Addiction, a word that often carries a heavy burden of misunderstanding and stigma, is a multifaceted condition that impacts millions of lives across the globe. From substance abuse, such as drugs and alcohol, to behavioral addictions like gambling and internet use, addiction manifests in various forms and affects different segments of the population.
Addiction is characterized by the compulsive engagement in a behavior or use of a substance, despite the negative consequences that follow. It is a complex interplay of psychological, genetic, social, and environmental factors. The American Society of Addiction Medicine (ASAM) defines addiction as a chronic disease of brain reward, motivation, memory, and related circuitry.
Before getting into the different types of addiction, it can be helpful to first understand how addiction works.
HOW ADDICTION HAPPENS
The Reward System
Addiction interferes with normal brain function, particularly in the reward system. When you do something you find enjoyable, whether that’s hanging out with your best friend, drinking a bottle of wine, or using cocaine, this reward system releases the neurotransmitter dopamine along with other chemicals.
Contrary to popular belief, dopamine doesn’t appear to cause feelings of pleasure or euphoria. In fact, it seems to reinforce your brain’s association between certain things and feelings of pleasure, driving you to seek those things out again in the future.
Cravings and Tolerance
The desire to experience this euphoric feeling again can trigger cravings for the substance or behavior, especially when you encounter the same cues (like a party where people are drinking, for example). These cravings often serve as the first sign of addiction.
As you continue using a substance or engaging in a behavior, your brain continues to produce larger amounts of dopamine. Eventually, it recognizes that there’s plenty of dopamine in your brain already and starts producing less in response to normal triggers.
There’s only one problem. Your brain’s reward system still needs the same amount of dopamine to function normally.
Before long, you feel compelled to use more of the substance to make up for what your brain isn’t releasing. This effect is called tolerance.
Disinterest in Other Activities
As addiction develops, it’s common to lose interest in hobbies and other things you once enjoyed. This happens because your brain no longer produces much dopamine in response to natural triggers, like listening to your favorite music or playing with your dog.
Even when you want to stop using a substance or engaging in a behavior, you might feel like you still need them in order to feel good about anything.
Loss of Control
Addiction usually involves an inability to control substance use or specific behaviors. This can result in job loss, health issues, and relationship concerns, among other things. In response, you might decide to quit the substance or behavior, only to find that you keep falling short, despite your best efforts.
WHAT IS CHEMICAL ADDICTION?
Chemical addiction can be tricky to talk about because there’s often confusion around what constitutes substance misuse, dependency, and addiction.
This is why the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recommends using the term “substance use disorder.” This classification includes more diagnostic criteria to help healthcare professionals differentiate between mild, moderate, and severe cases.
Many experts also prefer it because it avoids terms like “abuse,” which can further stigmatize addiction and prevent people from seeking help.
Common symptoms of a substance use disorder include:
- Cravings intense enough to affect your ability to think about other things
- Needing to use more of a substance over time to experience the same effects
- Experiencing unease or discomfort if you can’t easily access a substance
- Risky substance use, such as driving or working while using it
- Trouble managing work, school, or household responsibilities because of substance use
- Friendship or relationship difficulties related to substance use
- Spending less time on activities you used to enjoy
- An inability to stop using a substance, despite your best efforts
- Experiencing withdrawal symptoms when you try to quit
Some of the most common addictive substances include:
- Alcohol
- Opioids, including both heroin as well as prescription pain medication like oxycodone and morphine
- Cannabis
- Nicotine
- Amphetamines
- Cocaine
- Methamphetamine
WHAT IS BEHAVIORAL ADDICTION?
There is some disagreement around the concept of behavioral addiction and whether it is truly considered addiction. However, the DSM-5 now recognizes two behavioral addictions:
Gambling addiction
Gambling addiction, or gambling disorder, is characterized by an uncontrollable urge to gamble despite the negative consequences. The National Council on Problem Gambling (NCPG) estimates that about 2 million adults in the U.S. meet the criteria for gambling disorder, with another 4-6 million considered problem gamblers.
Internet addiction disorder
Like gambling, technology uses the variable ratio reinforcement schedule to create a rewarding experience. The schedule is unpredictable and varied, but it also has content that’s mood-enhancing or stimulating.
While most medical experts agree certain behavior patterns can become problematic over time, there’s still some debate around the point when behaviors become addictions, and what specific behaviors can become addictive.
For example, some might say that shopping, sex, and exercise addictions exist, but question if people could become addicted to something like Facebook.
