What is Addiction?

Compulsion, control, and consequence.
Addiction is a continuous pattern of compulsive use or need of something that one feels they lack control over and the inability to say no to it; a person will continue on this path of use despite adverse consequences to themselves, their relationships, and other aspects of their lives.

Major Components of Addiction

The unique individual: Who they are – their upbringing, values, environment, supports, and access to resources – their personal story.
The stimulus itself: How does the person interact with it and what effect does it have on them – what does it do for them?
The set and setting: the individual’s psychological and emotional frame of mind when engaged with the stimulus and the physical, social, and interpersonal environment when engaged with the stimulus.

Stimuli

Most often, when people think of addiction, they think of substances – drugs and alcohol. The most commonly used drugs in the U.S. and worldwide are alcohol first, then tobacco, and cannabis third. Alcohol withdrawal can actually kill a person. Alcohol has the highest risk of death and leads to more deaths than fentanyl use. Tobacco is currently the leading cause of preventable death.

There are other stimuli, such as gambling, shopping, porn, Internet gaming, and sex.

Getting Our Needs Met

Addiction is often the immediate solution for someone who is emotionally dysregulated as a means of coping with intolerably painful emotions and unfavorable situations. It is a way to get their needs met. I always ask, what is this doing for you, because it is providing some benefit. People want to escape pain and seek pleasure, so how is the stimulus helping you to achieve that? What are you escaping and what are you getting from the experience? It is human nature to be part of social groups, and substance use (and other stimuli one may be addicted to) tends to be part of social interactions. We want to feel connected to others and sharing interests and experiences with others allows us to get that connection. So, while we may seek and receive connection, is the method we are engaged in a healthy one?

Solutions

Brief interventions and behavioral therapies have the most evidence for being the most effective evidence-based therapies for addiction. Along with medication-assisted treatment (MAT) for opioid and alcohol addiction.