Substance Abuse Treatment

Changing Our View on Addiction


If I were to give you a pen and paper, how many types of addictions can you name? I’m not referring to “addiction” just in the traditional sense (i.e. alcohol and drugs). I’m talking about the ever-expanding use of the word (i.e. internet addiction, gambling addiction, shopping addiction, love addiction, sex addiction, Facebook addiction, pornography addiction). With all of these categories, it can leave us confused in how we view addiction.

The truth is that when people are seen by a mental health professional, there is no formal diagnosis of “Addiction.” There used to be separate diagnoses of Substance Abuse Treatment or Substance Dependence, but now in the new edition of the Diagnostic and Statistical Manual it’s simply on one spectrum – Substance Use Disorder. With this change in name also comes a new diagnostic category that includes “Addictive Behaviors.” Only gambling addiction is listed as of now, but there are others that are being studied, including internet addiction.

Where do these changes leave us, individually and as a society, in how we think about addiction? It’s hard for some to imagine how an Alcohol Use Disorder that is argued to be a “disease” is also the same as gambling, sex, or shopping. Although they are vastly different in some respects, I ask you to consider the ways in which they are exactly the same. I can illustrate this point by asking you a simple question: How do you deal with the negative events that happen in your life?

Whenever something bad happens in our lives, we arguably have 3 choices:

  1. Avoid it completely.
  2. Deal with it.
  3. Avoid it until we can rationally come up with a plan to move forward.

Each of us has probably made each of these choices at one point or another with varying levels of success. Although it sometimes feels easier to avoid situations completely, the problem arises when we avoid by numbing. A partner betrays us–we numb. We get laid off–we numb. We have a bad day–we numb. It’s natural to not want to deal with the hard truths, but not dealing with them doesn’t make it go away. You can put aloe on a sunburn; you can take a pill to get rid of the sniffles; you can put paint over rotted lumbar. However, underneath the paint job, the symptoms, and the burn is the pain you initially felt and the seed that ultimately harvested your current life circumstances. And so often what we do with that pain is what gets us caught into the addiction trap.

So whether you want to call your “drug” of choice alcohol, shopping, heroin, gambling, sex, love, internet–it doesn’t matter. We each have our own ways of coping with insecurities and life’s inevitable stressors. And it is our relationship with those stressors that can make the difference in how we numb.article continues after advertisement

None of this means that the genes involved in alcohol use and behavioral addictions, like gambling or internet use, are the same or that there is even one single gene. Just like anything else, there is a confluence of genetic, environmental and contextual factors that contribute to any one of the choices we make. We may not be able to change our genes and some of the cards life dealt us, but we can choose how we play our hand and the way we deal with those moments where life seems to try to get us to fold.

So I can give you the formal definition of an “addiction” and argue about whether it is valid, but on some level it doesn’t matter. Definitions will always be adjusted by being expanded or narrowed. At the core of an addiction is one’s inability to cope with some aspect of life. This doesn’t negate the role of pleasure seeking and urges that are part of the addiction equation, but if we don’t take inventory of our coping styles, we’re missing a key ingredient in our perception. How you cope is different than how your brother, sister, friend, parent, or neighbor copes. But what’s great is that we all have different tools in our toolbox that we can teach other. It is through this teaching that we can begin to expand our tools or coping styles and gain greater empathy for those using maladaptive tools that we no longer use or chose not to use in the first place.

I’ll leave you with a quote I recently heard by Seth Jaffe, a sober coach and interventionist, when discussing the death of Philip Seymour Hoffman,

 “A lot of people think the problem for Philip Seymour Hoffman was drugs. It wasn’t… that was his solution to his problem.”

Begin to think about what problem your “drug” is solving in your life. Can you begin to find alternative solutions that might work better? Let us know what tools you’re now using and how others can begin to use them too.