Types of Addiction
Table of Contents
The word “addiction” is typically associated with chemical addictions such as alcohol or drug abuse. But substance abuse is not the only kind of addiction.
There are also behavioral addictions—to activities such as gambling, shopping, or surfing the internet. And experts now believe that the two types of addiction have many similarities (along with some differences).1
This resource page provides people who struggle with chemical or behavioral addictions and their loved ones with basic information about these two varieties of addiction, including symptoms and risk factors; and options for effective treatment.
Two Types of Addiction
Today, most mental health experts recognize two types of addiction:
- Chemical addiction—which involves using addictive substances such as alcohol, nicotine, opioids, cocaine, heroin, etc., despite harmful consequences.
- Behavioral addiction—which involves a compulsive need to engage in specific activities such as eating junk food, shopping, watching pornography, checking social media, etc., even if these behaviors don’t offer any real benefit.
Behavioral addictions may also be classified as impulse control disorders. Impulse control disorders are patterns of behavior characterized by a lack of ability to control actions, urges, or emotions that negatively impact other people’s well-being. Pyromania, kleptomania, and trichotillomania are examples of impulse control disorders.
Risk Factors for Addiction
Many risk factors can contribute to a person developing a chemical or physical addiction.
People of any age, race, gender, ethnicity, economic status, or educational level can suffer from addiction. However, there are certain risk factors that can affect the likelihood and speed of developing an addiction.2
These risk factors fall into two main categories: genetics and environment (aka “nature” and “nurture”).
Genetic Risk Factors for Addiction
Some risk factors involve a person’s genetic makeup or how specific substances typically interact with the human body. Such hereditary and other risk factors for addiction include:
- A family history of addiction. Addiction—mainly chemical addiction—is more common in some families and likely involves an increased risk based on genetic traits. If someone has a blood relative with chemical addiction, they are at greater risk of developing a similar addiction. And once a person has started using a drug, the speed at which the use becomes abuse and then a full-blown addiction may also be influenced by inherited (genetic) traits that affect the disease progression.
- Having a mental health disorder. People suffering from mental health disorders such as post-traumatic stress disorder (PTSD), anxiety, depression, or attention-deficit/hyperactivity disorder (ADHD) are at greater risk of becoming addicted to alcohol or drugs. In such cases, the drugs are used as a coping mechanism to deal with uncomfortable feelings. However, substance abuse almost always exacerbates mental health disorders.
- Taking a highly addictive drug. Certain drugs—e.g., stimulants, cocaine, and opioid painkillers—tend to escalate into addiction more quickly than other drugs because of their effect on the human body. And certain methods of ingesting the substance—e.g., smoking or injecting—also may increase the potential for addiction.
Environmental Risk Factors for Addiction
Some risk factors are related to influences from a person’s family and/or social environments they are a part of. Environmental factors that play a role in the onset or continuation of addiction include:
- Family habits, beliefs, and attitudes—toward drug use or activities can become behavioral addictions. A lack of parental supervision and/or a tumultuous parent-child relationship can increase the risk of addiction. Parents or siblings who regularly consume alcohol or use drugs can increase the risk of chemical addiction among other family members. The same is true for having family members who gamble, watch pornography, or engage in other behavioral addictions: This increases the risk of similar addictive behavior among siblings who witness this behavior.
- Using drugs at an early age—can increase the risk of addiction because of how it affects the child’s developing brain; and the tendency of young children to mimic the behavior of their parents and older siblings.
- Peer pressure—can be a strong factor in starting to use and misuse drugs or engage in activities that become a behavioral addiction. This is particularly true for high-school or college students and people of a similar age.
Drinking games or fraternity/sorority hazing rituals involving alcohol consumption or drug use are examples of peer pressure. Compulsively checking social media accounts, binge eating, or excessive shopping are activities that can easily be exacerbated by peer pressure. As a result, these behaviors can escalate into a full-blown addiction.
Physical Addictions
Physical addictions include alcohol use disorder (AUD) and substance use disorder (SUD). Though these two can be distinguished, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes alcohol use disorder as a subset of the larger category, substance use disorder.3
While any addiction is associated with certain dangers, chemical addictions—such as alcohol use disorder and substance abuse disorder—can be most harmful to a person’s well-being. The social, financial, and legal consequences of chemical addictions also tend to be more damaging than behavioral addictions.
The dangers of substance abuse are based on the mechanisms of physical addiction. The brain chemistry of a person suffering from AUD or SUD is altered. The brain is altered so that its “new normal” requires the presence of the substance. The absence of the substance gives rise to intense cravings and—if these cravings are not satisfied—physical withdrawal symptoms.
