What IS Addiction?

When you put “addiction” into the almighty Google search engine window, you’ll see that there are “about 166,000,000 results.”

That’s a lot of places online where the word addiction shows up.

Aside from Wikipedia (no offense, guys), which seems to get itself as the first listing most of the time, Psychology Today is the top result and their definition begins with:

Addiction is 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 interferes with ordinary life responsibilities, such as work, relationships, or health. Users may not be aware that their behavior is out of control and causing problems for themselves and others.

That’s concise enough and seems to be a good start. However, in scrolling down on this same page, there’s a link to another article entitled Addiction in Society: Blinded by Biochemistry (https://www.psychologytoday.com/articles/201010/addiction-in-society-blinded-biochemistry), and its subtitle reads:

Scientists have been talking about addiction for a hundred years. Amazingly, they’re still trying to define just what the problem is.

Hmmmmm. Confused? I am, and apparently they (the scientists in charge of defining addiction) are too!

We in the world of psychology and psychiatry have a reference book we all use to accurately diagnose clients who come to us for treatment. With the proper diagnosis we can then align the client with the most appropriate treatment and therapy to create the best possible outcome.

This reference book is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or otherwise known as the DSM-5. It is reviewed and rewritten (hence, the most recent 5th edition) by an elite group of experts chosen from the American Psychiatric Association (APA).

These are the people who are supposed to know all about all mental health diagnoses, which includes addiction.

However, upon further review, there is hardly a word even mentioned about addiction in the entire DSM-5.

Huh? What?!! Anyone else confused?

Without getting into any opinions about the APA (PLEASE, don’t let me get started), there would seem to be something very wrong here.

Unless, that is, there’s really not a problem with addiction. In fact, according to these APA experts, apparently addiction doesn’t even exist.

Even the most untrained average every-day-person (I think) would see that there is something very wrong here.

But let’s continue in the search of the definition of addiction. Going back to the original Google search, there is also another listing on the first page (first page listings, according to Google, are supposed to be the most relevant) a little further down (http://www.asam.org/for-the-public/definition-of-addiction). It’s a page from the American Society of Addiction Medicine (ASAM), and their “short” definition of addiction is:

Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.

They seem to be a bit more tuned in to the world of addiction. Who are these people of the ASAM, and what’s their mission and purpose?

So glad you asked. Here it is, their mission statement:

• Increase access to and improve the quality of addiction treatment
• Educate physicians (including medical and osteopathic students), other health care providers and the public
• Support research and prevention
• Promote the appropriate role of the physician in the care of patients with addiction
• Establish addiction medicine as a specialty recognized by professional organizations, governments, physicians, purchasers and consumers of health care services, and the general public

In summary: This is a group of (mostly) physicians committed to bringing addiction into the limelight, especially within the world of medicine.

How refreshing!

But what about everyone else? How is the every-day-average-Joe supposed to get accurate and appropriate information about addiction so he can help prevent Josephine and Joe Jr. from getting caught in the perils of addiction?

There’s still a gap. A HUGE gap.

Addiction is just not thought of, or even considered, in most of mainstream.

And, therefore, the conclusion can be drawn that it has no relevancy and is not really a significant issue.

Do you know what the NUMBER ONE characteristic of any and all addictive behavior is?

Denial. Yes, the unwillingness to look realistically and honestly at one’s own addictive behavior.

But what if there was a “denial of denial”?

Huh?!!

In other words, if we’re denying that addiction is relevant and even the bulk of the medical community downplays its significance, then isn’t there a generalized denial of addiction and all the characteristics thereof?

It gets rather messy and confusing, to state it mildly.

So, why is it so important to know what exactly addiction is?

If you asked people in a random sampling, I doubt most would care all that much. They probably don’t see it as “that big” of a problem.

Yes, denial of denial.

Not that most people are blatantly denying addiction. They just simply lack information and understanding.

Part of this denial of denial is simply ignorance, and you can’t blame people for not knowing what they don’t know and weren’t taught.

We don’t even know how prevalent addiction is and how far reaching its destructive consequences are. We have some research, but mostly just “guesstimations.”

However, if you’ve been in the addictive deadly web, or have known someone close to you who has, then you know, at least to some degree, how devastating addiction is.

But how easy it is to forget, downplay and minimize. And I wouldn’t blame you, after all, who’d want to remember or re-live that pain, or those painful memories?!!

Oh, I almost forgot. After 30 years of working in the field of mental health and addiction, here’s my definition of addiction:

First, there are four primary areas of addiction: Substance, activity, people and emotions. All addictive behaviors create an illusionary pleasurable experience, and, at the same time, a temporary distraction from the authentic painful experiences of life, and these behaviors are continued, and often increased and intensified, to the point where they cause severe and significant negative consequences in one’s life and are continued despite these negative consequences.

I tried to keep it as short, understandable and concise as possible, but it still seems to be a bit too cumbersome. But maybe that’s part of the issue: It is just hard to explain and, therefore, understand.

But I will continue on my journey to bring addiction, addiction prevention and addiction treatment into the mainstream.

Yes, I’m not going anywhere, only staying on my mission, headed towards my vision, and doing so with great purpose.

Yes…I’m going to be in your face.

How about you? What are YOU going to do?

Marry YourSelf First!…the beginning of anti-addiction.