When most people contemplate addiction, they think about cigarettes, alcohol, and illicit drugs like crystal methamphetamine, cocaine, and heroin. And certainly those substances are highly addictive—they are incredibly difficult to quit once a person is hooked, and prolonged use/abuse typically results in any number of negative life consequences. But these obvious potential addictions are far from the only possible problem areas.
Though addiction has traditionally been viewed purely in terms of substances, the American Society of Addiction Medicine now embraces a much broader definition that encompasses not only drug and alcohol abuse, but process (behavioral) addictions. Of course, everything we ingest is a substance of some sort, and everything we do is a behavior of some sort, so just about anything can become an addiction. Below is a short list of things many of us eat, drink, or do on a regular basis that can and sometimes do turn into addictions.
Caffeine is a stimulant that occurs naturally in coffee, tea, and yerba mate plants. It is also added to numerous consumer products, including a wide variety of sodas, some candies, and most “energy” drinks. Regular caffeine users, even those who take in as little as 100 milligrams per day—the amount in half a cup of coffee—can develop physical dependency and experience withdrawal symptoms such as headaches, irritability, nausea, and fatigue when they don’t get their fix. While some people may think they just like coffee or other caffeinated products, many actually consume caffeine to stave off withdrawal symptoms (morning lethargy, mid-afternoon headache, etc). For the most part, the consequences of caffeine addiction are mild, though some people do experience anxiety or rapid heartbeat when caffeine is consumed to excess, and others may miss work or social engagements while dealing with symptoms of withdrawal.
Here’s a scary thought: Brain imaging shows that high-sugar, high-fat foods activate the same regions of the brain as heroin, opium, and morphine. In other words, processed sugar and fat (along with processed wheat and salt) stimulate the rewards center of the brain, causing many people to “binge” eat with cookies, chips, soda, and other “junk” foods. (Have you ever seen anyone binge-eat with salad greens? Probably not, because healthier, naturally grown foods don’t cause the same reaction in the brain.) So the next time you decide to unwind after a hard day with a pint of ice cream or a bag of cheese doodles and find yourself thinking, At least I’m not an alcoholic or an addict, you might want to think again.
Prescription drug abuse is the intentional use of a medication without a prescription, in a way other than prescribed, or for the experience or feeling it causes. The number of people using prescription medications is very much on the rise. This is especially true with young people. After marijuana, prescription medications are now the most commonly abused substances among high school seniors, with Vicodin and Adderall topping the list. Much like “hard” drugs such as heroin and cocaine, these doctor-prescribed medications flood the brain with dopamine. Over time this can produce cravings, tolerance, withdrawal, and all of the other symptoms (and consequences) of illicit drug addiction. The dangers of prescription medications are often underestimated because many people think that a doctor would never prescribe something that could harm them. This line of thinking makes it very easy to rationalize addictive behavior. The individuals most at risk for prescription medication addiction are adolescents, women, older adults, people with a family history of addiction, and those with an underlying psychological condition such as profound childhood trauma, anxiety, or depression.
Watching and masturbating to porn, having regular sex, having an affair, visiting a strip club, and even being sexual with a prostitute does not, per se, make someone a sex addict. Sexual addiction occurs when an individual loses control over his or her sexual behaviors, tries to stop but can’t, and experiences negative consequences as a result of his or her sexual acting out. Individuals who struggle with compulsive and addictive sexual fantasies, urges, and behaviors sometimes lose hours, even days, to the pursuit of sex, and their sexual acting out continues despite relationship, career, financial, and even legal problems. Thanks to the increasingly affordable and anonymous access to online sexual content (porn, virtual sex) and anonymous and/or casual sexual encounters (set up through chat rooms, dating sites, and “adult friend finder” smartphone apps), compulsive sexual behavior is affecting more and more people, at ever-younger ages. In fact, one recent study on hypersexual disorders found that for 54 percent of sex addicts the problematic behavior started before the age of 18.
Most readers probably remember Patricia Krentcil, a.k.a. “Tan Mom,” the 44-year-old woman with skin like shoe leather who was, in April of this year, charged with child endangerment after her 6-year-old daughter suffered first-degree burns in a tanning booth. Krentcil’s addiction is sometimes, perhaps jokingly, referred to as “tanorexia.” However, an addiction to tanning is a very real and very unfunny issue. Studies show that people who frequently use tanning beds experience changes in brain activity during their exposure to UV rays that mimic the patterns seen with drug use. Other studies show that frequent tanners exhibit classic symptoms of addiction, such as craving and withdrawal. So it appears that tanorexia may cause, in addition to skin cancer and other dermatological issues, psychological and emotional problems common to addiction.
This article is not meant to scare readers. After all, most people who drink coffee, eat junk food, and engage in other seemingly innocuous behaviors are able to do so in moderation. It is only when people lose control over the activity that it becomes problematic (in terms of addiction). If you or someone you know is concerned about one of the five activities delineated above or any other seemingly harmless behavior, try to stop for 30 days. If you are able to quit without experiencing cravings or withdrawal, you are probably not addicted. If, however, you become irritable, experience headaches, crave the substance/behavior, or are simply unable to stop, there may well be a problem that probably needs to be addressed with the assistance of a qualified professional.
David Sack, M.D., is board certified in psychiatry, addiction psychiatry and addiction medicine. He is CEO of Elements Behavioral Health, a network of addiction treatment programs that includes Promises Treatment Centers, The Ranch outside Nashville, Right Step drug rehab in Texas, and The Recovery Place rehab in Florida.
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Last reviewed: 5 Nov 2012