By Bonnie Phillips, Raju Hajela, and Donald Hilton Jr.

“The journey of addiction treatment is marked with significant societal, clinical, and scientific advances over the past few decades. Not too long ago, addiction was viewed as a moral failing and those suffering with addiction were treated harshly and with great prejudice and fear. One thing remains evident, significant change is difficult to come by, is met with resistance, and it takes the perseverance and vision of a collective force of individuals to bring about the change.

Addiction is one disease that has been maligned and misunderstood historically, as it presents in its myriad forms, yet clarity has emerged over the last 50 years to the recognition that it is a primary, chronic disease of brain reward, motivation, memory, and related circuitry, with manifestations along biological, psychological, social, and spiritual domains. The ongoing controversy over the acceptance of problem behaviors related to sex as part of addiction is very similar to the phenomenon which occurred with alcoholism and drug dependencies not that long ago however, when presented with the latest scientific advances the criticisms prove to be unfounded and outdated.

This article will address several of the main criticisms of sex addiction, including: sex addiction is not a recognized diagnosis and there is no unifying model or definition for sex addiction; sex addiction is based on moral and societal beliefs not on science and there is no scientific evidence for sex addiction; the sex addiction industry is a lucrative, money making industry; the

diagnosis of sex addiction takes away personal responsibility; and the real issue is not sex addiction but in fact other underlying issues and disorders. These criticisms will be addressed individually and collectively. In order to do so, we must first examine the history of addiction and the scientific developments which have underscored our understanding of the

brain mechanisms involved in addiction and the development of the disease model of addiction.

The view of addiction as a disease has been challenging for people, largely because the focus has been on the use of substances and related behaviors. [Over time], people recognized the common features of the disease of addiction and what was needed for recovery that eventually was verified by research. These discoveries have also impacted addiction treatment. These discoveries continue to expand as we are now able to see the impact of sex addiction on the brain. “For many years, experts believed that only alcohol and powerful drugs could cause addiction. Neuroimaging technologies and more recent research, however, have shown that certain pleasurable activities, such as gambling, shopping, and sex, can also co-opt the brain.” The brain experiences reward regardless of the source and addiction can be present when there is continued destructive behavior in spite of any adverse consequences (Hilton, 2014).

The scientific support for sex and other behaviors to be accepted as addiction goes well beyond one individual, model, or treatment program hoping to advance their agenda and gain professionally and economically. Accepting addiction does not limit or take away personal responsibility or offer excuse; rather, it allows each person to understand the biological, emotional, spiritual, and relational impact of addiction and take appropriate action. Thus, for drug addiction as well as for other addictions treatment approaches attend to the entire individual, combining the use of medications, behavioral therapies, and attention to necessary social services and rehabilitation. These might include such services as family therapy to enable the patient to return to successful family life, mental health services, education, and vocational training, and housing services” (Leschner, 2001). Acknowledging and being aware of the problem increases responsibility and personal action.

Addiction treatment has come a long way but has a long way yet to go. Decades of research and developments in the field of addiction medicine and neuroscience reveal the underlying brain mechanisms involved in addiction. Scientists have identified common pathways affected by addictive behavior as well as differences between the brains of addicted and nonaddicted individuals, revealing common elements of addiction, regardless of the substance or behavior. However, there remains a gap between the scientific advances and the understanding by the general public, public policy, and treatment advances. The realities of addiction in our country and in the world must be faced. One of these realities includes accepting natural or process aspects of addiction, such as sex, food, and gambling as integral to the disease processes just as chemicals, such as alcohol, tobacco and other drugs.”

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