Opinion » Columns » Vijay Nagaswami

Updated: August 7, 2010 15:46 IST

Overview of addiction disorders

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Writing in The Hindu in 2001, I had concluded a piece titled, ‘Who, me? An addict?’ by saying that many of us were “addicts waiting to happen.” The main thesis of the piece was that addiction behaviour was not confined to the abuse of chemicals, natural or synthetic, but included a wide range of things that one could get addicted to: shopping, love, gambling, sex and so on. Until now, there has not been much credible literature in a composite form available on these addictions and what can be done to manage them. Harvey B Milkman, Professor of Psychology at the Metropolitan State College at Denver, Colorado and Stanley G Sunderwirth, Emeritus Professor of Chemistry at Indiana University - Purdue University, Columbus, Ohio, have filled the breach remarkably well. In this book under review, which has been warmly received by reviewers in the United States and will soon be available in India, they have authoritatively addressed the different kinds of addictions, both of the chemical and non-chemical varieties, known to the human race. Milkman’s decades of experience in the management of addictions and Sunderwirth’s extensive experience on the neurochemistry of mood and behaviour have combined well.

Addiction disorders

Starting with an overview of addiction disorders and their neurochemical substrates, they have explored both the common addictions like alcohol, nicotine and other substance abuse, as also other types of addiction behaviour — for example, eating addictions, thrill-seeking behaviour (like jumping off buildings and gambling), compulsive shopping, gaming addictions, internet addictions, fantasy, and addictions to love and sex (both real and virtual). It would come as a bit of a surprise for an addict to know that dopamine, a neurotransmitter (a chemical messenger) in certain parts of the brain, is an important mediator of addictive behaviour, whatever one is addicted to. Obviously, some addictions cause more harm to the human body, while some others impact the human mind more. All these are carefully chronicled and well detailed.


The book concludes with a long section on how addictive behaviour can be re-canalised to produce ‘natural highs’ in constructive areas. In other words, if you are using your dopamine to get addicted to dangerous substances or pursuits, you can well use the same mechanisms to be addicted to ‘positive’ behaviours as well.

The authors’ prescription for this is simple and straightforward. What one needs to do is to control one’s negative thoughts and emotions through cognitive re-structuring; maintain close and intimate relationships; practise relaxation, mindfulness, and meditation; eat healthy; work out regularly; and meaningfully engage one’s talents through a process of self-discovery. If one does all of these, one is bound to appropriately utilise one’s natural mechanisms of producing ‘highs’ in a constructive manner, rather than succumb to addictions that require interventions.

If I do have a complaint about the book, it is that in the pursuit of comprehensiveness, Milkman and Sunderwirth have perhaps, sacrificed depth. So, while a large canvas has been painted, the details are not as finely etched out as one would have liked.

The extensive bibliography testifies to the huge volume of research evidence that has been drawn upon for the work. As I read the book, I was wondering what type of reader would benefit most from the book. It is too technical for the general reader, unless he/she has at least a basic knowledge of the working of the human brain.

On the other hand, it is not deep enough for the mental health professional. It does not even touch upon the first element of intervention, namely detoxification, let alone offering comprehensive intervention strategies or techniques. But the more I read it, I realised that the book would be an extremely valuable resource to the addiction rehab professional, social workers, volunteers, and perhaps even some addicts who would like to get a scientific understanding of what’s happening inside their brains and minds.

Written clearly and in a free flowing manner, and handsomely illustrated by Kenneth Axen, a biomedical research scientist, the book is a welcome addition to the arsenal of all the players in the ‘War on Addiction,’ a war that is slowly beginning to appear winnable, more and more.

CRAVING FOR ECSTASY AND NATURAL HIGHS — A Positive Approach to Mood Alteration: Harvey B Milkman, Stanley G. Sunderwirth; Sage Publications India Pvt. Ltd., B 1/I-1, Mohan Cooperative Industrial Area, Mathura Road, New Delhi-110044.

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