Addiction represents a special type of compulsive behavior pattern, in which a person's choice to not engage in the compulsion is severely compromised. Those who suffer from addiction have difficulty experiencing themselves as having any choice at all.

Addictions are complex in their causes and in their course of development. We know that the pleasure center of the brain exerts a powerful reinforcing quality on addictive behavior. We also know that significant changes in the brain's structure and functioning can take place over the course of addiction. Genetic studies have identified a clear connection between family history and the predisposition to become addicted, and psychological and environmental factors play an important role as well.

My professional experience includes thirty years of working with substance abuse and addiction in outpatient, inpatient, and residential treatment facilities. I have also had the opportunity to work with non-substance addictions, including compulsive gambling, compulsive sexual behavior, and compulsive internet use. The mechanisms at work in these destructive patterns of behavior are very similar to those in substance dependence.

If the motivation for change is high, a therapeutic approach aimed at behavioral and environmental changes can often be very successful. If this option is unrealistic, then more intensive outpatient services, or inpatient treatment and rehabilitation, may be recommended. Frequently self-help groups such as AA or NA can aid in producing a positive outcome. Comprehensive assessment at the outset is crucial to providing the most effective level of treatment based on an individual's needs.