When does something veer off from being normal and accepted to being called addictive? The answer isn’t in our neurosystems.
The ultimate accusation we can seemingly make about something today is that it is addictive. Like heroin is. Consider the fate of cigarettes in that regard. Talk now is about sugar being addictive. And what about marijuana?
But aren’t we awash in a sea of addictions? Aren’t we all addicted, more or less?
In the 19th century, opiates were used by virtually every man, woman, and child in America. A tinctured opiate solution, laudanum, was sold everywhere over-the-counter, and was used to help babies through teething and in order to sleep.
But opiate addiction was not considered a special problem in 19th-century America. There are two possibilities: One possibility is that people socialized their use (keep in mind that opium and coca have been consumed in Afghanistan, Asia, and South America for eons) so that opiates were taken in a traditional, controlled manner and people were rarely addicted to them.
The second possibility is that, if everyone around you is addicted to something, you can’t recognize the substance’s addictiveness or your own addiction. Was this the case for 19th-century opiate use?
Moving into the 20th century, consider smoking. When cigarettes were considered harmless—were even marketed for their health effects—people smoked relentlessly, in all settings, indoors and out. (Consider Mad Men.)
When the Surgeon General’s Report indisputably showed smoking caused cancer in 1964, there was an immediate, shocked reaction. About half of all smokers quit over the next decades, cutting smoking rates in the United States from roughly 40 to 20%.
Some people continue to smoke—oddly enough, less well-educated and poorer people with fewer resources, despite the rising cost of cigarettes. Still, no one today considers smoking healthy, and everyone recognizes that nicotine is addictive. Those who continue to smoke are now, in many places, social pariahs.
But let’s conduct a mind experiment: What if coffee and tea were discovered to cause cancer? Many people would quit making coffee in the morning or going to Starbucks—let’s guess half of all regular coffee drinkers. Others would say they wished to quit, but couldn’t just yet. And a defiant minority would say, “I don’t care if coffee causes cancer—life is unbearable without it!”
It turns out coffee isn’t dangerous (it is actually remarkably healthy). Its worst consequence is contributing to the apparently universal insomnia that grips America. So most people don’t have to (or don’t want to) quit.
But is coffee (caffeine) addictive? Don’t be absurd! On the other hand, as Archie Brodsky and I wrote in Love and Addiction:
“The sufferer is tremulous and loses his self-command; he is subject to fits of agitation and depression. He has a haggard appearance…. As with other such agents, a renewed dose of the poison gives temporary relief, but at the cost of future misery.”
The drug in question is coffee (caffeine), as seen by the turn-of-the-century British pharmacologists Allbutt and Dixon. Here is their view of tea: “An hour or two after breakfast at which tea has been taken … a grievous sinking … may seize upon a sufferer, so that to speak is an effort. … The speech may become weak and vague…. By miseries such as these, the best years of life may be spoilt.”
What seems dangerous and uncontrollable at one time, or in one place, becomes natural and comfortable to deal with in another setting.
Let’s turn to the present. Is there anything that people do seemingly compulsively all around us, which they don’t regard as addictive?
Have you been in a park, or airport, or bar lately and watched people check their smartphone or equivalent gadgetry incessantly, going back to their email, text messages, phone messages, personal newsfeed—what have you? They hardly ever look up at the sky outside, or to talk to the person next to them—sometimes the person they entered the space alongside, like their partner or children!
What about people taking these gadgets (and others, like iPods, iPads, whatever) to bed? There are two possibilities: Either they sleep alone, and the instrument becomes their main companion, one that never leaves their side. Or else they sleep with someone, but pay nonstop attention to their electronic companion instead of their real-life partner!
What is that exactly? What would happen—what happens—when occasionally they lose this gadget, or aren’t allowed to use it, or their battery runs out? How do people cope with their life and time without this crutch? Are they tense, at loose ends, almost unable to bear the passing time? Isn’t that withdrawal?
A few people point out serious negative health and life consequences from these electronic addictions. Some medical publications are even considering this seriously—if perhaps a little bit tongue-in-cheek. And there is rehab for smartphone addiction, just as there is for video game addiction.
But if everyone is addicted to their cellphone, Facebook page, Instagram (whatever the hell that is), who really cares? And if everyone drinks coffee at breakfast, can it really be called addictive? Or does normalcy protect us from the label “addiction?” Or are we not really even interested in addiction? Do we really only care about what are acceptable and unacceptable addictions?
Or is there a clinical justification for focusing on some addictions because they harm us?
As my fellow addiction psychologist and the president of SMART Recovery, Tom Horvath, recently wrote: “I suggest that everyone has addictive behavior, and some have problematic addictive behavior (at various levels).” I wrote a paper about marijuana’s addictiveness entitled, “Marijuana is Addictive—So What?” My point was we only worry about some of the myriad addictions in our lives. Something’s being addictive, taken by itself, doesn’t concern us.
By the way, do you know that psychiatry’s manual, DSM-5, recognizes only one addiction: compulsive gambling. No drugs are called addictive in the DSM-5. And only one more activity is being considered currently—electronic games. (No sex, or porn, or love? None of those can be harmfully addictive? Who makes these things up?)
That’s not horrifying; it’s unbelievable!
As for your personal concerns about an addiction, as Archie and I say in Love and Addiction: “Practically speaking, we can only make the personal decision to treat something as an addiction on the basis of how much we see it hurting us, and how much we want to be rid of it.”
For those seeking the definition of addiction in brainwaves, there can be no meaningful answer to these questions. Only when society (or you in your own life) considers an addiction harmful and disapproves of it will the red flag for addiction go up. That labeling process can change, sometimes quite rapidly.
So, to borrow some phrases from literature: Addiction, where is thy sting? (William Shakespeare) Never send to know who is addicted; it is you. (John Donne)
And that old classic: Addiction is as American as apple pie. (H. Rap Brown)
Stanton Peele, Ph.D., is the author of Recover! Stop Thinking Like an Addict. He is the recipient of career achievement awards from the Center for Alcohol Studies and the Drug Policy Alliance. His Life Process Program for treating addiction is available online. He last wrote about memoirists and alcoholism.