“As anyone familiar with the history of the diagnosis of addiction can tell you, the D.S.M.’s changes accurately reflect our evolving understanding of what it means to be an addict.” – Howard Markel

Yesterday’s New York Times included an interesting op-ed piece written by Howard Markel. The good news is that Dr. Markel’s article confirms what I’ve been writing about for more than a year. The not-so-good news is that, while a few scientists are starting to sniff in the right direction, it might take them a decade to catch up. The bad news is that the article provides insights into how unconscious “skeptics” (i.e. power, fear, money, approval, and esteem addicts) are already lining up to protect their right to continue indulging popular dopamine-triggering addictions.

Addicts are addicts. It doesn’t matter if they trigger dopamine with heroin, tobacco, food, power, money, doctoral degrees, status symbols, or religions, addicts do not like having their dopamine flow threatened.

The Diagnostic and Statistical Manual of Mental Disorders (D.S.M.) is in the process of threatening a lot of influential addicts’ dopamine flow by adding “behavioral addictions” to the manual. The D.S.M. is the standard reference work for psychiatric illnesses, so it makes sense for money, power, and esteem addicts to protect their favorite “behavioral addictions” from being exposed as mental disorders.

According to Dr. Markel, “Skeptics worry that such broad criteria for addiction will pathologize normal (if bad) behavior and lead to overdiagnosis and overtreatment. Allen J. Frances, a professor of psychiatry and behavioral sciences at Duke University who has worked on the D.S.M., has said that the new definitions amount to ‘the medicalization of everyday behavior‘ and will create ‘false epidemics.’ Health insurance companies are fretting that the new diagnostic criteria may cost the health care system hundreds of millions of dollars annually, as addiction diagnoses multiply.”

Dopamine-induced addictions are so powerful that addicts in high places can’t comprehend that many behaviors currently considered “normal” are actually pathological and symptomatic of a debilitating brain disorder.

It’s especially ironic to read the rationalizations of a Duke University employee, given that Duke was endowed by a major drug dealer, tobacco czar James B. Duke, who made his fortunes pushing a highly addictive substance.

Dr. Frances’ concerns about “the medicalization of everyday behavior” and creating “false epidemics” are patently absurd. In a rational, non-addictive society, Frances’ self-deception and denial would be viewed as symptoms of a very real epidemic that’s grown into the perfect pandemic.

When it comes to pandemics, what could be more perfect than a brain disorder that’s capable of keeping a professor of psychiatry from wanting to know he’s suffering from a brain disorder? Why doesn’t Dr. Frances want to know? Because addictions turn human beings into addicts who don’t want to know they’re addicts, because addicts don’t want to have to give up their addictions.

For addicts, all choices are reduced to protecting dopamine flow. Esteem addicts use advanced degrees, and money addicts use profits, to trigger the same dopamine that junkies trigger with heroin. Same dopamine, same self-deceptions, denials, and dishonesty.

I’ve been advised, many times, to avoid comparing “normal” people to junkies. Based on what is known about how dopamine turns most “normal” people off to learning about addictions and the contents of this site, the advice makes a lot of sense. Still, continuing the deception that money, power, approval, esteem, and religion addicts aren’t actually addicts would be as dishonest as arguing that junkies should be admired and emulated because they’re respectable opium connoisseurs and aficionados.

Once again, my apologies to junkies for comparing them to money and power addicts. If heroin addicts were one millionth as destructive as money or power addicts, heroin addiction would be a capital offense. But instead of getting arrested, money and power addicts (the most dangerous of all addicts) get rich, lionized, and idolized.

Dr. Markel’s article is both a hopeful sign that money, power, status, religion, and other dangerous addictions might one day make it into the D.S.M., and a depressing reminder that a mental disorder will keep powerful addicts (unconsciously) doing everything they can to keep their mental disorders from being exposed.

http://www.nytimes.com/2012/06/06/opinion/the-dsm-gets-addiction-right.html