Addiction (medicine)

from Wikipedia, the free encyclopedia

Dependency (colloquially addiction ) describes the unavoidable desire for a certain state of experience. The powers of the mind are subordinated to this desire. It affects the free development of a personality and the social opportunities of an individual. The term "addiction" is used in numerous official and unofficial institutions.

Medical and psychological technical term

In the official language of the World Health Organization (WHO), the term addiction existed from 1957 to 1963. After that, it was initially replaced by abuse and addiction . Finally, after 1969, the concept of abuse was discarded in favor of four defined classes of use :

  1. Unauthorized use is a use that is not tolerated by society.
  2. Dangerous use is a use with likely harmful consequences for the consumer.
  3. Dysfunctional use occurs when psychological or social demands are impaired.
  4. Harmful use has already caused harmful consequences (cell damage, mental disorder).

These terms have found their way into the ICD-10, but the Diagnostic and Statistical Manual of Mental Disorders -IV (DSM-IV) still uses the term "abuse". Based on this WHO classification, abusive and dependent consumption patterns in the socio-legal sense are diseases with legal status.

The professional and scientific use of language in the fields of medicine , psychiatry , psychology and social work meanwhile prefers the formulations of the ICD-10 and speaks of addiction and especially of the addiction syndrome for substance-related addictions. Avoiding the term addiction should avoid stigmatizing the sick and make it clear that addictions are diseases. The limitation of the dependency syndrome to material dependencies also draws attention to differences to non-material dependencies; this term is thus more differentiated than addiction, which indiscriminately comprises material and non-material dependencies.

Replacing it with "addiction syndrome" has been controversial in the American Psychiatric Association. Against the use of the term addiction, the associated stigmatization of those affected was put forward who take drugs that affect the central nervous system and were therefore considered "addicted" according to the definition in force at the time. The term addiction was used by the American Psychiatric Association until 1987 in DSM-III for addiction syndrome.

The term addiction is still widespread in society and is still used very frequently by the media.

Forms of dependence

Different forms of addiction are described in the fields of psychology and psychiatry :

A definitional problem is the long-term therapy of chronic pain conditions with opiates. Here there could be a “dependency” similar to the administration of insulin in diabetes.

Addiction medicine

The Addiction Medicine is a department of psychiatry . It deals with the prevention , detection , treatment and rehabilitation of clinical pictures in connection with the harmful use of psychotropic substances and substance-independent dependence .

The main research areas of addiction medicine are


Since the landmark judgment of the Federal Social Court of June 18, 1968, alcohol dependence is the first time a dependency syndrome has been recognized as a disease in the sense of statutory health insurance . Since then, you and other payers have assumed the costs for the treatment of accompanying illnesses of the addicts as well as for rehabilitation, maintenance, improvement and restoration of the ability to work.

The first chair for addiction disorders in Germany was established in 1999 at the Central Institute for Mental Health in Mannheim.

Substance desire

Substance desire or craving ( engl. Desire, desire ) is a technical term from the Addiction Medicine. Craving or constant craving describes the continuous and almost invincible desire of an addict to consume his addictive substance ( alcohol , tobacco , other drugs ). Craving is at the heart of the addiction and withdrawal syndrome . It has its neurobiological basis in the sensitization of the reward system in the brain, the mesolimbic system .

The greed for fatty and sweet foods in the case of obesity is also referred to as “craving”.

Discussion about the terms addiction and dependence

Criticism of the term dependency includes the linguistic equation of medically cared for patients with primarily physical dependence (e.g. pain patients receiving morphine treatment) and also strongly psychologically dependent people, such as heroin addicts or alcoholics. This is misleading and obstructive: it causes pain patients to fear the full picture of physical and psychological dependence. In the course of drafting the current version of the “Diagnostic and Statistical Manual of Mental Disorders” (DSM) by the American Psychiatric Association, consideration was given to the reintroduction of the term addiction.

Addiction in colloquial language

In colloquial language, the observer describes what, in his opinion, is pathological, excessive or compulsive behavior or use of substances. "Addicted to fame", "Addicted to chocolate" or similar expressions are from definitions of addiction in the medical sense z. B. to be distinguished according to the criteria of the WHO.

Etymology addiction

The word “addiction” ( Germ. Suhti- , ahd. Suht , suft , mhd. Suht ) goes back to “ sick ” (ahd. Siuchan , mhd. Sick ), the suffering from an illness or dysfunction. In today's linguistic usage, the adjective “siech” (also compare English sick , ndl. Ziek ) is only used regionally.

As early as 1888, Meyers Konversationslexikon defined “addiction” as an outdated word in medicine that used to mean disease (Latin: disease ) or suffering, e.g. B. in consumption , dropsy , obesity , epilepsy , jaundice and anorexia . For example, a "water addict" was not addicted to water, but suffered from water retention ( edema ).

