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

by Jaclyn Cosgrove Published: October 22, 2012
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The interview for this story is the longest conversation Greg Holbird has had on a phone in at least a year — and it was 20 minutes.

That's not to suggest that Holbird doesn't use his phone often.

On the contrary, Holbird uses his phone for 90 percent of his day. He lets his friends know where he is by checking in on Foursquare or Facebook. He sends several hundred text messages a day, averaging about 6,000 a month.

Even though the 36-year-old Tahlequah resident doesn't talk on his phone much, he doesn't leave home without it, at least, not on purpose.

“If I don't have my phone, I'm freaking out,” he said. “All I can think about is how long it's going to be until I can get back and get my phone. I'm always like, ‘Oh man, that would have been a great picture if I had my phone,' or, ‘I would have loved to tweet that if I had my phone,' or, ‘What am I missing on Facebook?' or ‘Did somebody text me, and I'm not getting it?'”

The National Institute of Drug Abuse defines addiction as “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”

It's common to hear people say they're addicted to something like using their cellphones or shopping or tweeting or drinking pumpkin spice lattes on a beautiful day, but — is that possible? Is it possible to be “addicted,” in the clinical sense, to something outside the realm of alcohol, prescription pain pills and illicit drugs?

During the first episode of Oxygen's “My Shopping Addiction,” the viewer learns about two women with “out of control” shopping habits. The women have significant debt. Their friends are worried. And through the show, they visit with clinicians who help them get a handle on their problem.

David Tolin, a clinical psychologist and the host of “My Shopping Addiction,” said that right now, the field of psychology is not entirely sure how to best classify shopping addiction.

The Diagnostic and Statistical Manual of Mental Disorders is used by mental health professionals throughout the country to classify what mental disorders their patients are suffering from.

Tolin said “shopping addiction” is not officially listed in the DSM as a psychiatric diagnosis. Instead, it's usually referred to as “compulsive buying” and is mentioned in the manual in the context of a cluster of conditions, known as impulse control disorders.

“I think that this is one of the things that is kind of sad about the field,” Tolin said. “In some ways, historically, the DSM has kind of held the field hostage.”

If something isn't in the DSM, then it's unlikely that insurance companies will cover treatment or that drug companies would consider developing a drug to treat the disorder. Also, the National Institutes of Health generally doesn't fund clinical research for something not in the DSM.

There are some clinicians who have suggested that compulsive buying and other kinds of out-of-control behaviors might be a form of addiction, Tolin said.

“Not that the person necessarily has a drug or a chemical in their system, but that the person essentially craves the behavior, they lose control over their ability to stop doing that behavior, and they keep doing the behavior despite the fact that it has adverse consequences for them.”

It's estimated that between 2 percent and 8 percent of Americans suffer from some form of compulsive buying behavior. Women make up a large chunk of the adults who suffer from the behavior.

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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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