By Richard P. Holm, MD

Addiction can be defined as the compulsive repeated use of a drug or substance (such as alcohol) or performance of a behavior (such as gambling). Dependence is different, occurring when repeated use of a drug (such as heroine) results in physical dependence which causes an unpleasant feeling of withdrawal when the drug is stopped. Addiction and dependence can occur separately, although they often run together.

At five-years-old, I was a thumb-sucker. I recall not being proud of it as my folks seemed progressively upset about my “addiction.” The process that finally helped me quit was when I was told I would not visit my grandma in Minneapolis until I stopped sucking my thumb. I remember many struggled attempts at quitting before I finally shook the monkey off my back. Addiction is a human condition that can affect any one of us.

The people in this country are currently caught in a terrible maelstrom of opioid addiction from which human beings of all ages, races and economic status seem unable to escape. Twice as many people suffocated to death from opioids last year than died of vehicular crashes. According to the website DrugFree.org, in 2010, something like 23.5 million people in the U.S. (about one in every ten over the age of 12) were addicted to alcohol, drugs, or something. Of those addicted, only one in ten would ever get help.

One expert stated that the financial and emotional toll of addiction is greater than the combined consequences of diabetes mellitus and all cancers put together. Think of all the lung disease and cancer that results from smoking; the cirrhosis and liver failure as well as the dementia that results from alcohol; the dental problems from methamphetamine use; and all the social consequences of addiction including accidental vehicular crashes, suicides, homicides, criminal behavior and incarceration.

Despite all this doomsday talk, I think we have room for hope if we realize that none of us is immune and everyone should take precautions. We should start with an open-eyed and honest approach with our youth, teaching the truth about addiction without making addictive behaviors a “forbidden fruit.” Our country desperately needs affordable addiction and mental health treatment options, available to all, without the negative stigma (and often unhelpful incarceration) that can follow. Spending for prevention and treatment of addiction would save us all significantly more than it would cost.

We also need more research to better understand addiction and what influences addictive behavior, even that as seemingly benign as sucking one’s thumb.