Behavioral Addictions Are they Really Addictions Thomas E

Behavioral Addictions: Are they Really Addictions? Thomas E. Legere, Ph. D.

How do we Decide?

Old School: DSM

We Need a NEW Model! From THREE Sources…

Source #1: The DSM

Source #2: What Those Who Suffer From the Disease Say

Source #3: Neurobiology

Three TYPES of Addictions

I. HARD Addictions: Alcohol & Drugs

II. SOFT Addictions: Nicotine & Caffeine

III. BEHAVIORAL Addictions

Three Levels of Addiction: • Mild • Moderate • Severe

Soft Addictions: “Soft” for a Reason

Proposed Behavioral Addictions: • Sex • Love • Gambling • Exercise • Eating

What Makes them “Real” Addictions (or not)?

Need Common Criteria for Hard Addictions & Behavioral Addictions

Honestly: The DSM is Not Buying Behavioral Addictions

DSM: • Compulsive Disorders • Pathological Behavior • Eating Disorders

Twelve Integrated Criteria (DSM, Experience, Neurobiology)

1. “Pleasure Pathway” In the Brain

2. Same Brain Chemicals Involved • Dopamine • Serotonin • Endorphins • Norepinephrine • Enkephalins • Acetylcholine • Gaba • Glutamate • Cortisone • Corticotrophin • Histamine • Anandamide

3. Tolerance

4. Use to “Intoxication”: “I Can’t Stop!”

5. Obsessive Dimension

6. Denial

7. Continued Use Despite Adverse Consequences

8. Progressive Escalation of “Intake” and Problems

9. Repeated Attempts To Control Use

10. Withdrawal

11. Incurable (Only Remission)

12. Effectiveness of 12 Step Program