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The Social and Cultural Milieu
We must also consider the enormous social-class differences in addiction rates. That is, the farther down the social and economic scale a person is, the more likely the person is to become addicted to alcohol, drugs, or cigarettes, to be obese, or to be a victim or perpetrator of family or sexual abuse. How does it come to be that addiction is a "disease" rooted in certain social experiences, and why in particular are drug addiction and alcoholism associated primarily with certain groups? A smaller range of addiction and behavioral problems are associated with the middle and upper social classes. These associations must also be explained. Some addictions, like shopping, are obviously connected with the middle class. Bulimia and exercise addiction are also primarily middle-class addictions.
Finally, we must explore why addictions of one kind or another appear on our social landscape all of sudden, almost as though floodgates were released. For example, alcoholism was unknown to most colonial Americans and to most Americans earlier in this century; now it dominates public attention. This is not due to greater consumption, since we are actually drinking less alcohol than the colonists did. Bulimia, PMS, shopping addiction, and exercise addiction are wholly new inventions. Not that it isn't possible to go back in time to find examples of things that appear to conform to these new diseases. Yet their widespread—almost commonplace—presence in today's society must be explained, especially when the disease—like alcoholism—is supposedly biologically inbred.
The Addiction Experience
Consider one strange aspect of the field of pharmacology—the search for a nonaddictive analgesic (painkiller).[4] Since the turn of this century, American pharmacologists have declared the need to develop a chemical that would relieve pain but that would not create addiction. Consider how desperate this search has been: heroin was originally marketed in this country by the Bayer company of Germany as a nonaddictive substitute for morphine! Cocaine was also used to cure morphine (and later heroin) addiction, and many physicians (including Freud) recommended it widely for this purpose.
Indeed, every new pharmaceutical substance that has reduced anxiety or pain or had other major psychoactive effects has been promoted as offering feelings of relief without having addictive side effects. And in every case, this claim has been proved wrong. Heroin and cocaine are only two obvious examples. A host of other drugs—the barbiturates, artificially synthesized narcotics (Demerol), tranquilizers (Valium), and on and on—were welcomed initially, only to have been found eventually to cause addiction in many people.
What this tells us is that addiction is not a chemical side effect of a drug. Rather, addiction is a direct result of the psychoactive effects of a substance—of the way it changes our sensations. The experience itself is what the person becomes addicted to. In other words, when narcotics relieve pain, or when cocaine produces a feeling of exhilaration, or when alcohol or gambling creates a sense of power, or when shopping or eating indicates to people that they are being cared for, it is the feeling to which the person becomes addicted. No other explanation—about supposed chemical bondings or inbred biological deficiencies—is required. And none of these other theories comes close to making sense of the most obvious aspects of addiction.
One of the key dynamics in the alcoholism or addiction cycle is the repeated failure of the alcoholic or addict to gain exactly the state he or she seeks, while still persisting in the addicted behavior. For example, alcoholics (in research, these are frequently street inebriates) report that they anticipate alcohol to be calming, and yet when they drink they become increasingly agitated and depressed.[5] The process whereby people desperately pursue some feeling that becomes more elusive the harder they pursue it is a common one, and appears among compulsive gamblers, shoppers, overeaters, love addicts, and the like. It is this cycle of desperate search, temporary or inadequate satisfaction, and renewed desperation that most characterizes addiction.
How do people become addicted to powerful experiences such as gambling? Actually, gambling may be far more addictive than heroin. More people who gamble have a sense of loss of control than have this feeling with narcotics: very few people who receive morphine after an operation in the hospital have even the slightest desire to prolong this experience. It is the total nature of the gambling experience (as practiced in Atlantic City casinos, for instance) that promotes this sense of addictive involvement. The complete focusing of attention, the overriding excitement of risk, and the exhilaration of immediate success—or usually, the negative sensations of loss—make this experience overwhelming for even the strongest among us.
Any experience this potent—alluring and at the same time holding out the possibility of serious disturbance to one's life—has great addictive potential. Gambling uplifts one and then can make one miserable. The temptation is to escape the misery by returning to the ecstasy. People for whom gambling serves as a major source of feelings of importance and power are quite likely to become addicted to gambling, at least for a time. When thinking of who becomes addicted to gambling, we should also keep in mind that heavy gamblers are frequently also heavy drinkers. In other words, those who seek power and excitement in the "easy," socially destructive form of gambling are very often those prone to seek such feelings in alcohol.[6]
Many of us, on the other hand, have had addictive gambling experiences. We did so when we were young and went to a local carnival for the promise of easy and exciting money. Plopping down our quarters at the booth where the man spun the wheel, we became increasingly distressed as our anticipated winnings did not materialize. Sometimes we ran home to get more of our savings, perhaps stealing from our parents to get money. But this feeling rarely continued after the carnival departed. Indeed, when we got older and gambled in a small-stakes pinochle or poker game with friends, we simply did not have the same desperate experience that gambling had led us to under different circumstances at a different time in our lives. Just because people have had acute—even addictive—experiences with something by no means guarantees that they will always be addicted to this activity or substance. Even when they are addicted, by no means is every episode of the experience an out-of-control one.
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