Image

What Is Addiction?

Psychological Perspective of Addiction

What Is Addiction? Graphics courtesy of University at BuffaloOpens in new window

Addiction, also known as a substance use disorder (SUD), is a behavior that involves a relationship with drugs or alcohol in which you use more than you would like to use, and you continue to use despite negative impact on your overall health and well-being.

According to the American Society for Addiction Medicine (ASAM)Opens in new window, drug addiction is a chronic, relapsing, and treatable brain disease characterized by an inability to control substance use despite knowing the negative effects it has on your health and well-being.

Psychology TodayOpens in new window defines addiction as a condition that results when a person ingests a substance (e.g., alcohol, cocaine, nicotine) or engages in an activity (e.g., gambling, sex, shopping) that can be pleasurable but the continued use/act of which becomes compulsive and intereferes with ordinary life responsibilities, such as work, relationships, or health. Users may sometimes not be aware that their behavior is out of control and causing problems for themselves and others.

Addiction occurs due to many factors, including your environment, genetics, brain chemistry, and life experiences.

People use drugs or alcohol and engage in some behavior to escape, relax, or to reward themselves. But over time, drugs/alcohol and even some behavior make people believe that they cannot live without them, or that they cannot enjoy life without using or engaging in them.

According to the criteria of the American Psychiatric Association (DSM-IV) and World Health Organization (ICD-10), addiction should meet three of the following:

  • Tolerance: using more and more drugs/alcohol or engaging more and more in a particular behavior over time.
  • Withdrawal: experiencing physical or emotional withdrawal when you have stopped using or engaging in a particular behavior. Some signs of withdrawal include anxiety, irritability, shakes, sweats, nausea, or vomiting when abstaining from the particular addictive drug or behavior. [cont.]
  • Limited control: using a substance or engaging in behavior more than you would like. This often times leads to regret after the activity but you still feel the need to continue using the substance or engaging in the behavior.
  • Negative consequences: continued use of substance or engagement in a behavior even after experiencing negative consequences to mood, self-esteem, health, job, education or family.
  • Neglected or postponed activities: putting off or reducing social, recreational, work, educational or household activities because of substance use or engagement in some behavior.
  • Significant time or energy spent: spending a significant amount of time obtaining, using, concealing, planning, or recovering from use of substance or engagement in behavior. This also involves thinking about the substance or behavior, concealing and minimizing usage and engagement but failing to sustain it.
  • The desire to cut down: thinking about cutting down or controlling usage of substance or engagement in behavior and unsuccessfully attempting to cut down or control usage or behavior.

Although these criteria are largely applied to substance addiction, they have recently been adopted in some behavioral addictions like gambling addictionOpens in new window, Internet addictionOpens in new window and video and computer game addiction.

One key question that arises when discussing addiction, especially behavioral addiction, is the fact that most behaviors that society may consider improper may well meet the above criteria.

So, what really distinguishes addiction from other improper behaviors or substances? This question is what distinguishes the biological, psychological cum philosophical and social cum cultural perspectives.

  1. Fecteau S, Agosta S, Hone-Blanchet A, Fregni F, Boggio P, Ciraulo D et al (2014) Modulation of smoking and decision-making behaviors with transcranial direct current stimulation in tobacco smokers: a preliminary study. Drug Alcohol Depend 140: 78 – 84.
  2. Garavan H et al (2000) Cue-induced cocaine craving: neuroanatomical specificity for drug users and drug stimuli. Am J Psychiatry 157: 1789 – 1798.
  3. Hari J (2013) Everything you think you know about addiction is wrong. TED TALK.
  4. Higgins ST, Budney AJ, Bickel WK, Foerg FE, Donham R, Badger GJ (1994) Incentives improve outcome in outpatient behavioral treatment of cocaine dependence. Arch Gen Psychiatry 51: 568 – 576.
  5. Ingersoll KS. Wagner CC (2011) Motivational interviewing: emerging theory, research, and practice. In: Johnson BA (ed) Addiction medicine. Springer, New York, pp 705 – 726.
  6. Ito R et al (2000) Dissociation in conditioned dopamine release in the nucleus accumbens core and shell in response to cocaine cues and during cocaine-seeking behavior in rats. J Neurosci 20:7489 – 7495.
  7. Kuss DJ, Griffiths MD (2012) Internet and gaming addiction: a systematic literature review of neuroimaging studies. Brain Sci 2:347 – 374.
  8. Martin-Soelch C et al (2001) Changes in reward-induced brain activation in opiate addicts. Eur J Neurosci 14: 1360 – 1368.
Image