Intended for healthcare professionals

Feature Substance misuse

More than a quick fix

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39434.460694.AD (Published 10 January 2008) Cite this as: BMJ 2008;336:68

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 metabolism, especially hunger. Metabolism
requires food to satisfy hunger and create health. But addiction short-circuits
metabolism by replacing food with addictive substances, 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 heightened sense of well-being. Euphoria enables us to
control our mood and avoid feelings of inadequacy and loneliness. But
euphoria disables our judgment and blinds us to the craving and sickness of
addiction. Ironically, addiction makes us feel more alive with euphoria, while
it insidiously kills us with craving and sickness. So addiction is a bad bargain,
with imaginary gains and real losses.


The most popular addictive substances are sweets, chocolate, cola, coffee,
tea, alcohol, tobacco, and drugs. Although some of these substances are
considered harmless fun, they all create insatiable cravings that reinforce
other addictions. For example, sweets, chocolate, cola, coffee, and tea
reinforce alcohol, tobacco, and drug addiction. So addictive substances are
seductive saboteurs that masquerade as familiar friends.


Addiction is big business. The craving of addiction supports the "food"
industry. "Food" companies that sell addictive substances spend millions of
dollars to advertise the imaginary gains and hide the real losses connected to
their products. The sickness of addiction supports the health-care industry.
If alcohol, tobacco, and junk food were eliminated, many hospitals, insurance
companies, and doctors would not have enough patients to stay in business.
So our economy depends on addiction, euphoria, craving, and sickness.

Competing interests:
None declared

Competing interests: No competing interests

13 January 2008
Hugh Mann
Physician
Eagle Rock, MO 65641 USA