Addiction

What is addiction?

It is ironic that there is still a fair amount of dispute over exactly what an addiction is. I shall describe it in terms of disease model theory as, although there is a level of contention to some assertions, it provides a good overview of both chemical and behavioural addiction and what they have in common.

Addiction is described as powerlessness over all mood-altering drugs and behaviours.

 

Chemical addictions (to mood-altering drugs)
Alcohol
Illicit drugs
Prescription drugs
Over-the-counter drugs

 

Behavioural addictions (to mood altering behaviours)
Compulsive gambling
Sexual addiction
Eating disorders
Addiction to the internet
Codependency
Compulsive shopping
Compulsive hoarding
Compulsive exercising
Self-mutilation
Workaholism

 

 

The disease of addiction is characterised by the following:

 

It is a chronic, progressive, incurable and often terminal illness.
This implies that periods of abstinence do not equate to ‘being cured’, but rather to being ‘in recovery’, as picking up a mood-altering substance will result in relapse, with the whole pattern of powerlessness kicking off again. Another implication of this is that over time both the powerlessness and the damages will become worse, and this illness, if untreated, is seen to stop at one of three terminals: death, jail or insanity.

 

The illness is defined by impaired control
This incorporates both ‘Loss of Control’ every time that the person uses, as well as impaired control. Impaired control implies that there may well be times when the person is able to stop using, but that there are also times when the person is unable to stop using, and that they are unable to predict in advance which times they will be unable to stop. Therefore, the impaired control happens after the first hit or drink.

 

Denial of loss of control
This is necessary in order for the addict to continue using in spite of the obvious damages being causes. The addict’s using is incorrectly seen to be contingent (secondary) to another problem (divorce, depression etc). Denial can include a blanket denial of there being a problem, a minimising of the problem, blaming the damages or extent of using on someone or something else, or often complex rationalisations or intellectualisations of the problem.

 

Unmanageability
This is the spiralling path of damages, deceit and immorality that inevitably accompanies addiction.

 

Addiction is a primary illness
Addiction (substance dependence) differs from substance abuse, which is defined as the use of mood-altering substances in a way that is pathological, but where their using is contingent (secondary) to another problem (divorce, depression etc.), and therefore tends to dissipate when the situational factor is cleared up. Addiction is primary, and when difficult situations in an addict’s life clear up this does not resolve their out-of-control using. An addict uses because they are driven to use, because they want to. The truth, therefore, is that addicts use on situations (feelings), not because of them.

 

It is not about fault
Addiction is not something that afflicts weak people or bad people, or unintelligent people, or even uneducated people. It is a somewhat mysterious illness that includes a degree of genetic predisposition, and as such is not about culpability. However, although anyone could become an addict, this does not mean that addicts have the right to harm themselves or others through their actions. It is the responsibility of the individual and/or their loved ones to seek treatment for this illness.