Addictive behavior

Addiction and dependence glossary
  • addiction – a biopsychosocial disorder characterized by persistent use of drugs (including alcohol) despite substantial harm and adverse consequences
  • addictive drug – psychoactive substances that with repeated use are associated with significantly higher rates of substance use disorders, due in large part to the drug's effect on brain reward systems
  • dependence – an adaptive state associated with a withdrawal syndrome upon cessation of repeated exposure to a stimulus (e.g., drug intake)
  • drug sensitization or reverse tolerance – the escalating effect of a drug resulting from repeated administration at a given dose
  • drug withdrawal – symptoms that occur upon cessation of repeated drug use
  • physical dependence – dependence that involves persistent physical–somatic withdrawal symptoms (e.g., delirium tremens and nausea)
  • psychological dependence – dependence that is characterised by emotional-motivational withdrawal symptoms (e.g., anhedonia and anxiety) that affect cognitive functioning.
  • reinforcing stimuli – stimuli that increase the probability of repeating behaviors paired with them
  • rewarding stimuli – stimuli that the brain interprets as intrinsically positive and desirable or as something to approach
  • sensitization – an amplified response to a stimulus resulting from repeated exposure to it
  • substance use disorder – a condition in which the use of substances leads to clinically and functionally significant impairment or distress
  • tolerance – the diminishing effect of a drug resulting from repeated administration at a given dose

An addictive behavior is a behavior, or a stimulus related to a behavior (e.g., sex or food), that is both rewarding and reinforcing, and is associated with the development of an addiction. There are two main forms of addiction: substance use disorders (including alcohol, tobacco, and cannabis) and behavioral addiction (including sex, gambling, eating, and shoplifting). The parallels and distinctions between behavioral addictions and other compulsive behavior disorders like bulimia nervosa and obsessive-compulsive disorder (OCD) are still being researched by behavioral scientists.

Defining addictive behavior presents a challenge, as the concept encompasses diverse behaviors, and therefore its usage has been contentious. Although, central to the definition is excessive dependence on a specific substance or activity, derived from the Latin term ‘to enslave.' Furthermore, addictive behavior describes patterns characterized by a loss of control and a compulsion to accept a reward despite severe consequences. This often manifests in compulsive engagement, prioritizing short-term gratification over long-term consequences, and a transition from impulsivity to compulsivity. Consequently, addictive behaviors create a spectrum of activities that entrap individuals in repetitive patterns, despite the adverse consequences, echoing the enslavement inherent in the notion of addiction.

Developments in research continue to reshape the human's understanding of addiction. Traditionally, addiction was largely associated with substance-use disorders, including alcohol and heroin, and therefore “non-substance-related (behavioral) addiction” was not listed in the two internationally used diagnostic manuals for mental disorders. However, contemporary research suggests that any stimulus capable of producing pleasure can lead to addiction. This shift broadens the scope of addiction to include excessive shopping, internet usage, computer gaming, gambling, and sex. Addictive behaviors, whether substance-related or behavioral, often involve deficiencies in inhibitory control, emotion regulation, and decision-making. There are significant overlaps in diagnostic symptoms between substance use and behavioral addiction, including dominance over one’s life, euphoric experiences, withdrawal symptoms, interpersonal conflicts, and the risk of relapse despite negative outcomes.

From a neurobiological perspective, behavioral addiction may affect brain neurotransmitter systems similarly to pharmacological substances, such as the dopamine system. These behaviors often follow a three-step cycle consisting of preoccupation (anticipation), binge intoxication, and withdrawal effect, with reinforcement playing a central role in each stage. Reinforcement occurs through positive experiences during the initial engagement, negative reinforcement to alleviate withdrawal symptoms, and conditioned reinforcement where cues associated with behavior or drugs trigger intense cravings, perpetuating the addiction.

Addiction is classified as a chronic brain disorder by the American Society of Addiction Medicine (ASAM). There are several reasons why people develop an addiction. A predisposition to the addictive qualities of substances may be inherited by some people, making it a genetic circumstance. Another cause for addictions could be the environment. Whether or not someone develops substance use problems can be influenced by their home and neighborhood, as well as the attitudes of their peers, family, and culture on substance use. Another cause of developing an addiction could be related to mental health issues: over 50% of individuals with substance use disorders have experienced mental health issues at some point in their lives. Even moderate substance usage might exacerbate mental health issues in individuals. The other view is from the moral standpoint which regards addictive behavior as an intentional choice was freely made by the addict.

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