Definitions &
Characteristics of Addiction
By:
Charles N. Roper, PhD, LCDC
How many legitimate
definitions of addiction are there? There are
hundreds—literally hundreds.
Which one is the best? Actually, there are several good
ones. Read on.
Morse & Flavin (1992)
Morse & Flavin’s (1992) definition
of addiction represents
the one traditionally utilized by treatment centers and substance
abuse counselors. It is very good and touches all of the bases.
Published in The Journal of the American Medical Association
(Vol. 68, No. 8), Morse & Flavin defined addiction thusly
(paraphrased for simplicity):
- Addiction is a primary,
progressive, chronic disease with genetic, psychosocial, and
environmental factors influencing its development and
manifestations. The disease is often progressive and fatal. It
is characterized by impaired control over use of the
substance, preoccupation with the substance, use of the
substance despite adverse consequences, and distortions in
thinking.
DSM IV (1994)
The DSM IV (1994) relies on
symptoms for its definition. The DSM says that addiction, or
dependence, is present in an individual who demonstrates any
combination of three or more of the following symptoms
(paraphrased for simplicity), occurring at any time in the same
12-month period:
- Preoccupation with use of the
chemical between periods of use.
- Using more of the chemical
than had been anticipated.
- The development of tolerance
to the chemical in question.
- A characteristic withdrawal
syndrome from the chemical.
- Use of the chemical to avoid
or control withdrawal symptoms.
- Repeated efforts to cut back
or stop the drug use.
- Intoxication at inappropriate
times (such as at work), or when withdrawal interferes with
daily functioning (such as when hangover makes person too sick
to go to work).
- A reduction in social,
occupational or recreational activities in favor of further
substance use.
- Continued substance use in
spite of the individual having suffered social, emotional, or
physical problems related to drug use.
Charles Roper (1998)
The following conceptualization
of addiction has proven to be understandable and meaningful to a
lot of people, both professionals and lay people alike. It
suggests that there are reliable, concrete differences between
Social Users of alcohol and drugs, Abusers of
alcohol and drugs, and Addicts, or those addicted to
alcohol and drugs. The categories break down as follows:
- Social User: One who uses
alcohol and/or drugs simply to enhance the pleasure of
normally pleasurable situations. The social user experiences
the following:
- No negative consequences;
- No surprises or
unpredictability;
- No loss of control;
- No complaints;
- No thoughts of or need for
limit setting.
- Substance Abuser: One who uses
to enhance pleasure and/or compensate for something negative,
such as physical or emotional pain, insecurity, fear, anger,
etc. The substance abuser experiences some or all of the
following:
- Occasional negative
consequences that are not repeated;
- Limit setting that is
adhered to;
- Promises that are made and
kept;
- Complaints are heard and
dealt with.
- Addict: One who uses to
celebrate, compensate, or for any other reason, legitimate or
not. The addict experiences some or all of the following:
- Negative consequences are
recycled;
- Limit setting &
promises to self or others are broken;
- Complaints are denied
and/or not heard;
- Reliable symptoms of
addictive disease become more evident. Reliable symptoms
include those listed under the DSM IV definition of
addiction and others, expressed as follows:
- Continued use despite
negative consequences;
- Loss of control, as in
more use than planned (broken limits);
- Unpredictability, as
in use despite plan not to use (broken promises);
- Compulsivity/preoccupation
in thinking;
- Denial; Use of
defenses to maintain denial;
- Build up of (or
"break" in) tolerance;
- Remorse & guilt
about use or behavior when using;
- Memory loss, mental
confusion, irrational thinking;
- Family history of
addictive behavior;
- Withdrawal discomfort
(physical, mental, emotional, and/or psychological).
John Bradshaw w/ Charles Roper
(1994)
The following conceptualization
of addiction is drawn primarily from the work of John Bradshaw. I
took his basic premise and expanded it to its present form. It
says that addiction exists in the individual who demonstrates a pathological
relationship with any mood altering experience that
results in ongoing, recurring life damaging negative
consequences. Within the context of this definition, the
following sub-definitions are offered:
- Pathological
refers primarily to the presence of the following:
- Denial and
delusion—defense mechanisms that look very crazy to the
objective, outside observer; and
- The intention to control
one’s use combined with unsuccessful attempts to do so.
- Mood altering
experience refers to both of
the following:
- Substances, including for
example, alcohol, illegal drugs, prescription drugs,
nicotine, caffeine, food, and sugar; and
- Behaviors, including for
example, gambling, work, sex, relationships, exercise,
religion, emotions, shopping/spending, and TV.
- Life damaging
negative consequences refers
to both of the following:
- The Obvious, including for
example specific health problems, specific legal problems,
accidents, and loss of jobs or relationships; and
- The Subtle, including for
example loss of self-respect or respect of family or
peers, lowered job performance or efficiency, arguments,
and generally negative attitude.
Obviously, this conceptualization
of addiction is broad and captures more than just alcohol- and
drug-addicted people. It suggests that addiction to alcohol,
heroin, nicotine, gambling, and shopping are all similar
conditions as long as they meet the criteria of the definition.
Biochemical, Neurochemical
Other definitions of addiction
include those that are based strictly on biological, biochemical,
or neurochemical presuppositions. They require evidence of a
genetic predisposition to addiction coupled with a biochemical or
neurochemical "error" or "malfunction" in the
brain. These conceptualizations of addiction may well prove to be
definitive. Time will tell.
In the meantime,
though, defining addiction according to behavioral symptoms
appears to offer the most reliable means of accurately diagnosing
addiction. In layman’s terms, "If it looks like a duck,
acts like a duck, walks like a duck, and quacks like a duck,
it’s probably a duck." Very simply put, if an individual is
having problems associated with his/her substance use, and really
tries but fails to control his/her use, then the chances are
pretty good that there’s an addiction lurking nearby. This is
especially true if these symptoms occur in cycles.
The Addictive Cycle
By: Charles N. Roper, PhD
1. Negative Consequences
Associated with Use leads to:
2. One's Intention to Control One's Use, which leads to:
3. Failure to Control One's Use, which leads to:
4. Denial and Other Defenses, which leads to:
1. Continued Use Despite Negative Consequences, which leads to:
2. One's Intention to Control One's Use, which leads to:
3. Failure to Control One's Use, which leads to:
4. Denial and Other Defenses, which leads to:
1. Continued Use Despite Negative Consequences, which leads to:
2. One's Intention to Control One's Use, which leads to:
3. Failure to Control One's Use, which leads to:
4. Denial and Other Defenses, which leads to:
1. Negative Consequences Associated with Use.
And without recovery, it goes on
and on and on and...
Please email your comments or questions
regarding this article to: croper1(at)austin.rr.com
(not a direct link in order to avoid address being picked up robotically
for spam).
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