ADDICTION OVERVIEW

Addiction, according to the National Institute on Drug Abuse, part of the National Institute of Health, is defined as, “a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.† It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control. Those changes may last a long time after a person has stopped taking drugs.”

Addiction is a chronic condition. The American Society of Addiction Medicine (ASAM) defines addiction as a chronic brain disorder.

Addiction doesn’t happen from having a lack of willpower or as a result of making bad decisions.

Your brain chemistry changes with addiction.

There are two main groups of addiction:

  • Substance addictions (substance use disorders).

  • Non-substance addictions (behavioral addictions).

Substance Use Disorders (Addictions)

The medical community and healthcare providers now refer to substance addiction as substance use disorder (SUD). The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, outlines specific diagnostic criteria for these disorders.

Substances with the potential for addiction include both prescription medications and non-medical drugs. Common examples are:

  • Alcohol

  • Caffeine

  • Cannabis (marijuana)

  • Hallucinogens (e.g., PCP, LSD)

  • Hypnotics, sedatives, and anxiolytics (e.g., sleeping pills, benzodiazepines, barbiturates)

  • Inhalants (e.g., paint thinners, aerosol sprays, gases, nitrites or "poppers")

  • Opioids (e.g., prescription opioids like codeine and oxycodone, as well as heroin)

  • Stimulants (e.g., prescription stimulants like Adderall®, as well as cocaine and methamphetamine)

  • Tobacco and nicotine products (e.g., cigarettes, e-cigarettes, vaping devices)

Despite their differences, all these substances strongly activate the brain's reward center, producing pleasurable feelings. This activation can lead to the development of substance use disorders.

Levels of Substance Use Disorders

Substance use disorders can range in severity:

  • Mild

  • Moderate

  • Severe (Addiction represents the most severe form of substance use disorder.)

While the use of addictive substances does not always result in SUDs, prolonged or problematic use can increase the risk of dependency and addiction.

NON-SUBSTANCE ADDICTIONS

Behavioral addictions can occur with any activity that’s capable of stimulating your brain’s reward system. Behavioral scientists continue to study the similarities and differences between substance addictions, behavioral addictions and other compulsive behavior conditions like obsessive-compulsive disorder (OCD) and bulimia nervosa.

The DSM-5 currently only recognizes gambling disorder as a diagnosable behavioral addiction in the subsection of “non-substance-related disorders” in the category of “substance-related and addictive disorders.”

The DSM-5 doesn’t currently include other behavioral addictions due to a lack of research on them. However, any activity or habit that becomes all-consuming and negatively impacts your daily functioning can cause significant mental, social and physical health issues, as well as financial issues in some cases.

Examples of potentially addictive activities include:

  • Gambling.

  • Eating.

  • Exercising or dieting.

  • Shopping.

  • Shoplifting or other risky behaviors.

  • Having sex.

  • Viewing pornography.

  • Video gaming (internet gaming disorder).

  • Using the internet (such as on your phone or a computer).

WHAT’S THE MOST COMMON DISORDER?

Alcohol use disorder is the most common substance addiction in the United States, followed by nicotine and marijuana. About 10% of people aged 12 or older in the U.S. have alcohol use disorder.