It is a lot easier for me to decide to switch my morning coffee to tea than to switch to orange juice. I don't think it is simply the routine. The internal reward system (whatever that is) seems to be pretty important. In my opinion, strong addictive substances like opioids completely remodel your reward system. Getting that A feels good but not as good as getting a refill. Just my two cents. I don't have any credibility on this issue just an observer.

I believe it really boils down to how you define addiction. There is a school of thought that considers routine like consumption of a dug of abuse to be a sufficient marker of 'addiction'. However, this theory does not take into account one of the hallmarks of substance use disorders: the negative reinforcement in the absence of the reward/rewarding behaviors. Stopping a routine behavior does not lead to withdrawal symptoms as severe as those resulting from abstinence/withdrawal from a substance of abuse does. 'Addicted' subject have bee shown to overcome adverse scenarios (e.g. foot shock in rodents) to continue to administer their drug of choice. However, there is little evidence of subjects overcoming similar punishment to continue engaging in habitual behaviors.

The line between habit learning and addiction is certainly a fine one and is still up for debate. However, having said that addiction is too broad a term and substance use disorders are broken down into positive reinforcement vs. negative reinforcement paradigms. Addiction is likely a result of an interplay between these behaviors. Attached is a wonderful circumspective on this very topic by two of the pioneers of this field.

http://www.ncbi.nlm.nih.gov/pubmed/24121188

Routines and addictions share a degree of automaticity, but the latter are highly motivated habits that can become compulsive. Thus, brushing your teeth is a routine, but this does not activate neural reward circuitry in the mesolimbic dopaminergic system and orbital frontal cortex (unless your toothpaste has some unusual added ingredients). One major theory ( Robinson & Berridge's 1993 incentivisation model) posits that stimuli present when rewards are evoked acquire motivational properties (ie, become incentives) through classical conditioning. These become salient, grab attention and contribute to cycles of compulsive drug use or gambling. By virtue of repetition this becomes increasingly automatic- as indeed is attentional engagement- and evades cognitive control. Moreover, the reward sensitivity is enduring and contributes to relapse after abstinence.

See also Everitt & Robbins aberrant learning theory for an alternative account of the acquisition of compulsive drug seeking behaviour.

I would call what you describe a "habit". I believe there are similarities, both behaviorally and in brain pathways, to addictions. In addition to materials suggested by others, you may be interested in works by Ann Graybiel, e.g., Annu. Rev. Neurosci. 2008. 31:359–87.

El ser humano es es muy complejo para tildar las adicciones a simples costumbres de rutina, si tu acostumbras a tu cuerpo a sustancias psi coactivas llámese como se llame, esa costumbre afecta tu cuerpo y este se siente mal si no consume la dosis diaria.. Y peor que esto, es que la adicción es progresiva y con lo que te sentías bien antes, ya no es suficiente y necesitas mas para calmar tu dolor a no sentirte mal.

It is always nice to see a researcher switching to a new paradigm and the link you seem starting to make between "routine" and "addiction" is in this sense, a new conception of human activities. First, you might refer to addictions broadly, not just psychotropic consumption, but also behavioral addictions. First and foremost, sexuality. And then, of course, we begin to touch on the question of everyday life and routines. What's more routine than sexuality! How many sexual fantasies stirred into consciousness per day? How masturbations per day/week? And who will dare to say that sexuality is not involving the mesolimbic reward system?

From addictions broadly conceptualized (substances and behaviors) is the problem of the boundary between addictions and routines, of everyday life activities. As establishing a limit is very controversial and arbitrary, we can solve this issue by passing from categorical to dimensional, which leads us to consider a first continuum between "everyday life addiction" and pathological addictions (remember the S. Freud's "everyday psychopathology" here also to solve the question of the difference between little pathological behaviors and big psychiatric psychopathologies). The same behavior can move along the dimensional axis. A smoking can be a little routine after Sunday lunch or a compulsion with 50 cigarettes per day. The same for cannabis or other drugs. Sexuality can be an orgasm a day, two orgasms a week, but at the other end of the addictive sexuality that may be 5-10 orgasms a day. A person can play the lottery twice a week, another can go every day at the casino. The work is a sacred routine for everyone, but we like to balance things on the way to relax at home every night and on weekends and go on vacation from time to time. However, some people may not be able to stop, bring work at home, do not go on vacation and work in an addictive way.

