Q. Dr. Anderson, tell me first, how do you define addiction?

A. Well, I am a radical about that.  First of all, "addiction" is just a model.  It is not something that's real.  It's a way of describing a set of phenomena, and it has been a really useful model for certain kinds of things, for example, alcoholism and heroin addiction.  It doesn't exist though.  It is just something that somebody made up.  Now, there are some physical characteristics that people have been able to associate with the model like certain kinds of changes in the brain and certain neuroreceptor sites and that kind of thing.  My opinion is that, although those associated physical characteristics are interesting, and perhaps even important, they are not really the crux of what is going on with someone who is experiencing a difficulty with abusing or overusing a substance.  Pretty much the universal definition of addiction is that people have cravings for substances when their blood levels of the substance drop, and they have a difficulty in discontinuing the habit of use.  And so, we can look at a scientific definition, which I do not use with my clients because the people who I am dealing with are not scientists.  They are basically just the general public, and what they mean when they say they are addicted is that they have been having  a hard time quitting.  They mean that they want something that they do not want to want anymore. They wish to stop using that substance, nicotine, for example. And, they mean that they are conflicted about it and they are having a difficult time quitting. That is really what most of them mean when they say they are "addicted".

Q. In this case, do you feel that addiction is a disease?

A. I do not think "addiction" fits the disease model very well.  For one thing, if we look at mumps or Alzheimer's disease, there are certain kinds of physiological and pathological changes that are going to occur consistently in people with mumps or Alzheimer's disease.  That is not true with addictions.  What you   Next page