The Cycle of Addiction: Stages and Treatment – According to the American Society of Addiction Medicine (ASAM), addiction is a chronic brain disease that impacts the brain’s reward, pleasure, memory, and motivation centers. Like most chronic diseases, it does not just come out of nowhere. Often, it takes a set of unfortunate circumstances that, over time, cause a person who would typically enjoy casual drinking or avoid drugs to become addicted to a substance.
Moreover, the process of developing an addiction tends to occur over a series of stages and often turns into a cycle of substance abuse, treatment, abstinence, then relapse. The stages of addiction can occur over a brief period or can take months or years to develop. A person who only drinks on occasion may, over the years, progress into a habit that eventually begins to resemble full-blown alcoholism.
Stages in the Cycle of Addiction
The addictive potential of some drugs, such as heroin, may be so powerful that a nearly immediate addiction may appear to develop. However, for the majority of people suffering from addiction, there are stages of substance abuse that lead to the person becoming addicted.
These stages include the following:
1. Initial use
Stage 1: Initial Use
There are many reasons why a person who ends up suffering from an addiction might experiment with the substance initially. This introduction could be as innocuous as receiving a prescription to treat pain or a mental health issue, as typical as having the first drink at age 21, or as unfortunate as being the target of peer-pressure. Regardless of how the initial use occurs, however, it is always the required first step in the cycle of addiction.
Whether that initial use is likely to result in addiction is mostly a matter of a person’s biology, upbringing, mental health, and other individual circumstances. Risk factors that can contribute to a higher risk of developing addiction include the following:
- Having a family history of substance use or other mental health conditions
- Experiencing childhood abuse or neglect
- Chaotic or unhealthy living environment
- Family or peer group that is acceptive of substance use
- Depression, anxiety, social problems, or loneliness
It is important to note that even these risk factors won’t inevitably lead the at-risk individual to develop a substance use disorder. Many other factors may contribute, including the person’s moral code, which may prevent him or her from trying drugs or alcohol in the first place.
Stage 2: Abuse
The next stage of the cycle of addiction is substance abuse. At this point, the person is using the substance repeatedly and inappropriately, and in a way that is potentially harmful. For example, it would constitute abuse if an individual who is using a prescription painkiller decides to ingest higher doses or take the medication more often, or if a person begins consuming drugs or alcohol in a binge-like pattern.
For illegal drugs such as meth or heroin, abuse technically occurs the first time (and every subsequent time) that a person uses the drug. With legal substances like alcohol or prescription medications, abuse is a little harder to recognize. It is often considered to be the point in which the individual begins using the substance to get high rather than for the “as directed” purpose of the substance.
Stage 3: Tolerance
When a person has been taking a substance for a prolonged period, the substance can cause changes in the brain that lead to tolerance – a condition in which the original dosage of the substance no longer induces the same mental or physical effect. As a result, the person may increase the dosage or frequency of use to try to achieve the original results.
Tolerance indicates that the neurochemistry of the brain has been altered in response to use of the substance. Over time, the person’s brain adapts and changes how it reacts to the drug’s presence. Continued abuse and increasing tolerance will lead to the next stage in the cycle of addiction – dependence.
Stage 4: Dependence
Dependence is a physiological state or condition in which the body requires exposure to some substance in order to function “normally.” For instance, a person who has been abusing meth or cocaine for an extended period may find it difficult to experience pleasure without the drug (anhedonia.) With dependence also comes withdrawal – unpleasant symptoms that manifest when the person tries to quit using the substance or dramatically cut back.
Not all drug dependence indicates that there is an addiction, however. For example, a person with attention-deficit hyperactivity disorder may be dependent on Adderall to perform adequately at work or school – this is not necessarily addiction.
In this case, the individual is using the medication according to a therapeutic regimen in order to rectify certain cognitive functions. Unless the person exhibits the following criteria for addiction, this person is considered to be dependent upon, but not addicted to Adderall.
Stage 5: Addiction
Addiction is a chronic mental health disorder that results in specific symptoms and behaviors that, according to the Diagnostic and Statistical Manual (DSM-V), include the following:
- Drinking more alcohol or using more of the drug than originally planned
- Failure to stop using the substance
- Experiencing strained relationships related to substance use
- Spending a considerable amount of time obtaining, using, and recovering from substance abuse
- Decreasing participation in previously enjoyed activities in favor of substance use
- Being unable to attend to personal responsibilities due to substance use
- Cravings for the substance
- Continuing to use the substance despite adverse health effects
- Routinely using the substance in dangerous or inappropriate situations, such as driving
- Developing tolerance for the substance
- Experiencing withdrawal symptoms when use is discontinued
In general, experiencing two or three of these symptoms is considered a mild substance use disorder, while experiencing four or five them is considered to be a moderate disorder. If the person experiences six or more of the symptoms, this is indicative of a severe substance use disorder or addiction.
Stage 6: Relapse
A hallmark of any chronic disease is the potential for relapse. For chronic conditions such as diabetes, relapse is often anticipated as the individual and medical personnel cooperate to devise a treatment that will make it possible to manage the condition.
Addiction is not much different from these conditions. Indeed, relapse rates for addiction – on average, 50% – resemble those for asthma and adult-onset diabetes. Sometimes, the initial treatment is not adequate, or the person begins by trying to quit without professional help, and, over time, the person loses control and relapses to drug use. However, relapse does not necessarily mean that the person has failed, only that the treatment being implemented needs adjustment.
Intervening in the Cycle of Addiction
An individual may undergo multiple attempts to discontinue using a substance before acknowledging that addiction is a factor preventing them from quitting. When addiction is diagnosed, however, it is possible to disrupt this cycle of addiction, abstinence, and relapse by receiving professional, evidence-based treatment.
Multiple methods, including behavioral therapies, group support, and other treatments for physical and mental health can help the person develop the tools needed to manage this chronic, debilitating condition. With motivation and the help of an experienced, certified addiction specialist, individuals can learn how to intervene in the cycle of addiction. Individuals can march forward into abstinence and a more positive, healthy future.
Contact Harmony Ridge Recovery today to discuss treatment options and begin your journey to reclaim your life, free from substance abuse and addiction!