Addiction chronicity: are all addictions the same?

Abstract

Background

All addictions have a recurring nature, but their comparative chronicity has never been directly investigated. The purpose of this study is to undertake this investigation.

Method

A secondary analysis was conducted on two large scale 5-year Canadian adult cohort studies. A subset of 1,088 individuals were assessed as having either substance use disorder, gambling disorder, excessive behaviors (e.g. shopping, sex/pornography), or two or more of these designations (‘multiple addictions’) during the course of these studies. Within each dataset comparisons were made between these four groups concerning the number of waves they had their condition; likelihood of having their condition in two or more consecutive waves; and likelihood of relapse following remission.

Results

Multiple addictions had significantly greater chronicity on all measures compared to single addictions. People with an excessive behavior designation had significantly lower chronicity compared to people with gambling disorder and a tendency toward lower chronicity compared to substance use disorder. Gambling disorder had equivalent chronicity to substance use disorder in one dataset but greater chronicity in the other. However, this latter difference is likely an artifact of the different time frames utilized.

Conclusions

Having multiple addictions represents a more pervasive condition that is persistent for most individuals. Substance use disorder and gambling disorder have intermediate and roughly equivalent levels of chronicity, but considerable individual variability, transient for some, but more chronic for others. In contrast, excessive behaviors such as compulsive shopping are transient for most, and their comparatively lower levels of chronicity questions their designations as ‘addictions’.

Keywords:

• Addiction
• chronicity
• longitudinal
• cohort
• gambling
• substance

Ethical approval

As this was a secondary analysis of publicly available data, informed consent and ethical approval was not sought.

Disclosure statement

No potential conflict of interest was reported by the author(s).