Intended for healthcare professionals

Feature War on Drugs

US surgeon general: doctors have central role in solving opioid epidemic

BMJ 2017; 356 doi: (Published 15 February 2017) Cite this as: BMJ 2017;356:j715

What is Addiction?

Addiction is a rebellion against the metabolic basis of life. Metabolism needs nutritious food to satisfy hunger and create health. But addiction replaces food with fun, hunger with euphoria, satisfaction with craving, and health with sickness. So addiction is a foodless 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, which makes us feel high but masks the craving and sickness of addiction. Ironically, addiction enlivens us with euphoria, while it deadens 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 seem 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.

Put poetically, 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

16 February 2017
Hugh Mann
New York, NY, USA