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Views & Reviews Personal View

Training in addiction medicine should be standardised and scaled up

BMJ 2015; 351 doi: (Published 28 July 2015) Cite this as: BMJ 2015;351:h4027

What is addiction?

Addiction is a worldwide mysterious plague that infests every level of society. It baffles and corrupts teachers, doctors, lawyers, police, and politicians. What is addiction, and why is it so powerful and pervasive?

Addiction is a rebellion against the metabolic basis of life. Metabolism requires nutritious food to satisfy hunger and create health. Addiction bypasses metabolism by replacing hunger with euphoria, satisfaction with craving, and health with sickness. So addiction is a flight from hunger to euphoria, with a stopover in craving, and a crash landing in sickness.

Euphoria is a false, fleeting sense of well-being. It covers up feelings of inadequacy and loneliness with euphoria, but blinds us to the craving and sickness of addiction. Ironically, addiction makes us feel more alive with euphoria, while it silently kills us with craving and sickness. So addiction is a bad bargain with imaginary gains and real losses.

The most popular addictions are sweets, chocolate, vanilla, cola, coffee, tea, alcohol, tobacco, and drugs. Although some of these are considered comforting, they all create insatiable cravings and sickness, with Jekyll & Hyde mood swings that reinforce other addictions. So addictions are seductive saboteurs that masquerade as familiar friends.

Addiction is bad business. Its euphoria, craving, and sickness underlie (undermine) our food, beverage, and healthcare industries. So addiction is a poison pill that makes us ill with sinister sequelae that go right to our belly, turn our mind to jelly, and make us silly willy-nilly.

Competing interests: No competing interests

13 August 2015
Hugh Mann
New York, USA