Are Behavioral Addictions the Same as Drug and Alcohol Addiction?

Are Behavioral Addictions the Same as Drug and Alcohol Addiction?

Are behavioral addictions the same as drug and alcohol addiction? The short answer is no. They’re not exactly the same that they’re synonymous. The better question that should be asked, though, is whether having a behavioral addiction is similar to having a drug and alcohol addiction, only this time it’s your behavior instead of drug and alcohol that’s causing the addiction. To make the distinction clearer, behavioral addiction is a type of addiction involving compulsion to engage in a rewarding behavior that’s not substance related. The lack of substance abuse is a significant difference because it’s the substance that makes one addicted to something chemically and psychologically.

So in turn, behavioral addictions are like “incomplete” addictions compared to substance addictions because there’s no substance changing your brain chemistry to induce physical addiction to said substance. Rather, it’s your own repeated behaviors and habit formation that has led you to turn some sort of hobby or act into an addiction altogether. Usually, you’ll struggle with refraining from a certain behavior, to the point of experiencing cravings that are hard to resist. You will also be limited in your awareness of the problems emerging from your obsession with a certain action or behavior.

Comparing Behavioral Addictions versus Substance Addictions

Behavioral addiction and substance addiction might be the same in certain aspects. Certainly, according to the ASAM definition of addiction, they truly are. The addict keeps doing behavior that has a natural reward, even to the point of negative consequences to his financial, social, mental, and physical wellbeing. Usually, this involves things like gambling or videogames. It can even extend to sex, watching television and movies, or excessive spending beyond one’s means from compulsive shopping and the like.

  • Not Included in the DSM-V: The limited proof or links between behavioral addiction and drug addiction has prevented most behavioral addictions from being included in the Diagnostic and Statistical Manual of Mental Disorders (5th Edition) or DSM-V. Gambling is the only behavioral addiction classified by the DSM-V as an addictive disorder. No other behavioral addictions are included in it. More studies need to be conducted in order to have a conclusive analysis on other behaviors that can lead to addiction. At the very least, more evidence can lead to them being included in future DSM editions as addictive disorders, but such studies are currently being conducted as we speak.
  • The Controversy Behind the Term Addiction: What’s considered an addiction and what isn’t has been a subject of controversy for a long time. The concept of addiction is difficult to pin down concretely. For instance, there are people who believe that the best way to assess that a person is an addict is to judge how often and how much he uses substances or engages in addictive behavior like gambling and technology. Others claim that addiction is instead a distinct pattern of behaviors linked to an activity or substance. Or it might be a distinct set of responses when no longer able to access the substance or engage the activity (withdrawal symptoms).
  • Addiction Requires Withdrawal Symptoms: experts don’t consider some behavioral addictions as addictions because they lack withdrawal symptoms that are consistently found in substance or drug addictions. For example, when compared to those who aren’t addicted, removing access to certain behaviors or substances will trigger obdurate pursuits, obsessive preoccupation, and withdrawal symptoms in those who are addicted to said behaviors or substances. Even when faced with adverse consequences like bankruptcy or ruined relationships, addicts cannot handle not being able to do or consume the things they’re addicted to.
  • An Ongoing Debate Regarding What’s Addiction and What Isn’t: Despite the ongoing debates regarding the most accurate definition of the addiction disorder and how it manifests, the majority of experts agree that dependence—whether it’s physical or psychological dependence—is the foundation that classifies whether something is an addiction or not. Although usually, drug addiction includes both physical and psychological dependence and most behavioral addictions involve psychological dependence alone because substances have that extra kick in them that sabotages your brain chemistry so that both your body and mind wants to keep taking drugs.
  • Defining Dependence in Addiction Terms: Someone is dependent on something whenever he continues to engage in the same behavior of consuming drugs, food, pornography or sex as well as engaging in gambling, watching television, or playing videogames despite persistent and terrible consequences. He can’t help himself. His consumption of something he’s obsessed with to the point of abuse has become his new normal so his body rejects it whenever he stops consuming said substance or doing said behavior. His dependence supersedes the consequences, with him always looking for the next hit.
  • The Manifestation of Addiction: Once an addiction has manifested, it can look quite different across individuals as well, as though it should be treated on a case-by-case basis. It usually differs in terms of negative consequences from the disorder and symptom presentation. In terms of symptoms, it can be related to behaviors, drugs, or alcohol. In terms of negative consequences, it can range from financial difficulty from having a gambling or shopping addiction to liver cirrhosis due to being addicted to alcohol. Long story short,

