The Stages Of Addiction – According to statistics for 2014, substance use disorders (SUDs) impacted the lives of more than 20 million adults in the U.S – accounting for over 6% of all Americans. In that same year, the group most affected by SUDs were people age 18-25, accounting for roughly 29% of the total amount of people affected by SUDs.
So how do people go from abstinence, to use, to abuse, to addiction? The truth is that anyone who uses drugs or alcohol is more or less in one of the stages of addiction, from first use onward. Of course, not all of these individuals are addicted – but they are, however, positioned on a spectrum of substance use, and could take a turn for the worse when the circumstances are just right.
The Stages of Addiction
Stage 1: Initiation
Most people try using drugs and alcohol for the first time during their youth. According to data collected by the Substance Abuse and Mental Health Services Administration, about 2.8 million people age 12 and up used an illegal drug or misused a legal drug for the first time in 2013, and more than 3.8 million people between ages 12-20 drank alcohol for the first time.
The initiation stage generally occurs during the teen years. Each day in 2013, an estimated 4,220 youths under the age of 18 used drugs or alcohol for the first time.
Adolescents or teenagers may try drugs or alcohol for the following reasons:
- Curiosity
- Peer pressure – friends or acquaintances they respect are doing it
- Lack of development in the prefrontal cortex, an area of the brain that regulates decision-making and controls impulses
- They see their parents or siblings doing it, or they are initiated through family environment
- They seek it out as a means to self-medicate for mental illness, family conflict, or trauma
Once someone has used drugs or alcohol, they may progress to further experimentation and move into more problematic stages of addiction, or they may quit once their curiosity has been satisfied or they find that they dislike the experience.
This decision can depend on a few factors, including the following:
- Availability of substances within the community and peer group
- Whether or not friends or family use drugs or alcohol
- Family environment, such as physical or emotional abuse, mental illness, or substance abuse in the home
- Personal mental health conditions such as depression, anxiety, or ADHD
Stage 2: Experimentation
The experimentation stage of the stages of addiction starts when a person begins using drugs or alcohol in certain situations, such as at parties, nightclubs, or during social gatherings.
Substance use in this stage is usually socially-charged and is associated with fun, ‘unwinding,’ and a lack of consequences. The person may only think of using substances occasionally, and there are no physical cravings. At this stage, drug or alcohol use can be controlled (i.e., the person can stop if he or she wants to) and be purely impulsive (i.e., the person uses spontaneously, not regularly, and they are not dependent).
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), you are at relatively low risk for developing an alcohol use disorder if you are:
A. Female, and have no more than three drinks per day, and no more than seven per week total.
B. Male, and have no more than four drinks per day, and no more than fourteen per week total.
Stage 3: Regular Use
During stage 3 of the stages of addiction, substance use is more frequent. The person may not use every day, but there may be a predictable pattern, such as every weekend, or they may always use under a similar set of circumstances (e.g., when stressed, lonely, or in social situations).
At this stage, you probably use drugs or alcohol with other people, but you may start to use alone, as well. You may be absent or late to school or work due to use, or recovering from use (hangovers).
Stage 4: Problematic Use
As the stage name suggests, substance use is beginning to result in adverse consequences. The person may have been charged/convicted of a DWI/DUI or drug possession or had other negative legal repercussions. Work or school performance may be suffering, and relationships with others are probably becoming strained. The person may be hanging out with a new group of friends, and his or her behavior almost certainly has changed.
In short, risky or problematic drug or alcohol use threatens your safety and that of others but does not yet meet the criteria for a substance use disorder.
Stage 5: Dependence
The fifth stage of addiction is dependence, which includes tolerance and may have symptoms that are either physical or mental. Tolerance occurs when the person requires more of their substance of choice to achieve the same ‘high.’ This happens due to the brain’s inclination toward “repeated exposure = diminished response” in reaction to the regular use of a drug.
Dependence is characterized by a dysfunctional pattern of alcohol or drug use, resulting in significant impairment or distress. When the brain develops a dependence, it has, essentially, grown accustomed to the substance’s presence and has become incapable of functioning normally without it.
When the user tries to discontinue use, he or she will then experience unpleasant withdrawal symptoms and drug cravings as the body tries to reestablish equilibrium. Withdrawal symptoms may include the following:
- Sweating
- Rapid pulse
- Tremors
- Insomnia
- Nausea and vomiting
- Agitation
- Anxiety
- Depression
Other signs of dependence include a high rate of substance use, such as using more frequently or in higher doses, and relapsing after attempting to quit. Also, considerable time is spent obtaining the substance, using it, and recovering from its use.
Stage 6: A Substance Use Disorder
A person is in the 6th stage of addiction which he or she can be diagnosed with a substance use disorder. A SUD exists when a user meets any of the following criteria:
- The user believes he/she cannot face life without drugs or alcohol.
- The user cannot control use.
- The user continues to use despite the harm that is done to one’s health and life.
- The user is deceptive about use, especially about the amount and frequency.
- Friends, family, and activities the user once enjoyed are neglected or avoided.
- The user does not recognize the problems with his/her behavior or relationships with others.
A substance use disorder is more than the sum of its symptoms, however. A SUD is a chronic condition, meaning that it is often slow to develop and of a prolonged duration, especially without treatment.
Substance use disorders are diseases that often involve multiple relapses, meaning that recovery will often include setbacks. In fact, the relapse rates for SUDs are similar to those of other chronic conditions, such as diabetes, hypertension, and asthma.
Stages of Addiction: Treatment
Fortunately, there are effective ways to treat SUDs, so you can indeed regain control over your life, health, and well-being.
After a medical detox period, behavioral therapy combined with medication is often the recommended course of treatment. There is also individual and family counseling available for additional support, as well as groups such as AA, NA, and Al-Anon.
The longer you stay in rehab, the less likely you are to relapse, so long-term programs generally offer the best potential for a successful recovery. Our center offers both inpatient and outpatient treatment and uses a comprehensive, evidence-based approach that provides clients with the skills they need to achieve abstinence and enjoy long-lasting wellness and sobriety.
Contact us today to find out how we can help you on the road to recovery!