Are everyday addictions involving brain reward system? Are these little addictions subject to the mechanisms of positive and negative reinforcements? Yes, certainly, because it is unclear how the reward system would be in a binary functioning: OFF for certain behaviors and ON for other behaviors. All our brain and our reward system operate continuously. Evidence of positive reinforcement in everyday addictions is, precisely, that we create everyday life addictions, we create systems of routines in our lives and we do that because it gives us pleasure and/or background relief. We love the daily life humdrum and we build it, we organize our activities. Against this evidence are the thrill-seekers (HSS, high sensation seekers) who do not like very much routines and are seeking novelty. However, these people also have their routines (every night Peter will jump 5 times upper the bridge with his parachute), they work, masturbate, eat, watch TV. They like to break their routines, but to break one's routines one must have routines!

Negative reinforcement is well there, but it is more difficult to highlight it than in the case of pathological addictions. To observe a withdrawal syndrome after stopping a routine, just delete this routine ... and not replace it with something else, another routine! One can observe the withdrawal, for example, when a person loses his job (unemployment, retirement), when a person ends up in jail and loses all his usual routines, when waiting in a transport, in a waiting room, when television is burned, when the sexual partner disappears ... The most beautiful demonstrations of negative reinforcement are the effects of desafferentations (sensory deprivation) which they are "natural" (solo sailor, walking in the desert or on the ice, spending days in the cabin of a bomber) or experimental (sensory isolation tank). Here are highlighted the hedonic function of the routines and needs of stimulation of our brain.

Because another question arises: how is it that the work serves the adaptation to society, but it is also a source of satisfaction? How to explain sexuality to serve reproduction, but which is also a source of pleasure? How is it that wine (in small doses) may be a health benefit (I'm french!), but also brings so much pleasure? Again, we are faced with the temptation to arbitrary ask, to say what is a "good" (positive) addiction and what is a "bad" addiction, the first serving adaptation and the second for the pathological pursuit of pleasure. But this is wrong, this border does not exist. In fact, the second continuum to consider is between "pragmatic" and "hedonic" functions of each of our behaviors, our everyday life activities. All our activities have this dual function: pragmatic and hedonic. They are adapting, but they also give us pleasure, at the same time! I eat to sustain me physiologically, but I also eat for pleasure and that is why the recipes exist, as well as family meals and restaurant with friends. And what's more routine than eating! We can imagine an axis, with "pragmatic" on one end and "hedonic" on the other end, and a slider which slides along this axis. Eating as routine, the cursor is around the middle of the axis. Interrupting an exciting video game for a quick sandwich and the cursor moves to the left, the pragmatic. Going to a good restaurant with friends and the cursor moves to the right, the hedonic. Getting up at night to compulsively empty the fridge and there the cursor will completely go to the hedonic end, it is bulimia. Most behavioral addictions can easily slip from one extreme to the other of the hedonic/pragmatic axis. For the consumption of psychotropic substances, pragmatic and hedonic seem to merge, it is as if the axis is shortened. Tobacco, cannabis, alcohol, drugs, psychotropic medicines, there is a pragmatic dimension, with a form of adaptation to the world, to himself, his psychopathology, his suffering (anxiety, depression) and a hedonic dimension also, it's obvious.

From there, we can begin to see things in a unified manner. This is why I propose the concept of a system of pragmatic activities/and hedonic actions. Each of our behavior is both a pragmatic activity and a hedonic action with a cursor that can move between pragmatic and hedonic. All activities/actions together form a "system", that is to say an organization of activities/actions. This is what we mean by saying "routines", "habits". One can find good examples that highlight the existence of this system, when it is upset: losing his job, losing his life partner, ending up in prison, ending up in a refugee camp, in another country, another culture. After that, we should not be surprised about people who go camping with their TV not to miss the evening news or serial!

