The article discusses the relationship between psychoactive substance use disorders and behavioral addictions, highlighting similarities in their natural history, phenomenology, tolerance, comorbidity, genetic contributions, neurobiological mechanisms, and treatment responses. Behavioral addictions, such as pathological gambling, internet addiction, and compulsive buying, share features with substance addictions, including impaired control over behavior, craving, and withdrawal. The authors argue that these disorders should be classified together in the DSM-V under "Addiction and Related Disorders," which would include both substance use disorders and non-substance addictions. However, the classification of other behavioral addictions remains uncertain due to limited data. The article also explores the neurobiological basis of these disorders, emphasizing the role of neurotransmitter systems such as serotonin, dopamine, and glutamate. It discusses the genetic and familial links to behavioral addictions, as well as the effectiveness of treatments, including psychosocial interventions and medications like naltrexone and topiramate. The article concludes that while there is growing evidence supporting the classification of behavioral addictions alongside substance use disorders, further research is needed to fully understand their nature and develop effective treatments.The article discusses the relationship between psychoactive substance use disorders and behavioral addictions, highlighting similarities in their natural history, phenomenology, tolerance, comorbidity, genetic contributions, neurobiological mechanisms, and treatment responses. Behavioral addictions, such as pathological gambling, internet addiction, and compulsive buying, share features with substance addictions, including impaired control over behavior, craving, and withdrawal. The authors argue that these disorders should be classified together in the DSM-V under "Addiction and Related Disorders," which would include both substance use disorders and non-substance addictions. However, the classification of other behavioral addictions remains uncertain due to limited data. The article also explores the neurobiological basis of these disorders, emphasizing the role of neurotransmitter systems such as serotonin, dopamine, and glutamate. It discusses the genetic and familial links to behavioral addictions, as well as the effectiveness of treatments, including psychosocial interventions and medications like naltrexone and topiramate. The article concludes that while there is growing evidence supporting the classification of behavioral addictions alongside substance use disorders, further research is needed to fully understand their nature and develop effective treatments.