Neuroscience and Society

Classifications of Addictions

Alexander Skvortsov


Introduction

Addiction is a pain that many people know all too well. It is the immense, never ending struggle of battling monstrous, undefeatable impulses. Addictions can create such a feeling of desire that even the most strong-willed person cannot resist. In fact, many people unaffected by addiction assume that those addicted to a substance or activity are simply weak; however this is simply false. Addiction is much more than a mundane lack of willpower. According to Dr. George Koob, director of NIH’s National Institute on Alcohol Abuse and Alcoholism, “The brain actually changes with addiction, and it takes a good deal of work to get it back to its normal state. The more drugs or alcohol you’ve taken, the more disruptive it is to the brain.” [1]. This article will explore what addiction is, how it works, and the differences between addiction and temptation.

 

Overview

    The word addiction is defined by the American Society of Addiction Medicine as “a primary, chronic disease of brain reward, motivation, memory and related circuitry.” An addiction is, as follows, a disease characterized by a strong impulse to use a given substance or to partake in a given activity.  Addictions work primarily through the reward, motivation, and habitual response areas of the brain, and are based in chemical restructuring of the brain.

    A way to easier understand exactly how potent addiction is lies in one of its synonyms: dependence. The word dependence brings up a feeling of insecurity, weakness, and subservience. As a child is dependent on a parent, so is an addicted individual to their item of choice.

    A commonplace misconception regarding addictions is that of exclusivity to chemicals. While addictions to drugs are the most destructive, and so receive the most attention from researchers, addiction can be divided into 2 general categories: substance and behavioral.

 

Substance Addictions

    Substance addictions are dependencies developed to a brain-modulating substance, or drug. Drug addictions almost always begin by choice- the affected individual must make a conscious decision to take their first shot, smoke their first cigar, or inject their first dose of heroin. This can result in a powerful first high, which prompts the individual to repeat the drug intake. As they continue this process, their tolerance rises, increasing the threshold of substance necessary for the high to occur. As a result the individual can often proceed to consume greater and greater quantities of the drug, inevitably resulting in an addiction. Every chemical substance can be addicting, with the most common drug addictions being alcohol, tobacco, marijuana, cocaine, heroin, and methamphetamines.

    A relatively new threat lies in prescription drugs. Those very same medicines, antidepressants and antibiotics that are engineered specifically to help make our lives easier, can end up destroying lives at alarming rates. A study by the Foundation for a Drug Free World found that prescription drug overdoses have overtaken those of Heroin, Methamphetamine, and Cocaine combines, forming an alarming 45% of overdose deaths[2].

    Caffeine is incredibly prevalent, and not often thought of as addictive. It is generally considered safe for relatively common consumption, and is consumed by a vast majority of Americans: about 90%. As a matter of fact, the per capita daily caffeine consumption is above 250mg of caffeine, more than in 12 ounces of coffee [3][4]. Caffeine can be found in many drinks, including coffee, some teas, most soft drinks, dark chocolates, and several over-the-counter (OTC) medications. Research shows that large doses of caffeine, especially those over 200 mg daily, can result in a negative mood, increased anxiety, and other detracting effects [3]. The hypothesis that caffeine is addictive is supported by the phenomenon of caffeine withdrawal symptoms. Abstinence from doses as small as 100 mg can result in withdrawal symptoms, which include, but are not limited to, headaches, fatigue, difficulty concentrating, irritability, depression, anxiety, flu-like symptoms, and sleepiness [3]. Severity of withdrawals from caffeine varies. Approximately 70% of caffeine-dependent individuals experiencing a caffeine withdrawal have reported impairment in their functional lives [3].

    Another rare, yet tragic result of substance addiction is neonatal abstinence syndrome (NAS). Cases of NAS result from abuse of opiate substances by an expecting mother during pregnancy. If drug use continues through the pregnancy, the baby might be addicted to the drug at birth [5].

