The World Health Organization (WHO) has declared that video gaming can cause an addiction much the same as substance use and gambling. In the most recent article I’ve read on the topic of addiction written by Lindsay Tanner, an AP medical writer she asks the question, ” Now that the world’s leading public health group says too much Minecraft can be an addiction, could overindulging in chocolate, exercise, even sex, be next?” She goes on to say, “probably not” which is quite interesting considering sex addiction (although perhaps not in those exact terms) is already a diagnosis that is being treated at rehabs around the country.
Her article, like so many regarding addiction, is filled with confusing rhetoric, speculation and misinformation.
“Under a looser definition, addiction is considered “a disease of extreme behavior. Any behavior carried to extreme that consumes you and keeps you from doing what you should be doing becomes an addiction as far as life is concerned,” said Dr. Walter Ling, a UCLA psychiatrist.”
So here Dr. Ling states that diagnosing addiction is entirely subjective, meaning it is based fully on a personal judgment of what is acceptable behavior and what is not acceptable behavior. The question is who gets to decide when a behavior becomes extreme and what people should be doing? Now I know you can give all kinds of examples from your own personal judgments what you find acceptable and unacceptable, but we each have our own opinions. Many people blame substance use for choices and behaviors that harm others. For example a person who drinks heavily and neglects their children would fall into the category of “alcoholic” based on the perception that their alcohol use is causing the child neglect, but is alcohol consumption the reason they are neglecting their children, or are they simply neglectful of their children and they drink heavily? You may not think this is an important distinction, but what makes it important is it is a criteria for diagnosing substance use disorder (i.e. addiction). According to Dr. Ling, there is a causation wherein consumption of the substance is causing people to shirk their obligations or duties.
When I was in college studying behavioral science, my professors warned us repeatedly not to misinterpret a correlation for a causation. It was the primary purpose of our behavioral research course, yet it is the number one problem in addiction research and treatment that I see today. The fact is there are some people who like to drink heavily and are what most people would classify as neglectful to their children. But there are also people who don’t use substances at all and are neglectful to their children, and then there are great, nurturing parents who drink in a way that many people would consider excessive. Certainly there may be a correlation between heavy substance use and child neglect or other behaviors that negatively affect others, but there are far too many variables to even begin to assume causation. And there are many cases that disprove causation entirely.
Another assertion in the article that is not supported by research is this one:
“Certain drugs including opioids and alcohol can over-activate the brain’s reward circuit.”
If this were actually the case, wouldn’t we see everyone who is prescribed opiates becoming “addicts” by their definition? In reality, it’s actually less than 1% of people who are prescribed opiates ever develop a problem with them, and even those people who do develop a problem by and large get over the problem at some point — most on their own. So this assertion is absolutely not supported by the data. In fact, the data disproves it completely.
I found this assertion to be ill informed as well:
“Caffeine is a stimulant and also activates the brain’s reward system, but to a much lesser degree than addictive drugs. The “reward” can make people feel more alert, and frequent users can develop mild withdrawal symptoms when they stop, including headaches and tiredness. Caffeine-containing chocolate may produce similar effects (as opiates). Neither substance (caffeine containing products) causes the kinds of life problems found in drug addiction…”
Really? Researched obesity much? Most people don’t eat chocolate for the caffeine, they eat it for the sugar, and heavy sugar consumption causes some of the most deadly diseases known to man.
“But addiction means an inability to control use “to the point where you’re failing at life,” she (Dr. Ellen Selkie, a University of Michigan physician) said.”
Yet another definition that relies entirely on subjective analysis and a lie. Video gaming, gambling and substance use are always voluntary activities. Loss of control has not only never been proven, it has been disproven repeatedly. And who says when someone is “failing at life”? What definition of being successful at life is used? I guess you could say if someone ends up homeless or in jail, that’s “failing at life,” but what about someone who goes to work every day, pays their bills and drinks alone, nightly until they pass out? Is that person “failing at life”? Or what about the highly driven, highly successful professional who likes to party with friends on weekends using copious amounts of alcohol and drugs? Is that person “failing at life”?
“Research suggests excessive gambling can affect the brain in ways similar to addictive drugs. Since the diagnostic manual was last updated, in 2013, studies have bolstered evidence that excessive video gaming may do the same thing, and some experts speculate that it may be added to the next update.
The manual doesn’t include sex addiction because there’s little evidence that compulsive sexual behavior has similar effects on the brain.”
So gambling can give you the same “high” as “addictive drugs”, but not sex? Do I even need to go there with this one? I would dare say that most people find sex highly pleasurable. That is not the case with gambling, video games or substance use.
“Insurers, including Medicaid and Medicare, use billing codes listed there to make coverage decisions. The American Psychiatric Association’s manual is widely used for defining and diagnosing mental disorders. If conditions aren’t listed in these documents, insurance coverage for treatment is unlikely.”
And here it is again, the pièce de résistance, the money. People must be diagnosed with an imaginary disease in order to be able to get insurance pay for them to get help. There is no other disease or ailment where this is a justification for making that ailment a disease. What if instead of labeling people with a lifelong diagnosis for a problem that all research points to being completely temporary, we change the definition and understanding of addiction all together? What if we acknowledge that some people struggle at times with behaviors that may become problematic for them? Most stop the behavior when they feel it’s problematic, but some may want help. Instead of labeling them with a lifelong diagnosis so that their insurance will pay for professional help, what if the diagnosis was much more accurate? What if the definition of addiction described exactly what is happening — people have a strong preference for an activity that they feel has become problematic and are seeking guidance to stop or moderate the activity?
I can tell you based on what I’ve seen, read and researched, by changing the definition of addiction, and eliminating the disease/disorder diagnosis, outcomes would improve dramatically. When people are told the truth, that they are in control, that they do have the power to adjust their substance use, video gaming, gambling, etc., and they are provided a pathway to evaluate the utility of that behavior to them and reassess their preference for it, change becomes easy and natural. When they are diagnosed with a lifelong illness, that is out of their power to change, and that renders them powerless over their own thoughts (which are labeled as “cravings“), triggers (which are outside influences that are believed to control them), and substances or activities, the vast majority struggle for the rest of their lives. They are then forced to deny themselves something they believe has value to them, and that they want to do.
It’s time for a real change regarding addiction in this country and the world. It’s time to take a fresh look at the research and redefine the problem entirely. Only then will the trends begin to change. Only then will those struggling be able to find the solution they are seeking. The only people that benefit from adding more “addictions” to the ever-growing list are treatment providers who profit off of keeping people powerless and diseased and trapped in their industry model.