Addictive behavior

Addiction and dependence glossary[1][2][3]
  • addiction – a biopsychosocial disorder characterized by persistent use of drugs (including alcohol) despite substantial harm and adverse consequences
  • addictive drug – psychoactive substances that with repeated use are associated with significantly higher rates of substance use disorders, due in large part to the drug's effect on brain reward systems
  • dependence – an adaptive state associated with a withdrawal syndrome upon cessation of repeated exposure to a stimulus (e.g., drug intake)
  • drug sensitization or reverse tolerance – the escalating effect of a drug resulting from repeated administration at a given dose
  • drug withdrawal – symptoms that occur upon cessation of repeated drug use
  • physical dependence – dependence that involves persistent physical–somatic withdrawal symptoms (e.g., fatigue and delirium tremens)
  • psychological dependence – dependence socially seen as being extremely mild compared to physical dependence (e.g., with enough willpower it could be overcome)
  • reinforcing stimuli – stimuli that increase the probability of repeating behaviors paired with them
  • rewarding stimuli – stimuli that the brain interprets as intrinsically positive and desirable or as something to approach
  • sensitization – an amplified response to a stimulus resulting from repeated exposure to it
  • substance use disorder – a condition in which the use of substances leads to clinically and functionally significant impairment or distress
  • tolerance – the diminishing effect of a drug resulting from repeated administration at a given dose

An addictive behavior is a behavior, or a stimulus related to a behavior (e.g., sex or food), that is both rewarding and reinforcing, and is associated with the development of an addiction. There are two main forms of addiction: substance use disorders (including alcohol, tobacco, drugs and cannabis) and behavioral addiction (including sex, gambling, eating and shoplifting).[4] The parallels and distinctions between behavioral addictions and other compulsive behavior disorders like bulimia nervosa and obsessive-compulsive disorder (OCD) are still being researched by behavioral scientists.[5]

Defining addictive behavior presents a challenge, as the concept encompasses diverse behaviors, and therefore its usage has been contentious. Although, central to the definition is excessive dependence on a specific substance or activity, derived from the Latin term ‘to enslave.[6] Furthermore, addictive behavior describes patterns characterized by a loss of control and a compulsion to accept a reward despite severe consequences. This often manifests in compulsive engagement, prioritizing short-term gratification over long-term consequences, and a transition from impulsivity to compulsivity.[7] Consequently, addictive behaviors create a spectrum of activities that entrap individuals in repetitive patterns, despite the adverse consequences, echoing the enslavement inherent in the notion of addiction.[8]

Developments in research continue to reshape the human's understanding of addiction. Traditionally, addiction was largely associated with substance-use disorders, including alcohol and heroin, and therefore “non-substance-related (behavioral) addiction” was not listed in the two internationally used diagnostic manuals for mental disorders. However, contemporary research suggests that any stimulus capable of producing pleasure can lead to addiction. This shift broadens the scope of addiction to include excessive shopping, internet usage, computer gaming, gambling, and sex.[9][10] Addictive behaviors, whether substance-related or behavioral, often involve deficiencies in inhibitory control, emotion regulation, and decision-making.[6] There are significant overlaps in diagnostic symptoms between substance use and behavioral addiction, including dominance over one’s life, euphoric experiences, withdrawal symptoms, interpersonal conflicts, and the risk of relapse despite negative outcomes.[11]

From a neurobiological perspective, behavioral addiction may affect brain neurotransmitter systems similarly to pharmacological substances, such as the dopamine system.[12] These behaviors often follow a three-step cycle consisting of preoccupation (anticipation), binge intoxication, and withdrawal effect, with reinforcement playing a central role in each stage. Reinforcement occurs through positive experiences during the initial engagement, negative reinforcement to alleviate withdrawal symptoms, and conditioned reinforcement where cues associated with behavior or drugs trigger intense cravings, perpetuating the addiction.[13]

Addiction is classified as a chronic brain disorder by the American Society of Addiction Medicine (ASAM).[5] There are several reasons why people develop an addiction. A predisposition to the addictive qualities of substances may be inherited by some people, making it a genetic circumstance. Another cause for addictions could be the environment. Whether or not someone develops substance use problems can be influenced by their home and neighborhood, as well as the attitudes of their peers, family, and culture on substance use.[5] Another cause of developing an addiction could be related to mental health issues: over 50% of individuals with substance use disorders have experienced mental health issues at some point in their lives. Even moderate substance usage might exacerbate mental health issues in individuals.[5] The other view is from the moral standpoint which regards addictive behavior as an intentional choice was freely made by the addict.[14]