Some of the more common addictive substances include:
- Alcohol
- Nicotine/tobacco
- Cocaine
- Cannabis/marijuana
- Opioids such as heroin and fentanyl, as well as prescription pain medications such as oxycodone, hydrocodone, codeine, and morphine
- Barbiturates, benzodiazepines, and sleeping pills
- Amphetamines such as Adderall
- Methamphetamine
- Hallucinogens such as LSD, mescaline, psilocybin, PCP, cannabis, MDMA (ecstasy), ketamine, salvia
- Inhalants such as glue or shoe polish
Behavioral Addictions
Behavioral addiction, such as internet addiction, is similar, in specific ways, to physical dependence. Both involve strong urges to engage in a behavior that has negative effects. Like chemical addictions, behavioral addictions may be fueled by the release of dopamine from the brain’s reward center.
The most obvious difference is that instead of being addicted to a substance, the person is addicted to a behavior. They may also become addicted to the feelings associated with a specific action or behavior. And most of the signs of drug addiction are absent in behavioral addiction.4 Cravings and withdrawal symptoms are not as intense or potentially dangerous in behavioral addiction.
Common behavioral addictions include:
- Gambling
- Internet
- Facebook/social media
- Shopping
- Exercise
- Food/binge-eating
- Sex
- TV or video games
- Pornography
- Work
- Cutting (self-harm)
- Plastic surgery
- Risky behavior/thrill-seeking
Simultaneous Chemical & Behavioral Addiction
It’s also important to note that some people may be addicted to behavior and substances. There are many drug addicts, for instance, who also have a gambling addiction. And it’s not uncommon for people with a shopping addiction to struggle with alcohol addiction.
In such cases, the two addictions may be mutually reinforcing or function more or less independently. In either case, treating individuals suffering from a chemical and a behavioral addiction must address them.
Signs & Symptoms of Addiction
Both physical and behavioral addictions are characterized by a persistent urge to repeat certain behaviors or use specific addictive substances regardless of the harm. People struggling with addiction typically spend a lot of time and money supporting their habit. Sometimes their drive to fuel the addiction is to the detriment of other parts of their lives.
Common symptoms of substance use disorder include:5
- Intense cravings for the substance and a lack of ability to stop using it.
- Increasing tolerance, i.e., the need to use more of the substance to get the same effect.
- Feelings of uneasiness or discomfort if one can’t easily obtain the substance.
- Risky behavior while using the substance, e.g., drunk driving or having unprotected sex.
- Difficulty meeting work, school, or family responsibilities because of substance use.
- Relationship difficulties related to substance use.
- Spending less time participating in activities that one used to enjoy.
- Experiencing withdrawal symptoms when one tries to quit.
Common signs of a behavioral addiction include:
- Difficulty avoiding the behavior.
- Spending an excessive amount of time engaged in the behavior.
- A strong urge to engage in the activity even if it causes distress or negatively affects one’s life.
- Using the behavior to mask or ignore or hide from unwanted emotions.
- Being secretive about the behavior or lying to other people about the amount of time engaged in it.
- Experiencing irritability, restlessness, anxiety, depression, or other psychological withdrawal symptoms when attempting to quit.
Treatments for Physical Addiction
Treatment for physical addictions tends to involve a combination of individual and group therapy and medication. Such treatment protocols can be administered in residential or outpatient programs.
Residential Treatment
Residential treatment involves staying at a treatment facility where trained therapists and medical professionals support the detox and rehab process. Some residential programs only last a few weeks, while others continue for several months to a year.
Therapy
Therapeutic support for addiction recovery includes psychotherapy and counseling to explore the root causes of the addiction. Clients also learn new healthy habits and self-care rituals. They may learn how to relax and have fun in ways that don’t involve the addictive substance, which helps to prevent relapse.
Types of therapy that have proven effective in treating chemical addictions include cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT).6,7
Cognitive Behavioral Therapy
A therapist utilizing cognitive behavioral therapy will encourage the client to notice how thoughts, emotions, and behavior are interrelated; and how replacing problematic thought patterns with more positive or helpful ones can be useful in unwinding the addictive behavior.
Such a therapist can also help the client cultivate more productive coping skills. This includes learning how to relate skillfully to difficult emotions—including cravings for the addictive substance.
CBT techniques can reduce the impulse to engage in addictive behaviors. The therapy may also help people struggling with addiction reframe their perspective and view life’s challenges differently.
Mindfulness-Based Cognitive Therapy
Mindfulness-based cognitive therapy combines the ideas of cognitive behavioral therapy with meditative practices and insights.
