THE MOST IMPORTANT UNRESOLVED ISSUE IN THE ADDICTIONS - CONCEPTUAL CHAOS

This article suggests that the field of addiction study and treatment remains in a state of conceptual chaos. The addictions is an emerging scientific field that lacks conceptual clarity. To develop the precisi on necessary for scientific advance, we must begin by developing impro ved definitions of substance use, abuse, dependence, and addiction. Co mplicating matters, psychoactive substance use is not a necessary and sufficient cause of addiction. For example, pathological gamblers expe rience addiction, including tolerance and withdrawal, often in the abs ence of any drug use. The neurobiology of subjective experience may be a more important factor in helping to explain addictive behaviors. Co nsequently, this article concludes that it is improper to consider dru gs as the necessary precondition for addiction. Better operational def initions will advance addictions research.