"Night and day. Day and night."

"The needle tears a hole.
  The old familiar sting.
  Try to kill it all away
  but I remember everything"
                       Trent Reznor- "Hurt"

      Most of us will never truly comprehend serious, life altering addictions. We may think we know the moment by moment struggle of an addict because we admit  to current or former battles with caffeinated  beverages, food or cigarettes. What is compulsion versus addiction? Why do some people turn into addicts and others don't?
     Addiction can be used to describe a physical or biological compulsion. There is an over reaction of the brain to specific stimuli. Overtime, addicts build up a tolerance for the substance which causes them to need more and more of a stimulant in order to create a high. Surprisingly, most addictive behavior isn't related to either physical tolerance or exposure to such cues. Human beings compulsively surf porn sites, gamble, shop or use drugs in reaction to being emotionally stressed. We do this whether or not we have a physical addiction. There is a compulsion to act out. Since these psychologically based addictions are not formed from drug or brain effects, they can account for why people frequently switch addictive actions from one drug to a completely different kind of drug, or even to a non-drug behavior. This type of behavior is disturbingly shocking for many but described perfectly in the short documentary clip above from  "A Deadly Dance"(2013), a film about modern day heroin addiction in the Northeastern US.
      The focus of the addiction isn't what matters but the need to take action under certain kinds of stress. For example, most people who smoke, smoke more cigarettes when they are nervous or stressed out. Smokers may begin to chain smoke under duress. When a smoker decides to quit, the stress of life doesn't magically disappear. After a smoker conquers their physical nicotine addiction they may turn to food and begin to eat compulsively. Stress is the psychological trigger. Treating this type of addiction requires an understanding of how addictions psychologically work. We become mindful of our triggers and habits.
     We need to move away from feeling that addictions are purely pleasure seeking
 and  hedonistic, are due to lack of moral fiber or strength of character and move more towards understanding how to truly help people who are clearly suffering. Shaming and guilt do nothing to help those with compulsive or addictive personalities. If we truly wish to help people with addictions we must allow them to express themselves freely. We need to observe what is going on inside and out. We need to understand why they act and feel the way they do. At this point there are still arguments for and against nature versus nurture. Experts continue to debate whether drug dependence and addiction mean the same thing. Effective treatment and compassion is key. Compassion is always key.