Addiction

Abstract

While addiction is a familiar term, it lacks a precise technical definition. Theories of addiction differ as to whether addiction is seen as a unique form of habit or only as a habit that is particularly strong . Traditionally, habit has been associated with the concept of reinforcement, and most drugs that are claimed to be addictive for humans have been shown to be reinforcers in animal models. The primary theoretical disagreements have to do with the issue of physical dependence; classical dependence theories hold that a drug‐taking habit only becomes an addiction when the frequency of use establishes autonomic and metabolic adaptations such that drug intake becomes required for normal homeostatic function. In this view drug intake becomes compulsive because the addict needs the drug to self‐medicate withdrawal distress. Physical dependence, readily demonstrated in the case of opiates and other depressant drugs, is associated with drug tolerance such that increasing doses are required to “self‐medicate” the autonomic distress that results from drug detoxification. However, classic dependence signs are absent in the case of the psychomotor stimulants cocaine, amphetamine, and nicotine; indeed, withdrawal from these drugs has effects generally opposite to opiate and alcohol withdrawal symptoms. Nonetheless, self‐administration of these substances can be as compulsive as—and more physiologically harmful than—self‐administration of opiates. Thus alternatives to dependence theory have stressed the role of drugs as powerful reinforcers, reinforcers that can elevate mood state above normal levels and can establish or reinstate compulsive drug‐seeking habits even in nondependent subjects. The brain mechanisms involved in foraging for and ingesting addictive drugs are much the same as those involved in more natural motivated behaviors such as foraging for and engaging food or sexual partners. Thus such habits such as compulsive eating, compulsive sexual behavior, and compulsive gambling are increasingly labeled addictions. Recent brain imaging studies support the view that drug addiction shares common mechanisms with these other compulsive behaviors.

Experimental manipulations of behavioral economic demand for addictive commodities: a meta‐analysis

“…tanning, internet use) under such conditions would be a further test of their addictive properties . Given the presumed difference in pharmacological potency between substance and behavioral addictions , graded effect sizes may exist between manipulations and demand for different indices, which future moderator analyses across commodities could illuminate empirically. Further, changes in some demand indices for the manipulations reported in the current analyses have not been reported often enough for inclusion, and thus future studies should fully report all demand indices to more adequately determine the extent of heterogeneity across different aspects of demand.…”

Applying behavioral economic theory to problematic Internet use: An initial investigation.

“…Research does support the presence of neurological changes and deficits among those with behavioral addictions (Balconi et al, 2017; Beutel, Wo, Duven, & Mu, 2014), albeit at a lower intensity than substance-related addictions. This, however, suggests a “quantitative rather than qualitative difference” between these addictions (Wise, 2002), and highlights the possibility of a spectrum of addictive behaviors that could partially be dictated by strength of neurological effect while still acknowledging the behaviorally similar aspects of the phenomena.…”