Addiction is not easy to diagnose and sometimes hard to define, experts say

by Jaclyn Cosgrove Published: October 22, 2012
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Some researchers have found that when a person is exposed to the stimuli that makes them want to engage in their impulsive unhealthy behavior, the parts of the brain that are involved with inhibition, in particular the frontal lobes of the brain, seem to not be working very well, Tolin said.

This means people who are compulsive shoppers or gamblers, for example, aren't very good at shutting off their behavior. This doesn't absolve them from their behavior, for people can learn control with practice.

A study from a United Kingdom company found that about 66 percent of people the company surveyed were fearful of losing or being without their cellphone. SecurEnvoy also found that 41 percent of people had two or more phones to stay better connected.

One answer addiction researcher David Friedman wants to know is — how many of those people were anxious or fearful people to begin with?

Friedman, a professor in physiology and pharmacology at Wake Forest University School of Medicine, said addiction is a word that has a specific scientific medical meaning that has been widely debased by its use in general conversation.

“So when people say they're addicted to mobile phones or whatever, what they're really saying is, ‘I use it a lot. I like to use it a lot, and sometimes it gets in the way of other things I might be doing,' which are characteristics of addiction, but I think the important metric is, what's the extent of their use or ‘disability'?” Friedman said.

If you look at the fourth volume of the Diagnostic and Statistical Manual, you'll find the way they define addiction is by using a list of seven or eight symptoms. If a person suffers from three or four of those symptoms, they meet the criteria for addiction, he said.

And most people who are talking about shopping or phone use or chocolate don't meet those criteria. Although their use might be over the top, it's not obsessive or compulsive, he said. It's not a behavior that a person will continue, even after they've been evicted, lost all of their money and friends and have been arrested, he said. A drug addict, on the other hand, won't stop.

“There may well be people whose behavior is so extreme that they would meet the criteria for an addiction,” Friedman said. “However, the numbers of those people compared to the number of people who actually do that behavior are really, really small.”

By comparison, one in 10 people who try any class of drugs will eventually become a serious abuser or an addict. The number of people who are truly addicted to their cellphones or actually addicted to shopping is much lower in comparison, he said.

Diagnosing addiction is hard enough, even with people abusing drugs or alcohol. There's no biological marker, no absolute that will tell a doctor there's a problem.

“It's not easy territory to tread in,” Friedman said. “And I think the only way to deal with it is to get down to the details of each case and say, ‘Oh yeah, this one is totally over the edge, and this one is more like normal,' depending on the details, and stop using the word addiction for everything and anything, just because it's a convenient word to describe extreme behavior.”

by Jaclyn Cosgrove
Medical and Health Reporter
Jaclyn Cosgrove writes about health, public policy and medicine in Oklahoma, among other topics. She is an Oklahoma State University graduate. Jaclyn grew up in the southeast region of the state and enjoys writing about rural Oklahoma. She is...
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So when people say they're addicted to mobile phones or whatever, what they're really saying is, ‘I use it a lot. I like to use it a lot, and sometimes it gets in the way of other things I might be doing,' which are characteristics of addiction, but I think the important metric is, what's the extent of their use or ‘disability'?”

David Friedman

Professor in physiology and pharmacology at Wake Forest University School of Medicine

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