When families call our drug rehab and alcohol treatment center for help, they often struggle with being uncertain whether or not their loved one has an addiction. Even professionals in the field sometimes confuse addiction with substance abuse, so it’s not surprising when families have trouble telling the difference. While there are a number of tests out there, we recommend a very simple test we call the “3 Cs of Addiction“.
Basically, the 3 Cs stand for 3 characteristics that must be present in order for a bad habit to be considered an addiction. An addiction can be to a substance such as drugs or alcohol, or to a process like gambling or sex.
Unfortunately, the word ‘addiction’ has become part of pop culture and is increasingly being used to describe anything that brings so much pleasure that one can’t help themselves. Chocolate and coffee are common examples, neither of which meet the criteria for a true addiction. This can be better understood with a review of the 3 Cs as follows:
C #1 – Compulsion
Compulsion is obsessive behaviour that individuals demonstrate when it comes to their bad habit. The key here is that compulsion happens before the individual indulges in their bad habit. Examples include:
- Excessively talking about your bad habit
- Daydreaming about your bad habit
- Spending most or all of your time with people that share your bad habit
- Scheduling your day around your bad habit
C #2 – Control
Control refers to what happens after you start consuming or participating in your bad habit. Once started, people who have no control are unable to:
- Set limits on the amount consumed
- Honour basic commitments such as oral hygiene, housekeeping, making dinner for your kids, or showing up for work
- Engage in risky behaviour that endangers the health or well-being of one’s self or others
C #3 – Consequences
A consequence is defined as the outcome of an action. In order for a bad habit to qualify for C #3, the consequence has to be negative and the bad habit must continue in spite of continued negative consequences. Examples include:
- Continuing with the bad habit even after your doctor warns you it is killing you
- Repeatedly getting into trouble with the police
- Falling into debt, but continuing to spend on your bad habit
- Refusing to quit your bad habit even after your spouse leaves you
The Most Important C: Consequence
It is important to note that having one 2 out of 3 of the characteristics would suggest that an individual is only abusing a substance or a process. Typically, the ‘C’ that separates most people with dependencies from those that only abuse is consequences. For most individuals, when the consequences of continued abuse get bad enough, they typically stop or cut back. This is not the case for people with addictions.
Applying Specific Bad Habits to the 3 Cs of Addiction Test
Let’s look at some specific bad habits to see if they are true addictions based on the criteria established by this test:
Coffee can be a morning ritual which could narrowly count as C #2 – compulsion. However, most people rarely drink more than a few cups a day (C #1 – control). As for consequences, coffee doesn’t fit the bill. You may get cranky if you have too much caffeine and it may even stain your teeth or give you bad breath but these consequences are not grave enough to meet the 3 C criteria.
Many children and teenagers are spending excessive time playing online video games. These games can range from single-player to massively multiplayer online role-playing games (MMORPG) where hundreds, even thousands, can be playing the same game online. Popular MMORPG titles include the World of Warcraft and Maple Story. Internet gaming also includes online gambling which is now a multi-billion dollar industry (see the Gambling section below).
Individuals who participate in online gaming certainly exhibit clear signs of an inability to control the amount of time they spend playing once they start. Online gamers also exhibit signs of compulsion as many kids will find other ways to play even when their parents restrict their use such as going over to a friend’s house to play or going to the local internet cafe. As for consequences, the biggest negative consequence is the amount of time lost to being on the computer. This is time that could arguably be spent involved in other more fulfilling activities. Whether wasting time, however, can be considered a negative consequence is debatable.
Patrick Carnes, a noted psychologist and author on sex addiction refers to sex addiction as “a compulsive behaviour that completely dominates an person’s life and can include: compulsive masturbation, compulsive heterosexual and homosexual relationships, pornography, prostitution, exhibitionism, voyeurism, indecent phone calls, child molesting, incest, rape and violence”. Patrick Carnes even describes sexual anorexia, similar to eating disorders, is a form of addiction where depriving oneself of sex can create feelings of power and invincibility from emotional pain.
However, many other sex experts, particularly sexologists, argue that compulsive sexual behaviour is not an addiction since sex is a perfectly natural activity, necessary for reproduction.
The Diagnostic and Statistical Manual of Psychiatric Disorders, Volume Four describes sex addiction, under the category “Sexual Disorders Not Otherwise Specified,” as “distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used.” According to the manual, sex addiction also involves “compulsive searching for multiple partners, compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships and compulsive sexuality in a relationship.”
Sexual compulsivity, however, definitely meets the criteria for the 3 C Addiction Test since marital breakup is often the result of those who choose to engage in prostitution, internet porn while incest, rape and voyeurism can and does lead to legal problems. Such behaviours must be repeated in spite of negative consequences in order to meet the 3 C criteria.
One of the better known addictions, gambling can certainly lead to compulsive behaviour as many gamblers have been known to spend hours away trying to figure out how to beat the house. As for control, many gamblers have been known to promise themselves they would limit their bets to $100 and end up losing their homes by the end of the evening. The consequences of gambling can range from personal bankruptcy to divorce. For a person with a gambling addiction, however, superstition and a distortion of the real odds of winning keep the compulsive gambler coming back for more.
So, remember, the next time you hear the word “addiction” being used in the media keep in mind that true addictions should meet the three criteria: compulsion, control, and consequences.