Are Behavioral Addictions Real?

Are Behavioral Addictions Real?


You have undoubtedly heard about things such as sex addiction, food addiction, video game addiction, and so on. But are those things actually real in the same way that alcohol addiction is real? Are they functionally similar to, say, painkiller addiction?

The new thinking is that these behavioral addictions are probably not as “real” as we once thought they were.

Psychology Today says that “the idea that these problems are extremely stable and persistent is inaccurate, for a great majority of the people experiencing them.”

What does that mean?

Let’s break it down a bit. When we talk about behavioral addiction such as sex, food, gambling, or video game addiction, we have to discuss that with a certain frame of reference. So most of us are using the drug and alcohol addiction model as our frame of reference for this discussion. We know that someone who is addicted to painkillers will continue to seek those out unless they seek out professional help and start working some sort of program. Even after the opiate addict goes and gets professional treatment, they might relapse and continue to struggle with their drug addiction for the rest of their lifetime. The alcoholic or drug addict does not appear to spontaneously go into remission from their addiction; even if they are clean they could go back to full blown addiction with just one drink or one pill. They are addicted for life.

So when we apply this same model and this same thinking to behavioral addictions such as video games, does it really hold up? Does it make sense to compare the two things–drug addiction and video game addiction–and then prescribe the same sorts of treatment for the two? Is a 12 step program just as helpful for food addiction as it is for alcoholism?

The new research is indicating that we are making a mistake when we compare these behavioral addictions to drug or alcohol addiction, because they really are not the same thing.

In the article above it points out that many people with a behavioral addiction will naturally “grow out of it” within a few years, with or without any intervention or treatment. In fact, the rate of people who escape those behavioral addictions is the same for groups who had help versus those who had no help at all. This is definitely not the case when it comes to alcoholism and drug addiction, where we see people who are untreated end up in jails, institutions, or just plain dying due to the fact that they did not seek out any professional help.

In other words, if you look at a study that tracks 100 people who are addicted to video games, you will see that most of those people, maybe 80 percent, will report in 5 years or less that they are no longer addicted to them. Nearly all of those people will have escaped from the addiction without seeking professional help.

Now if you take 100 people who are addicted to heroin and you track those 100 people after 5 years, you are probably going to find that about only 3 to 5 percent are going to say that they are completely clean and sober after 5 years. And of those people who got clean, a huge portion of them will have gone to treatment services of some kind in order to do it.

That is what the research is indicating from the study that was done–the behavioral addictions are just not persistent problems in the way that the media is currently making them out to be. So if you read the headlines and you follow the media coverage of something like food addiction, or video game addiction, they are making it out to be the same level of severity and persistence that happens with drug and alcohol addiction. And that simply is not the case.

Why is this important? It is important for us to be accurate when we are talking about addictions so that we can be accurate in prescribing to people the right level of treatment.

You can send a person to see a therapist for one hour each week. That is a certain level of treatment services.

But you can also send a person to a 28 day inpatient program, where they then follow up with 6 weeks of IOP, while seeing a therapist one on one, going to support group meetings every day, and so on. This is another level of intensity when it comes to treatment services.

So we have found that for some alcoholics and drug addicts, doing the latter course of treatment–the one that is high intensity–is the right choice. They need all the help that they can get, and sending them to see a therapist for 1 hour each week is just not enough help to make a dent in their addiction.

On the other hand, most of these people who are suffering from behavioral addictions really could benefit from seeing a therapist for 1 hour each week, and many of them apparently do not even need that much help in order to spontaneously heal themselves. If this is truly the case then it does not make sense for us to talk about painkiller addiction and video game addiction using the same exact terms. At best we are misleading people about the severity of these conditions, and at worst we are diverting people into treatment options that make no sense at all for their condition. We don’t want to see someone who is strung out on heroin believing that they just need to talk to a counselor in order to “cure” their condition, just because their cousin did that when he was “addicted” to video games. Likewise, it doesn’t make sense to send someone with a food addiction to a 28 day program followed by long term rehab and intensive counseling and group therapy, because that is apparently overkill for a food addiction (while it may be just enough to help someone with a serious drug or alcohol dependency).

The language that we use to talk about addiction and behavioral disorders is important, because the language defines the concepts and how they relate to each other. If you look at the mortality rates for opiate addiction and compare that to the mortality rate for video game addiction, you start to see the real truth. To be honest, I doubt that there is even a statistic out there that attempts to define the mortality rate for video game addicts. On the other hand, you see opiate mortality rates in the headlines today quite regularly. This is a clue that the two conditions are of a very different scope, and comparing them to each other using the same language and terms can be downright misleading.