AddictionAddictive Behaviors The Difference Between an Addiction and a Compulsion ByElizabeth Hartney, BSc, MSc, MA, PhDElizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. Learn about our editorial processUpdated on May 10, 2022Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by John C. Umhau, MD, MPH, CPEMedically reviewed byJohn C. Umhau, MD, MPH, CPEJohn C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. He is the medical director at Alcohol Recovery Medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH).Learn about our Medical Review BoardTetra Images / Getty Images Table of Contents View All Table of ContentsAddiction vs. CompulsionPleasure vs. ReliefDenial vs. RealityTreatmentFrequently Asked Questions While people may use the words "addiction" and "compulsion" interchangeably, they are not the same thing. A critical feature of this distinction is that the compulsions of addictive behaviors lead to a sense of pleasure in the brain, whereas compulsions independent of an addiction lack the related sense of satiation and related brain circuitry. The misuse of addiction vs. compulsion causes confusion for everyone, especially those experiencing these conditions. However, it also creates confusion for professionals trying to help people progress through treatment. Addiction vs. Compulsion In order to understand the meaning of the two terms, it is essential to look at the common features that they share as well as their key differences. Addiction is a broad term used to describe the process by which someone becomes dependent on a particular substance or behavior. In contrast, compulsion is a narrow term used to describe the intense urge to do something, which can sometimes lead to a behavior.Compulsions do play a role in the addiction process. As an addiction develops, it often will involve a feeling of compulsion to take an addictive substance, such as alcohol or heroin, or to carry out an addictive behavior, such as gambling or sex. Compulsions are also a symptom of obsessive-compulsive disorder (OCD). Someone with OCD may have a compulsion to engage in a behavior like washing their hands, tying their shoes, or checking the stove as a way of trying to alleviate anxiety. Compulsions in OCD are often directly related to obsessions, which are repeated thoughts that generate distress.OCD SymptomsObsessionsUnwanted thoughts and imagesAvoidance of triggersCompulsionsRituals to control obsessive thoughtsAddiction SymptomsIntense urges for the substanceUsing more to get the same effectInability to stop in spite of negative consequencesWithdrawal symptoms Pleasure vs. Relief A major distinction between addiction and compulsion is the way they are perceived. People with OCD may feel a sense of relief when taking part in compulsive behavior, but they don't feel pleasure; someone with an addiction, however, does experience pleasure through their behavior, at least at the onset. For someone with OCD, compulsions develop as a way to mitigate the anxiety or fear that their obsessions are causing. Someone with an obsession with contamination, for example, may develop compulsions that involve excessive washing and cleaning.Compulsions often cause emotional distress when they're carried out, even if they do offer some temporary relief. In the case of addiction, the desire to use the substance or engage in the behavior involves an expectation that it will be pleasurable. This expectation of pleasure is so strong that someone with an addiction will continue their behavior even in spite of the negative consequences it can cause, like:Financial problemsHealth issues and physical discomfortSocial disapprovalLegal consequencesDecreased self-esteem For people with addictions, there often comes a point where they don’t really enjoy the addictive behavior. Instead, they are just seeking relief from the urge to engage in it. This is compounded by the experience of withdrawal that often happens when they stop taking the substance or engaging in the behavior. Although this can resemble the way someone with OCD engages in compulsions because the pleasure is gone, the original motivation to engage in the behavior was to feel good. Denial vs. Reality Another major distinction between an addiction and a compulsion has to do with awareness and acceptance of reality. Someone with OCD may often be aware that their obsessions are not realistic or that their compulsions are excessive or illogical. They may even feel disturbed by their thoughts and their need to carry out a compulsive behavior, yet they do it anyway to relieve their distress. In contrast, people with addictions often have memory and cognitive impairment and lack this same level of insight. They may not recognize the negative consequences their addiction is causing. This is known as denial, and it's a core component of the addictive process in the brain.It can be difficult for someone with an addiction to realize that their substance use or behavior is causing problems in their life, and recognizing this fact is a very important step toward recovery. Treatment Addiction and OCD can both cause major disruptions in your life. However, both conditions are treatable, and it's important to seek professional help. Treatment for Compulsions Treatment for OCD may involve a combination of medication and therapy: Medications can include antidepressants like selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), and your doctor may augment these with an antipsychotic.Therapy for OCD is generally a form of cognitive behavioral therapy (CBT), which involves learning to recognize and change your thought patterns. Exposure therapy is often helpful for people with OCD, as it helps you learn how to tolerate anxiety-inducing objects or thoughts without performing a compulsion. Treatment for Addiction Treatment for addiction can vary based on what you are addicted to. If your addiction involves a substance, your doctor may prescribe medication to help you detox safely and deal with symptoms of withdrawal. Your doctor may also prescribe medication to address the neurochemistry associated with pleasure in the brain. For example, naltrexone is a medication that blocks the sense of pleasure induced by opiates. Your doctor may prescribe this medication to block compulsions related to cravings for alcohol and opiates, as well as for behavioral addictions. Therapy is also an important component of addiction treatment. This may include individual or group counseling, as well as a stay in a residential treatment facility. A Word From Verywell While addition and compulsion share some commonalities, they mean different things. Compulsions do play a part in addiction, but these are different than the compulsive behaviors that people engage in as part of OCD. If you are experiencing compulsions or an addiction, talking to your doctor or mental health professional is an important first step. By getting an accurate diagnosis, a health professional can recommend appropriate treatments that can help. If you or a loved one are struggling with compulsions or an addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.For more mental health resources, see our National Helpline Database. Frequently Asked QuestionsIs compulsive gambling a type of addiction?Gambling disorder, which is sometimes referred to as compulsive gambling, is recognized in the DSM-5 as a type of behavioral addiction. Signs of this condition include a preoccupation with gambling, trouble controlling the behavior, financial problems due to gambling, and continuing the behavior despite negative consequences.Learn More:Signs of Compulsive GamblingHow do you overcome compulsive addiction?Treatments are available that can help people overcome compulsive behaviors and addictions. For compulsions related to OCD, treatment often involves medications and therapy such as CBT or exposure and response prevention therapy. Addiction treatments can vary from one substance to the next, but often also involve the use of medications, therapy, and supportive care.What is the difference between addiction and a compulsive disorder?Addiction is a chronic condition that involves taking a substance or engaging in a behavior to gain pleasure and relieve discomfort. Compulsive disorders involve experiencing an uncontrollable and overwhelming urge to do something. A compulsion may help relieve the distress caused by an obsession, but it does not produce feelings of pleasure. 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.el-Guebaly N, Mudry T, Zohar J, Tavares H, Potenza MN. Compulsive features in behavioural addictions: The case of pathological gambling. Addiction. 2012;107(10):1726–1734. doi:10.1111/j.1360-0443.2011.03546.xSussman S, Sussman AN. Considering the definition of addiction. Int J Environ Res Public Health. 2011;8(10):4025-4038. doi:10.3390/ijerph8104025National Institute of Mental Health. Obsessive-compulsive disorder.Heather N. Is the concept of compulsion useful in the explanation or description of addictive behaviour and experience? Addict Behav Rep. 2017;6:15-38. doi:10.1016/j.abrep.2017.05.002Pickard H. Denial in addiction. Mind Lang. 2016;31(3):277-299. doi:10.1111/mila.12106Yau YHC, Potenza MN. Gambling disorder and other behavioral addictions: Recognition and treatment. Harv Rev Psychiatry. 2015;23(2):134-146. doi:10.1097/HRP.0000000000000051By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. 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