Addictions can invade every facet of our lives. Whether we are the addict, in close relationship with an addict, or deal with it at work or in friendships our hope is this series will help with understanding and seeking help to work through and come out the other side healthy and whole. So please stick with us and post comments or email us and ask us questions.... we are here to help!
Addiction can often times be a very slippery concept.
In many cases, the word addiction is often used very flippantly in conversation, to indicate that someone has been playing a new smartphone game very often or has found a new favorite flavor of ice cream.
And yet other times, the word addiction is used only in hushed or somber tones, to identify a problem that an individual may not be ready to admit or to discuss a tragic reality that has destroyed an individual’s being or even ended their life.
Using a single word to cover such a wide range of human experience can often lead to confusion and misunderstanding. This is why it becomes so important to develop a true and profound understanding of the concept of addiction, its signs and symptoms, the factors which cause it, and the factors that can be used to control and alleviate it.
In this three-part series on addiction, our goals are to first define what addiction is, then to understand why and how addictions happen, and finally to look and see what we can do about addiction.
For our first exploration of addiction, we’ll try to gain a better understanding of what addiction really is.
Prevalence of Addiction
The first thing to realize about addiction is simply how widespread the problem truly is.
For many of us, when we think about addiction, cinematic images come into our minds of heavy users or hard drugs, with bruises running up their forearms, serious discoloration of the skin, and a general aura of desperation and primal anxiety.
And while it’s true that this is one way that addiction can manifest, in this case for regular users of heavy drugs such as heroin or methamphetamines, this view of addiction is incomplete.
The danger in considering addiction only a disease that has very serious, very noticeable detrimental effects is that it can potentially serve to externalize the problem. If addiction is built up in our minds as something that only happens to bad people who live in seedy places and commit evil acts, we will have that much more of an inclination to deny the possibility that addiction could happen to us.
But the reality is that addiction could happen to each one of us: There are a wide variety of potential manifestations of addiction, and the prevalence is much higher than we would like to admit.
One recent study concluded that across 11 different substances and behaviors, the estimated prevalence of addiction in US Americans ranges from 15% to 61%, with a final estimate that 47% of the United States’ population suffers from maladaptive signs of an addictive disorder over the course of a 12-month period.
Even if the lowest number (15%) is the case, this is still alarming: This would mean, for example, that among a 6-person friend group, one of these individuals is seriously struggling with a disease.
What Addiction Isn’t
However, it’s also important not to go too far in one direction and naïvely assume that everyone has an addiction. Yes, the problem is widespread and deserves serious attention, but it’s also a negative to take things to the extreme: Addiction is not an accusation that should be leveled glibly.
Addiction is very different than habit, but it’s important to note that the two share a similar neural foundation.
When we do something pleasurable, such as eat a food that we enjoy, perform a certain form of physical exercise, or even just have an enjoyable conversation with a dear friend, a reward pathway is triggered in our brain. The pleasure of the experience reinforces the neural pathway responsible, and reinforces our desire to perform the action again.
If this pleasure circuitry wires us to consistently seek out opportunities to eat healthy foods, exercise, and seek out social connections, so much the better. This represents the development of healthful habits.
However, if this same circuitry and this same reward pathway wires us to require pathological substances or activities in order to receive that same feeling of pleasure and that same release of neurotransmitters, this is where the line is drawn between habit and addiction.
What Addiction Is
The difficulty in defining addiction and separating it from habit lies in the fact that there are a number of different substances or processes that a person may become addicted to, and so the specific signs and symptoms can vary widely.
However, a common sense definition of addiction across all different situations lies in the following combination of factors:
Of course, for people who are unclear whether the problematic substance use or erratic behavior of a friend, a loved one, or even of themselves manifests a “real” addiction, the factors provided above will likely still provide a frustrating degree of ambiguity:
What different substances or behaviors allow for addictions? When does a problem become serious enough to be labeled a “serious life problem”? How different does a person need to act for their behavior to be a “noticeable deviation” from their usual way of acting? How consistently do they need to abstain?
These are all perfectly valid questions. And while the information provided above and in the subsequent two parts of this series will hopefully provide some additional clarity, the sad truth is that in many cases it will ultimately be very difficult to say for certain.
The important thing to remember is that if you are at all concerned about whether you or someone close to you could have an addiction, trust those feelings of concern and act on them.
In Part 3 of this series we will discuss appropriate social responses to addiction, as well as how to manage the symptoms and etiologies that we will outline in Part 2. But above all else, remember that you are never alone, and that mental health professionals trained in dealing with addiction are available to help you make those tough decisions and to help you understand addiction.
Sussman, S., Lisha, N., & Griffiths, M. (2011). Prevalence of the addictions: A problem of the majority or the minority? Evaluation & the Health Professions, 34(1), 3-56.