Stages of Addiction
In 2017, the National Survey on Drug Use and Health (NSDUH) reported that 1 in 12 American adults suffer from a Substance Use Disorder (SUD). So what are SUDs and how does someone go from experimental use to a full blown addiction? While everyone may have a different story, the causes and stages of addiction can be generally categorized into a few recognizable steps. Being able to identify the steps can be crucial in preventing SUDs.
What is a Substance Use Disorder (SUD)?
Drug addiction or medically known as SUD, is a disease where an individual is unable to control their desire to use legal or illegal drugs. Drugs are anything that has a physiological effect when introduced to the body (such as snorting, drinking, smoking, etc). Some common drugs include alcohol, nicotine and marijuana.
Stage 1: Experimentation
Most addictions start with experimentation. It is not unusual to see experimentation occur early on in someone’s life. While it may not directly lead to an addiction, it does open the door for future use. According to a 2013 survey from the Substance Abuse and Mental Health Services Administration (SAMHSA), 3.841 million people tried alcohol for the first time between the ages of 12-20 years old. Experimentation may occur for a variety of reasons such as:
- Peer pressure
- Pure curiosity
- Availability of drugs (opportunity)
- Mental health issues
Most people who experiment with drugs are looking for the social benefits they have heard about, whether it is because a friend recommended it or media and culture presents it as a positive experience. For example, alcohol is prevalent in media and most cultures around the world. People usually view it as a fun substance that takes the edge off in social situations. Many teens and young adults likely see no harm in trying a few drinks. A lot of media depicts alcohol use while rarely showing consequences. You could even binge drink and still technically not move past the experimentation phase as college students and party goers will typically binge drink at parties and social atmospheres.
At this stage, there are no cravings and the desire to continue use may not even appear with some drugs. However, the possibility remains that further experimentation with other drugs occur. With certain substances, like alcohol impairing judgment, people are more open to risk. This is likely why a great number of people are open to trying other various substances. That is not to say alcohol use alone absolutely leads to experimentation or addiction to other substances. Simply it is a potential factor.
Stage 2: Regular Use
At this stage, individuals will incorporate a drug into their daily routine whether they are aware of it or not. Everyday use may not occur but there is a pattern to your use. Even if it becomes a weekend-use drug or it is purely circumstantial (ex. you use it when you’re stressed or bored), it is still considered regular use.
You may not be fully addicted at this point but it is possible for regular use to lead to addiction.
Stage 3: Problem/Risky Use
With risky use, the drug has now become a negative influence in your life. It is possible this is because you are missing school or work or engaging in dangerous behavior such as driving under the influence. Your relationships begin to deteriorate and your behavior begins to change for the worse.
Stage 4: Substance Use Disorder/Addiction
SUD is a chronic disease which means it is slow to develop and may be hard to notice at first. You begin to have desires and crave the drug and feel as if you cannot function without it. Depending on the drug, you will develop a tolerance which means you will not be able to use the same amount every time as the ‘high’ you experience decrease. This will cause you to use higher doses in order to achieve the desired feeling. Unfortunately, the risk of overdosing increases once you develop a tolerance because you will be chasing that first high experience.
Psychological dependence will fully develop at this stage because you feel as if you cannot function or be happy unless you take the drug. Physical dependence will also develop at this stage in the form of withdrawals.
Criteria for SUDs
The American Psychological Association (APA) recently updated its manual on SUD diagnosis (The Diagnostic and Statistical Manual of Mental Disorders- DSM-5) to help better understand what is medically considered as an addiction. It is divided into 3 categories with a list of traits which determine which category an individual would be considered under.
Those who meet:
- 2-3 criteria are considered to have a mild disorder
- 4-5 criteria are considered to have a moderate disorder
- 6+ criteria are considered to have a severe disorder
Some of the criteria includes:
- The substance is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful effort to cut down or control use of the substance.
- Craving, or a strong desire or urge to use the substance, occurs.
- Continual use of substance results in issues with significant obligations in work, school or home
- Use of the substance continues despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of its use.
More information is available in the APA DSM-5 guide. Knowing the criteria and the stages of addiction are helpful in recognizing one’s own problems or their loved one’s potential issues.
What causes addiction?
Addiction is often confusing at first glance because it is hard to wrap your mind around why you have desires to do things that you know are not good for you. It comes down to the chemistry of your brain. Our brain contains a chemical known as dopamine. Dopamine is known as the ‘feel good’ chemical. It releases in our body when we do things that are pleasurable such as eating, drinking or having sex. In our primitive days, it is what would motivate us to hunt, gather and produce offspring.
Drugs such as alcohol promote the release of dopamine in the body. Dopamine is responsible for a feeling of euphoria commonly associated with drug use. Our desire to feel a sense of euphoria or feel good in general will cause us to replicate or continue those actions which produce it- such as drinking alcohol. As our bodies develop a tolerance to a drug, our desire to chase that dopamine high will encourage the use of higher doses.
The stages of addiction are not universal, nor are they complete for every individual’s experience. Nonetheless, knowing the stages of addiction is helpful for many people to be wary of substance use and abuse. Treatment for SUDs can be challenging but it is most certainly possible. The very nature of addiction means that relapse is not only possible, but likely. It is important for treatment to include a plan to prevent and manage relapse.
Completely curing an addiction takes time and dedication as well as a very fundamental change in the behavior of the individual. Addiction to multiple substances does make treatment more challenging. That is why it is more important than anything to find a competent treatment center equipped to handle all of your needs. If you or a loved one is struggling with addiction, please contact us today.