From this "systemic", organizational model, we can otherwise consider the difference between "normal" and "pathological." In fact, this difference will be conceptualized as the changing of variables in the system of activities/actions. Three variables can be considered: the salience (the force of investment in activities/actions in the system), the variety (the range of activities/actions available in the system) and vicariousness (the possibility of substituting an activity/action by another in the system). A healthy system is marked by a low salience (all activities/actions are invested in a balanced way), a wide variety (the system has many activities/actions available) and a large vicariousness (the system can easily allow substitution between activities/actions). Conversely, a "pathological" system (ie in the context of pathological addiction) is marked by a high salience (the system is centered around a hedonic monopoly), a small variety (few activities/actions are available outside activity/action monopoly) and low vicariousness (it is very difficult to replace the activity/action monopoly by another activity/action even when the monopoly has to be broken) .

Three publications in English for more information:

https://www.researchgate.net/publication/258270290_Towards_a_hedonology_A_science_of_hedonic_management?ev=prf_pub

https://www.researchgate.net/publication/12429447_Addiction_as_a_function_of_action_system_properties?ev=prf_pub

https://www.researchgate.net/publication/258246310_Towards_an_ecology_of_action?ev=prf_pub

Article Towards a hedonology: A science of hedonic management

Article Addiction as a function of action system properties

Article Towards an ecology of action

VERSION FRANÇAISE DE MA RÉPONSE :

Il est toujours très agréable de voir un chercheur basculer dans un nouveau paradigme et le lien que vous semblez commencer à réaliser entre "routine" et "addiction" va en ce sens, d'une nouvelle conception des activités humaines. En premier, vous faîtes certainement référence aux addictions au sens large, pas seulement les consommations psychotropes, mais aussi les addictions comportementales. Au premier rang desquelles, la sexualité. Et là, bien sûr, nous commençons à toucher à la question du quotidien et des routines. Quoi de plus routinier que la sexualité ! Combien de fantaisies sexuelles agitées dans la conscience par jour ? Combien de masturbations par jour/semaine ? Et qui osera dire que la sexualité ne met pas en jeu le système mésolimbique de récompense ?

A partir des addictions au sens large (substances et comportements) se pose le problème de la frontière entre les addictions et les routines, les activités de la vie quotidienne. Comme poser une limite est très controversé et arbitraire, on peut résoudre ce problème en passant du catégoriel au dimensionnel, ce qui nous amène à envisager un premier continuum entre les "addictions de la vie quotidienne" et les addictions pathologiques (souvenez-vous de la "psychopathologie de la vie quotidienne" de S. Freud, ici aussi pour résoudre la question de la différence entre les petits comportements pathologiques du quotidien et les grandes psychopathologies psychiatriques). Un même comportement peut se déplacer tout au long de l'axe dimensionnel. Un tabagisme peut être une petite routine du dimanche après déjeuner ou une compulsion avec 50 cigarettes par jour. La même chose pour du cannabis ou d'autres drogues. La sexualité peut être de un orgasme par jour, deux orgasmes par semaine, mais à l'autre extrémité de la sexualité addictive ce peut être 5-10 orgasmes par jour. Une personne peut jouer au loto deux fois par semaine, une autre peut se rendre tous les jours au casino. Le travail est une sacrée routine pour tout le monde, mais on aime bien équilibrer les choses en rentrant se détendre à la maison tous les soirs et les week-ends et partir en vacance de temps en temps. Cependant, certaines personnes peuvent ne pas pouvoir s'arrêter, ramener du travail à la maison, ne pas partir en vacance et travailler d'une façon addictive.

