Video games are addictive, officially

Addiction and Recovery

By Bob Gaydos

Some young males may be addicted to video games.

What many parents the world over have been proclaiming for quite some time is now official: Some individuals -- mostly young males --- are literally, not just figuratively and annoyingly, addicted to playing video games. That is the determination of the World Health Organization, which after considerable study and debate, recently added gaming disorder to its International Classification of Diseases, a primary source of information for doctors worldwide.

The United Nations agency did not put a time frame (how many hours a day) on what would be considered addictive gaming, but rather, put video gaming in the same category as gambling addiction -- a behavior that becomes “a priority” and which the individual is unable to stop despite numerous negative life consequences. These include loss of a job, loss of friends, broken relationships, poor health, bad grades and other assorted issues that might arise for someone who played, say, Fortnite, the current video game rage, for 14 to 16 hours a day while neglecting work, school, food, sleep, family, friends, showers … real life.  

While this classification might seem overdue to some, it is not without controversy. For one thing, the W.H.O. zeroed in on video gaming, both online and offline, but did not include use of the internet and smartphones, which certainly are vehicles for obsessive behavior. For another, the American Psychiatric Association did not include gaming in the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders, choosing to call it a "condition for further study."

Some critics of the WHO classification suggest that gaming was targeted because of heavy lobbying by some countries, such as China and South Korea, which have large populations of video gamers and are desperately looking for help in treating them. But some mental health professionals say official WHO designation could improve public education, research, insurance coverage and development of treatment programs, which at the moment are scarce and expensive. They say including the gaming industry -- with its legion of experts on creating reward-and-reinforcement scenarios -- in the conversation can only help.

Not surprisingly, most creators of video games (who have an economic motivation to be considered) and their legion of players responded negatively to the classification, arguing with the methodology of some studies and saying the results have been far from conclusive. They also say studies on gaming are relatively new and note that some studies have shown benefits to playing video games, including improved thought processes (lots of strategy to figure out), greater motivation (lots of levels to reach and competition to be won), and improved memory and hand-eye coordination (essential for good gaming). In these regards, they say, gaming is akin to young people playing sports or joining clubs.

Finally, there is also disagreement among mental health professionals about whether the gaming is the cause or the effect of such common co-occurring disorders among obsessive gamers as anxiety and depression.

Still, whether it is an official mental health disorder or one deserving further study, no one argues that playing video games to the point that the player suffers negative consequences in other areas of life is good for one’s health. So, while the APA has not classified gaming as a disorder, it has come up with nine criteria for identifying it, should it make that official decision. They are similar to those used to identify other officially classified addictions:

1. Pre-occupation. Do you spend a lot of time thinking about games even when you are not playing, or planning when you can play next?
2. Withdrawal. Do you feel restless, irritable, moody, angry, anxious or sad when attempting to cut down or stop gaming, or when you are unable to play?
3. Tolerance. Do you feel the need to play for increasing amounts of time, play more exciting games, or use more powerful equipment to get the same amount of excitement you used to get?
4. Reduce/stop. Do you feel that you should play less, but are unable to cut back on the amount of time you spend playing games?
5. Give up other activities. Do you lose interest in or reduce participation in other recreational activities due to gaming?
6. Continue despite problems. Do you continue to play games even though you are aware of negative consequences, such as not getting enough sleep, being late to school/work, spending too much money, having arguments with others, or neglecting important duties?
7. Deceive/cover up. Do you lie to family, friends or others about how much you game, or try to keep your family or friends from knowing how much you game?
8. Escape adverse moods. Do you game to escape from or forget about personal problems, or to relieve uncomfortable feelings such as guilt, anxiety, helplessness or depression?
9. Risk/lose relationships/opportunities. Do you risk or lose significant relationships, or job, educational or career opportunities because of gaming?

Obviously, the more “yes” answers there are, the more likely the individual has a problem with video gaming, whether it’s labeled an official addiction or not. Denying it out of shame or guilt or fear won’t help. In fact, the WHO classification is intended to eliminate those obstacles and provide an avenue to help. If the video gamer has trouble stopping or cutting back, consider consulting a professional addiction counselor.

There is also help available online from those who understand the problem because they’ve been there:

-- On-line Gamers Anonymous, a 12-step, support and recovery organization “for gamers and their loved ones who are suffering from the adverse effects of excessive computer gaming”: olganon.org

-- Computer Gaming Addicts Anonymous (CGAA), “a recovery fellowship, based on the model of Alcoholics Anonymous”: cgaa.info.