Defining Behavioral Addiction

Addiction and dependency concept as a human brain being lured and surrounded by fishing hooks as a risk symbol and metaphor for a drug addict or the danger of alcoholism gambling and drug abuse smoking as a mental health problem.

Behavioral addiction is (ostensibly) the addiction to certain behaviors involving compulsion, particularly when it comes to rewarding acts not related to the mind-altering effects of certain substances. It’s a natural or organic type of addiction perpetuated by repeated habits. Between both disorders of substance and non-substance addiction have similar neurocognitive deficits like issues with executive functioning. To wit:

  • The FoSB Gene Transcription Factor: The same set of neural adaptations in the reward system is involved when one becomes addicted to behaviors or to drugs, usually with the gene transcription factor known as ΔFosB. More to the point, ΔFosB has been identified as playing a necessary, sufficient, and even central role when it comes to developing and maintaining addiction. It’s present in both types of addiction, so you know that they’re both real addictions comparable to the destructiveness of drug dependence.
  • Psychiatric and Medical Classifications: Behaviors aren’t identified as addictions in the clinical setting though because no diagnostic models are currently available that includes such criteria in the first place. As far as the DSM-V is concerned, behavioral addictions like gambling, videogame, food, social media, Internet, or sex addiction has been proposed as part of a new class addictions. However, the only category included in the DSM-5 is gambling addiction while on the appendix it has also included Internet gaming addiction as a condition earmarked for future study.
  • Behavioral Addictions or Impulse Control Disorders? Behavioral addictions are at times referred to as impulse control disorders. They’re recognized as addictions that can be treated even though they seem like the psychological addiction component you can find from any addict who has already been detoxified from his physical and chemical addiction to any given substance. However, this addiction type doesn’t involve chemical alteration of your brain. You yourself naturally change your brain chemistry to the point of addiction because of your addiction to certain behaviors or things.
  • Excessive Behaviors Lead to Addiction: The type of behaviors that, when done excessively, can be classified as addictive are shopping, exercise, Internet usage, playing video games, using computers, watching pornography, sexual intercourse, food, and gambling. The same way you develop hobbies or routines that become second nature to you by rote memorization, muscle memory, and internalizing them through repetition, so too can you become too obsessed with certain actions that are rewarding, leading you to treat their presence in your life as your new normal (as in the case of drug addiction).
  • Food Addiction Research on Rats: Quite a number of behavioral addiction research studies have been conducted. For example, food addiction research came about back in 2009 by a study conducted by the Scripps Research Institute. According to the researchers, there’s proof that the same molecular mechanisms linked with human drug addiction are also present in compulsive overeating among fat rodents. To be more specific, vulnerability towards drug addiction in humans and overeating among obese rats were linked to the dopamine D2 receptor. While drugs more directly changes brain chemistry, repeated behaviors can induce addiction too.
  • More about the Neurotransmitter Dopamine: Further reductions of the receptor increased compulsive eating among rats that are exposed to a high fat diet. This D2 receptor responds to dopamine, which is a central neurotransmitter related to natural highs that you get when you accomplish something rewarding that the brain wishes to get repeated again and again since it’s usually constructive and progressive. Dopamine is released whenever someone undergoes satiating and rewarding experiences such as those involving psychoactive drugs, food, or sex.
  • ASAM’s Public Statement: According to what the American Society of Addiction Medicine proclaimed in a public statement on August 2011, all addictions are now defined in terms of brain changes rather than restricting them to substance abuse dependence. To be more specific, ASAM defines addiction as a chronic and primary disease of brain memory, motivation, reward, and related events. In other words, behavioral addictions are covered by this description of addiction even though certain addictions, such as sex addiction, still doesn’t have a DSM-V entry as of yet.

