If you’re reading this article I can almost guarantee that you’re not terribly interested in any discussion that features research findings on brain imaging or reward pathways. My guess is you’re seeking an explanation of the WHAT, WHY and HOW of addiction that makes sense to you. You’re hoping for one of those epiphany moments when the fog lifts and all is revealed.
The question being asked is
“Addiction: What is it? Why me? Why can’t I just stop? How come it showed up in my life and not in the life of my neighbour or my sister?”
I hope my words will enlighten you. Having had a relentless longing to understand these questions as they related to me personally fuelled my interest and years of study deepened my understanding. But definitions do not necessarily square with insight. I hope my attempt to put clothes on the definition will further your understanding of what is meant when we use the word ‘addiction’.
The Burning Question: What is Addiction?
The World Health Organization defines addiction as:
“a persistent, compulsive dependence on a behaviour or substance. Addiction has been extended to include mood-altering behaviours or activities…”
As you can see from the above definition, today it’s more helpful to take a broader view in order to more fully understand exactly what we mean when we speak of addiction. Think of addiction as a process of increasing desire that expresses itself in different ways through many different objects – alcohol and other drugs, gambling and spending, excessive exercising, shopping, working, gaming - even eating, as so many of us already know.
Increasing desire means that a relationship is developing between you and your substance or behaviour. It’s an intensely powerful relationship without which you cannot imagine living your life. The power of this relationship is so strong that it drives all else from your mind’s eye. You crave it relentlessly, persistently and without relief until you succumb to its demands. You repeat this pattern over and over again regardless of the wreckage it creates in your life and the lives of others.
Addiction describes an out of control relationship with an object of desire. The individual feels an overwhelming urge to engage in using the substance or doing the activity and therefore it continues over time in a repetitive pattern despite the negative consequences to self and/or others. Preoccupation, craving and negative consequences are hallmarks of the disorder.
And here’s the kicker. It’s not the substance or activity that causes addiction although it can unquestionably be said that certain substances lend themselves very easily to addiction, it’s the RELATIONSHIP, the level of desire that creates the situation of craving, compulsion and negative consequences.. If you want it desperately enough in your life, it is, for you, addicting.
Addiction, as a behaviour can be quantified. Think of it as a condition which resides somewhere on a scale from 1 to 10. At the 1 level, the involvement with the substance or activity is low. At the 10 end, the individual is in serious trouble and the effects of the behaviour being acted out are transforming his or her life. An individual can find his or her niche anywhere along the scale. Indeed, much of the debate within families can be tied to where on the scale individuals are placed by themselves and others. Rarely, is there agreement. There is no set point on the scale at which we can say the person has crossed the line into addiction territory. That point is different for everyone. Addiction is no longer thought of as a single, static disease entity – once you’ve got it, you’ve got it for life. You can move up or down the continuum. More addicted, if you will, at one point in time until you take some action to change your placement on the scale.
One can be more severely addicted than someone else, in other words, at or close to 10 on our scale. With work and a desire to change, however, this individual might well move from, say, an 8 to a 3 at which point addictive acting out is no longer an issue.
Before you roll your eyes and click another link on your computer let me say emphatically that all of this discussion about scales and placement matters not one whit. All you really need to know in order to understand if you have a problem is to ask yourself if you crave your substance or activity obsessively and once you succumb; you’re transported to a different place and time. After the event, there are the negative consequences to cope with that cost you and loved ones dearly. The costs in fact are grave - lost family, job, money, self-respect and on and on it goes. Despite your very best intentions, the cycle begins all over again and plays out each time in a very predictable fashion. Craving, loss of control, persistence and compulsion and ongoing negative consequences becomes the pattern of your life.
Why me?
Ask the question “Why not me?” Everyone, and I mean everyone, can be vulnerable to addiction at some point in time. The more coping skills and supports in your life, the less likely vulnerability will have you reaching out for the same favoured substance or activity time and time again. You will be utilizing more effective methods to solve your problems and you will not be battling it out alone.
Again, I repeat: Everyone is vulnerable to addiction at some point in their life. When you’re battling stress and that feeling of desperation wells up in your gut, your level of vulnerability is escalating. The more adept you are at handling stress and the more resources and supports you can call on to help you, the lower your risk of spiraling into addictive behaviour. Remember, addiction is all about an intensely private and personal relationship. It’s just the two of you, together again. When you’re feeling stressed you seek comfort in what you know from experience works. If you reach for the same pacifier each time, the attachment grows. Soon it will be the craving that signals reaching out for the trusted friend. Before you know it, that friend is your greatest enemy.
Why Can’t I Just Stop?
Think about this for a moment. If every substance or activity were inherently addictive, then WE WOULD ALL be spinning out of control with something. This does not happen. Believe it or not, there are people who occasionally use heroin or cocaine and do not become dependent on it. Certainly no one would suggest you try such a thing, but it’s none the less, quite true. The heroin or cocaine addict, on the other hand, has a much different relationship with the substance than the occasional user. Life depends on it, not just to escape withdrawal, but to escape a life without the relationship.Addiction is not about the substance or activity at all. Addiction is the active back and forth engagement (relationship) you have with YOUR substance or YOUR activity. You are not passive in this relationship. It’s not that the ‘something’ has you in its grip. You have each other in a grip. And when that ‘something’ is not there, you crave and obsess about it until the situation is remedied. First cigarette, first sip, first bite of double -fudge cake. All of your earthly cares vanish in that moment. In what seems but a moment, you are swiftly returned to reality and facing, with horror, the calamitous results. Choruses of never again are heard. Promises are made again. Then the craving dragon breathes fire on you and once again you say: “This time will be different. I’ll control it this time. I’ll just have one or two.”
Here we go again. And the results:
- The father who leaves his kid sleeping in the car while he gambles his paycheck away.
- The obese teenager who’s feeling sick with shame and the discomfort of her physical body, who will have to face the hideous remarks of her peers at school.
- The grandmother who drinks herself into oblivion while the two year old rifles through cleaning liquids under the sink.
We shudder in disgust. This is what addiction is. This powerful relationship that’s really impossible to adequately describe has the power to destroy lives and relationships like nothing else. And so when someone says, “just stop”, I hope you now have some idea of why that seems so impossible to someone who’s addicted.
I should also note that the three examples I’ve given above are people who have been addicted for some time. They are at the extreme end of the scale. If our scale measures behaviour from, say, 1 to 10, they would be close to the 10 end.
The more extreme your behaviour and the more negative consequences that are piling up around you, the more addicted you are. And yes, it’s possible to be mildly addicted. Let’s use our gambler again. Let’s say that it is only recently that his family has noticed he’s away from home more than usual. Sometimes, the older kids have to baby sit when he doesn’t come home early. His wife has noticed that a bill wasn’t paid on time and makes a mental note to inquire about it. Compared to the behaviour of our gambler above, the second example shows that consequences have begun – hours away from home, a slight shortage of money, not available to be with the little ones when mom is at work and the teenagers are playing hockey, but the relationship the gambler has with his activity is not nearly as all-powerful as gambler number 1. The downward spiral has begun. It will be up to the gambler himself how far into addictive living he goes.
What is Addiction?
I’ve used up a lot of your time and my energy to explain that… “Addiction is an out of control behaviour with a substance or activity. Craving drives the behaviour and it results in increasing negative consequences. The pattern is repeated persistently over time.”
I hope this article has increased your understanding of this highly complex and multifaceted problem.
The following post Defining and Understanding Addiction is republished from www.MethadoneClinicUSA.com
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