ADDICTION is a pattern of compulsive use of alcohol and other drugs, described in DSM IV as A Substance Use Disorder.
In this blog I am going to use the term PSYCHOPATHY interchangeably with the terms ANTISOCIAL PERSONALITY DISORDER (ASPD) and SOCIOPATHY. These three terms describe essentially the same personality disorder marked by the following symptoms:
– a lack of empathy,
– a compulsive pattern of challenging authority, breaking rules, and victimizing others;
– the refusal to accept responsibility for the consequences personal behavior;
– the tendency to lie, cheat, steal, and manipulate others with little concern for the consequences; and
– the tendency to avoid responsibility by blame the victim or the enforcer when caught by the consequences of their own behavior.
A PERSONALITY DISORDER is an habitual pattern of believing, perceiving, thinking, feeling, acting, and relating to others that begins in early childhood, persists into adulthood, affects many areas of life and causes problems in social and occupation functioning.
Addictive disorders, described in the DSM as Substance Use Disorders, are not personality disorders. Addiction is a condition marked by:
– the obsession with and compulsion to use alcohol and other mind-altering substances;
– a compulsive pattern of use resulting in a loss of control over the ability to self-regulate the quantity, frequency, and duration of substance use; and
– secondary life and health problems caused by the progressive loss if control.
Psychopathy and addiction, although they share some characteristics, are not the same type of disorder. Some, but not all people suffering from addiction also have psychopathy. Some, but not all people suffering from psychopathy also abuse or become addicted to alcohol and other drugs. These are coexisting or co-occurring disorders that are different in kind.
Psychopathy is a personality disorder. Addiction is not!
There is no evidence that there is any personality style or disorder that causes addiction. People with all variations of healthy personality styles and personality disorders can become addicted.
The research suggests that chronic stage alcoholism and drug addiction creates some symptoms that look like the symptoms of antisocial disorder.
As people stabilize from acute withdrawal and post acute withdrawal (PAW), these symptom rapidly decrease as measured by standard personality tests within the first thirty days of sobriety.
Therefore, it is important to indicate days of sobriety and neuropsychological stability before deciding if antisocial behaviors are long-term personality traits or temporary traits related to the pain and dysfunction of withdrawal.
The diagnostic criteria that separate Psychopathy (Antisocial Personality Disorder), from the other cluster B personality disorders (Histrionic, Narcissistic, and Borderline) are not well established and tend to overlap. It is estimated that about 3-5% of the population suffer from ASPD (which is marked by violating laws and social norm)s, and as many as 20% are socially conforming psychopaths who lack empathy, challenge authority, victimize others, are deceptive, and do not learn from experience.
These socially conforming psychopaths wreak havoc and destruction all around them and destroy lives but are skilled at shifting the blame onto others (flipping the script) and avoiding legal consequences.
Alcoholics and prescription drug addiction have about the same incidence of psychopathy as the general population. In late stage addiction, the severe symptoms of intoxication, withdrawal, and post acute withdrawal can look like the symptoms of ASPD especially in a society that highly stigmatizes addiction.
People who use and/or become addicted to illicit (illegal) drugs are another story. Psychopaths are drawn to illegal drugs by their compulsion to challenge authority, break rules, and find excitement through extreme manipulation and risk-taking behavior. As a result, the incidence of antisocial behavior and psychopathic personality disorders is higher among illegal drug addicts than in alcohol or presciption drug addicts.