A substance abuse disorder does not just happen in an instant. It is a chronic disease that develops over time and is not the first time someone uses addictive substances. There are various models of the different stages of drug addiction and alcohol abuse. This post will look at these stages.
1. Initiation
This first stage of addiction happens occurs in four ways.
Curiosity – Someone hears about a substance and tries it
Peer pressure – People a person knows that persuade or pressure them into trying their substance of choice.
Prescriptions –Prescription medications, often prescription painkillers, initiates the addiction cycle.
Home environment – In homes where drug abuse or people binge drink, such behavior is seen as typical, and there is little avoidant response.
Additionally, there is also a link between people with mental health issues and drug and alcohol use, indicating that such people are more likely to engage in risky use.
The first use or first drink introduces potential addicts to the possibilities of how pleasurable use may be. It can be very enticing and may lead to the second stage. At this stage, though, it seems harmless enough, and because a person can control their consumption, they consider that they will be able to do so in the future.
2. Experimentation
In this stage, illegal drugs and alcohol are used in different contexts and may be mixed with other drugs. In experimentation, there is little craving for the drug, and physical dependence is absent. The belief about the ability to control use going forward may be reinforced. At this point, the user is not an addict, and if they compare themselves to an addict, they see their involvement with drugs as being manageable, which at this stage it is.
3. Regular Usage
The third stage starts when a substance becomes a part of a pattern and is used regularly. This does not necessarily mean daily but can be on the weekends or when clubbing.
This is a transitional phase. More than any other stage except the 7th, decisions made now establish the future for most people. At this stage, people may experience negative consequences such as work performance being affected and an increased number of hangovers.
4. Risky Usage
When people reach risky usage, the occasional negative effects of stage 3, regular usage, become more frequent and severe. This is when things like DUIs start to happen, and work or academic performance declines noticeably.
In daily life, behaviors start to change, and actions such as:
Theft of money, substances of choice, or saleable items
Neglecting work and/or family
Attempting to hide or gloss over their drug or alcohol use, trying to convince others that their concern is unwarranted
Hiding drugs from others
Changing peer groups and starting to mix with others who exhibit addictive behavior,
If the substance of choice is a prescription medication, they may visit multiple doctors or change doctors frequently
Losing interest in previous activities
Engage in risky behavior such as driving drunk or having unprotected sex
Self-care starts to decline
May become financially compromised
5. Dependence
Dependence involves three elements. These are:
Tolerance – As the use of a substance becomes more frequent, higher amounts are needed to achieve the same effect.
Physical dependence - this is defined as the point when not drinking or using results in withdrawal symptoms.
Psychological dependence – also known as “chemical dependency,”refers to the condition of experiencing drug cravings.
Not all of the above conditions may be present at the start, but most will eventually be present at the end of the stage. They usually occur in this order. Someone may show tolerance but not be physically dependent. People cannot exhibit physical dependence without developing substance tolerance.
6. Addiction/Substance Abuse Disorder
These terms are interchangeable, with substance abuse disorder (SUD) being the term used in psychiatric circles.
The extent of substance use disorders can be mild, moderate, or severe, depending on how many diagnostic criteria are present. The assessment will include criteria like:
Being unable to face life with drugs or alcohol.
Inability to control use.
Continuing to use a substance even though it has severe, negative effects on health and life.
Lying about use, particularly regarding quantity, but also frequency.
The addict avoids friends and family, becoming increasingly isolated.
They give up activities they used to enjoy before.
The addict cannot or will not recognize the problems caused by and associated with their behavior or interpersonal relationships, often blaming others for any issues.
During this stage, this chronic disease is in full swing. There is an ever-increasing risk of physical damage and overdose. Substance abuse disorders damage motivation, memory, decision-making, learning, and emotions.
The behaviors mentioned in stage 4 have now become a constant issue. Increasing inability to manage is, for some, is when they realize they have reached a low point in their lives and find the courage to attempt to change. This leads them to the final stage.
7. Crisis and Treatment
There comes a point for many addicts where they enter a crisis period, where they are reduced to a point where it is necessary to admit to their inability to cope with their substance abuse. This is when in 12-step programs say people say they "admitted they were powerless over their addiction and that their lives had become unmanageable".
There are many treatment options. These include 12-step programs or other support groups, outpatient treatment programs, and admission to a residential center.
Several interventions may be used. These include medical detox to alleviate withdrawal symptoms, dealing with any co-morbid mental illness, and various therapies to help reduce the chances of returning to the vicious cycle of this disease. There is much for the addict in recovery to deal with.
Significant changes are needed to maximize the chance of staying clean. The person with a fully-fledged substance abuse disorder has often burned many bridges and now needs to rebuild relationships with family members. Support is vital in becoming and staying recovered.
Not every addict reaches this point and instead stays in the sixth stage. Others will enter this stage and not complete it. Others will complete it and, at some point, relapse letting the cycle of addiction continue. The relapse percentage is between 40 and 60 percent. Despite these figures, this is the stage of hope.
Summing up
We have looked at the stages of addiction in this post and the focus has been on addiction to substances but remove the element of physical dependence and much of what is written here can be applied to other addictions such as gambling, sex, online gaming, and eating. The progression from initiation to addiction follows the same pattern and the recognition of the crisis is necessary to enter the treatment phase.
It can be argued that the presence of a treatment stage is a commercial add-on that treatment centers can use to promote their services. I disagree. In the life cycle of any disease, ranging from flu to cancer, treatment is necessary to emerge from that illness.
Unlike several decades ago, addiction is now seen as a chronic disease. Like any other chronic illness, it is progressive and can, with treatment, be dealt with.
These stages reflect the entire life of this disorder.