Addiction Explained: From History to Modern Understanding 

 Due to it’s complexity, a simple definition of addiction can be difficult to find.  It can be overwhelming to do an online search to gain an understanding of all that addiction entails. While the abundance of information and knowledge sharing is incredible, for those searching for education, it can lead to information overload and analysis paralysis.

This article aims to provide an easy-to-understand explanation of what addiction is. We will start with some history of addiction and how the view of those who have an addiction has changed over the years.

 The History of Addiction

 The concept of addiction is longstanding in human history. There are references to mind-altering substance abuse dating back to 3000 BCE in Mesopotamia; however, the significant modern development in understanding came in 1804 when British physician Thomas Trotter formally described alcoholism as a medical condition in 1804. Many decades later, Trotter was proven right.

Different temperance movements sprung up in the Western world throughout the 1800s. The goal of these organizations was total abstinence from distilled spirits, viewing the spirits themselves as the root of the problem. These movements viewed substance abuse as a moral failure or lack of willpower on the part of the person with an addiction.

 In the United States, the temperance efforts led to the government enacting alcohol prohibition from 1920-1933. We know in retrospect that this action was wholly misguided, not only failing to stop the flow of alcohol but also creating a new class of criminal activity.

 Also, in the United States, Alcoholics Anonymous was formed by Bill Wilson and Dr. Bob Smith. Up until that time, there was no dependable treatment for alcoholism. The medical community, clergy, and loved ones were utterly helpless, with the alcoholic often ending up in sanitariums.

 AA grew slowly as the approach involved one-to-one help but grew exponentially throughout the 1940s and 1950s. The movement had a few triggers for significant growth, including the article by Jack Alexander in The Saturday Evening Post in 1941 and other more localized articles.

 Marty Mann, the first woman in AA, championed the effort that led to the program’s most significant growth. In 1944, she founded the National Committee for Education on Alcoholism (NCEA), which later became the National Council on Alcoholism and Drug Dependence (NCADD). She was relentless in her mission to educate the public on alcoholism as a disease, reduce stigma, and promote treatment and recovery.

 She traveled the world with this mission, forever changing the world’s view on addiction. At the time, the medical community had few supporters of the “disease concept” of alcoholism, including early pioneers in the NCEA, but Marty was steadfast in spreading the word.

 It wasn’t until 1956 that the American Medical Association officially recognized alcoholism as a disease. With the support of the organization she founded, this would not have been possible without the efforts of Marty Mann. AA and the world owe her an outstanding debt.

The Complexities of Addiction

A psychological definition of addiction:  Addiction is a state of mental or physical dependence (or both) on the use of alcohol or other drugs. The term is often used interchangeably with substance dependence and applies to behavioral disorders such as sexual, internet, and gambling addictions.

 As mentioned, understanding the causes and other aspects of addiction is complex. Here are just a few things we know about addiction:

 The Science behind it: Many reputable research studies have proven that addiction affects the brain in tangible ways. We know that dopamine, a chemical messenger, is at the center of an internal reward system as it releases “feel good” chemicals into our bloodstream when we experience something pleasurable. When we pursue pleasure, the body starts to reduce the dopamine produced, requiring more substance or activity to maintain the good feeling. In the long term, this activity will change our brain structure.

 Psychological and Social Aspects – There are many psychological factors and social influences that can be the origin of the uncomfortable feelings that we are trying to avoid with addictions. Often, things like trauma, undue stress, and mental health disorders may occur in our childhood or teenage years that we have no healthy way to process. (trauma, stress, mental health disorders).

 Also, we are susceptible to social influences such as peer pressure, environment, and our family that contribute to addiction. We may be introduced to substances by peers, or they are used in our families to feel good and have fun. A person with addiction issues will typically graduate from the feel-good and have-fun phase into using substances as an escape from reality.

 The Difference Between Habit, Dependence, and Addiction – This can be another confusing element in understanding addiction. A habit is repeating a behavior routinely, often without thought. While some habits are hard to break, they typically do not ruin our lives.

 Dependence occurs when continued substance use leads to physical reliance, resulting in withdrawal symptoms upon cessation. Dependence can happen on non-mind-altering medically prescribed substances, so the physical reliance in itself is not an addiction. We will cover what addiction is in the next section.

 A Simple Definition of Addiction 

The clinical definition of addiction is a helpful description but does not help the individual identify if they may have an addiction. I prefer a much simpler definition that one can use to measure one’s current situation and determine if an addiction exists.

 My definition is any activity (gambling, sex, or work) or substance (alcohol, drugs, or food) that one uses to escape from uncomfortable feelings like stress, anxiety, fear, or depression. When the use of the activity or substance creates ongoing unacceptable negative consequences in one’s life, and one cannot quit, then addiction is active.

 In my definition of addiction, I believe almost any activity can be addictive. Some are trickier than others—for example, food and work addictions. One must eat, and one must work, right? Of course! So, the key is to look objectively and honestly at the consequences of our behavior regarding food and work. The deciding factor between whether or not someone has an addiction comes down to “Is it ruining my life?” and knowing it is ruining my life, “Can I quit without help?”

An Example 

Let us proceed with a less tricky and seemingly absurd example: gardening as an addiction. I understand this may be the most ridiculous thing you can imagine, but please bear with me. I am using this example as an extreme to show that even the most harmless activity can have unacceptable negative consequences. Gardening falls along the lines of work addiction, where one may work to avoid uncomfortable feelings.

Negative Consequences:

Spending so much time gardening that basic needs are ignored, such as eating, personal hygiene, feeding the kids, maintaining relationships, or paying bills may be examples. 

Spending money on gardening (plants, tools, fertilizers) beyond what one can afford. Instead, money for rent, food, and utilities is spent on gardening.

Taking excessive time off work, lying, and calling in sick so one can garden all day. Avoiding any other responsibilities outside of work would also be an example.

Breaking the  Example Down

There is no denying that gardening has many benefits. It can feed your family, relax your mind, and add beauty to the world. However, if it is ruining our lives and we cannot quit, it is still an addiction.  The definition focuses on the behavior and consequences surrounding the activity, not the activity itself.

One might say, “I would rather be addicted to gardening than drugs.” While gardening may not have the physical implications and social stigma of drug addiction, it is not productive to compare addictions. Those with addictions often use this form of comparison as a form of denial.

Any addiction taken to extremes can significantly impact one’s life. Once again, looking at the behavior and the consequences is the point. If the two together are wreaking havoc on a person’s life or that of their loved ones, it may be time to at least acknowledge there may be a problem.  

Conclusion

Addiction has been a part of society for millennia. It was not until the 19th and 20th centuries that substance abuse problems were recognized as a societal problem in addition to an individual issue. Understanding took a drastic upturn in the 1950s with Marty Mann’s work, and the research continues today to understand the disease better.

If, after reading this article, you have determined that you or someone you love has an addiction, know that there are solutions to the problem. There are many different approaches to treating addiction, and if you are unsure where to start, you can read my article on treatment options or reach out to your family doctor and start a conversation. 

Resources:

Home Page – Alcoholics Anonymous

Home Page – Narcotics Anonymous

Home Page – National Institute on Drug Addiction