Addictive substances are present everywhere in our current society, from the most anecdotal social situation to cinema, television and the consumption of other types of media. If we think about addiction, tobacco comes directly to mind: This kills up to half of the people who consume it, 7 million people on Earth die annually directly from this addictive substance and only 5% of smokers who try to quit on their own succeed.
When nicotine is administered to the body, the brain sends stimulating signals to the adrenal glands (in the kidneys), which release the hormone adrenaline and increase circulating levels of dopamine, a neurotransmitter associated with well-being. Changes in the dopaminergic circuit and substance abuse cause variations in the mesolimbic and mesocortical circuits: in the end, the more a drug is consumed, the more it is needed to achieve the same gratification. It is estimated that nicotine is 5 times more addictive than cocaine.
If we talk about addictions, describing the mechanism of action of tobacco, heroin, cocaine or alcohol is simple: substances enter the body that stimulate the patient, cause damage in the process and generate resistance and withdrawal syndromes. In any case, things get complicated when we look at attention to non-substance addictions, such as gambling, video games, Internet use, and other events If you want to know everything about the subject, keep reading.
Addiction, from a clinical point of view, is a psychosocial disorder characterized by the repeated use of drugs or, failing that, the performance of certain activities that may be deleterious for the patient and the environment that surrounds him. For the addiction mechanism to take place, the person must have continued access to the problematic substance/event, since it is exposure to the stimulus that enables tolerance and, therefore, dependence.
We are faced with a series of multifactorial clinical entities that are very difficult to address, since physiological, genetic, epigenetic mechanisms (activation/inhibition of genes depending on the environment), age, environment and many other things play an essential role in their development. Without going any further, the chances of developing certain addictions if the parents also have them are 60% and up to 90% of addicts have other associated psychiatric problems.
According to the American Psychological Association (APA), humans can develop addiction to 10 substances: alcohol, caffeine, cannabis, hallucinogens, inhalants, opiates, sedatives, hypnotics and anxiolytics, stimulants and tobacco. So, from lorazepam to relax in a moment of extreme anxiety to heroin, there is no doubt that A person can end up developing dependence on any of these substances if they consume them enough
So far, everything seems pretty straightforward. The Diagnostic and Statistical Manual of Mental Disorders (DMS-5), published by the APA in 2013, provides very clear and easy-to-follow definitions and diagnostic criteria for substance abuse. Anyway, what about addictions without substances?
Addictions without substances
In the media, bombastic names are increasingly seen to designate disorders related to typical activities that we carry out in our daily lives. Interaction with the reader is sought and, therefore, sometimes the truth is ignored in pursuit of a click. To define which addictions are clearer without substances, anecdotes are not enough well we have to turn to professionals in psychology.
We begin by citing what the APA does not consider potentially addictive activities. Among them, we find the following: shopping, tarot, dancing, tanning, work, board games, sex or sports. According to the DMS-5, “There is insufficient evidence to establish the diagnostic criteria and descriptions of the course of illness necessary to identify these behaviors as mental disorders.”
As you can see, almost nothing that is considered socially addictive today outside of substances has been supported by the scientific community, at least for now. Anyway, yes There are some examples that show that addiction without substances is possible
Pathological gambling: an addiction without substance
Gambling addiction, for example, is a disorder equated to substance addictions in every sense so it was cataloged in the DMS-5 in the block of “Substance-related disorders and addictive disorders.”
It is not surprising, since studies have shown that brain activation when receiving a large cash prize is similar to that observed in a cocaine addict receiving a dose. Norepinephrine and dopamine play an essential role in the development of gambling addiction, as does the mechanism that gets people hooked on tobacco.
As with any other disorder, There must be a diagnostic criterion that can support it We obtain the following guidelines for detecting a problem gambler from the American Psychological Association (APA):
For a person to be diagnosed with this disorder, they must present at least 4 of these 8 traits for a period of one year or more As we are dealing with a disease, there are standardized criteria that allow its evaluation.
Video games: example of addictions without unproven substances
On the other side of the coin we find, for example, video games. Although the repeated use of this form of entertainment at the expense of personal well-being and the environment has received recognition by the WHO in its International Classification of Diseases (ICD), the APA has not found sufficient scientific evidence to classify it as a disorder. , that is, we are facing the opposite case to gambling addiction.
The biggest controversy is that It is not really known whether video game addiction is a disorder in itself or a symptom of another psychological pathology This has encouraged much research, information seeking and debate among medical entities, but a clear answer has not yet been found. As long as this “disorder” is not included in the diagnostic manuals, it cannot be considered as such.
With these lines we do not mean that chronic exercise, compulsive shopping or playing video games 10 hours a day are not examples of addictions without substances. What we intend to do is place special emphasis on the fact that there is not enough information about these events and, therefore, It cannot be fully elucidated whether they are isolated clinical entities or part of another larger painting.
For example, compulsive exercise may be a diagnostic criterion for detecting muscle dysmorphia (vigorexia), but the act itself without context does not indicate a disease by itself. For all these reasons, you have to be careful when labeling a behavior as addictive.
