how it is used in modern populations.

Modern betel nut use — across the South and Southeast Asian, Pacific, and East African populations where it is common — involves the prepared betel quid: sliced or crushed areca nut seed, betel vine leaf, and calcium hydroxide (slaked lime), sometimes with tobacco and other additions.

This preparation is chewed rather than simply held in the mouth.