In 2011, the American Society of Addiction Medicine reclassified addiction as a “chronic brain disorder.” Unsurprisingly, some were outraged by this. For many, addiction is not an illness, and any attempt to define it as one is absurd. Addiction, they argued, is an excuse for weakness and self-indulgence. Others disagreed, welcoming it as a more progressive and enlightened way of dealing with the problem. But, whether addicts are selfish hedonists or helpless victims, one thing can be agreed upon – addiction causes suffering. Around 20% of annual deaths in North America are linked in some way to addiction. And experts in the UK have estimated that addiction costs the economy more than cancer and diabetes combined. It is also very common. In the United States, for example, around 8% of the population is addicted to alcohol or drugs.
What Is an Addiction?
An addict is seeking to alter his psychological or emotional state. He wishes either to enhance a feeling (joy, happiness, numbness), blot one out (depression, trauma, fear, loneliness, emptiness), or do both at the same time. Those with little sympathy for addicts tend to focus on the first of these wishes, arguing that addicts have brought it on themselves – they wanted to have a good time by experimenting with drugs, or to get rich quick by visiting the casinos, now let them face the consequences. Those with more sympathy will stress the second wish, adding that the life of an addict is hardly an enjoyable one.
People do not choose to be addicts, neither do they become addicts overnight. Addiction is a process. At first, the addict only needs a small amount of heroin, money, or sex to make him feel better. Gradually, a tolerance builds and he needs a little more to achieve the same result. Then a new tolerance develops and an even greater amount is needed. And addicts face the additional problem of withdrawal. Once they have adjusted to a certain amount of the drug, a biochemical or emotional balance is established. As soon as their ‘drug’ is removed, whether that be the shopaholic’s credit card or the heroin addict’s needle, withdrawal symptoms begin. That in turn makes a relapse even more likely.
Most addicts are addicted either to a substance or to a form of behavior. So, for example, an alcoholic is addicted to a substance, a gambler to a pattern of behavior. Both find it impossible to stop. Other common addictions include drugs, sex, shopping, and eating. Some even become addicted to other people. Time and again individuals become entangled in romantic relationships that cause them intense unhappiness, and yet they cannot extricate themselves. And this raises another point about addiction – it is usually harmful. Of course, people do become addicted to things that improve their life. A so-called ‘health freak’ might become addicted to exercise, or a student may become addicted to her books. But even in these cases the addictions usually end up causing harm. Both feel compelled to do these things, often against their wishes, and usually at some cost. The health freak, for example, may actually end up harming her body. She may become obsessed with maintaining a six-pack, overdo it at the gym, exhaust her body, miss work and even trigger anorexia. The devoted scholar never feels that she has read enough or knows enough, and in her obsessive devotion to learning she may ruin her marriage or neglect her children. Addiction is usually compulsive, uncontrollable, and ultimately harmful.
Causes
Addiction often begins as a form of self-medication: an individual is suffering in some way, tormented by the memory of sexual abuse, perhaps, or the collapse of a marriage. This leads to insomnia, depression and agoraphobia. But rather than taking antidepressants or committing to a course of psychotherapy, they buy a bottle of vodka or contact their local drug dealer instead.
Shame can also lead to addiction. Many people go through life feeling inadequate in some way. Perhaps they are obese, have a low status job, or feel like a failure in the eyes of their family. Addiction rates are especially high among the homeless and unemployed. This is usually put down either to boredom or the wish to escape a miserable situation. But they may also wish to escape the shame they feel. The problem with shame is that its victim tends to become caught in a vicious circle: he feels ashamed of something, so he tries to blot out the feeling with alcohol or drugs, which in turn leads to job loss, rotten teeth and ballooning weight, thus increasing his shame, which he tries to blot out all over again, and so on.
The Wider Context
Addiction also needs to be understood in a wider context. No alcoholic, gambler or cocaine addict ever raised himself alone on a deserted island. Therapists can often trace an addiction back to the family. The obvious example is the heroin addict who was sexually abused by her father or uncle and uses the drug as a pain-killer. Others may have felt unwanted and unloved and so developed some kind of addiction to fill the hole. Children are like little sponges, soaking up everything their parents tell them. A gambling addict, for example, may have been raised by a whiny, self-pitying father who convinced him that the family was hard done by and that work was a waste of time. Then of course there is simple imitation. Addicts may begin by imitating a parent. An alcoholic will have often been raised by alcoholic parents. Some react with disgust and commit to a life of sobriety, others simply follow the same path.
The cultural context also needs to be taken into account. A young man raised in a culture that celebrates heavy drinking and considers it a sign of manliness is more likely to become an alcoholic than one born in a society that regards it merely as a cowardly escape. Addiction is also common within groups who feel ignored, despised, or robbed of their identity. In 2006, for example, the New Zealand Herald reported that the Maoris (the native people of New Zealand) were twice as likely to develop a substance addiction as other ethnic groups. Some argue that this is due to their sense of wounded pride and lost identity. Members of African tribal groups, for example, can also suffer in this way when they move to the sprawling shanty towns on the edges of big cities. Addicts may even be reacting to the nihilism and empty consumerism of modern life.
Addiction is a serious business. Not only does it cause immense suffering to the addict himself, it also hurts those who love him. A gambler, for example, may blow the family savings, while an alcoholic may neglect his children. Addiction is also very expensive. The U.K.’s tax-funded National Health Service, for example, spends around £730 million a year just on treating heroin addicts. And the additional cost in crime, anti-social behavior, and family breakdown is incalculable.