Yes, Sex Addiction Really is an “Addiction” (And Why It Matters)

The American Society of Addiction Medicine recently came out with the following definition of addiction:

“Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”

Note the key words “chronic,” “brain,” and “substance use and other behaviors” (my italics).  There is now ample evidence that behaviors such as persistent hooking-up for casual sex, excessive internet pornography use, serial seduction and affairs etc. are sexually compulsive behaviors that share the salient aspects of other kinds of addictions.  For example:

-Drugs, cybersex, gambling, and even internet gaming all produce a drastic increase in brain chemicals related to pleasure pathways which can become addictions in the same way.

-Those people with the “disease” develop a tolerance and need an increase in the frequency of the behavior as well as needing more extreme behavior for gratification.

-The behavior follows a progressive course unless it is treated

-The behavior produces dire consequences in the addict’s life.

There is even evidence that the various kinds of addiction can share a common origin in brain development due to a variety of problematic early life experiences. (See also my previous blog post This is Your Brain on Cyber Porn).  Regardless of upbringing, teenagers are particularly vulnerable to addiction due to the fact that their brains are not yet fully developed.  The brain of an 18 year-old is thought to be 80% developed with the last 20% being the frontal lobes (around age 25 or 26).

So why is it important to define the various forms of sexually compulsive behaviors as “addictions?”  My top 5 reasons are:

1. Conservatively, 3-5% of the U.S. population suffers from sexual compulsivity and teens are increasingly engaging in compulsive use of pornography.  This is a significant public health issue just in terms of the numbers.

2. Lives are destroyed by sex addiction: marriages crumble, jobs are lost, people are ostracized and incarcerated and children are exposed to potentially damaging experiences.

3. Sex as an addiction can be treated and people can recovery and lead normal lives with healthy sex lives.  Viewing sexual compulsions simply as “perverted” or as “moral” failings is counterproductive in that it prevents people getting help.

4. Acknowledging that sex addiction is a brain disease resulting in behavioral compulsions allows the people around the addict to be more compassionate and less punitive and judgmental. And by the same token they get to suffer less themselves in the long run.

5. We as a society have one foot in the dark ages when it comes to sexual issues.  We often prefer to retreat into concepts of good and evil.  What we are doing is walling off a human problem and compartmentalizing it.  This is turn leads to the “schizophrenic” cultural trends of increasingly explicit portrayals or sexual imagery in the media on the one hand and branding teens as sex offenders for “sexting” on their cell phones on the other.

So people, could we finally stop asking “is sex addiction an addiction?”