There are substance addictions, and then there are behavioral addictions. What is the difference?
Substance addiction is chemical addiction. If you are putting chemicals into your body, then you are dealing with a substance abuse problem. Now of course this gets a little tricky, because there are some weird exceptions that some people make:
* Food addiction is technically about putting chemicals into your body. But the nature of that type of addiction is really more behavioral in nature, rather than chemical. Of course, science may prove this idea wrong some day, and show that certain people have a biological or chemical imbalance that makes food more like a drug to them.
* Some chemical addictions such as Marijuana are really more behavioral in nature. Even though there is a definite chemical in marijuana called THC, the way that people have dependence on the drug is not so much from a dependency standpoint, but more from a behavioral one. Yes, you can still get addicted to marijuana, and yes, you can become dependent on it, but most people who do so are really dependent on medicating their mood and their emotions. This differs from other drugs (such as opiates or alcohol, for example) where the body itself is craving the chemical and definite physical withdrawal symptoms exist when you do not use the drug.
* Behavioral addictions can include things such as gambling, sex, and even reading. At some point, we have to ask ourselves how loosely we use the term addiction, and what it really applies to. If someone is hooked on reading and they spend all of their free time reading books, is this really an addiction? Certainly it is an escape, and it might even be very harmful, but it is tough to say if it is really an addiction in the same way that substance abuse can create addiction.
* Treatment for behavioral addictions can sometimes mimic substance abuse treatment, which can be a bit of a joke. I personally think this is a bit ridiculous at times. The idea behind drug and alcohol treatment (at least traditionally) is that the addict is going do die if they continue to use drugs or alcohol. They are led to find God and thus turn their life around with a spiritual experience. This is of course very rare and difficult to do unless you are extremely desperate for change and are knocking on death’s door.
Now when you try to apply this model to behavioral addictions (which has been tried in almost every single instance….sex addicts anonymous, overeaters anonymous, etc.) then you have a bunch of twelve step programs that are supposed to be the answer for everyone, but only really work for those who are truly desperate. In my opinion, the consequences of most behavioral addictions are not stark and deadly enough for the 12 step model to really work well with them. Of course there are exceptions and there are people who do find some success in treating a behavioral addiction with the 12 step program. But what I am saying is that it is just not the best fit, because the 12 step model works well only if there is extreme desperation involved.
The tough thing about substance and chemical addiction is that they are really 2 addictions in one. You are dealing with the physical element of addiction and the physical cravings, but you are also dealing with the behavioral element that comes along with a lifetime of substance abuse, and the psychological addiction to the drugs or the alcohol as well. So really, any chemical addiction also has a behavioral addiction lying underneath of it.