If you’re concerned that a friend or family member is struggling with an addiction to drugs or alcohol, it’s natural to question how the problem started. Sometimes it seems like the affected individual developed an addiction practically overnight; but more often than not, there are a series of stages that each person goes through before substance use becomes a full-blown addiction.
While each case of addiction varies, being aware of these stages can help you monitor when drug or alcohol use starts to become problematic for yourself or a loved one.
WHAT IS ADDICTION?
The American Society of Addiction Medicine (ASAM) defines addiction as a chronic brain disease characterized by dysfunction of the brain’s circuitry for reward, motivation, and memory. Like many diseases, addiction is progressive. This means that, without treatment, addiction tends to get worse over time and can result in disability or premature death. Addiction also follows suit with other chronic diseases in that it goes through periods of relapse and remission.
Recognizing that addiction is a disease is important, as friends and family members of an addicted individual may feel that he or she should be able to simply stop using drugs or alcohol without treatment. There is a common misconception that people addicted to drugs or alcohol lack morals, willpower, or don’t love their friends and family. However, This is rarely the case. Since chronic drug or alcohol use changes the chemistry of the brain, much of the time, individuals struggle to quit without treatment. For many, engaging in evidence-based drug or alcohol treatment and ongoing recovery activities is necessary to maintain long-term sobriety.
THE FIVE STAGES OF ADDICTION
The five stages of addiction typically evolve in this order: experimentation, regular use, problem or risky use, dependence, and addiction. Learning the signs and symptoms that typically occur with each stage may help you identify drug or alcohol abuse or addiction in yourself or a loved one.
Most often, initial drug or alcohol use is voluntary and infrequent. Motivation for use can vary, but there are a few common reasons why individuals begin turning to drugs or alcohol.
To seek relief from physical pain, anxiety, depression, or stress.
We’ve all heard of having a drink to “take the edge off” or using alcohol as a “social lubricant.” In addition to that, maybe you know people who use marijuana to unwind at night or someone who takes opioids for chronic back pain. The reality is, many people begin to use drugs or alcohol in an attempt to ease physical or psychological distress. This can be in response to daily stressors, after a traumatic life event such as losing a loved one or a job, dealing with chronic pain from a medical condition (such as fibromyalgia), or while recovering from an injury or surgery.
Sometimes, individuals will be prescribed drugs by doctors to help ease their symptoms. Certain drugs, like opioids, are associated with modulating pain and may be prescribed by medical professionals for those suffering from chronic pain or after specific events such as surgery. Benzodiazepines, also known as “benzos”, are prescription tranquilizers that are commonly used to treat anxiety, panic disorders, and insomnia.
To enhance performance
Individuals may begin using drugs to increase cognitive or athletic performance. Stimulants, such as Adderall or Ritalin, are becoming more commonplace for teens and adults who want to feel more alert, awake, and focused. However, these drugs (and others commonly prescribed for ADHD) have a high risk for addiction or abuse when taken outside the direction of a physician. Anabolic or androgenic steroids are often abused by those looking to increase athletic performance or improve appearance by building more muscle mass. Although these drugs do not create a feeling of euphoria, they can have severe physical and psychiatric effects when taken long-term. Continuing to use steroids in spite of these negative effects may be a sign of addiction.
To fit in
Teens and young adults may begin using drugs or alcohol because “everybody else is doing it” or because they’re submitting to peer pressure. This is particularly problematic, as research shows the earlier an individual begins using drugs or alcohol, the more likely he or she is to develop an addiction.
In this early experimentation phase, many individuals are able to stop using without treatment. Those who transition into the next stage of addiction typically do so because they feel drugs or alcohol are benefiting their lives by easing their pain or stress, increasing cognitive or athletic performance, or positively affecting their social status.
It’s important to note that the use of prescription drugs taken as directed by a medical professional and the consumption of alcohol or other legal substances (like marijuana in some states) by legal aged adults is seen as socially acceptable and may not be cause for concern unless symptoms of problem use, dependence, or addiction (as described below) are present.
- REGULAR USE
Over time, experimentation may evolve into using drugs or alcohol regularly. This may not be every day, but does tend to follow a pattern, such as using every weekend or in predictable situations or circumstances (like when around certain friends, or when dealing with anxiety or stress). In this phase, the individual may still only be using around friends or family, so use can continue to seem social. The predictable pattern is the red flag, as regular use can start to become a habit.
- PROBLEM OR RISKY USE
The next stage of addiction is problem or risky use. Individuals may begin to put themselves or others at risk while under the influence, start experiencing financial or legal problems due to substance use, start to have problems at work or school, or may begin to strain relationships with friends, family, and significant others.
Some signs to look for in adults may be: drinking or using drugs and driving, absence from or tardiness to work, getting a DUI or receiving other legal charges while drunk or high, or becoming defensive with friends or family members when asked about their substance use.
Teenagers may develop behavioral problems, start receiving bad grades or unexcused absences from school, begin to hang out with a new group of friends, be involved in car accidents, or be charged with a Minor in Possession (MIP).
The fourth stage of addiction is dependence. Dependence can be physical, psychological, or both. An individual becomes physically dependent to a drug when he or she begins to experience symptoms of tolerance and withdrawal. Tolerance means a person’s body starts to adapt to the drug and he or she has to continually use more of said drug to experience the same desired effects. Withdrawal is defined as experiencing a set of physical or mental symptoms (that vary based on the drug) when the individual stops or cuts back on use. Psychological dependence means the affected individual needs the drug to feel normal and may begin to experience cravings for the drug.
Dependence is different than addiction, as physical dependence may develop with long-term use of any drug (even prescription drugs being taken as directed). Consequently, it’s important to note that physical dependence does not necessarily indicate an addiction is present, but may be a symptom of addiction.
An individual is seen as having an addiction when drug or alcohol use has become compulsive and out of control. The addict continues to use drugs or alcohol even if he or she is experiencing negative or harmful consequences due to substance use. The affected person typically experiences intense cravings for the drug and often experiences symptoms of tolerance and withdrawal.
A person who has transitioned from substance use to addiction should be seen as having a medical condition. More often than not, people suffering from addiction have experienced physical and psychological changes that make stopping drug or alcohol use on their own incredibly difficult if not downright dangerous. In this stage, those suffering from addiction should be under the care of medical professionals while entering the recovery process.
WHEN TO SEEK TREATMENT
If you’re concerned that you or a loved one is developing an unhealthy relationship with drugs or alcohol, you do not need to wait until a full-blown addiction is present to seek treatment. In fact, the earlier a person gets help, the greater likelihood that he or she will see positive outcomes in the recovery process.
For additional reading, you can check out our marijuana addiction treatment, opiate addicion treatment and other treatment options under “What We Treat” at the top.
We’re here to answer all your questions regarding treatment and can help determine if our program is the best fit for you or your loved one.