The American Psychological Association (APA) chose not to include these behavior patterns in the DSM-5, citing the lack of scientific, peer-reviewed evidence necessary to develop standard criteria for diagnosis. However, general signs of a potential behavioral addiction include:
- Spending large amounts of time engaging in the behavior
- Having urges to engage in the behavior even if it negative affects daily life, responsibilities, or relationships
- Using the behavior to manage unwanted emotions
- Hiding the behavior or lying to other people about time spent on it
- Having difficulty avoiding the behavior
- Experiencing irritability, restlessness, anxiety, depression, or other withdrawal symptoms when attempting to quit
- Feeling compelled to continue the behavior even when it causes distress
Common behavioral addiction people often seek therapy or other professional support to address include:
Shopping addiction
Shopping addiction, also known as compulsive buying disorder, or compulsive shopping, affects about 18 million adults in the United States. It’s described as the compulsion to spend money, regardless of need or financial means. While many people enjoy shopping as a treat or as a recreational activity, compulsive shopping is a mental health disorder and can cause severe consequences.
Exercise addiction
Exercise addiction isn’t a formal diagnosis, but some people may use the phrase to refer to a compulsive urge to work out intensely and frequently despite possible adverse consequences.
Food addiction
Food addiction is a behavioral addiction characterized by an obsessive relationship with food. Individuals with food addiction often engage in binge eating, leading to obesity and other health issues. The Yale Food Addiction Scale (YFAS) is a tool used to identify food addiction, with studies indicating that about 5-10% of the population may suffer from this condition.
Sex addiction
Sex addiction is described as a compulsive need to perform sexual acts in order to achieve the kind of “fix” that a person with alcohol use disorder gets from a drink or someone with opiate use disorder gets from using opiates.
Internet/social media addiction
Internet addiction has become increasingly prevalent with the rise of digital technology. This addiction can include compulsive use of social media, online gaming, and browsing. Research from the International Journal of Neuropsychopharmacology suggests that around 6% of the global population may be affected by internet addiction, with higher rates in countries with widespread internet access.
PATHWAYS TO RECOVERY
Recovery from addiction is possible, but it requires a comprehensive and individualized approach. Treatment options vary depending on the type of addiction and the needs of the individual.
Detoxification
Detoxification is often the first step in treating substance abuse disorders. It involves clearing the addictive substance from the body under medical supervision. Detox can be challenging and may require medication to manage withdrawal symptoms.
Therapy and Counseling
Therapy and counseling are crucial components of addiction treatment. Cognitive-behavioral therapy (CBT) is particularly effective in addressing the underlying thoughts and behaviors that contribute to addiction. Other therapeutic approaches include motivational interviewing, family therapy, and group therapy.
Medication-Assisted Treatment (MAT)
For certain substance addictions, medication-assisted treatment (MAT) can be beneficial. MAT involves using medications like methadone, buprenorphine, and naltrexone to manage withdrawal symptoms and reduce cravings. This approach is often used for opioid and alcohol addiction.
Support Groups
Support groups, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), provide a community of individuals who share similar experiences and support each other in recovery. These groups follow a 12-step program that emphasizes accountability, spiritual growth, and peer support.
Behavioral Interventions
Behavioral interventions are essential for treating behavioral addictions. Techniques like exposure therapy, contingency management, and mindfulness-based interventions can help individuals manage their compulsive behaviors and develop healthier coping mechanisms.
Addiction, in all its forms, is a pervasive and challenging issue that affects individuals, families, and communities worldwide. Understanding the many faces of addiction, from substance abuse to behavioral addictions, is the first step in addressing this complex condition. By recognizing the signs, understanding the impact, and promoting pathways to recovery, we can create a society that supports individuals in their journey towards a healthier, addiction-free life.
Education, prevention, and compassionate treatment are essential in combating the various types of addiction. As we continue to learn more about the nature of addiction and develop more effective interventions, there is hope for those struggling with addiction to lead fulfilling, productive lives. The fight against addiction is ongoing, but with awareness, support, and dedication, recovery is within reach for everyone.
ABOUT CUMBERLAND HEIGHTS
Cumberland Heights was founded in 1966 with a firm, focused mission: to transform lives, giving hope and healing to those affected by alcohol or drug addiction.
We’re a nonprofit organization, a resource of leading clinical expertise, and the first Tennessee addiction treatment center to achieve certification from the American Society of Addiction Medicine. We’re also a community. At Cumberland Heights, staff, alumni, and advocates walk with each patient through every step on the journey to recovery, helping them rewrite their story – a story of hope, healing, and happiness.
We exist to serve those who are seeking addiction treatment in Middle Tennessee, and we have a Cumberland Heights program near you! Our main campus is located in Nashville, Tennessee, but we have treatment centers across the state of Tennessee in Jackson, Chattanooga, Knoxville, Murfreesboro, Franklin, Clarksville, Crossville, Cookeville, and more.
We’re here to help. If you or a loved one would like to learn more about Cumberland Heights, click here or call 615-314-3856.
