Chemical and Behavioral Addiction Overview Part 2: Similarities, Differences, and Treatment Approaches for Addictive Behaviors

This podcast episode, "Chemical and Behavioral Addiction Overview Part 2," hosted by Dr. Donnelly Snipes, delves into the similarities and differences between chemical and behavioral addictions, emphasizing that both involve engaging in a behavior or substance use to escape distress, despite negative consequences. The core argument is that while the DSM may not formally recognize many behavioral addictions, their underlying mechanisms and impact on an individual's life are profoundly similar to chemical dependencies. Both types of addictions trigger the brain's dopamine system, norepinephrine, and endocannabinoids, providing a sense of pleasure, relief, or escape from pain, and often lead to physiological tolerance and psychological withdrawal symptoms. A key distinction highlighted is that abstinence, a common goal in chemical addiction treatment, is often not ideal or even possible for many behavioral addictions such as food, sex, shopping, or exercise, as these are integral parts of human life. This necessitates a different treatment approach focused on moderation, healthy engagement, and finding alternative, less harmful ways to meet underlying needs. The episode also differentiates between substance use for functional purposes (e.g., psychotropic medication) and addictive use, stressing that negative psychosocial consequences are integral to the definition of addiction. It also touches on the concept of "substitution" where individuals replace one addiction with another, which is seen as a failure to achieve full recovery. Practical insights include the importance of understanding the "trigger and function" of addictive behaviors, recognizing that "behavior is communication" signaling unmet needs or distress. Treatment principles revolve around making sobriety or healthier alternatives more rewarding than the addictive behavior. The "decisional balance exercise" is introduced as a tool to help individuals weigh the physical, emotional, cognitive, environmental, financial, relational, and spiritual benefits and drawbacks of both the addiction and sobriety, thereby increasing motivation for change and identifying alternative coping mechanisms. The broader implications extend to a more nuanced understanding of addiction beyond just substance abuse, encompassing a wide range of human behaviors. It underscores the biopsychosocial consequences of addiction, including neurotoxicity, mental illness, trauma, and general life losses. The discussion on chaos and drama as potential addictive behaviors expands the traditional view of what constitutes an addiction, highlighting how early life experiences can shape a person's comfort with certain states and their neurochemical responses. Ultimately, the episode advocates for a holistic, function-based approach to understanding and treating addictive behaviors, recognizing the individual's struggle and the need for effective, sustainable coping skills.

What we're really talking about is engaging in the use of a person relationship substance or activity in order to escape from distress and continuing to engage in that behavior despite negative consequences that are caused directly or even indirectly by that behavior.

Once something starts causing problems and you continue to do it anyway that's when we start saying hey there might be something going on here.

Our bodies do this with insulin they do it with uh dopamine it does it with cortisol you know whenever the balance of chemicals and neurochemicals in the body starts to go wonky lack of a clinical term the body automatically tries to adjust in order to balance it out again.

Psychological withdrawal symptoms are often a sign that the body is saying hey our balance is out of whack and we need an extra surge of xyz chemical.

Abstinence is not ideal for some behavioral addictions most people are not interested from abstaining from sex for the rest of their life people can't abstain from food for the rest of their life and have any quality of life.

People who replace a chemical addiction with behavioral addictions are not finding full recovery what they're doing is just numbing in a different way continuing to take the edge off.

Behavior is communication what was that behavior saying and to me that behavior was saying i don't feel well i need some relief and the skills and tools you're giving me ain't cutting it right now and i'm scared.

When faced with two choices the tendency for a person is to choose the more rewarding option to increase motivation for change the less rewarding choice i.e sobriety must become more rewarding.

Your addiction is serving a purpose what are some other maybe healthier or less harmful ways that you could meet those same needs.