Addiction, as a word, is a noun which in modern sense was first attested in 1906, in reference to
opium (there is an isolated instance from
1779, with ref. to tobacco). The first use of the adjective
addict (with the meaning of "delivered, devoted") was in
1529 and comes from Latin
addictus, pp. of
addicere ("deliver, yield, devote," from
ad-, "to" +
dicere, "say, declare").
[1]
Addiction was a term used to describe a devotion, attachment, dedication, inclination, etc. Nowadays, however, the term
addiction is used to describe a recurring
compulsion by an individual to engage in some specific activity, despite harmful consequences to the individual's health, mental state or social life. The term is often reserved for
drug addictions but it is sometimes applied to other compulsions, such as
problem gambling, and
compulsive overeating. Factors that have been suggested as causes of addiction include
genetic,
biological/
pharmacological and
social factors.
Decades ago addiction was a
pharmacological term that clearly referred to the use of a tolerance-inducing drug in sufficient quantity as to cause tolerance (the requirement that greater dosages of a given drug be used to produce an identical effect as time passes). With that definition, humans (and indeed all mammals) can become addicted to various drugs quickly. Almost at the same time, a lay definition of addiction developed. This definition referred to individuals who continued to use a given drug despite their own best interest. This latter definition is now thought of as a disease state by the medical community.
Physical dependence, abuse of, and withdrawal from drugs and other miscellaneous substances is outlined in the
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV TR). Terminology has become quite complicated in the field. To wit, pharmacologists continue to speak of addiction from a physiologic standpoint (some call this a physical dependence); psychiatrists refer to the disease state as dependence; most other physicians refer to the disease as addiction. The field of psychiatry is now considering, as they move from DSM-IV to DSM-V, transitioning from "dependence" to "addiction" as terminology for the disease state.
The medical community now makes a careful theoretical distinction between
physical dependence (characterized by symptoms of
withdrawal) and
psychological dependence (or simply
addiction). Addiction is now narrowly defined as "uncontrolled, compulsive use"; if there is no harm being suffered by, or damage done to, the patient or another party, then clinically it may be considered compulsive, but to the definition of some it is not categorized as "addiction". In practice, the two kinds of addiction are not always easy to distinguish. Addictions often have both physical and psychological components.
There is also a lesser known situation called
pseudo-addiction.
[2] (Weissman and Haddox, 1989) A patient will exhibit drug-seeking behavior reminiscent of psychological addiction, but they tend to have genuine pain or other symptoms that have been undertreated. Unlike true psychological addiction, these behaviors tend to stop when the pain is adequately treated.
The obsolete term
physical addiction is deprecated, because of its connotations. In modern pain management with opioids physical dependence is nearly universal. While opiates are essential in the treatment of acute pain, the benefit of this class of medication in chronic pain is not well proven. Clearly, there are those who would not function well without opiate treatment; on the other hand, many states are noting significant increases in non-intentional deaths related to opiate use. High-quality, long-term studies are needed to better delineate the risks and benefits of chronic opiate use.
Not all doctors agree on what addiction or dependency is. Traditionally, addiction has been defined as being possible only to a psychoactive substance (for example
alcohol,
tobacco and other
drugs) which ingested cross the
blood-brain barrier, altering the natural chemical behavior of the brain temporarily. However, "Studies on phenomenology, family history, and response to treatment suggest that
intermittent explosive disorder,
kleptomania,
pathological gambling,
pyromania, and
trichotillomania may be related to
mood disorders, alcohol and psychoactive
substance abuse, and
anxiety disorders (especially
obsessive-compulsive disorder).
[3]
It is generally accepted that addiction is a disease, a state of physiological or psychological dependence or devotion to something manifesting as a condition in which medically significant symptoms liable to have a damaging effect are present.
[4]
Many people, both psychology professionals and laypersons, now feel that there should be accommodation made to include psychological dependency on such things as
gambling,
food,
sex,
pornography,
computers,
work, exercise, cutting,
shopping, and
religion[5] so these behaviours count as diseases as well and don't cause
guilt,
shame,
fear,
hopelessness,
failure,
rejection,
anxiety, or
humiliation symptoms associated with, among other medical conditions,
depression[6],
epilepsy,
[7] and
hyperreligiosity.
[8] In depression related to religious addiction "The religious addict seeks to avoid pain and overcome shame by becoming involved in a belief system which offers security through its rigidity and its absolute values."
[9] While religion and spirituality may play a key role in psychotherapeutic support and recovery, it can also be a source of pain, guilt and exclusion, and religious themes may also play a negative role in psychopathology.
[10] Although, the above mentioned are things or tasks which, when used or performed, do not fit into the traditional view of addiction and may be better defined as an
obsessive-compulsive disorder,
withdrawal symptoms may occur with abatement of such behaviors. It is said by those who adhere to a traditionalist view that these withdrawal-like symptoms are not strictly reflective of an addiction, but rather of a behavioral disorder. However, understanding of
neural science, the brain, the nervous system, human behavior, and
affective disorders has revealed "the impact of molecular biology in the mechanisms underlying developmental processes and in the pathogenesis of disease".
[11] The use of thyroid hormones as an effective adjunct treatment for affective disorders has been studied over the past three decades and has been confirmed repeatedly.
[12] In spite of traditionalist protests and warnings that overextension of definitions may cause the wrong treatment to be used (thus failing the person with the behavioral problem), popular media, and some members of the field, do represent the aforementioned behavioral examples as addictions.
Recently, some have modeled addiction using the tools of
Economics, for instance, by calculating the
elasticity of addictive goods and determining to what extent present
income and
consumption has on future consumption