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What Are The Stages of Addiction?

Addiction is an insidious disease that affects millions of Americans every year. According to the 2020 National Survey on Drug Use and Health, 40.3 million people aged 12 or older had a substance use issue during the past year. Despite the pervasiveness of the disease, addiction seems to catch many people unaware. As a result, those who begin to suspect that they may be suffering from substance abuse find themselves asking the same question: What are the stages of addiction?


It is commonly accepted in the world of substance abuse treatment that there are five stages of addiction: initial use, abuse, tolerance, dependence and, finally, addiction. Understanding the addiction cycle, and the realities of each stage within it, is important for identifying substance issues and deciding to seek treatment. Let’s take a closer look at each stage of the addiction cycle and identify warning signs that people can keep an eye out for.


Stage One: Initial Use
There are innumerable reasons why a person might choose to try a substance for the first time. It can be as casual as a high-school kid trying to look cool and smoking marijuana for the first time. Maybe an adult breaks an arm and finds themselves taking painkillers for the first time at the behest of their doctor. An initial use event can even be something as benign as trying alcohol at a bar for the first time after turning 21. It’s important to point out that initial use of a substance does not guarantee addiction, but we do know that every case of addiction has a moment of initial use.


Whether or not a person is likely to become addicted after an initial use scenario is usually entirely dependent on individual circumstances. From genetics and family history, to psychological state and stress, there are many factors that can be warning signs of an issue with addiction.


Stage Two: Regular Use
There is an argument to be made for the value of trying new things. There are millions of people around the world who have tried an illicit substance at some point in their lives, and never developed an issue with addiction. One of the major differentiators between those types of people is the move from initial use to regular use.


Stage two of the addiction cycle, regular use, occurs when an individual begins using a substance on a consistent basis. Regular use can be difficult to notice as an outsider because many substance users at the regular use stage are high functioning. That means that at this stage of the addiction cycle a person is using a substance consistently, but it is not yet negatively affecting their ability to operate normally in their day-to-day lives.


Stage Three: Risky Use
Stage three of the addiction cycle, risky use, is what is considered the tipping point. Those individuals who find themselves in stage three are far more likely to end up at stage five, addicted, than those who only reach stage two of the addiction cycle. Risky use can be difficult to identify since the concept of risk is subjective. The best way to identify risky use is to notice a change in the behavior of the individual using. That can be as simple as a person needing to leave a meal to smoke a cigarette when they never used to do that, or as surreptitious as someone driving to meet a dealer multiple times a week. What constitutes risky use will be unique to each individual.


Stage Four: Dependence
Dependence is the stage of the addiction cycle where the health of the individual becomes genuinely concerning. Over time, an individual can become both physically and mentally dependent on their substances. The most well known example of this is the shakes that alcoholics exhibit if they have been sober for too long.


Once a person has entered the dependence stage of the addiction cycle they will likely be exhibiting major behavioral changes to those who know them well. At this point, obtaining a substance will be top-of-mind for the affected individuals for most of their waking hours.


The more they continue to use, the more intense their physical addiction can become. Depending on the type of substance being abused, the only way to safely detox the user involves professional treatment. Alcohol and opioids for example have withdrawal symptoms that are so intense they can kill the user during the process. That’s why professional care is critical to anyone who has entered stage four of the addiction cycle.


Stage Five: Addiction
The fifth and final stage of the addiction cycle happens when an individual can no longer function in their daily life without using their substance of choice. At this point, obtaining and using their substance is the top priority in this individual’s life. Careers, family and even food will all be considered secondary behind obtaining their substance to a person who finds themselves in stage five of the addiction cycle.


Consistent use of a substance over an extended period of time will always lead to drug or alcohol addiction. The severity of that addiction can vary greatly depending on the substance that is being abused. While some people are more predisposed to this disease than others through a myriad of risk factors, no one is completely immune from the dangers of addiction.


When an individual has reached stage five of the addiction cycle, the most effective path forward is to change their behaviors surrounding their abuse. The most efficient way of doing so is professional addiction treatment.


Here at Sunshine Behavioral Health we have made it our mission to provide the highest quality substance abuse treatment services and deliver them with passion, integrity, and company spirit. We are dedicated to providing individuals with the tools they need to overcome their substance abuse dependencies and learn to manage co-occurring disorders. If you, or someone you know, is suffering from substance abuse we encourage you to visit Don’t wait another day, Sunshine Behavioral Health is here to help.


Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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