Whatever you do, be honest. If you or a loved one are talking about it, if it is a cause for concern, if it has caused problems, then it’s a problem, official addiction or not. Don’t wait for the debate to be resolved.

It’s all in the game

• About 2.6 billion people play video games worldwide.
• Two-thirds of American households include video game players.
• The great majority of those who play video games do not display addictive behavior.
• Young males log more hours weekly on video games than do young females.
• The Entertainment Software Association says annual worldwide revenue for the industry should reach $180 billion by 2021.
• Fortnite: Battle Royale, the current hot video game in which 100 players battle to be the last one standing on the island, recently earned a reported $300 million in one month. It has a reported 40 million-plus players, some of whom are obsessive. The game is free to play, but players can buy add-ons (weapons, tools, resources, etc.) to enhance their chances of victory.

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Know the warning signs of problem drinking

Addiction and Recovery

By Bob Gaydos

More than three drinks a day or seven per week
 is considered risky drinking for women.

There are “heavy-hitters,” “weekend warriors,” and petite women with ”wooden legs” who can drink burly construction workers under the table. There are also “social drinkers,” who simply enjoy a bottle of good wine with dinner and others who appreciate a few beers after a softball game.

Problem drinkers? Maybe, maybe not. More to the point, maybe a few at risk of becoming problem drinkers. April being Alcohol Awareness Month, it’s a good time to review personal drinking habits, if just to see if there are any warning flags of a potential future problem that can be avoided. It’s worth the time.

According to the National Institute of Alcohol Abuse and Alcoholism, about 88,000 people die from alcohol-related causes each year, making it the third leading preventable cause of death in the United States. Alcohol use disorder (AUD) affects 15-18 million adults. It’s a major health issue, but drinking is so ingrained in our society that many people are reluctant to look at their own drinking patterns. This common resistance to self-reflection, along with a lack of information on the risks of abusing alcohol, can be harmful to your health.

For example, having a high tolerance for alcohol, often worn as a badge of pride, is a reason to be wary. People with a high tolerance are likely to drink more and hang out with people who drink more and more often. They are at higher risk for AUD (alcoholism) and serious health problems affecting the liver, heart or brain caused by alcohol abuse. This is not to mention the obvious risks of drinking and driving and other physical harm as the result of impaired judgment.

Just one more example, for those who feel they drink “in moderation.” The NIAAA, which does research on these things, says, for men, more than four drinks on any day or more than 14 per week and for women, more than three drinks on any day or seven per week is “heavy” or “at risk” drinking. A standard drink is defined as one containing .6 fluid ounces of “pure” alcohol, regardless of the liquid -- a 12-ounce can of beer or a 1/1/2 ounce shot of some 80-proof liquor are the same.

The agency offers a list of questions to help determine if you have an alcohol abuse problem or are at risk of one:

In the past year, have you:

• Had times when you ended up drinking more, or longer, than you intended?
• More than once wanted to cut down or stop drinking, or tried to, but couldn't?
• More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
• Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
• Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
• Spent a lot of time drinking? Or being sick or getting over other after-effects?
• Continued to drink even though it was causing trouble with your family or friends?
• Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
• Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
• More than once gotten arrested, been held at a police station, or had other legal problems because of your drinking?
• Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?

Says the NIAAA: “Depending on the symptoms and their severity, just one or two can be a red flag. The more symptoms you have, the more urgent the need for change. The symptoms toward the top of the list tend to be early signs of potential trouble, whereas the ones further down the list indicate that you have moved further down a risky path.”

If you take the test on the NIAAA website (https://www.rethinkingdrinking.niaaa.nih.gov), it will provide individual feedback. The site is anonymous.

The gauge for determining alcohol abuse is actually simple: Alcohol is a problem when it causes problems in your life -- at home, at work, with your health.

Regardless of the results of the test, there are several factors that suggest quitting drinking might be advised:

• You’ve tried to cut down, but can’t.
• You have had some symptoms previously.
• Alcohol affects a physical or mental condition or it interacts with medication.
• You are pregnant.
• You have a family history of alcohol problems or a personal history of alcohol-related injuries.

The NIAAA website offers suggestions for cutting down on drinking if you think it could become a problem. If it already is, seek professional help. It won’t get any better by avoiding it.

