Substance Abuse vs. Process Addictions

To fully understand the difference between substance abuse and process addiction – and how the two are actually related – it is important to define both terms.

Substance abuse is defined by the University of Maryland Medical Center as the inappropriate use of illicit drugs, such as cocaine and heroin; the use of prescription or over-the-counter medications that causes individuals to experience negative consequences; and the use of alcohol despite negative consequences. These negative consequences can include:

  • Failure to maintain responsibilities at home, work, and school
  • Strained interpersonal relationships
  • Legal ramifications
  • Financial difficulties
  • Physical health problems
  • Development of a substance use disorder

A substance use disorder is most often a product of substance abuse. Individuals may develop a tolerance to the substance of choice, which leads to using more and more of the substance to achieve the desired effect. This can result in physical and psychological dependence; physical dependence alone does not necessarily constitute a substance use disorder. The National Institute on Drug Abuse states that physical dependence occurs even when prescription medications are used appropriately, and describes a natural phenomenon in which the body adapts to the presence of the drug in the system. Psychological dependence involves emotional symptoms, such as anxiety, when the drug is stopped.

Substance abuse, at least the first occurrence, is voluntary. When addiction or substance use disorder develops, individuals exhibit behaviors that are described as drug-seeking. It is thought that repeated drug use contributes to these changes.

What Is a Process Addiction?

The major difference between a substance use disorder and a process addiction, sometimes referred to as a behavioral addiction, is obvious: As an article published in the International Journal of Preventative Medicine states, individuals are not exposed to substances and do not experience the physical signs and symptoms of a substance use disorder.

Some may wonder if it is possible to become addicted to certain behaviors, such as spending money, gambling, eating, smartphone use, or sex. The American Psychological Association states that it is, due to the fact that addiction involves repetitiveness, high frequency, and excessive use, whether the focus is a substance or a behavior. The same characteristics of a drug addiction – continuing use of the substance despite negative consequences, inability to stop using the substance even if it is desired, and cravings – also apply to a process addiction.

What Substance Abuse and Process Addictions Have in Common

When individuals repeatedly abuse drugs, they are not concerned about what happens after they have used the drug, as they are merely in search of a high. The same can be said in regards to a process addiction. Individuals may not be thinking of what will happen after they gamble, binge eat, or have a one night stand with a stranger; they are thinking about the feelings and the pleasure that the act brings them. It could be said that an individual experiencing a process addiction may present with the same changes in the brain that are consistent with addiction that may be seen in an individual with a substance use disorder, according to Stanford University.

Some of the signs of process addictions may mimic those of a substance use disorder:

  • Tolerance: While individuals who use substances may feel they need to take more of a drug to achieve the effects, those with a process addiction may increase the frequency or severity of their behavior for the same reason.
  • Withdrawal symptoms: Those who use substances can experience physical symptoms, but those with a process addiction may experience profound anxiety if they cannot engage in their behavior of choice.
  • Inability to stop the behavior: Those with process addictions and substance use disorders may wish to stop engaging in the behavior, but they are unable to do so.
  • Primary focus: People with substance use disorders and process addictions often spend large amounts of time planning, engaging in, and recovering from the behaviors involved in the addiction (drinking, using drugs, shopping, etc.).

It is also possible to experience both a substance use disorder and a process addiction simultaneously.

Types of Process Addictions

Process addictions come in many forms, such as:

  • Shopping addiction
  • Gambling addiction
  • Food addiction
  • Love addiction
  • Sex addiction
  • Internet addiction
Individuals who exhibit signs of compulsive gambling, according to the Massachusetts Institute of Technology, are often no longer looking to win; instead, they are gambling to enter a “zone” in which they can ignore life’s problems. The article also suggests that individuals are merely after the “flow” of the experience.

Overeaters Anonymous assists those in the recovery from food-related process addictions, such as compulsive eating, binge eating, and other eating disorders. Stanford describes bulimia as a possible process disorder as well. In those who overeat, dopamine deficiencies may be to blame. Stanford University also suggests that the dopamine deficiency may resemble that of an individual with a substance use disorder.

There is not a great deal of information regarding sex addiction. According to The Professional Counselor, the term hypersexual disorder applies to those who exhibit signs of addiction in regard to sex and sex-related activities.

Process addictions come in many forms, and they are often harmful. As a result, they should be addressed with behavioral therapies. Likewise, substance abuse and addiction can bring great damage to those who suffer from them. When substance abuse and process addictions occur together in the same person, comprehensive treatment that addresses both conditions is necessary.

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