what is addiction?
Addiction is a term that is loaded with stigma, preconceived notions, shame, guilt and misunderstanding. In order to treat addiction effectively, we first have to define it clearly, so that our judgement is not clouded by the baggage that is usually associated with the term. As per the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), what is commonly referred to as addiction is medically termed Substance Use Disorders (SUDs)1. This classification includes both substance abuse and substance dependence. The American Psychiatric Association (APA), the publisher of the DSM-5, defines SUD as “a complex condition in which there is uncontrolled use of a substance despite harmful consequences.”2
While this definition covers the crux of substance-related addiction, such as alcoholism or drug addiction, it does not address behavioural addictions. The underlying structure, however, is the same. Behavioural addiction refers to the compulsive engagement in an activity in spite of negative consequences. Almost any behaviour can become an addiction. However, the most common behavioural addictions we encounter in a clinical setting here at Journey are:
– Porn Addiction
– Sex Addiction
– Gambling Addiction
– Gaming Addiction
– Shopping Addiction
– Food Addiction
Simply put, addiction can be defined as the inability to stop a certain behaviour, or the consumption of a substance, in spite of any resulting detrimental effects.
what constitutes compulsion?
A common misconception in the classification of addiction is that someone needs to be using a substance or engaging in a behaviour on a daily basis in order to be classified as an addict. This is an untrue and harmful belief as it regularly causes denial, which in turn impedes one’s process of recovery. This is not to say that some addicts do not use almost constantly, but the majority of individuals who suffer with either an SUD or a behavioural addiction do not.
A telling sign in the diagnosis of an SUD is the cyclical nature of how a patient uses. If an individual only drinks alcohol on the weekends, but does so on most or all weekends, and to the point whereby negative effects begin to creep into their life, this is indicative of an SUD. Similarly, if an individual only bets when a certain sporting event is on but bets whenever it is on and in a manner that detrimentally affects their life, they can be considered to be suffering from a behavioural addiction, more specifically a gambling addiction.
This cycle does not only follow a periodic pattern in a time sense. Instead, the impetus for an individual’s use of a substance or participation in an activity, can take the form of people, places and things. These are colloquially referred to as “triggers.”3 When exposed to a trigger, an individual undergoes an emotional response that may lead to substance or behavioural misuse. For example, an individual who suffers from porn addiction may be triggered by seeing a scantily-clad person. In turn, the emotional response to this visual stimulus would cause the individual in question to watch porn.
The permutations of this process are nearly endless and as a result an important part of addiction treatment is the identification of an individual’s triggers and creating coping strategies for them.
dimensions of consequence
The consequences or negative effects that are referenced in the definition of addiction can take many forms. A common source of denial for patients in early recovery lies in their belief that their problem is non-existent, or not severe enough to warrant concern. To justify this, they might point to the fact that they are still employed and/or that they are financially stable. However, these justifications do not acknowledge there are many facets that comprise a healthy and functional lifestyle. Below are some of the dimensions of one’s life that consequences can affect along with examples of how they can be affected:
– Academic (Non-attendance, lower grades, late submissions)
– Career (Late for work, non-attendance, pushing back deadlines)
– Community (
– Emotional (Unstable moods, reduced empathy)
– Family (Lying to family members, not meeting commitments, worsening relations)
– Financial (Spending beyond one’s means, taking out debt)
Link between addiction and dependence
1: Classification of SUDs according to the DSM-5 – https://www.ncbi.nlm.nih.gov/books/NBK519702/
2: APA definition of SUD – https://www.psychiatry.org/patients-families/addiction/what-is-addiction
3: What are emotional triggers? – https://www.verywellmind.com/what-does-it-mean-to-be-triggered-4175432