What Are The Examples of Behavioral Addictions?

Family of wife and husband gambling online

Behavioral addiction is like substance-related addiction in terms of both being disorders that affect the neural circuitry of the brain’s reward system. Dependence to a certain behavior to the point of addiction is typically recognized by compulsive, repetitive involvement in rewarding such behavior despite being faced with adverse consequences. In other words, if the consequences of doing something deter you from doing it despite how pleasurable it is, then it’s not an addiction.

Examples of behavioral addictions include the following:

  • Gambling: One of the most recognized forms of behavioral addiction. The thrill of having to risk it all and winning against the odds might keep a gambler from knowing when to stop gambling, even though he’s losing more times than he’s winning. This obsession might even result in him gambling away and losing more of his money than he’d win. When one is addicted to gambling, it’s like getting a ticket straight to the poorhouse.
  • Shopping: Speaking of tickets to the poorhouse, certain persons (stereotypically, it’s women, but men can also end up becoming spendthrifts themselves) might become so obsessed with shopping for clothes, shoes, food, furniture, cars, appliances, and other material things that they end up living beyond their means. They’re also spending more money than they make, which might have then end up bankrupt and in debt like a gambler would just to feed their shopping obsession.
  • Sex and Pornography: You can become so addicted to sex that your quality of life suffers from your obsession with it. Ditto with pornography thanks to its increased accessibility care of the Internet. Now most anyone with an Internet connection can look at porn. Sex addiction is tough to categorize because in today’s more liberated society, what was considered excessive and taboo before is now considered normal to the point that keeping people from engaging in it is seen as discriminatory.
  • Technology: Technology addiction is certainly a Late 20th and Early 21st Century kind of addiction covering videogames, Internet, smartphones, PCs, and television. All the way back to the 1980s, parents were worried about their children becoming couch potatoes staring listlessly into the TV. Well, come the 1990s to 2010s, their issues with tech addiction just became worse thanks to the rise of videogames, Internet, and smartphones.
  • Exercise: You can have too much of a good thing. While there is no question that exercise will do everyone good, it is actually possible for you to exercise too much if you’re chasing that natural high that one gets from endorphins produced after jogging or lifting weights excessively. When you exercise beyond what’s needed, you can end up with injuries, excessive weight loss, and potential steroid addiction all for the sake of getting into shape.
  • Food Consumption: Obesity is quickly becoming a problem throughout most countries in the world. Food addiction is a real thing that needs to be seriously addressed in rehab. Like with alcoholism, eating too much and being fat has become somewhat normalized in today’s society, which contributes to the spread of excessive overeating and the complications associated with obesity like diabetes and possible cardiovascular issues. The solution here is to learn to not overeat as well as develop an exercise plus diet regimen to lose all that weight.

The DSM-V Classification of Behavioral and Gambling Addiction

The revised DSM-V of 2013 now includes the Substance-Related and Addictive Disorders category in order to replace the old category of Substance-Related Disorders from DSM-IV-TR. Even though behavioral addictions were considered for inclusion by the DSM committee, only gambling was ultimately chosen as an example of behavioral addiction. The disorder was included under the Non-Substance-Related Disorders subcategory of the Substance-Related and Addictive Disorders category.

As for gambling disorder, it’s characterized by problematic, compulsive gambling behavior that results in significant distress or impairment in regular life quality. In order to meet its criteria according to the DSM-V, the addict must exhibit four or more of the following indicators over the course of a year:

  • As a result of excessive gambling, he’s reliant on others for money.
  • He makes repeated failed attempts to abstain, reduce, or control his gambling sessions.
  • He is regularly distracted or preoccupied with gambling at online or brick-and-mortar casinos.
  • He is excessively irritable or restless when attempting to abstain or control his gambling tendencies.
  • Increasing amounts of money should be wagered in order for him to feel the same thrills as before.
  • He looks for gambling spots and opportunities to cope with work stress or feelings of psychological distress.
  • He regularly attempts to get that win by returning to gamble even after he has lost time and time again, like a drug addict chasing a high.
  • He exhibits erratic behavior, such as concealing or minimizing his involvement with gambling to friends and family by outright lying to them.
  • He has impaired performance at school, reduced effectiveness at work, or strained interpersonal relationships because of his gambling problem.

