Our understanding of addiction has grown, and continues to grow, dramatically. Addiction to alcohol, nicotine and illicit drugs is certainly nothing new. That the chronic and uncontrolled use of mood altering chemicals in the face of obvious risk and self-harm may be a matter far beyond simple failure to exercise willpower is almost universally accepted, especially among addictions specialists. Science continues to unveil the mysteries behind the biochemistry of substance abuse and addiction. As our understanding of addiction has grown, so has our understanding of the broad scope of addictive behaviors.
No longer limited to the chemicals - legal and otherwise - we take to socialize, relax, escape into or, in some very literal cases, ease our pain, addictions can form around a broad spectrum of behaviors and activities that have nothing to do with adding outside molecular compounds to our bodies. What is insidious about these activities and behaviors is how commonplace most of them are - almost all of us engage in some of them, and some of us in most of them, with no ill effects. For a few of, however, an otherwise innocent diversion can hijack the brain's dopaminergic reward system just as surely as any drug.
Addictions to food, gambling, spending money, relationships and sex (as is Jerry in our vignette), the internet, computer gaming, and other seemingly innocuous activities are in the spotlight lately. Our rapidly expanding knowledge of these non-chemical addictions is in part driven by the speed and expanse of the media. One of the last big news stories of 2009 may ultimately be about sex addiction (and that going to the short irons is rarely helpful at most minor traffic accidents). Legalized gambling is widespread and growing, as is the debate over and news coverage of its risks. The food issues of common folk are spotlighted on The Biggest Loser, and of celebrities in the supermarket checkout rags. Ironically, while the information society we live in is responsible for spotlighting the problem of addiction it is also largely responsible for its spread. Take sex, shopping, or gambling addictions. Both sex (pornography, online hookups, adult service advertisements, etc) and gambling/gaming (whether for fun or cash) are literally a click away. Shopping no longer requires the effort to go out and hunt; now you can drain your bank account online while sipping coffee in your underwear. Actually, a lot of the sex and gambling probably happen that way, too.
Eating, gambling, shopping, sex, the internet, working out, fantasy leagues, and even church-going are just some of the things people do for fun or escape that, with the wrong person and in the wrong circumstances, can go awry. What we choose for recreation is what we have learned stimulates our reward system, the physical and chemical structures designed to recognize and reward pleasurable events by releasing serotonin and dopamine. This is a good thing, but in certain individuals, or at certain times, the reward, and the urge to replicate it, is so strong that the reward system is hijacked. Maybe the brain chemistry is already compromised in some way. Maybe the activity fills an emotional void. Maybe something else altogether, but the reward system is hijacked and a relatively harmless behavior can become an all-consuming addiction. And the truth is the addiction IS chemical in nature. The brain becomes addicted to its own serotonin and dopamine boost.
It is hard for a lot of us to accept these non-traditional addictions as real but they are. The true addict will experience the same sense of need as their drug or alcohol addicted counterpart; the same cravings; the same withdrawal and other physiological changes. They will also begin experiencing consequences, such as alienation and loss of family, relationship and job troubles, financial difficulties, and many of the same or similar health and physical problems. Working out is good. Working out six hours a day seven days a week, missing your kids birthday party, ignoring your spouse, losing sleep, and not being able to pull yourself away from the gym is bad. It is also a common addiction. There is nothing wrong with the internet and it has opened the world up to everybody with a computer and web access. It has also presented a world of temptations just waiting to hijack reward systems everywhere. And sex, done right, is physically and emotionally healthy and fun. Done wrong, especially when used as a drug, it destroys.