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Test your knowledge on addiction

Addiction and recovery

By Bob Gaydos

The more things change, the more some other things seem to stay the same. This is particularly true in the field of addiction and substance abuse. With (a) an opioid epidemic sweeping the nation, (b) a growing nationwide movement to legalize the use of marijuana for medicinal and even recreational use, and (c) a growing consensus that the “war on drugs” has failed, a new administration in Washington seems determined to stick to the old, law-and-order approach to addiction.

This suggests that, while we may be in the midst of an unprecedented technological revolution, some of us may still be operating with outdated information. That’s why, from time to time, I devote a column to facts about alcohol and drug addiction. After all, if we’re going to treat it as a war, or as a crusade against a major health issue, we should know what we’re up against.

And, since Americans love quizzes, I’ve put one together to test your addiction IQ. It’s updated from one I offered a few years ago. Quizzes may be fun, but obviously this is a serious issue. The questions and answers are based on reports and other published materials of the National Center on Addiction and Substance Abuse.

What’s your addiction IQ?

1. a) 10 million; b) 20 million); c) 40 million; d) 60 million Americans 12 or older have substance abuse problems.
2. a) 15%; b) 25%; c) 50%; d) 75% of all high school students have used addictive substances, including cigarettes, alcohol, marijuana or cocaine.
3. More than a) 50%; b) 60%; c) 75%; d) 90% of people with a substance problem began smoking, drinking or using other drugs before age 18.
4. a) 26%; b) 36%; c) 46%; d) 56% of children under age 18 live in a household where someone age 18 or older is smoking, drinking excessively, misusing prescription drugs or using illegal drugs.
5. Seven in 10 people with the chronic diseases of high blood pressure, major depression and diabetes receive treatment. How many people who need treatment for substance problems receive any form of care? a) 1 in 10; b) 2 in 10; c) 3 in 10; d) 5 in 10.
6. The National Institute on Alcohol Abuse and Alcoholism defines risky drinking for women as: a) 3; b) 7; c) 10; d) 12 drinks in a week.
7. The NIAAA defines risky drinking for men as more than: a) 12; b) 14; c) 16; d) 20 drinks in a week.
8. Among people with a prescription drug use problem, nearly: a) 25%; b) 30%; c) 50%; d) 75% have another substance problem.

    9. Of every dollar state and federal governments spend on substance problems: a) 2 cents; b) 5 cents; c) 10 cents; d) 25 cents goes to prevention and treatment.

True or false

   10. Having a high tolerance (feeling less effect from the substance with continued use) is a sign that the person is not addictive.

   11. Because they use substances at lower levels than men, women typically progress from substance use to addiction more slowly than men and experience the health consequences of substance use, such as death, cancer, heart disease and memory problems, less intensely than men.

   12. Addiction, substance use and abuse are the largest preventable and most costly health problems facing the U.S. today, responsible for more than 20 percent of deaths in the U.S.

   13. Addiction, substance use and abuse cause or contribute to more than 70 other conditions requiring medical care, including cancer, respiratory disease, cardiovascular disease, HIV/AIDS, pregnancy complications, cirrhosis, ulcers and trauma, and account for one-third of all hospital in-patient costs.

   14. Total costs to federal, state and local governments of addiction, substance use and abuse are at least $468 billion per year – almost $1,500 for every person in America.

    15. Addiction can’t be a disease because it is caused by the individual’s choice to use drugs or alcohol.

Answers: 1(c); 2(d); 3(d); 4(c); 5(a); 6(b); 7(b); 8(d); 9(a).

10: False. High tolerance is a warning sign of a possible substance problem.

11: False. Women generally progress more quickly than men in addiction and suffer more intensely.

12, 13 and 14: True. Just putting out some perspective on the scope of the problem.

15: False, according to National Center on Addiction and Substance Abuse: “While the first use (or early stage use) may be by choice, once the brain has been changed by addiction, most experts believe that the person loses control of his or her behavior. Choice does not determine whether something is a disease. Heart disease, diabetes and some forms of cancer involve personal choices, such as diet, exercise, sun exposure, etc. A disease is what happens in the body as a result of those choices.”

Keep score yourself. The only way to fail is to ignore the issue altogether.

* * *

More info:

www.centeronaddiction.org.

www.niaaa.nih.gov.

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