Addiction: What is it?

A medical definition of addiction is hard to pin down. But most of us feel like we know what it means: doing something you can't stop, even though it interferes with daily living and good relationships. It's something that controls you, despite good intentions to stop it.

Chemical dependence

The American Psychiatric Association lists alcohol, amphetamines, barbiturates, cocaine, narcotics, nicotine and many other chemicals as substances that people can become addicted to.

People are considered chemically dependent if they meet three of the following criteria over 12 months:

• a need for more of the substance to "feel good" or achieve intoxication
• having withdrawal symptoms after stopping use or using the substance to avoid those symptoms (See withdrawal symptoms for alcohol, cocaine, narcotics and nicotine.)
• using more of the substance than usual, or for longer than intended
• a continued desire for the substance or unsuccessful attempts to cut down or stop using it
• spending a lot of time to obtain, use or recover from the substance
• giving up or cutting back on important social, work-related or recreational activities
• continuing to use the substance even though it's causing problems

Addictive behaviors

Beyond substance abuse, an addiction may involve any behavior -- gambling, spending money, eating, having sex, etc. -- that interferes with your daily life.

You can consider yourself addicted if…

• you get defensive or irritable when people criticize it
• you feel guilty about it
• you try to cover it up or get secretive
• you're unable to cut down

Whatever the source, addictions affect the "reward area" of the brain. Addicts experience a "rush" when they engage in the behavior they're addicted to. The craving for that rush keeps them from being able to quit.

What causes addiction?

Many opinions surround exactly what causes addiction.

The National Council on Alcoholism and Substance Abuse calls addiction "a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal."

Often, it seems that people whose parents abused substances tend to become addicts themselves. Some experts say it might be genetics, while others say it could be a learned behavior.

An emotional problem

In his book The Heart of Addiction, Lance Dodes, MD, calls addiction an emotional problem. He notes that some patients who have trouble stopping an addictive behavior feel better as soon as they decide to resume the behavior. Such relief occurs even before the activity itself occurs.

Dodes describes a man with alcoholism who spent nearly an entire day trying to fix his computer. His frustration mounted until he decided to go out for a bottle of vodka. Just deciding to buy the vodka helped the man to feel more in control.

Dodes believes that people can learn to identify and understand what makes them lose their resolve to avoid an addiction, then replace the addictive behavior with something more productive. For most, this means a lot of hard work with a therapist.

The addictive personality

You may have heard "addictive personality" used to describe someone who is more likely to develop an addiction than someone with a different personality. But Craig Nakken in his book The Addictive Personality, says this type of personality "gets created from the illness of addiction." In other words, one develops an addictive personality after the addiction takes hold.

If someone with an addictive personality gives up one addiction, he or she is likely to replace it with another one. Nakken says, "On some level, the addict will always be searching for an object or some type of event with which to form an addiction."

To stop addictive behavior and feel content with their lives, people must acknowledge their addictive personality and learn how to break that cycle, Nakken contends.

When addiction takes hold

People seem more vulnerable to addictions at certain times in their lives. Losing a loved one or a job, realizing that something you hoped for won’t happen, or moving to a new place can create situations that make you prone to addictive behavior.

Overcoming addiction

Addiction seems to come from an interplay of emotional, genetic and learned factors. No matter what the cause, people who suffer from addictions -- and their loved ones -- need professional help and a lot of soul searching to overcome their problem.

For many, 12-step programs, such as Alcoholics Anonymous, work well. Others succeed by working closely with a therapist to understand what triggers their addictive behavior. Medication therapy can help some as well.

Finding help

If you or someone you love has an addiction, there are many ways to find help.

• Get advice from your doctor.
• Look in your local telephone book for programs listed under "alcoholism" or "drug use."
• Show up at a 12-step meeting (for example, Alcoholics Anonymous)
• Ask friends or co-workers if they know of a good therapist.
• Visit the United States Department of Health and Human Services’ substance abuse treatment facility locator.

Related Links

Alcohol and drug inventory

Allina Behavioral Health Services

Drugs: Is someone using?

Performing an intervention

Alcohol problems

First published: 02/01/2003
Last updated: 09/01/2005

Reviewed by: Tim Gibbs, MD, medical director, Outpatient Clinic, Abbott Northwestern Hospital Behavioral Health Services; Paul Goering, MD, medical director, United Hospital Behavioral Health Services; Paul Kleeberg, MD, medical director, Internet/Intranet Services, Allina Hospitals & Clinics; Donna Krzmarzick, RN, director, Cambridge Medical Center Behavioral Health Services; Robin McAlister, MD, psychiatrist, Mercy Hospital; Anil Sipahimalani, MD, Allina Behavioral Health Services - Northtown Clinic; Susan Tabor, RN, BSN, director, United Hospital Behavioral Health Services