The Bottom Line

Searching online for porn on a tablet

There exists evidence that both addiction types—drugs and behaviors—share common psychological and biological characteristics, as though addiction can happen even without directly overriding your reward system and dopamine supply like coke would as long as you obsess and chase after certain rewarding things for a long enough time, even to the point where desensitization only makes you want to do such things more to chase after that dopamine high. Indeed, it’s suggested that addiction can develop with any activity that’s done in excess depending on the upbringing and genetic propensity to being addicted a person is.

Thusly, you can become pathologically laser-focused on pursuing the high or reward from engaging in certain behaviors you’re obsessed on doing to your detriment. You can also use the behavior to relieve yourself from distress or stress, just like with drugs. While some behaviors are more constructive than others, when you become addicted it usually means you can’t help but keep doing this act to the point of negative consequences sooner or later. Too much of any thing is bad for you, even what’s normally considered as good (like food or sex).

Lanna Rehab Got You Covered with Behavioral Addictions

The DSM-V specifically defines addiction as behaviors, substances, or objects that provide someone with a feeling of reward through sensations of pleasure can lead to addiction. This is because behavioral and substance addictions share the same links in terms of the changes in your brain’s neural pathway for its reward system. Sure, some drugs have a more direct impact to your reward system and supply of dopamine or endorphins, but behaviors that are done or abused enough times to excess can also lead to these neurological changes. In light of this, you can depend on Lanna Rehab for help on this front.

They also offer behavioral addiction rehab in the form of Cognitive Behavioral Therapy, Dialectal Behavioral Therapy, and the 12-step program that are also used in substance addiction in order to help wean you from your bad habits and obsession to things like gambling, technology, and sex. To learn more about their services, just call Lanna’s hotline ASAP right now.

Martin Peters

Martin Peters has a BA (Hons) Dip HE Dip RN CSAT III and is the Group Program Director Lanna Healthcare. He is a Registered Nurse and Certified Substance Abuse Therapist working in the mental health field since 1994; Martin has had a wide range of experience in management and supervisory roles within established healthcare systems, and has provided consultancy services to a number of private and public sector organizations in the UK and Asia in terms of management, policy writing, accreditation and recruitment. Martin’s addictions experience has been in developing inpatient services in Thailand since 2009, both clinical and operational. He has been instrumental in expanding and developing a non 12 step inpatient treatment centre and opening a further inpatient centre with a 12 step approach, implementing KIPU Electronic Records, strengthening hospital partnerships, introducing a Scholarship for students under the Masters in Addiction Studies Program at The ASEAN Institute for Health Development and working with an international accreditation body. Martin has also been a speaker at several international conferences on addiction, including ASEAN conferences and has also guest lectured at Mahidol University (Thailand), University of Sarghoda (Pakistan) Institute of Medical Sciences (Pakistan) and has been a representative on the CARF Standards Advisory Committee for 2016.In 2015. Martin became a Co-Founder of Lanna Healthcare, launching Lanna Rehab in March 2016 and opening Jintra in January 2018. In June of 2018, Martin was involved in the merger of Lanna and DARA, becoming Thailand's biggest private licensed operator. Martin is currently a Joint and Asia Health Co Ltd Owner Operator of Lanna Healthcare Co Ltd, which under its umbrella manages Lanna Rehab in Chiang Mai, Jintra Rehab in Chiang Mai and DARA Rehab in Koh Chang - all Thailand MoPH Licensed Addiction Facilities providing world-class treatment in Thailand.