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Addictions
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Dealing With Bad Habits and Addictions
Why do we often break our most noble New Year's resolutions? Why--at any time of the year--do
we sometimes seem so powerless to make healthful changes in our lifestyles? These are questions
that my patients often ask when I speak to them about lifestyle change. There is a myriad of common
problems that they struggle with. There is the overweight diabetic who cannot seem to break away
from chocolate, the habitual smoker who cannot seem to give up cigarettes, and the individual with
high blood pressure who cannot seem to stick with the exercise program that he knows he needs.
No matter whether your challenges are similar to or very different from those examples, all of us
at times struggle with the need to change our most established habits. Why do we find it so difficult?
Some would say the problem is that we are dealing with addictions. No doubt there is much truth
in this insight. However, not every lifestyle struggle is the result of an addiction, even though
there are addictive components to many of our behaviors. Furthermore, even if the area we need to
change is not a forthright addiction, an understanding of some of the basic approaches to dealing
with addictive habits can help us with those lifestyle challenges.
What is an Addiction?
What really is an addiction anyway? Surprisingly, even the experts give different definitions as to
what constitutes addiction. For example, Stedman's Medical Dictionary defines it as "habitual
psychological and physiological dependence on a substance or practice that is beyond voluntary
control."1 This definition is a good start. To help us get a clearer view of what constitutes an addiction,
let us look at five common characteristics of addictions, as listed in Figure 1: Common
Characteristics of Addictions.2, 3, 4
Not all of these criteria have to be met for a habit to be classified as an addiction. But the
broad scope of effects arising from addictive agents is helpful to be aware of. Whether a habit
is classified as an addiction is not the important issue. What is critical is that many habits have
addictive components and dealing with the habit as an addiction is likely to meet with success where
other approaches have failed.
The most important aspect of an addiction is crystallized in Stedman's definition where it speaks of a
loss of control. This element of compulsion is the most critical aspect of addictive behaviors. For
example, a person who decides to eat just one chocolate in a box but ends up eating half the box is
likely demonstrating an addiction to chocolate based on this probable evidence of compulsive eating.
True, the person may not go through a withdrawal syndrome if the use of chocolate is stopped; there
may be no signs of desiring progressively larger amounts of chocolate--yet, the critical compulsive
element is there. The same could be true of ice cream addicts or those who compulsively watch television.
Of course, those who are addicted to nicotine, alcohol, or drugs will fit the classic addiction
definitions more strictly. However, the truth is that any habit in your life that is not totally
under your voluntary control displays an addictive element--whether or not it is called an addiction.
The Problem with "Moderation"
Why is a broader definition of addiction so important? It is crucial in view of the fact that many
people never break free of their most ingrained habits because of the fallacy of "moderation."
I find this true especially in the area of problem foods. Consider the example of the person who
could not control the consumption of chocolate. Many health educators would say it is fine to use
chocolate--if it is used in moderation. This advice misses an important point; that is, an
individual who has a compulsive relationship to a food can no more use it moderately than an alcoholic
can return to "moderate" drinking or a nicotine addict can return to "moderate" smoking. In dealing
with any addictive habit, total abstinence for life is necessary.
References
1 Addiction: Stedman's Electronic Medical Dictionary version 3.0 (CD-ROM). Based on Stedman's
Medical Dictionary--26th edition. Williams and Wilkins, 1996.
2 Addiction: Friel JP, editor. Dorland's Medical Illustrated Medical Dictionary--26th edition.
Philadelphia, PA: WB Saunders Company, 1985 p. 29-30.
3 Schuster CR, Kilbey MM. Prevention of Drug Abuse. In: Last JM, Wallace RB, editors.
Maxcy-Rosenau-Last Public Health and Preventive Medicine--13th edition. Norwalk, CT: Appleton and
Lange, 1992 p. 769, 773.
4 Jaffe JH. Drug Addiction and Drug Abuse. In: Gilman AG, Goodman LS, et al, editors. Goodman
and Gilman's The Pharmacologic Basis of Therapeutics--7th edition. New York, NY: MacMillan
Publishing Company, 1985 p. 532-540.
Notice of Credit
The article above is compliments of the Uchee Pines Institute, Seale, Alabama, a teaching and
treatment facility devoted to natural remedies. For mor information, call 334-855-4781,e-mail:
ucheepine@csi.com, or visit their Website:
http://www.ucheepines.org.
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