Introduction
Few people would disagree that addiction is one of the major problems facing the developed world. But there are many different (and deeply contradictory) ideas about the best way to respond. It is hard even to get people to agree on a definition of addiction, or what a solution to the problem might look like. This is an attempt to provide a useful starting point for discussing the options available to us.
The nature of the problem
Some discussions of addiction assume that addiction is some kind of problem with illegal drugs. But you can be addicted to an activity (such as gambling, sex, too much food, too little food, and various forms of risk-taking), and you can be addicted to legal drugs (such as alcohol, antidepressants, nicotine, sedatives and caffeine). For convenience, we often treat alcoholism as a distinct problem, but it is as much a drug addiction as any other.
There are many definitions of addiction.
- NHS: Addiction is defined as not having control over doing, taking or using something to the point where it could be harmful to you. (This seems far too wide: falling in love with the wrong person would qualify, as would needing to drive a car to get to work.)
- National Institute on Drug Abuse: Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain. It is considered both a complex brain disorder and a mental illness. Addiction is the most severe form of a full spectrum of substance use disorders, and is a medical illness caused by repeated misuse of a substance or substances. (This seems far too limited: addiction is not only connected with drug taking.)
- Me: Addiction is a motivated habit. That's it. We have many habits, and we need our habits so that we can focus our attention where it can be useful - so habits are generally helpful. Most habits simply enable us to get something done without thinking about it, but some habits give us a reward (usually the reward is that they help us feel good, or stop us feeling bad) - and when a habit rewards us, we are motivated to repeat and reinforce that habit. From this perspective, an addiction is an addiction, whether or not it is actually or potentially causing harm. (If you can find a reference to this definition being used elsewhere, please let me know: I have talked about it with various people who treat addicts, and they were not familiar with it.)
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