Est-ce que les addictions de la vie quotidienne impliquent le système cérébral de récompense ? Est-ce que ces petites addictions sont soumises aux mécanismes de renforcements positifs et négatifs ? Oui, certainement, car on voit mal comment le système de récompense aurait un fonctionnement binaire : en arrêt pour certains comportements et en fonction pour d'autres comportements. Tout notre cerveau et notre système de récompense fonctionnent en permanence. La preuve du renforcement positif dans les addictions de la vie quotidienne est que, justement, nous créons des addictions de la vie quotidienne, nous créons des systèmes de routines dans nos vies et nous faisons cela car cela nous procure un plaisir et/ou un soulagement de fond. Nous aimons le train-train du quotidien et nous le construisons, nous organisons nos activités. La contre-preuve ce sont les chercheurs de sensations fortes (HSS, high sensations seekers) qui n'aiment pas trop les routines et qui recherchent la nouveauté. Cependant, ces personnes ont aussi leurs routines (tous les soirs Pierre va sauter 5 fois du haut du viaduc avec son parachute), ces personnes travaillent, se masturbent, mangent, regardent la télévision. Elles aiment casser leurs routines, mais pour casser ses routines il faut en avoir !

Le renforcement négatif est bien là, mais il est plus difficile à mettre en lumière que dans le cas des addictions pathologiques. Pour observer un syndrome de manque après l'arrêt d'une routine, il suffit de supprimer cette routine et... de ne pas la remplacer par autre chose, une autre routine ! On peut observer le manque, par exemple, lorsqu'une personne perd son emploi (chômage, retraite), lorsqu'une personne se retrouve en prison et perd ainsi toutes ses routines habituelles, lorsqu'on doit attendre dans un transport, dans une salle d'attente, lorsque la télévision est grillée, lorsque le partenaire sexuel disparaît... Les plus belles démonstrations de renforcement négatif sont les effets des désafférentations (privations sensorielles) qu'elles soient "naturelles" (navigateur solitaire, marcher dans le désert ou sur la banquise, passer des journées entières dans la carlingue d'un bombardier) ou expérimentales (caisson d'isolation sensorielle). Là, sont mis en lumière la fonction hédonique des routines et les besoins en stimulation de notre cerveau.

Car une autre question se pose : comment expliquer que le travail serve l'adaptation à la société, mais qu'il soit aussi source de satisfaction ? Comment expliquer que la sexualité serve à la reproduction, mais quelle soit aussi source de plaisir ? Comment expliquer que le vin (à petite dose) puisse être un bienfait pour la santé (je suis français !), mais aussi apporter tant de plaisir ? Là encore, on est face à la tentation de poser des arbitraires, de dire ce qui est une "bonne" (positive) addiction et ce qui est une "mauvaise" addiction, les premières servent l'adaptation et les secondes servent la recherche pathologique du plaisir. Mais cela est faux, cette frontière n'existe pas. En fait, le second continuum à envisager et celui entre les deux fonctions "pragmatique" et "hédonique" de chacun de nos comportements, de toutes nos activités de la vie quotidienne. Toutes nos activités possèdent cette double fonction : pragmatique et hédonique. Elles servent l'adaptation, mais elles nous procurent aussi du plaisir, en même temps ! Je mange pour me sustenter physiologiquement, mais je mange aussi pour le plaisir et c'est pour cela que les recettes de cuisine existent, ainsi que les repas familiaux et entre amis. Et quoi de plus routinier que de manger ! Il faut donc imaginer un axe, avec "pragmatique" à une extrémité et "hédonique" à l'autre extrémité et un curseur qui glisse le long de cet axe. Manger comme routine, le curseur et vers le milieu de l'axe. Devoir interrompre un passionnant jeu vidéo pour avaler un sandwich et le curseur va vers la gauche, le pragmatique. Aller dans un bon restaurant avec des amis et le curseur va vers la droite, l'hédonique. Se lever la nuit pour vider compulsivement le frigo et là le curseur va complètement sur l'extrémité hédonique, c'est la boulimie. La plupart des addictions comportementales peuvent facilement glisser d'un extrême à l'autre de l'axe pragmatique/hédonique. Pour les consommations de substances psychotropes, le pragmatique et l'hédonique semblent se confondre, c'est comme si l'axe se raccourcissait. Tabac, cannabis, alcool, drogues, médicaments psychotropes, il y a une dimension pragmatique, avec une forme d'adaptation au monde, à soi-même, à sa psychopathologie, à sa souffrance (anxiété, dépression) et une dimension hédonique aussi, c'est évident.

