The Stages of Addiction

The National Institute on Drug Abuse defines addiction as “…a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”

Healthcare professionals generally agree that there are five stages of addiction. The National Institute on Drug Abuse defines addiction as “…a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”

Addiction is a neurological disease because it alters the structure of the brain. It becomes difficult for a person who is suffering from addiction or substance use disorders to experience a normal, biological sense of well-being without the help of the substance they’ve become addicted to.

Below are the five common stages of addiction.

  1. First Use/Experimentation. This is where a person learns how a substance makes them feel. Even one episode of experimentation can result in significant harm. Experimental use often serves as a gateway to the cycle of addiction. It is easy to say, “it won’t happen to me” but the truth is that nobody really knows how their body will respond to exposure to drugs. For some, this first exposure to addictive substances is taking prescribed medication for a specific issue.
  2. Continued Use/Social Use. When experimentation leads a person to return to the substance, it becomes obvious that a person likes how the drug makes them feel (at least initially). This is the phase where regular use of the substance starts becoming problematic. During this phase, a person will begin to notice that they’re not bouncing back as quickly after use as they once did. This is because it is taking the brain longer to chemically repair itself after each use. In the case of prescription drugs, a person may enter this phase simply by following their doctor’s orders.
  3. Risky Use/Tolerance. When experimentation leads a person to return to the substance, it becomes obvious that a person likes how the drug makes them feel (at least initially). This is the phase where regular use of the substance starts becoming problematic. During this phase, a person will begin to notice that they’re not bouncing back as quickly after use as they once did. This is because it is taking the brain longer to chemically repair itself after each use. In the case of prescription drugs, a person may enter this phase simply by following their doctor’s orders.
  4. Dependence. Once they are dependent on a substance, a person will have negative physical side effects without that substance, perhaps even experiencing withdrawal symptoms, just like with substance use disorders. Behavioral changes become obvious at this point, and may even start to be dangerous. Dependence is a biological response in which the brain has rewired itself to function with the substance, and can’t function properly without it. Withdrawal symptoms can include flu-like symptoms, sweats, or shakiness. These symptoms will likely disappear once a person is able to get their hands on the substance that they need. With dependence to drugs or alcohol, a person will not feel normal if they’re not using. This is the sign that the addiction is taking hold.
  5. Addiction. At this point, it is nearly impossible for a person to stop using drugs or alcohol, even when they no longer enjoy it or they are experiencing serious problems as a result of drug use. A person will experience a loss of control and find that they are unable to stop themselves from using and are unable to predict how much of the drug they will need or end up taking once they start using it. Addiction leads to significant impairment in their everyday lives, work, relationships, and physical health. When suffering from addiction, a person may feel that they have lost everything. He or she may be in denial, unwilling or unable to face the disease.

There is a lot of room for variation within each of the five stages; each person’s struggle with addiction is unique. Some people are genetically predisposed to addiction because of their family history, but that is not a guarantee that a person will become an addict. A person’s mental health/mental illness may also be a factor and even people with no predisposition can just as easily and just as certainly develop an addiction.

Addiction is a progressive disease. A person doesn’t start out having a physical dependence on any substance. It is important to know and be able to recognize the five stages, risk factors, and signs of addiction, whether in yourself or in a person that you care about, so that you can seek help as early as possible. Treatment can be successful, and the earlier a person starts getting the treatment that he or she needs from medical professionals, the easier the path to recovery will be.

Related: Personality Changes in an Addict