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What is addiction?

Dr. Mike Dow, PsyD
Addiction Medicine Specialist

There are 2 physical hallmarks of addiction: tolerance and withdrawal. Tolerance is needing more and more of a substance or behavior to produce the same results. Withdrawal is the presence of symptoms when you try to take the substance or behavior away. If either one of these are present, addiction is present.

There are also psychological hallmarks of addiction: powerlessness, cravings, compulsivity, and consequences. Addicts report feeling powerless over their drug of choice, and admitting one's powerlessness is one of the key components in 12-step programs. Addicts may feel anything from a minor craving to an uncontrollable compulsivity drawing them to their drug of choice. No matter the addiction, consequences of greater and greater severity are almost always present. This downward spiral is when the addict reports reaching "rock bottom," and hopefully, this state will persuade him or her to seek treatment.

Addictions can be classified into 2 types: substance addictions and process addictions. Substance addictions means that you are ingesting a psychoactive substance such as drugs or alcohol. Process addictions include gambling, love, sex, and shopping. Food has traditionally been considered to be a process addiction, but recent studies suggest that food may actually fall into the substance addiction category.

Dr. Timothy W. Fong, MD
Neurologist

Addiction is a brain disease. It is no different than diabetes, heart disease or cancer. It's a disease that comes with biological, psychological and social risk factors and causes. It can be prevented and treated. Untreated, it can last a lifetime.

Addiction is not a moral failing. It does not occur because somebody isn't ready to get serious about life. It doesn’t mean somebody's greedy or lacks good judgment. Addiction is characterized by continuing use or engagement in a behavior despite harmful consequences. It doesn't mean just drugs or alcohol. People can be addicted to shopping, gambling, internet use, work and exercise.

Seth  Jaffe
Addiction Medicine Specialist

During all the years I used heroin and opiates, I wanted to stop more times than I can count. I told myself that I will not use heroin/opiates any longer. I made a solemn vow that I would stop using but was never able to keep that vow. Over many years that vow would be made and then broken each time. When I finallly stopped using heroin/opiates, I thought I would be OK. I thought that heroin and opiates were my problem. I started smoking marijuana on a daily basis, thinking that since it wasn't physically addictive I could control my smoking and be able to stop when I wanted to. To my surprise, I couldn't stop smoking for one day even when I tried. I started to make the same solemn vow about not smoking marijuana as I did with heroin and opiates and I got the same broken vows over and over again.

This is addiction, the inability to stop even when you want to. Making promises over and over to your loved ones that you mean with all your heart, only to braeak those promises over and over again. This feeling of powerlessness creates the downward spiral of addiction.

Addiction will make you believe that you’re in control and you can stop using if you really wanted to, or it tells you that you can’t and that there is no hope. It will tell you that recovery will never work for you. Addiction is a liar.
 

One of the more serious brain-related disorders that is attributed to chemical malfunctions in the brain is addiction. We become addicted to substances that increase or release certain chemicals in our brain.

Specifically, those certain substances like nicotine release the pleasure chemical dopamine, and your body craves more of it-which leads to a habitual behavior to keep pumping dopamine into your system. Dopamine doesn't cause all addictions, but it may give some insight into the theory that such things as carbohydrates can be addictive. The feel-good chemical released after eating them is what drives the craving for more.

Lack of adequate sleep decreases the release of this feel-good chemical (and hormones as well). Not getting enough sleep may be one of the reasons you can get addicted to many of those aging simple carbohydrates and sugars, as well as the aging fats that are imposters of real food.
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YOU: The Owner's Manual, Updated and Expanded Edition: An Insider's Guide to the Body that Will Make You Healthier and Younger

Between your full-length mirror and high-school biology class, you probably think you know a lot about the human body. While it's true that we live in an age when we're as obsessed with our bodies as...
Dr. Howard J. Shaffer, PhD
Addiction Medicine Specialist

People allude to addiction during everyday conversation, casually referring to themselves as "chocolate addicts" or "workaholics." Addiction is not a term clinicians take lightly. For the first time, and with considerable debate, the term "addiction" has appeared in a diagnostic manual (DSM5); this new classification includes “substance-related and addictive disorders.” In addition to substance use disorders, this addiction class now includes behavioral addiction (e.g., gambling disorder, which previously was classified as an impulse disorder). Historically, drug use disorders were divided into dependence and abuse categories. Now, substance use disorders only carry the moniker of "dependence."

Laypeople alike often use a conventional definition that invokes three C's:

  • Craving for the object of addiction, which can be mild to intense
  • Loss of Control over use of the object of addiction
  • Continued engagement with the object of addiction despite adverse consequences.

To illustrate, the new DSM5 describes, “The essential feature of a substance use disorder is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems” (p. 483).

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Arlington, Va.: American Psychiatric Association.
 

Dr. Edward Phillips
Physical Therapy Specialist
Loss of control over a substance or behavior and continued craving for it despite negative consequences characterize addiction. Imaging technologies that show the brain responding similarly to different pleasurable experiences have persuaded many experts to consider addiction to be a single disorder with varied expressions.
An addiction is when a person has a physical and/or psychological dependence on something. Common forms of addiction include tobacco, alcohol, or other drugs but could even include food, sex, or gambling. Addictions can be physical, in that the body "needs" the target of addiction to function properly, or they can be psychological, meaning the person believes he or she absolutely needs the object or activity of addiction. Sometimes the difference between these two is clear-cut, but not always. Regardless of the type, an addiction is nearly always detrimental to overall health, whether because of direct effects on the body or indirect consequences on lifestyle and therefore health. If you think you or a loved one has an addiction, treating it will more likely be successful if multiple resources are used beyond a doctor, such as counseling or support groups.
Jan Campbell
Nursing Specialist
An addiction is when you continue to do something you know is harmful for you but you crave it and can't control the urge to get it because of that "high" feeling, knowing full well that you will come crashing down when the addicted agent is removed. If you continue to do a behavior that you know is harmful to you and you can't easily or don't want to stop it, you are addicted. No matter how you want to rationalize it, you are addicted, and it is your choice to remove the harmful agent from your life so you can create balance and become healthy again.

Addictions come in many forms. One could be addicted to such things as shopping, spending, gambling, overeating, undereating, sex, a relationship, drugs or alcohol, excessive exercise, working; and this list could go on and on. The bottom line is that many get into an addictive situation without ever intending to. They somehow lose themselves to the addictive agent, and before they know it, they feel as if they are unable to live without it. The agent gives them a temporary high that they continue to crave. They give their power away to this agent, many times at any cost. Sometimes the cost could be deadly. Because of their addiction, everything they have loved could be lost, including themselves.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.