A partir de là, on peut commencer à envisager les choses d'une façon unifiée. C'est pour cela que je propose ce concept de système d'activités pragmatiques/et d'actions hédoniques. Chacun de nos comportements est à la fois une activité pragmatique et une action hédonique, avec un curseur qui peut se déplacer entre pragmatique et hédonique. Toutes nos activités/actions forment ensemble un "système", c'est-à-dire une organisation des activités/actions. C'est ce que l'on veut dire en disant "routines", "habitudes". On peut trouver de bons exemples qui mettent en lumière l'existence de ce système, lorsqu'il vient à être bouleversé : perdre son emploi, perdre son partenaire de vie, se retrouver en prison, se retrouver dans un camp de réfugié, dans un autre pays, une autre culture. Après, il ne faut pas s'étonner des gens qui partent en camping avec leur télévision pour ne pas rater le journal ou le feuilleton du soir !

A partir de ce modèle "systémique", organisationnel, on peut envisager autrement la différence entre le "normal" et le "pathologique". En fait, cette différence va être conceptualisée comme la modification de variables dans ce système d'activités/actions. Trois variables peuvent être envisagées : la saillance (la force d'investissement des activités/actions dans le système), la variété (l'éventail des activités/actions disponibles dans le système) et la vicariance (la possibilité de substituer une activité/action par une autre dans le système). Un système en bonne santé est donc marqué par une faible saillance (toutes les activités/actions sont investies d'une façon équilibrée), une grande variété (le système possède de nombreuses activités/actions disponibles) et une grande vicariance (le système peut aisément permettre des substitutions entre activités/actions). A l'inverse, une système "pathologique" (donc dans le cadre des addictions pathologiques) est marqué par une forte saillance (le système est centré autour d'un monopole hédonique), une faible variété (peu d'activités/actions sont disponibles en-dehors de l'activité/action monopolistique) et une faible vicariance (il est très difficile de substituer à l'activité/action monopolistique une autre activité/action, même lorsque le monopole vient à être brisé).

Trois publications pour en savoir plus :

https://www.researchgate.net/publication/258246388_On_hedonic_management_prolegomena_to_a_hedonology?ev=prf_pub

https://www.researchgate.net/publication/12459585_Addictions_and_action_systems?ev=prf_pub

https://www.researchgate.net/publication/258246308_Vers_une_cologie_de_l%27action?ev=prf_pub

Article [On hedonic management, prolegomena to a hedonology]

Article Addictions and action system

Article Vers une écologie de l'action

It seems there is a certain comfort in routines, as they are by definition predictable and often provide salient rewards including self-satisfaction, health benefits, promote organization, and approval of parents and others. There is also a heavy external component to routines as we have certain prescribed routines we participate in such as meal times, holidays, work days and hours. The most prominent routine of course is day and night.

My impression is that we tend to differentiate between addictions and routines mainly on the negative aspects of addiction such as negative consequences and harmful “risky” behaviours. When routines become negative and harmful to the individual we begin to ask about OCD and anxieties.

In one sense the comparison is difficult, for example one of the standard definitions of addiction is “failed attempts to quit” which fits well for cocaine abuse but not really for brushing your teeth.

You bring up an interesting topic as I have observed persistent and unique routines occurring within addictive behaviour, however we tend to use the term “ritualized” behaviour but routine behaviour fits also.

Certain substances also seem to promote routine behaviour for example stimulant class drugs tend to heighten an individual’s alignment with routine behaviour as opposed to alcohol which degrades usual behaviour.

I think routines assist us greatly in smoothing out the edges of our daily lives, and also provide important predictability and a “sense” of greater control.

