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Comment by johnkpaul | Hacker News Reader

I've often wondered if the word "addiction" is formally defined enough to have discussions like this from some common ground.

Does anyone know? There seem to be many different definitions depending on where I google.

Reading this article, I find it hard not to focus solely on my own belief that all carbohydrates, and sucrose/fructose/glucose in particular are extremely addictive. This article even compares, using dopamine, smoking with "temptation for food." I'm fairly sure that anytime someone is "tempted for food", that there are carbohydrates involved, but obviously it's hard to know without that original formal definition.

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The best formal description I've seen of addiction (from a therapy perspective) is: behavior that negatively impacts your life in a way that you can't control. Addiction is thus very specific to individuals, not to substances.

If it's a behavior that one can control (as in stop doing it) then it's a legitimate choice and not addiction. If someone walking by a plate of cookies can't avoid eating too many then it is clearly addiction for that person.

Refined sugars are highly addictive for a lot of people, even to the point of feeling withdrawals.

It's also possible to consume refined sugars in moderation for other people.

Ah ok, so from that perspective there _could_ be someone for which heroin is not addictive. That makes sense, although I don't think that this is the definition that most people use.

Heroin is likely not addictive for most people. The chance of prescription opioid addiction is about 25%, and I wouldn't expect heroin to be noticably more addictive as a chemical substance. https://www.cdc.gov/drugoverdose/opioids/prescribed.html

https://www.jrf.org.uk/sites/default/files/jrf/migrated/file... is a very small survey of heroin users, some of whom report controlled or occasional use.

https://www.drugabuse.gov/publications/research-reports/hero... shows that with 90K-170K new users per year from 2006 to 2016 resulted in 600K total dependent users in 2016 in the U.S., so not all first-time users become dependent and presumably the 2016 count includes people who tried heroin for the first time before 2006.

https://www.cdc.gov/drugoverdose/data/heroin.html confirms that the difference in new users and final dependent users wasn't all due to deaths, either.

There's still a possibility that only rehab keeps people from becoming dependent but the numbers are harder to find for that.

Anecdotally, I've known a few people who claimed to use cocaine and even heroin occasionally, and I don't have any reason to think they were addicts in the sense that they were compelled to use it. Indeed, at least for snorted cocaine, the most common reaction I've heard from first time users is basically "what's the big deal?" - aka the effects just weren't as intense as expected based on the reputation.

Meanwhile, I've only met one person who has been able to use cigarettes occasionally (a few times a year). Everyone else has been at at least a daily smoker, and while I know quite a few people who have successfully quit, it's almost always been a rough experience with multiple attempts required before succeeding.

If cocaine and heroin were legal and cheap, I'd probably be more concerned if a friend took up smoking than either of them. Conversely, if cigarettes were illegal, I'd be really concerned if a friend took up smoking.

> Meanwhile, I've only met one person who has been able to use cigarettes occasionally

Well, there is also selection bias: you assume people like this just don’t smoke. I enjoy smoking, but I don’t smoke, and there was no problem for me to stop. There was some research that some percentage of population genetically is not pre-disposed for smoking addiction.

I agree. Otherwise, we would have to accept that a lot of people are addicted to coffee.

The closest I know of for a formal definition of "addiction" is the "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition's" criteria for substance use disorders. It lists 11 criteria. The more that match, the more severe the disorder. https://pastebin.com/HA9BipGn

:-) wow this is awesome. I'm assuming this is a pastebin because the actual list is secret information?

No, it's just a book that costs money. Search "DSM 5" on Amazon.

DSM V also introduces "Gambling disorder" under the same category (Substance-Related and Addictive Disorders). The diagnostic criteria are:

* Preoccupation – Thinking a lot about gambling

* Increased Tolerance – Needs to gamble more than before

* Tried to stop – Cannot stop gambling

* Withdrawal – Irritable when not gambling

* Escape – Gambles to get away from it all

* Chasing – Often returns to try and win back losses

* Lying – Dishonest about amount & frequency gambling

* Loss of Control – Continues gambling despite consequences

* Receiving Bailouts – Borrows money to gamble or pay debt

Matching four or more indicate the subject has a gambling disorder. 4-5 indicates low severity, 6-7 moderate, 8-9 severe.

I scored 9. I've been in recovery (with GA) since 1998.

EDIT: formatting.

A lot of /specific/ food cravings aren't actually carbohydrate-related but tend to be (more often) mineral or (less often) vitamin cravings. That said, women's cycles /do/ result in cravings for macronutrients, but those are definitely not something brought about by big sugar but rather an evolutionary byproduct.

Interesting! Obviously I don't have research for this in either direction. I know a lot of people that take daily multivitamins that would still consider themselves to have "cravings".

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