These historical disease names usually only described the most striking symptom. The consumptive "fades away", water collects in the water addict, the obese is too fat, the jaundice turns yellow, the alcoholic drinks too much, the anorexic is emaciated. Through uses such as rage and lunar addiction, addiction was also understood as a morbid desire. This gave rise to the modern term addiction in the sense of dependence in the 20th century. Initially he referred to C. v. Brühl-Cramer 1819, only on drunkenness ( alcoholism ). Other addictions were later referred to as addictions. Since 1829, Christoph Wilhelm Hufeland 's "opium addiction" - in the 18th century still called " servitus " - has been documented.

The Middle High German collective Gesucht or Gesühte (also wanted ) referred to epileptic recurring ailments such as epilepsy or epilepsy, gout or arthritis, etc.


Web links

See also

Portal: Drugs  - Overview of Wikipedia content on drugs
Portal: Psychology  - Overview of Wikipedia content on the subject of psychology
Portal: Mind and Brain  - Overview of Wikipedia content on Mind and Brain

Individual evidence

  1. a b Addiction . In: Lexicon online for psychology and education
  2. For example, the “Addiction Research Project” of the Federal Ministry of Education ( Memento from January 31, 2009 in the Internet Archive ), the German Society for Addiction Medicine and the German Society for Addiction Psychology
  3. Goldfinch u. a. (Ed.): Compendium. Psychiatry, psychotherapy, psychosomatic medicine. Karger, Basel 2002.
  4. Ruthard Stachowske: Parents with addictive disorders. (PDF) (No longer available online.) Jugendhilfe Lüneburg gGmbH / Ulm University Hospital, archived from the original on April 27, 2014 ; accessed on May 16, 2019 (1.42 MB).
  5. a b Robin L. Fainsinger, Vincent Thai, Gary Frank, Jean Fergusson: What's in a Word? Addiction Versus Dependence in DSM-V . ( Memento from February 5, 2012 in the Internet Archive )
  6. File number 3 RK 63/66
  7. M. Haney: Self-administration of cocaine, cannabis and heroin in the human laboratory: benefits and pitfalls . In: Addiction Biology . tape 14 , no. 1 , January 2009, p. 9–21 , doi : 10.1111 / j.1369-1600.2008.00121.x , PMID 18855806 , PMC 2743289 (free full text).
  8. JD Steketee, PW Kalivas: Drug wanting: behavioral sensitization and relapse to drug-seeking behavior. In: Pharmacological reviews. Volume 63, number 2, June 2011, pp. 348-365, doi: 10.1124 / pr.109.001933 , PMID 21490129 , PMC 3082449 (free full text) (review).
  9. KJ Steffen, SG Engel, JA Wonderlich, GA Pollert, C. Sondag: Alcohol and Other Addictive Disorders Following Bariatric Surgery: Prevalence, Risk Factors and Possible Etiologies. In: European eating disorders review: the journal of the Eating Disorders Association. Volume 23, Number 6, November 2015, pp. 442–450, doi: 10.1002 / erv.2399 , PMID 26449524 (Review), (PDF)
  10. NM Avena, P. Rada, BG Hoebel: Evidence for sugar addiction: behavioral and neurochemical effects of intermittent, excessive sugar intake. In: Neuroscience and biobehavioral reviews. Volume 32, number 1, 2008, pp. 20-39, doi: 10.1016 / j.neubiorev.2007.04.019 , PMID 17617461 , PMC 2235907 (free full text) (review).
  11. ^ C. O'Brien, N. Volkow , T. Li: What's in a word? addiction versus dependence in DSM-V. In: American Journal of Psychiatry. 2006; 163, pp. 764–765 full text ( Memento from August 31, 2009 in the Internet Archive ) with numerous references to official bodies that use the term addiction .
  12. Addiction . In: Duden, definition of terms.
  13. Duden, Etymologie: Dictionary of Origin of the German Language.
  14. Claudia Wiesemann: Addiction. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , pp. 1365 f .; here: p. 1365.
  15. Andreas-Holger Maehle: self-tests and subjective experience in opium research of the 18th century. In: Würzburger medical history reports , Volume 13, 1995, pp. 287-297, here: p. 292.
  16. ^ Max Höfler: German book of names of diseases. Piloty & Loehle, Munich 1899 (Reprographic reprint: Olms, Hildesheim / New York 1970 and 1979, ISBN 1-174-35859-9 ), p. 706.
  17. See also Jürgen Martin: Die 'Ulmer Wundarznei'. Introduction - Text - Glossary on a monument to German specialist prose from the 15th century. Königshausen & Neumann, Würzburg 1991 (= Würzburg medical-historical research. Volume 52), ISBN 3-88479-801-4 (also medical dissertation Würzburg 1990), p. 132.