Addiction is one of the most common mental illness in the United States. In 2017, nearly 20 million people in the US over the age of 12 were caught in the grips of addiction to alcohol, tobacco, or other drugs. Drug abuse can be deadly. It is a difficult topic to discuss as there’s a huge stigma surrounding the treatment and diagnosis. But it’s important that we continue to contribute to the dialogue surrounding substance abuse disorders. Through education, we can give people the resources they need in order to find help. The first step is knowing the basics: the signs and five stages of addiction. Once you have an understanding of this, you can seek the help you or a loved one may need through addiction treatment centers and certified medical professionals.
The first stage of substance abuse is experimentation. This generally starts during the teenage years. Most first-time drug users experiment with drugs or alcohol for the first time before the age of 18 years old. This is a complicated stage because it’s difficult to gauge whether or not this use will become a more serious issue. Users in this stage generally dabble in drugs or alcohol through social means, at parties or gatherings. During the first stages, most people don’t have cravings as they still have control over their substance use.
More often than not, this stage is without any serious legal or social consequence and most users in this stage are testing out drugs or alcohol under the guise of having fun, entertainment, or coping with emotional, mental, or physical pain. This stage can be complicated because oftentimes during this phase, users are taking opioids prescribed by a medical professional immediately following an injury.
Why are they using? How much are they using? How often do they use? It’s important to keep mental notes in this stage in order to determine whether or not their substance abuse is beginning to progress into the next stage which is regular use.
The second phase in the five stages of addiction is regular use. Once progressing through the experimentation phase, using becomes a part of their routine. Often times, people in this stage will begin using drugs and alcohol on the weekends or in their downtime.
It’s not always noticeable that their usage has increased because often they are still using in a social setting or with other people… but regular users will use while they’re alone too. Users here are becoming more reliant on their substance of choice because they like the way the substance makes them feel. For users taking prescribed drugs, they continue to use out of a perceived necessity.
Generally, the effects of the drug are different – it takes regular users longer to bounce back and push through their drug or alcohol hangover. This often results in missed social engagements or events. The brain in this stage is taking longer to repair itself. Changes occur in their behavior: aggression, depression, reduced inhibitions or impulse control, and anxiety. Here, the substance becomes more important in their lives and can continuously become more problematic.
Sometimes users show no signs of dependency in this stage and could quit without the help of others. That said, if the user is showing signs that this is not the case, it would be in their best interest to encourage them to seek counseling or outpatient treatment.
The line between regular and risky use is gray because the concept of risk is so subjective. Typically, in this stage, the abuse begins to affect a person’s life and create instability. Here users begin to lose control of their drug use and will begin to engage in dangerous or risky behaviors in order to fuel their habit.
Grades may drop, classes may be missed, a drink or two (or three) after work becomes being too drunk to drive. People often lose their jobs, are arrested, lie to loved ones, frequently engage in unprotected sex, or break up with partners or end friendships. Risky use will be characterized by the physical warning signs of addiction as well. These include physical dependency, cravings, fatigue, and preoccupation with using again. The possibility of quitting seems more difficult and complicated here.
In this stage, inpatient treatment or rehabilitation is the best way to cope. Short term or long term, it would be best to encourage them to go to a treatment center to help them remove themselves from social situations or triggers.
Tolerance is the fourth stage of addiction. While the chemical makeup of the brain is not directly affected just yet, things do take a serious turn here because the brain is becoming more accustomed to regular drug use. People are continuing to use their substance of choice despite the negative (and detrimental) physical, financial, or emotional effects their abuse has had on their lives.
Their health, job, friends, and a family are of no consequence in this phase and they will do anything to chase their high. Because their bodies are becoming more tolerant of their substance of choice, users in this phase up dosage or increase potency. They also begin to use this to stave off withdrawal like flu-like symptoms nausea and muscle pain, rapid heart rate, shakiness, sweating, or even seizures.
If you’re trying to get a loved one help in this stage, it’s best to encourage a detoxification process with the help of a professional at a center because, in this stage, a relapse often occurs if users try to quit on their own. At a detox center, users will go through a withdrawal process in a safe, monitored environment or be provided medication to help minimize withdrawal symptoms or discomfort.
The final phase of the five stages of substance abuse is an addiction. This is the most detrimental stage when dependency becomes a full-blown disorder. People in this phase experience intense cravings and will use until these cravings go away or dissipate. There’s a sense of desperation that comes along with this stage as using has become the only way for them to feel normal.
Because all control has been given over to the disease, their lives are often chaotic and they have an inability to function without their substance of choice.
Giving up the substance without help or support at this stage can prove nearly impossible and users can experience chronic relapses. Professional addiction treatment is needed once an addiction has been developed. On the reverse, in this stage, people are often in denial of their disease. They are under the impression that they don’t have any issues at all.
Overcoming addiction is a battle many people face. You are not alone. If you or a loved one is struggling through the stages of addiction, it’s crucial that you seek the help you need. The picture of substance abuse might be dark, but professional help is a viable option through all of the stages of addiction.