ASAM also affirms that sexual behaviors can be addictive:

We all have the brain reward circuitry that makes food and sex rewarding. In fact, this is a survival mechanism. In a healthy brain, these rewards have feedback mechanisms for satiety or 'enough.' In someone with addiction, the circuitry becomes dysfunctional such that the message to the individual becomes 'more', which leads to the pathological pursuit of rewards and/or relief through the use of substances and behaviors.

If you view porn, are you an addict or merely a user?

This question used to be a silly one for most porn users. Prior to the Internet, porn use (if any) bore some relation to authentic libido. When one had had enough, the magazine went back under the mattress. Internet porn, however, has the power to override natural satiety mechanisms in many brains. This increases the risk of the addiction-related brain changes ASAM addressed. 

With respect to porn, it's not time spent viewing or what you're looking at that determines whether your brain has changed. Instead, watch for these signs:

• Inability to abstain;
• Impaired impulse control;
• Cravings;
• Diminished grasp of one's problems; and
• Problematic emotional responses. (Detailed ASAM list)

Curious how these telltale symptoms might show up in today's porn users? We've culled the following questions from actual reports of self-identified porn addicts. Many users do not make the connection between their symptoms and their porn use until they abstain from porn for weeks, but these questions, and the remarks below them, may help you determine whether you need to seek help to reverse unwanted changes and restore your brain to balance.

• Have you tried to stop using porn and failed? Did you notice withdrawal symptoms?
• Do you experience intense cravings when you have no access to porn for several days?
• When you use again do you notice rapid escalation to more extreme material?
• Have you noticed changes in your sexual tastes?
  • Have you explored new types of porn in order to attain earlier levels of excitement?
  • Are you viewing things that never turned you on?
  • Are you using porn that does not match your sexual orientation?
• Is porn viewing the most exciting thing in your life? Does life seem dull otherwise?
• Do you feel powerless to stop yourself from using porn if you see or experience something you associate with porn use, such as:
  • being alone in the house,
  • seeing a TV show with your favorite fetish hinted at or portrayed,
  • seeing news about a favorite porn star?
• Do you see potential mates differently—more as body parts than as people?
• Since using Internet porn, do you feel more tongue-tied, unsafe, awkward or anxious around other people—especially potential mates?
• Is it harder to connect with others? Do you feel lonelier? Are you more worried about what others think about you?
• Have you (or those who care about you) noticed you:
  • procrastinate more than before using, have lower motivation (don't care), chronic fatigue, brain-fog, or difficulty concentrating or remembering things?
  • have become more anxious, restless, impulsive, stressed, irritable, unhappy, pessimistic, emotionally numb, or depressed?
  • have become more secretive, or isolate more?
• Have you noticed declines in your sexual function during sex: more rapid ejaculation (PE), inability to maintain an erection without self-stimulation, porn or porn fantasy (even if you can get rock-hard to porn), delayed ejaculation (or inability to orgasm), less satisfying orgasm, need the lights on during sex to get aroused, not turned on by attractive partner, no desire for sex?
• Have you noticed declines in your sexual function during masturbation: unable to masturbate without porn or porn fantasy, need for more vigorous masturbation ("death grip," faster strokes), weaker (or rapidly fading) erections, climaxing with a semi-erection, more frequent urination?
• Since using Internet porn, do you feel like you've lost your "mojo," or sex appeal? Do you doubt your attractiveness or feel more anxious about the dimensions/appearance of your genitals?
• Does your voice feel more nervous, shallow, tight, or unnaturally high? Shallow breathing?
• Have you masturbated to the point of abrasions or other physical damage?
• Can you fall asleep without using porn? Do you have more trouble sleeping soundly through the night?
• When under stress do you use more porn?
• Do you have intrusive porn flashbacks?
• Are you risking your job, education or relationship to watch porn, or spending too much money on it?
• Have you lost a relationship or job, or dropped out of school due to your porn use (or symptoms related to it)?
• After climaxing, do you notice more intense mood swings (irritability, depression, anxiety)?

These users have noticed symptoms that may indicate brain changes: