Millions of Americans are diagnosed with a substance use disorder each year. While most people can have a beer or two now and then in moderation, many progress from casual use of drugs or alcohol to full-blown addiction. But how, exactly, does this happen? There are several stages of addiction, each of which comes with its own set of signs and symptoms that can be identified as the condition escalates over time.
Do you know what signs to look for you in yourself or a loved one? These 7 stages are as follows:
Many people first use drugs or alcohol before reaching adulthood. Despite alcohol being illegal to buy or consume for those under age 21, it is often easily obtainable from older family members, friends, and others. Common drugs such as marijuana and amphetamines are also readily available in both urban and rural areas.
It is estimated that every day thousands of teens under age 18 use drugs or alcohol for the first time. Why? Common reasons include sheer curiosity and peer pressure. But one key factor is that teenagers have limited development in the prefrontal cortex, a region of the brain responsible for impulse control and decision-making.
Once a person has used a substance, he or she may feel their curiosity has been satisfied, or they may progress into the experimentation phase. Factors that may affect this decision include the following:
- Availability of drugs or alcohol
- Whether friends or family use substances
- Home environment, including physical, emotional, or sexual abuse
- Existing mental health conditions, such as anxiety, depression, bipolar disorders, and ADD/ADHD
The experimentation stage typically begins when a person starts to use drugs or alcohol in certain situations, like in party environments or during times of stress. Using substances in this stage is often tied to occasional social circumstances.
During this stage, a person may only have thoughts of using occasionally, and as such, behavior can be controlled and cravings will not be significant. He or she will not have developed a tolerance or dependence and will not have incurred any notable adverse consequences. Even if a person binges occasionally, this is done consciously, rather than drinking uncontrollably as an automatic response.
3. Regular Use
At this point, substance use has become more frequent. The person may not use every day, but there is likely a predictable pattern (e.g., using every weekend), or use may repeatedly occur under the same set of circumstances (e.g., due to stress, boredom, depression, etc.)
At this stage, the person will probably use drugs or alcohol with others in social situations but may also begin to do so when alone. He or she may miss school and work due to hangovers. There may be concern about losing a drug or alcohol source because substance use has become associated with the idea of escaping negative emotions or situations and also withdrawal symptoms that onset when the person tries to quit or cut back.
4. Problematic and Risky Use
Substance use, by this point, has begun to take a toll on a person’s life. Driving under the influence may occur, and work or school performance may be suffering. Relationships with others may become strained, one’s circle of friends may have changed, and his or her behavior has almost certainly been altered for the worse.
Risky or problematic use threatens a person’s safety (as well as the safety of others) but does not yet meet the criteria for a substance use disorder.
Three components characterize dependence. These are tolerance, physical dependence, and psychological dependence.
Tolerance develops over time as a person requires more and more of alcohol or a drug of choice to achieve the same effects. The person may begin to use ever-increasing amounts just to experience the effects he or she did initially.
Physical dependence, when discontinuing the use of drugs or alcohol, provokes a withdrawal response. At this point, the body has grown accustomed to the presence of the substance and can no longer function correctly without it. Physical dependence can even happen to patients who have legitimate prescriptions for certain medications, such as those related to opioids or benzodiazepines.
Withdrawal symptoms that occur when a person tries to quit using a substance they are dependent on are often highly unpleasant, and can, in some instances, be life-threatening. These effects are often the reason why people return to drug or alcohol use as a means to relieve pain and discomfort.
Physical dependence is also referred to as having a “chemical” dependence, because, as is implied, the body is literally dependent on the presence of the chemical. People with physical dependence and not a psychological one will likely want to quit using eventually but find it difficult and need to be weaned off the substance.
Psychological dependence is hallmarked by drug cravings, a high rate of substance use that is uncontrollable, and likely compulsive drug-seeking behavior. This type of dependence is emotional in nature and does not necessarily need a direct physical component.
While physical and psychological dependence tend to go hand-in-hand, they do not always. A person can have a psychological dependence on a substance without having a chemical one. For example, experts believe that it is possible to develop an emotional dependence on hallucinogenic drugs such as LSD. However, research has shown they tend to have little to no potential for chemical dependence.
6. Substance Use Disorder
A person is living with a substance use disorder when he or she meets the following criteria: He/she…
- Cannot face life without their drug of choice
- Cannot control drug or alcohol use
- Continues to use despite the incurrence of harm to his/her life
- Lies about using, such as how often and how much
- Becomes withdrawn from family and friends
- Neglects activities once enjoyed
- Fails to acknowledge the problems that drug-using behavior has caused
A substance use disorder is more than just the sum of its parts, however. It is a chronic, potentially life-threatening disease, may be slow to develop, and individuals who suffer may go through continual cycles of relapse and recovery throughout their lives. In fact, relapse rates for SUDs are similar to those of other chronic diseases, including diabetes, asthma, and hypertension.
Substance use disorders can be challenging to manage because they affect almost every region of the brain, including those responsible for the regulation of emotion, memory, judgment, motivation, learning, movement, and reward-related circuitry in the brain. They occur, in part, because chronic substance use floods the brain with dopamine and other feel-good chemicals that induce feelings of pleasure, relaxation, and reward.
These effects encourage people to keep using, and over time, the brain becomes less able to produce these chemicals on its own. In other words, the person now needs the substance to feel even relatively normal, let alone happy. It may take a considerable time for dopamine levels to return to where they should be, and as a result, relapse is a high risk until this occurs.
Fortunately, substance use disorders are treatable, allowing people who suffer to regain control over their lives, health, and well-being.
Rehab centers, such as Just Believe Detox, offer medical services as well as long-term, comprehensive programs that include evidence-based modalities such as psychotherapy, counseling, group support, aftercare planning, and more.
The more intensive and long-lasting treatment is, the better the outcome for an individual struggling with a substance use disorder will be. If you are ready to take that step, we urge you to start now and contact us today!