Now controversially spans all sorts of behaviours

---

42
 | New Scientist | 14 September 2019
Is it really
addiction?
A diagnosis that used to be for substance abuse 
now controversially spans all sorts of behaviours.
Moya Sarner
digs into the science
I
AN used to play online video games 
through the night and into the next day. 
Over eight years, he lost his job, his home 
and his family. “I would have told you I loved 
my children more than anything – and I do 
love my children very dearly – but the truth 
is I loved the feeling of going online more,” 
he says. “It made me feel settled, it was a way 
to cope and it was a physical craving.” 
For Ian and others like him, video games feel 
as addictive as a drug. In May, the World Health 
Organization (WHO) reached a similar 
conclusion, including gaming disorder in its 
International Classification of Diseases for the 
first time. Studies suggest that between 0.3 and 
1 per cent of the general population might 
qualify for a diagnosis. In the UK, plans are 
under way to open the first National Health 
Service-funded internet addiction centre, 
which will initially focus on gaming disorder. 
But some argue that to pathologise 
problematic gaming as an addiction is a 
mistake. In 2017, a group of 24 academics 
argued against attributing this behaviour to 
a new disorder. “Of particular concern are 
moral panics around the harms of video 
gaming,” they wrote, which have been 
seen in the fears around games like
 Fortnite
. 
Such hysteria, the group argued, could lead 
to premature or incorrect diagnoses. 
Others simply claim that addiction to 
gaming, and to other behaviours such as 
sex, isn’t real, and that suggesting it is 
M
A
RC
O
PIUNT
I/
G
ET
T
Y
Features
trivialises the issue of addiction or lets people 
off the hook for their actions.
It isn’t surprising that this is a complex 
issue when you consider that even 
professionals can’t agree on a definition 
of addiction. “If you speak to 50 psychologists, 
we’ll all give you a completely different 
answer,” says Mark Griffiths, director of 
the International Gaming Research Unit 
at Nottingham Trent University, UK. 
One way to carve up addictions is whether 
they relate to substances or behaviours. Take 
cigarettes. Louise was smoking 60 a day when 
she was 15 years old and she has repeatedly 
tried to stop. “I absolutely hate the taste and 
smell of cigarettes, but I still smoke,” she says. 
For many people, nicotine takes such a strong 
hold over the brain that you don’t even need 
to enjoy smoking to keep doing it.
This kind of substance addiction originally 
formed the basis of addiction research, which 
is relatively new. “There was no neuroscience 
of addiction 50 years ago,” says Barry Everitt, 
a behavioural neuroscientist at the University 
of Cambridge. Then in the 1960s and 70s, 
pioneering studies identified the primary 
targets of addictive drugs within the brain: 
the dopamine system, also known as the 
reward pathways. The greater the surge of 
the neurotransmitter dopamine triggered 
by the substance, the more euphoric the high.
This discovery spurred a number of possible 
explanations of addiction. Some researchers