Marc Lewis Ph.D.

Addicted Brains

Behavioral Addictions vs. Substance Addictions

Whether it's drugs, booze, sex, or gambling, the brain can't tell the difference

Posted Jun 17, 2013

I was recently at a conference on behavioral addictions. Two days of talks by experts—psychologists, neuroscientists, psychiatrists, clinical researchers, etc.—who want to understand compulsive gambling, eating disorders, hypersexuality, and internet or gaming addiction. It was not only a great conference, but it happened to be in Budapest—a real bonus. 

As a one-time drug addict who now studies drug addiction, I knew  a lot about substances, but not a thing about the behavioral addictions. My naive view was that they were cheap imitations of the real thing. Was I ever wrong.

In two days I learned so much, met so many amazing people, discovered new research strategies, new devices, new recovery tools. For example, I chatted for an hour with a man named Robert Pretlow, a physician who spent two years—full-time—developing a cell-phone app that lets you chat with other recovering individuals, warns you about addictive triggers, reminds you about your own effective coping strategies, records your progress day by day. It's like having a treatment center in your pocket. Dr. Pretlow is using it to study eating disorders, but it seems that it could be applied to many other addictive problems as well. 

I learned about the hidden dangers in sex and gambling. What's it like when you really can't stop?

So, it might seem counterintuitive, but heroin addicts, codependent partners, gaming addicts, and sex addicts are very, very much alike. In other words, you don't have to be a heroin addict or an alcoholic to wreck your life. You can wreck it just as well by spending 18 hours a day on the internet, while the bills pile up, the unemployment cheques fizzle out (and you didn't notice), and your wife starts packing, not only her stuff but the kids' stuff too. You might reply: yeah, sure, but

In the next few posts I'm going to try to synthesize what I've learned about behavioral addictions—how they develop, how they stabilize, and most of all how the same or at least overlapping brain changes underlie all addictions.