Understanding and Defining Addiction in an Honors Context

INTRODUCTION Exploration and development of identity, autonomy, sexuality, academic functioning, and peer relationships are important age-appropriate tasks of adolescence and emerging adulthood (Baer & Peterson; Cicchetti & Rogosch; Erikson). During college, this developmental stage may manifest as questioning prior beliefs and assumptions and exploring fresh philosophies and behaviors (Schulenberg & Maggs). Many emerging adults try out what they believe are different facets of adult life. Some of the requisite experimentation may include risk-taking behavior, including experimentation with alcohol, cigarettes, and marijuana (Baer & Peterson; Shedler & Block; Winters). College provides opportunities to experiment with potentially addictive substances at peer-run social events that often include alcohol and other substances (Schulenberg & Maggs). The combination of a mindset poised for exploration and a developmental period with enhanced opportunity for experimental behavior makes college a unique time to explore the high-risk behaviors that are prevalent within emerging adult communities. While large courses may usher university students through the research about what constitutes addictions, honors programs offer an invaluable resource for exploring more fully these value-laden, high-risk, and timely questions. In small, discussion-based honors classes, emerging adults are able to actively explore their questions, thoughts, and previous conceptions about addiction in a manner that would not be possible in larger classes. The students emerge from my 300-level honors class--titled "Yeah, I Like It, but I'm Not Addicted": Exploring the Meanings and Consequences of Addiction--with a more thorough understanding of addiction as well as analytical skills that will help them navigate both academic and personal contexts in college. PROGRAM RATIONALE SELECTION OF THE COURSE TOPIC As a clinical psychologist trained in addiction and pediatric health, I continue to be drawn to the parallels between substance use and other types of health-risk behaviors. In conducting clinical interventions for people struggling with such behaviors as severe overeating or pathological undereating, I continue to notice that the relevant empirically supported treatments (ESTs) for these discrepant behaviors are almost identical. For example, across substance use, obesity, and eating disorder interventions, the ESTs include an identification of the function of the disordered behavior (e.g., "What are the things that you like about drinking? ," "How does drinking benefit you? "), a plan for replacing the disordered behavior with a more benign behavior that serves the same function (e.g., going to a non-drinking social event instead of a bar), and a plan for handling cravings and avoiding urges to engage in the disordered behavior (e.g., "What can you do instead of drinking when you feel you really need a drink? ") Over time I have found that these clinical parallels highlight a common pattern of behavior that is quite similar across substance use, binge eating/overeating, and eating disorders, all of which I see as addictions. The neuroscience literature has recently come to the same conclusion, suggesting that there are common neural pathways across these three types of addictive behaviors (e.g., Volkow & Wise). The question of what other behaviors might belong in this paradigm continues to intrigue me. In particular, I have been drawn to the work of Jon Krakauer, who explores the stories of people engaged in a variety of excessive and somewhat fanatical behavior, including a death-defying journey to climb Mount Everest (1999), an excessively focused and extremely intense nomadic journey to an untimely death in Alaska (1997), and the violent behavior of a small segment of a zealous religious group (2004). A key question is how these different behaviors might fit a collaboratively generated definition of addiction. …