There is increasing awareness in neurobiological commonalities between chemical addictions like alcoholism and other behavioral addictions like food addiction or pathological gambling, such as how cues for the rewarded substance/activity elicit activation of mesolimbic incentive-motivational neurocircuitry. Personality/behavioral studies show decrements in willpower/executive control in both chemical and non-chemical addiction. There are elements of increasing automatized behavior over time in both classes. In fact, pathological gambling has been touted recently as a human model system/condition for addiction neurobiology because the neurocircuitry involved does not get chemically damaged by alcohol and other drugs.

I think you have to consider the possibility of OCD when discussing routine addiction.

Dr. Gerstein,

As a non-psychologist, I wonder if there is a rigorous descriptive definition of addiction, on the basis of which to be able to give a straight answer to my question and to distinguish clearly between various types of addictions. From what I have read, the popular (encyclopedic) definitions employ behavior (as being repetitive) and adverse consequences (as effect of that repetitive behavior), while the “abnormal” element is keeping that behavior despite the adverse consequences. We have then the behavior, the adverse consequences and no object of behavior in the definition (of course, objects can be further related to behavior and thus classifications can be done on the basis of them).

Now, you say that routine has no object of behavior. If we take as objects physical objects, you are right. But if we extend them to include mental states or sensations, routine would have as object of behavior comfort for example (including here a fear of novelty, change, etc., which perhaps turns it into phobia). Comfort can be also considered as reward. Of course, habit/routine/cyclicity is strongly embedded in our biological makeup and manifests in our daily life, as all the answerers pointed out. But is this enough for not considering routine fitting the definition of addiction? As for adverse consequences, we could find some if we seek, especially social; for instance, unpleasing the partner.

A weakness of the (popular) definition – in my opinion – is the absolute status of the “adverse consequences”, which seems to be not relativized to subject’s awareness. Does it count when labeling a behavior as addiction whether the subject is or isn’t aware (or convinced) of those consequences?

In sum, my questions revolve around the definition of addiction, which is of course related to that of abnormal behavior. If somehow we would arrive at the conclusion that routine is a normal behavior and still an addiction, such definitions (if any rigorous) should be revised.

Maybe the Goodman's 1990 commentary could help (or more confuse!) you. Even this paper ("Addiction: definition and implications," link below) is not very young, it is yet a good basis for your thinking.

Goodman says for "addiction": « A process whereby a behavior, that can function both to produce pleasure and to provide escape from internal discomfort, is employed in a pattern characterized by (1) recurrent failure to control the behavior (powerlessness) and (2) continuation of the behavior despite significant negative consequences (unmanageability). »

Goodman see addictive trouble as a « hierarchically superordinate category », which can be applied on a variety of "objects", from subtances to behaviors (even mental behaviors).

In this perspective substance abuse, but also anorexia/boulimia, paraphilies, obsessive compulsive trouble, impulse control disorder, can be seen as addictions (and I would ad repetitive patterns of thinking in certain depressions).

But, concerning habits (and most of the addictions), I think it is important to consider: 1) positive reinforcement (the hedonic dimension, pleasure); 2) the negative reinforcement (fighting against psychic suffering as anxiety, depression); 3) secondary negative reinforcement (the negative consequences of a bad habit or a pathological addiction, as health problems, family and social difficulties, lost of work, legal problems, etc.). These three points are important factors that impact an habit or an addiction. (sorry for my pour English).

http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.1990.tb01620.x/pdf

Just coming back from the 28th International Congress of Applied Psychology (ICAP2014) in Paris, I heard an interesting conference of Bas VERPLANKEN (University of Bath) untitles: "On the yin and yang of habits: the power of repetitive action and thinking". It was completly in the frame of your question about routine and addiction. "Most of the time, what we do is what we do most of the time". A good introduction! What I kept from this:

- the link with addiction.

- not rational and willing behaviors, but behaviors generally linked to clues from the environment.

- habits can drive to biases in decision making (like addictions finally).

- habits give pleasure (hedonic function), even bad habits!

Following the link below for more...

http://www.bath.ac.uk/psychology/staff/bas-verplanken