The Stages of Addiction

Various stages of addiction manifest through different periods of a person's substance use. For some people, they can develop a substance-related habit quickly, within months, for example. Others may need to use substances for an extended period before progressing along the spectrum of disordered drug use, which could mean several years.

Addiction is a progressive chronic disease. It may start with experimentation, but a person can go from an initial use to abuse to developing tolerance then to substance use disorder, which may require clinical treatment like that found in a residential rehab. Professional treatment is necessary for many people who have addictive behaviors, so they can successfully recover and abstain from continued use of drugs or alcohol. When you add in periods of relapse, you can see that addiction is part of a chronic cycle which can include some or all the stages below—sometimes simultaneously.

Initial Use

Addiction is a disease that affects millions of Americans, but many can't point to when they first began abusing substances. Some people try drugs or alcohol for the first time because they are curious and seek new experiences. Others have mental health troubles and use drugs as self-medication. When combined with the addictive nature of some substances, these factors mean many reasons could lead to a person's initial use of drugs and alcohol.


What follows initial use is a stage of substance abuse, when a person uses drugs or alcohol too often and in damaging ways. The effects of increased use can be different for each person. Usually, the results depend on the substance a person uses. However, when a person uses drugs or alcohol to cope with certain situations, mental or emotional trauma, for example, it could increase the likelihood of that individual escalating further along the cyclical stages of addiction.


When using a prescription drug, alcohol or abusing other substances for a long time, the chemicals can change the brain, which eventually can lead to building up a tolerance. The brain may adapt to the drugs by decreasing its natural response to them. If an individual has been using a substance for a while, they may need increasingly larger doses to feel the desired effect. This tolerance is the body's way of compensating for the presence of the substance and making it more challenging to achieve high levels of euphoria or effects like those the person felt when initially using and with lesser amounts.


According to the National Institute on Drug Abuse, the brain and body can become dependent on a substance with time, but not all drug dependence means a person has an addiction. When a person has a chemical reliance on a drug, they cannot function normally without the substance. This dependency is different, for instance, then when a person has a preexisting health condition and "needs" a drug to be healthy because it is not the medicine that caused impairment or dysfunction.

Substance Use Disorder

Addiction is a severe manifestation of a substance use disorder (SUD) that a doctor can diagnose based on criteria found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Some of these signs can include:

• an inability to quit drug use or alcohol consumption

• substance use-related interpersonal problems

• physical cravings for a substance

• having withdrawal symptoms when not using

• persistent use despite adverse health complications

There are six other criteria described in the DSM-5. A person needs only two or three symptoms to receive a mild substance use disorder diagnosis and six or more for a diagnosis of having an addiction or severe SUD.


It can be challenging to quit drugs with no help. It often happens that people will start by trying to stop on their own and they may relapse. Although it may not be an indicator of total failure, any experience with relapse needs correct handling. However, relapse is not the case for everyone. If a person is receiving treatment for their substance use, like staying in residential rehab and has an effective recovery plan for when they get discharged, they have a better chance of staying off drugs.


Residential treatment provides care around the clock. Many rehabs are luxurious and offer a safe, relaxing and comfortable environment for detox, which helps a person eliminate toxins and heal from the physiological reactions to drug cessation.

Treatment is constructive and helps individuals examine damaging beliefs and maladaptive behaviors. It's essential to have a fresh start. To make a long-term recovery, following stays in residential treatment programs, many individuals need to participate in outpatient activities or some engaging aftercare program to better their chances of a successful recovery. Belonging to a community of peers who are also recovering in supportive environments lowers the chances of relapse and helps people become more functional in their daily lives.


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