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What Are The Stages Of Addiction?

Updated: Dec 2, 2022

The road to addiction is different for every person. Some people take their time while others go from zero to 60 like that. Irrespective of which substance is based and for how long, all addiction follows the same stages. So why should you know about the stages of addiction? This is why:

  • The harmful use of alcohol results in 33 lakh deaths each year.

  • According to 2016 WHO data, 5.6% of the human population uses illicit drugs, such as cannabis, amphetamines, opioids, and cocaine. Cannabis is the most used with almost 20 crore users.

  • Some 3.1 crore persons have drug use disorders.

  • Almost 1.1 crore people inject drugs, of which 13 lakh are living with HIV, 5.5 lakh with hepatitis C, and 10 lakh with both HIV and hepatitis C

All these statistics can be drastically improved, if you simply know what stage of addiction you’re in, and get the help you need. Recognizing the signs early can help you get a head start on the road to recovery. Remember, brighter days can still be ahead.

Stage 1: Drug Experimentation

Experimentation is defined as the voluntary use of drugs without experiencing any negative social or legal consequences. The experimentation stage begins when you start to use drugs or alcohol in specific situations, like teens in party atmospheres or adults in times of particular stress.

Substance use at this stage is a social matter that you associate using with fun, ‘unwinding’. There are no cravings at this stage, and substance use can be controlled (i.e. you decide consciously to use with the risks in mind, and you can stop if you want to) or impulsive (i.e. you use unpredictably, and unexpected accidents or harm can come from substance use, but you do not use regularly, and you are not dependent).

Stage 2: Regular Use, Misuse stage

Experimental use becomes regular drug use when the user starts to incorporate the drug into his or her usual routines. It starts to become a habit for you. You may not use every day, but there may be a predictable pattern (using every weekend) or you may use under the same set of circumstances (when you’re stressed, bored, lonely, etc.). You may miss school or work due to hangovers. There may be worries about losing your drug source since substance use has become tied to the idea of escaping negative emotions or situations.You aren’t yet reliant on the drug for your physical or psychological function, but you’re starting to train your brain to respond to the rewards of using the drug, such as:

  • Pain relief

  • Stress reduction

  • Weight loss

  • Relaxation in social situations

  • Satisfying sleep

  • A pleasurable high

In this phase, you still have control over your drug use. You could probably stop if you wanted to, but you’re satisfied with the effects of the drug, and you don’t really want to give it up. Since you still experience positive effects of drug use, the drug is positively reinforcing you to keep repeating your behaviour of seeking it. Also, you are likely to notice that you’re not bouncing back as quickly after getting “high.” This is because it’s taking the brain longer to chemically repair itself and return to normal balance. Regular, heavy use of drugs or alcohol has begun to take a toll on your life, health, and safety.

Stage 3: Risky Use/Abuse

The line between regular use and risky use/abuse is a very thin one, and is usually defined as continued use of drugs in spite of severe social and legal consequences. As the name suggests, substance use at this point has begun to take a negative toll on your life. Your performance at work or school may be suffering, and your relationships with others is, too. You may have changed your circle of friends, and your behaviour has almost certainly changed.

This is the stage where the warning signs of addiction will begin to appear: craving, preoccupation with the drug, and symptoms of depression, irritability and fatigue if the drug is not used. Substance abuse will not involve physiological dependence or tolerance. For example, use of substances in weekend binge patterns may not involve physiological dependence; however, it may have adverse affects on a person’s and possibly others’ lives. It also increases risky behaviours such as driving under the influence, unexplained violence, stealing or other petty crimes to fund drug use, prostitution to fund drug use, and symptoms of depression and anxiety. You may embarrass yourself socially, experience relationship or marital stress, and have trouble fulfilling work responsibilities.

Once drug use advances to the abuse stage, quitting becomes more difficult. You may try to quit, but you can’t seem to fight the cravings. It’s hard to imagine living without the drug, even though your drug use is making your life feel more and more unmanageable.

Stage 4: Dependence

The difference between risky use and dependence, is that at this stage you have developed tolerance, and physically and psychologically dependent on the drug. Let’s take them one by one.

Tolerance: Because the body has adapted to the presence of the drug, the dose you took when you were first starting out seems minimal now; you need a lot more of the drug to get high or relax. Needing more of the same substance to feel the same high is known as tolerance. While the dopamine released by the drug caused a rush pleasure at first, now it becomes more difficult to experience pleasure without it. At this stage, the substance is negatively reinforcing your behaviour, that is, you’re taking the substance to avoid unpleasant consequences.

Physical Dependence: If you are experiencing withdrawal symptoms when the substance is removed, this is a strong sign of dependence. Depending on the drug, you may experience tremors, sweating, a rapid heart rate, seizures, nausea, muscle pain, bone pain or goose bumps.

Psychological dependence: Occurs when you experience drug cravings, a high rate of substance use (using more frequently, using more of your substance of choice, or both), and using again after attempting to quit.

Once you reach the dependence stage, quitting on your own isn’t usually an option. Your body and mind rely on the drug — unless you go through detoxification and seek medication therapy or psychotherapy, you’ll not be able to stop using the drug.

These stages are cumulative. For example, you can have a tolerance for a substance without being physically dependent and be physically dependent without being psychologically dependent, but you cannot be psychologically dependent without being physically dependent and having developed a tolerance.

Stage 5: Addiction

You know you’re living with a substance use disorder when:

  • You cannot control your use.

  • Being secretive: You may use the substance alone or in secret.

  • You lie about your use, especially about how much you are using.

  • You continue to use despite the harm that comes to your health and life.

  • You avoid friends and family.

  • You have given up activities you used to enjoy.

  • Financial difficulties

  • Chronic relapses when you try to quit

  • Physical changes in appearance: Depending on the substance of choice, the physical effects may vary. However, almost all addicts look drained. They may look pale and tired, rather than refreshed and awake. With a substance like heroin, addicts may pick at their skin and develop lots of wounds on their faces.

  • Disease

These stages are simply a roadmap. Not everyone has the same reaction to addiction, and not everyone will go through all of these stages. Some people may go directly from Stage 1 to Stage 5. Other people may bounce around between stages and never reach Stage 5. These stages are just guidelines. What is important is that if you reach Stage 3, Stage 4, or Stage 5, you need to start treatment. At that point, you need help from a professional.

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