In the hands of a person whose brain is wired for addiction, a poker chip or credit card can be as dangerous as booze or cocaine.
Dr. Joseph Beck, chairman of psychiatry at Ingalls Memorial Hospital in Harvey and medical director of the Illinois Institute of Addiction Recovery at Ingalls, is an addiction specialist whose recent talks have focused on process addictions, such as gambling and viewing Internet pornography, and how the physiological reactions in addicts are similar to those addicted to alcohol or drugs.
"The 12-steppers have been talking about this stuff as an addiction forever," Beck said. "That's why a lot of groups like Gamblers Anonymous came into existence. Finally, the brain science is catching up with what people already know to be true."
People can be physiologically addicted to shopping, eating, sex, gambling and other compulsive behaviors as well as alcohol and other substances.
“Addictions that are not related to substances are called process addictions and consist of a compulsion to repeatedly engage in an action, such as gambling or sex, until that action causes serious negative consequences to the person’s physical, mental, social and/or financial well-being,” Beck said.
The neurochemical processes of pleasure and reward are identical to those in drug or alcohol addiction. However, even when the science supports it, society has its own reaction.
"We're up against a huge stigma that this is a willpower issue or an ethical or moral issue," Beck said.
The data for process addictions is weaker than with substance addiction.
"A lot of research needs to be done," he said.
Dr. Matthew Teolis, vice president of medical affairs for Franciscan St. Margaret Health, has studied addiction for more than 25 years. He said the role of biochemistry and environmental factors in addiction is not "either/or;" rather, it is, "both/and."
"High exposure to alcohol is not the cause," Teolis said. "It must be combined with a genetic predisposition."
Science has no tests to determine a predisposition for addiction.
Some people can drink to excess and not become dependent. Others are genetically predisposed to become addicts, making excessive drinking a path to alcoholism, Teolis said.
For addicts, taking drugs, drinking, eating, gambling, having sex and engaging in other behaviors trigger the release of a feel-good chemical in the brain. Over time, if they don't maintain that behavior, they feel disphoria, "not quite feeling the way they want to," Teolis said.
"And that is relieved in re-engaging in the behavior," he said.
In nonaddicts, trying alcohol or drugs may lead to a pleasant experience, but once the chemical is out of their system, their normal brain chemistry kicks in.
Addicts, on the other hand, suffer from an unconscious inability to recognize ugly truths about themselves, things that might be frightening. It's called denial.
"Addicts have a really hard time recognizing it until the loss and the pain exceed a certain threshold," Teolis said.
Numbers on addiction can be hard to come by.
"It's very difficult to get reliable statistics, because our society attaches condemnation, ridicule and shame to this condition," Teolis said. "Our society fails to recognize addictive disorders as diseases."