DSM-V's announcement that the psychiatric diagnostic manual will, for the first time, call something addictive that doesn't involve substance abuse—gambling—has opened the floodgates.
It is intriguing to consider how gambling was placed in this category, since there isn't an "addiction" task force for DSM-V, only a substance-related-disorders one. So who decided gambling was the one thing people did, other than to consume drugs and alcohol, that was addictive and how did they decide that?
Charles O'Brien, M.D., a leading "addiction = chronic-brain-disease" proponent and chair of the substance-disorders group, announced the inclusion of gambling because “pathological gambling and substance-use disorders are very similar in the way they affect the brain and neurological reward system.” Thus it seems O'Brien, rather than the task force of consulting substance abuse specialists, perhaps in league with colleagues at the pinnacle of the "addiction = chronic-brain-disease" movement (like Nora Volkow), spearheaded the adoption of this position.
Where does that leave all the other candidates for inclusion in the addiction category, leading entries for which are sex and games? For them to be included, will they also have to be "shown" to affect the same "brain and neurological reward system" as drugs and gambling? Is there any powerful experience that does not affect this system? Did O'Brien really scrutinize reams of PET scans of gamblers to find that their reward systems were impacted in the same addictive way as cocaine and alcohol abusers?