What we mean when we talk about addiction – Part 2

addiction2In Part 1 of this series, I talked about the challenge of understanding addiction. This challenge is illustrated — and also shaped — by the fact that word itself means different things to different people. I pointed out how the word has been around for a long time in the English language, and that its emphasis has shifted.

Today we use the term in four distinct ways. Maybe it would be helpful to create subcategories. In his great book “The Globalization of Addiction,” addiction researcher Bruce Alexander does exactly that. In the book, he outlines four types of addiction, giving them the names “addiction 1” “addiction 2” “addiction 3” and “addiction 4.” I’m going to give them different names, which might help clarify the distinctions.

 

1. Chemical Addiction 

The first of Alexander’s categories of addiction is the traditional view: “An overwhelming involvement with alcohol or drugs.” This is one of the most common understandings of the word, with its focus limited to chemical dependence — drug addiction and/or alcoholism.

The keyword here is “overwhelming.” This word is important — this is not simply involvement with alcohol or drugs, but overwhelming involvement. This is when drugs are a significant (and destructive) part of one’s life. Estimates vary today about how prevalent chemical addiction is in our society. Estimates are that 5-10% of Americans are addicted to alcohol in this way, and about 5-8% are addicted to illegal drugs, meaning 12-15% of Americans suffer this kind of addiction … chemical addiction.

 

 2. Chemical Use/Abuse

This usage of the term addiction is more controversial. It refers to the ongoing use of “harmful” substances of any kind. This understanding of addiction is at play, for example, when a person goes to rehab for ongoing marijuana use. Some people say that since marijuana is illegal, a person who uses it at all must have a problem with it.

The challenge here is that the line between what constitutes the “use” and “abuse” of a substance can be very hard to determine. When does a recreational drug user become an addict? At what point does someone’s participation with a drug become “overwhelming?” In the minds of many people, some drugs are so destructive to users’ well-being that it’s best to treat even their occasional use as an addiction.

 

3. Behavioral Addiction

Behavioral addiction is “overwhelming involvement in something that affects one’s life negatively.” This obviously applies to the abuse of alcohol and other drugs (“chemical addiction”), but this use of “addiction” is more broad. The focus here is on processes or behaviors: things like food, sex, gambling… things that take control of a person’s life and become destructive for them.

The argument could be made that this type of addiction is still chemically-based. For example, in sex addiction, a person gets addicted to the chemical reaction that takes place in the brain during a sexual experience. This is the case with food, gambling, shopping, video games, work, and so on. But the key here is the broad understanding of the sources or objects of addiction. In this understanding, object of the addiction is not a chemical, it is an activity or behavior.

 

4. Positive Addiction

Addiction four is “strong dedication to a pursuit or cause that is helpful and constructive … but may become so absorbing that other aspects of life are neglected.” This goes back to the 1884 definition, “the giving over of oneself to some pursuit.” It might include things like being really into fitness or some sport, or hyper devotion to a certain cause. The activity or focus of attention is actually good and healthy, but it may be that our involvement with it gets to be so great that we are neglecting other things in life.

A positive addiction may seem similar to a behavioral addiction — the difference is whether or not the object is a good and worthy pursuit, and whether or not its pursuit is destructive to us. Think of the difference, for example, between someone “addicted” to pornography and someone “addicted” to running.

The lack of consensus on what addiction really is makes it difficult to help those who suffer from it. I feel that the most helpful and most accurate way of looking at addiction is the third definition, an overwhelming involvement in something that is destructive. This still leaves room for confusion and disagreement about what constitutes “overwhelming” involvement, but at least it gets us started.

What do you think?

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