  1. ^ Nestler EJ (December 2013). "Cellular basis of memory for addiction". Dialogues in Clinical Neuroscience. 15 (4): 431–443. PMC 3898681. PMID 24459410. Despite the importance of numerous psychosocial factors, at its core, drug addiction involves a biological process: the ability of repeated exposure to a drug of abuse to induce changes in a vulnerable brain that drive the compulsive seeking and taking of drugs, and loss of control over drug use, that define a state of addiction. ... A large body of literature has demonstrated that such ΔFosB induction in D1-type [nucleus accumbens] neurons increases an animal's sensitivity to drug as well as natural rewards and promotes drug self-administration, presumably through a process of positive reinforcement ... Another ΔFosB target is cFos: as ΔFosB accumulates with repeated drug exposure it represses c-Fos and contributes to the molecular switch whereby ΔFosB is selectively induced in the chronic drug-treated state.41 ... Moreover, there is increasing evidence that, despite a range of genetic risks for addiction across the population, exposure to sufficiently high doses of a drug for long periods of time can transform someone who has relatively lower genetic loading into an addict.
  2. ^ Malenka RC, Nestler EJ, Hyman SE (2009). "Chapter 15: Reinforcement and Addictive Disorders". In Sydor A, Brown RY (eds.). Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York: McGraw-Hill Medical. pp. 364–375. ISBN 978-0-07-148127-4.
  3. ^ Volkow ND, Koob GF, McLellan AT (January 2016). "Neurobiologic Advances from the Brain Disease Model of Addiction". New England Journal of Medicine. 374 (4): 363–371. doi:10.1056/NEJMra1511480. PMC 6135257. PMID 26816013. Substance-use disorder: A diagnostic term in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) referring to recurrent use of alcohol or other drugs that causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home. Depending on the level of severity, this disorder is classified as mild, moderate, or severe.
    Addiction: A term used to indicate the most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug. In the DSM-5, the term addiction is synonymous with the classification of severe substance-use disorder.
  4. ^ "Top 10 Most Common Addictions in the U.S." Addiction Center. Orlando, FL: Recovery Worldwide LLC. Retrieved 2021-03-07.
  5. ^ a b c d "Addiction". Cleveland Clinic. Retrieved 2023-11-07.
  6. ^ a b Yücel M, Lubman DI, Solowij N, Brewer WJ (December 2007). "Understanding drug addiction: a neuropsychological perspective". The Australian and New Zealand Journal of Psychiatry. 41 (12): 957–968. doi:10.1080/00048670701689444. PMID 17999268.
  7. ^ Everitt BJ, Dickinson A, Robbins TW (October 2001). "The neuropsychological basis of addictive behaviour". Brain Research. Brain Research Reviews. 36 (2–3): 129–138. doi:10.1016/s0165-0173(01)00088-1. PMID 11690609.
  8. ^ Heather N (December 2017). "Is the concept of compulsion useful in the explanation or description of addictive behaviour and experience?". Addictive Behaviors Reports. 6: 15–38. doi:10.1016/j.abrep.2017.05.002. PMC 5800587. PMID 29450234.
  9. ^ Popescu A, Marian M, Drăgoi AM, Costea RV (May 2021). "Understanding the genetics and neurobiological pathways behind addiction (Review)". Experimental and Therapeutic Medicine. 21 (5): 544. doi:10.3892/etm.2021.9976. PMC 8014976. PMID 33815617.
  10. ^ Grant JE, Potenza MN, Weinstein A, Gorelick DA (September 2010). "Introduction to behavioral addictions". The American Journal of Drug and Alcohol Abuse. 36 (5): 233–241. doi:10.3109/00952990.2010.491884. PMC 3164585. PMID 20560821.
  11. ^ Alavi SS, Ferdosi M, Jannatifard F, Eslami M, Alaghemandan H, Setare M (April 2012). "Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views". International Journal of Preventive Medicine. 3 (4): 290–294. PMC 3354400. PMID 22624087.
  12. ^ Foddy B (January 2011). "Addiction and its sciences-philosophy". Addiction. 106 (1): 25–31. doi:10.1111/j.1360-0443.2010.03158.x. PMID 20955490.
  13. ^ Koob GF, Simon EJ (January 2009). "The Neurobiology of Addiction: Where We Have Been and Where We Are Going". Journal of Drug Issues. 39 (1): 115–132. doi:10.1177/002204260903900110. PMC 2901107. PMID 20622969.
  14. ^ Henden E, Melberg HO, Røgeberg OJ (2013). "Addiction: choice or compulsion?". Frontiers in Psychiatry. 4: 77. doi:10.3389/fpsyt.2013.00077. PMC 3736117. PMID 23966955.