By Michael Prager
Institute chairman
It starts out like a riddle or joke, but it’s not.
“Two people walk into a bar. They imbibe the same substances in the same amounts. One goes home to bed and the other ends up in the gutter. What happened?”
Though this version cites alcohol, it can be true of any “addictive substance.” That phrase is in quotation marks because though obviously, some substances (and behaviors) are commonly known culprits — from cocaine to marijuana, gambling to shopping — the substances don’t ensure addiction will strike those who ingest (or participate in) them. It is generally accepted that about 15 percent of people exposed to these culprits become dependent on them.
Although its landscape is far more complicated, it is the same with food addiction. Not everyone who eats, say, ice cream or chocolate or onion rings will develop an unhealthy relationship with them. But some will — probably around 15 percent of those exposed to those substances.
The American Psychiatric Association has specific criteria for determining whether one’s “unhealthy relationship” rises to the level of what it calls a substance-use disorder, or what you might call addiction. These include intending to eat an amount but end up eating more, wanting to cut down or stop using a substance but not managing to, or continuing to use the substance even when it affects relationships or causes other problems.
A key element separating addiction from other disorders is the phenomenon of craving. For reasons of genetics, upbringing, and/or environment, putting a substance into one’s bloodstream, or engaging in a particular practice, triggers a biochemical sensitivity and the individual is off and running in an unhealthy direction.
This is precisely why abstinence is vital to an addict’s recovery. Avoiding a substance or behavior will not solve one’s addictive problem, because the biochemical trigger is only one facet of it. But continuing to engage with the substance or behavior will make it far more difficult to make any headway.