 

Behavioral Addictions

    The second, underestimated form of addiction is that of behavioral addictions. There is evidence to support that any and all stimulating activities can be addictive. Behavioral addictions work the same pathways and processes as substance addictions [6]. As stated above, the difference lies in that the addicting entity is an activity/experience rather than a chemical neuromodulating substance. This means that while substance abuse can directly create addictions, behavioral addictions do so through indirectly through activation of primarily dopaminergic neurotransmitters (more on that in our Basics of Neuroscience article on how addictions mechanically work). Behavioral addictions can be based on a myriad of activities, and can be linked to a variety of emotional effects, including material acquisition, adrenaline release, distraction. Most addictions work through a combination of several of these effects.

    Material acquisition is the gain of property. The most basic behavioral addiction based on material gain is that of shopping. Shopping addictions generally develop as the affected individual spends more and more money on superfluous material possessions. With time, the individual starts to derive more pleasure from the process of acquiring goods than with the goods themselves, and can find themselves locked in a perpetual shopping spree. While going to the mall with friends is a perfectly healthy, normal way to spend time, using shopping as a way to escape stress can lead to, or be a sign of, a shopping addiction.

    A second type of addiction linked to material acquisition is gambling. Gambling takes many forms, such as casino games, online fantasy sports, slot machines, and other activities in which money is invested, and can be lost or gained due primarily to chance. Gambling is also linked to adrenalinic addictions, or those related to the release of adrenaline. While gambling, an individual will often feel an immense thrill due to suspense and excitement. Unfortunately, gambling rarely pays off- many perpetual gamblers find themselves in financial crises.

    Another major adrenalinic addiction, although less distinct as an addiction, is addiction to risky, dangerous activities. These activities will alert the nervous system of danger, releasing in a pleasurable rush of adrenaline. Yet another addiction linked to adrenaline is the condition of video game dependence. Many thriller action games can be littered with emotional, stressful obstacles which, when overpowered, result in a sudden rush of adrenaline[7].These video games include various shooters and rpgs, as well as horror themed games.

    As with gambling, video games do not fit neatly into one category. Video games can also be associated with the class of addictions primarily associated with distractions. Video games can provide a dull, white-noise distraction from hard, stimulating work, resulting in their prominent use by procrastinators. One can often find himself resorting to a video game as a way to escape the boredom of doing hard, menial work, whether physical or mental. As a result, an addiction forms, easily solidified and amplified by the use of video games for hours upon hours.

    The other major addiction used as a distraction is an internet addiction. This includes social media as well as web surfing and other internet usage. This is similar to video game addictions, and often serves as an escape from work. A major feature of internet addictions is an obsession with connecting with other people through the internet. Although keeping in touch with your friends online is totally normal, some individuals find themselves only communicating with other people through the web.


References


  1. Yenigun, S. (2013, February 11). Video game violence: Why do we like it, and what’s it doing to us? Retrieved September 25, 2016, from NPR, http://www.npr.org/2013/02/11/171698919/video-game-violence-why-do-we-like-it-and-whats-it-doing-to-us

  2. Alavi, S. S., Ferdosi, M., Jannatifard, F., Eslami, M., Alaghemandan, H., & Setare, M. (2012). Behavioral addiction versus substance addiction: Correspondence of psychiatric and psychological views. Int J Prev Med, 3(4), 290–294. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354400/

  3. Neonatal abstinence syndrome: MedlinePlus medical encyclopedia. Retrieved September 22, 2016, from MedlinePlus medical encyclopedia, https://medlineplus.gov/ency/article/007313.htm

  4. Meredith, S. E., Juliano, L. M., Hughes, J. R., & Griffiths, R. R. (2013). Caffeine use disorder: A comprehensive review and research agenda. Journal of Caffeine Research, 3(3), 114–130. doi:10.1089/jcr.2013.0016

  5. Caffeine Dependence. Retrieved September 22, 2016, from Johns Hopkins Psychiatry BPMU, https://www.hopkinsmedicine.org/psychiatry/research/bpru/docs/caffeine_dependence_fact_sheet.pdf

  6. International Statistics. Retrieved September 22, 2016, from Drug Free World, http://www.drugfreeworld.org/drugfacts/prescription/abuse-international-statistics.html

  7. National Institute of Mental Health (2015). Addiction. Retrieved September 17, 2016, from https://newsinhealth.nih.gov/issue/oct2015/feature1.

Alexander Skvortsov

Alexander Skvortsov


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