THE BLOG
03/18/2010 05:12 am ET Updated Nov 17, 2011

What If We Had A National Institute Of Addiction?

We don't have one now - we have a National Institute on Drug Abuse (NIDA). This nomenclature has consequences.

Foremost, we fight drug use of all kinds, and only drug use, as addictive - even though (a) a majority of Americans have used illicit substances (and quite a few still do), (b) everyone knows the overwhelming majority of drug users (like drinkers) don't become addicted, and (c) we feed our children ever more potent, potentially addictive, pharmaceuticals.

Meanwhile, government agencies and official psychiatry ignore non-drug addictions - like gambling, sex, and video games, to name a few. The official diagnostic manual of the American Psychiatric Association (DSM-IV) does not use the term "addiction," but only dependence. Yet the only thing it views people as becoming dependent on are substances.

One other consequence of this state of affairs is that we view addiction as a medical disease. This is easier to do when we think of addiction as stemming from the action of particular drugs. The NIDA is preoccupied with taking brain images of drug users. True, you can find brain activation from sex, love, video games, food, etc. - but that just doesn't fit well into the disease category.

Crazy Uncle Joe Biden - you know, the one who drank near-beer at the President's White House garden beer bash - actually proposed changing the name of the NIDA. His last official Senatorial act before becoming VP was to rename the NIDA the "National Institute on Diseases of Addiction" in his proposed "Recognizing Addiction as a Disease Act of 2007."

Apparently, his Senate colleagues didn't get on the bandwagon. This might have been because Biden simply mishmashed the subject further. The name change suggests taking a broader view of addiction. But it actually is about saying that all drug abuse (or use) is addictive and that it's a disease. What about all those people who smoke marijuana - they're really all addicts?

I don't think where Joe was headed was: "Let's restrict our attention to addictive drug users and others who become destructively involved in addictive habits of all sorts." That's a little far outside his ken. He was simply reifying the NIDA's existing ideas, to wit, "Drug use - and only drug use - is addictive. That's why we oppose drug use of all kinds."

Can you see what it's going to take to get us off center on this topic? We need to recognize that (1) addiction is an extreme of behavior that may occur with drugs, but also with other compelling habits, (2) it can't be linked to specific chemical compounds or types of brain action, (3) we'll simply have to evaluate habits in terms of the impact they have on people's lives.

That's a pretty big conceptual leap. You might try making it at home, though.