MBCT supports the client in cultivating a new kind of relationship with thoughts, emotions, sensations, and perceptions. These aspects of experience are fully welcomed and intimately explored—without becoming overwhelmed or collapsing.
The client regains their freedom by increasing clarity and stability concerning the perceptual components of the addictive impulse.
Medication
In some cases, pharmaceutical medications are used to support recovery from addiction.
Medication may be administered in a medically-assisted detox to help alleviate withdrawal symptoms. Medications can also help reduce cravings and prevent relapses in people recovering from a substance use disorder. These disorders may include alcohol, nicotine, or opioids.
For instance, there are currently three drugs approved by the FDA for treating opioid dependence: buprenorphine, methadone, and naltrexone.
Support Groups
Group therapy and peer support groups can play an important role in addiction recovery.
This includes twelve-step programs such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). These programs provide the opportunity to connect with and receive support from other people working toward recovery from chemical addiction.
Treatments for Behavioral Addiction
Treatment approaches can vary with chemical addiction, but therapy is usually the primary component in recovery.
As with physical addictions, cognitive behavioral therapy (CBT) is often most helpful for behavioral addictions,8 as are mindfulness-based approaches. In both cases, the client learns new ways of understanding and relating to thoughts and emotions. Which helps the client to unwind from the behavioral addiction.
Self-help groups and other forms of peer support can help treat behavioral addiction, particularly when combined with individual therapy.
And finally, research suggests a range of medications that may, in some instances, be beneficial in resolving behavioral addictions.9
The First Step Toward Healing
The first step toward healing from addiction is recognizing that there is a problem. This takes courage on the part of the person struggling with the addiction. It may also require an intervention by the affected person’s loved ones.
The second step on the road to recovery is finding skilled mental health professionals to support the recovery process.
Enhance Health Group has multiple mental health treatment centers in Orange County, California. The centers offer detox, inpatient, and outpatient programs for drug addiction and mental health disorders.
Individualized treatment programs at each facility are provided in a private, scenic setting. This environment of natural beauty offers support for the deep healing of recovery from addiction.
Treatment paths offered by the Enhance Health Group include:
- Inpatient and outpatient mental health treatment
- Outpatient drug rehab
- Virtual mental health treatment
The potent therapeutic modalities employed by highly trained and compassionate mental health professionals include:
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Anger management
- Group therapy
- Grief & loss counseling
- Self-harm counseling
A combination of individual and group therapy allows the unique circumstances of each client to be skillfully addressed on their road to recovery from addiction and creating a healthy and joyful new life.
Please contact us today to learn more about the range of therapeutic services offered by Enhance Health Group, or to discuss which treatment path might be most beneficial for someone struggling with a chemical or behavioral addiction.
References & Resources
- Alavi SS, Ferdosi M, Jannatifard F, Eslami M, Alaghemandan H, Setare M. Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views. Int J Prev Med. 2012 Apr;3(4):290-4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354400/
- Understanding Drug Use and Addiction DrugFacts. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugfacts/understanding-drug-use-addiction
- Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) American Psychiatric Association. https://psychiatry.org/psychiatrists/practice/dsm
- Yau YH, Potenza MN. Gambling disorder and other behavioral addictions: recognition and treatment. Harv Rev Psychiatry. 2015 Mar-Apr;23(2):134-46. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458066/
- Substance Abuse/Chemical Dependency. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/substance-abuse-chemical-dependency
- An, H., He, RH., Zheng, YR., Tao, R. (2017). Cognitive-Behavioral Therapy. In: Zhang, X., Shi, J., Tao, R. (eds) Substance and Non-substance Addiction. Advances in Experimental Medicine and Biology, vol 1010. Springer, Singapore. https://link.springer.com/chapter/10.1007/978-981-10-5562-1_16
- Garland, E.L., Howard, M.O. Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research. Addict Sci Clin Pract 13, 14 (2018). https://ascpjournal.biomedcentral.com/articles/10.1186/s13722-018-0115-3
- An, H., He, RH., Zheng, YR., Tao, R. (2017). Cognitive-Behavioral Therapy. In: Zhang, X., Shi, J., Tao, R. (eds) Substance and Non-substance Addiction. Advances in Experimental Medicine and Biology, vol 1010. Springer, Singapore. https://link.springer.com/chapter/10.1007/978-981-10-5562-1_16
- Yau YH, Potenza MN. Gambling disorder and other behavioral addictions: recognition and treatment. Harv Rev Psychiatry. 2015 Mar-Apr;23(2):134-46. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458066/
