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The 5 Stages of Addiction Behavioral Roadmap

It’s impossible to know exactly how many people in the United States battle addiction issues, but it is possible to isolate the 5 Stages of Addiction most people generally follow along the road to getting there.

If we narrow the focus solely to alcohol, opioids and other drugs, such as marijuana, cocaine, and methamphetamines, experts believe an estimated 24 million people struggle with the disease of addiction.

However, that number doesn’t account for other types of addictive disorders, such as gambling, pornography, or food and eating disorders.

Stages of Addiction

The science of not just treating addiction, but how people become addicted is clearer than ever before. Recognizing behaviors that present potential warning signs is a key to interrupting the cycle.

In general, most healthcare professionals agree there are 5 stages of addiction. Most of the stages are not actually considered addiction per se, but they all lead up to it.

The definition of addiction, according to NIDA (The National Institute on Drug Abuse), is “…a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.” It’s classified as a brain disease because it alters the chemical structure of the brain.

In particular, the response of the neurotransmitters in the brain like dopamine are responsible for pleasure, and they change over time due to extended use of drugs or alcohol.

This makes it more difficult for a person to experience a normal, biological sense of wellbeing without abusing whatever substance they’ve become addicted to.

What’s important to remember, though, is that this is a progressive disease and people don’t start out in an addictive phase of physical and psychological dependence.

What Are The 5 Stages of Addiction?

There can be some overlap between the various levels of addiction, and not everyone will follow the same path through each phase.

The roadmap below outlines the 5 stages of addiction that most people follow from the first time they use a substance until it becomes an addictive behavior.

1. The First Stage of Addiction – First Use or Experimentation

Everyone remembers the first time they got drunk or the first time they got high.

Most people think the first stage of addiction is considered “experimentation.” In actuality first use does encompass some form of experimentation with alcohol or drugs for many people.

But it also includes those people who are taking a medication that was medically prescribed by their physician for a specific issue.

People who take a prescribed medication aren’t experimenting with getting high and they are simply following a doctor’s orders for health reasons.

Whether the first use is out of a sense of adventure, peer pressure, or a medical necessity, people will learn and understand how the substance makes them feel through this first-time use.

2. Continued Use

Continued use of a substance, in the case of a person with a prescription, might be out of a requirement or feeling the need to use the medication.

For an individual that experimented not too long ago and returned to the substance, it’s clearer that they like how the drug makes them feel.

Also, in the continued use stage, a person is likely to notice that they’re not bouncing back as quickly after getting high or using the substance. This is because it takes the brain longer to chemically repair itself and return to a normal balance of homeostasis.

It’s important to note, the continued use phase can go on for a very long time without ever causing any problems for majority of people.

What Are the Stages of Addiction?

3. Tolerance is the Third Stage of Addiction

Tolerance occurs after a period of continued use of drugs or alcohol, and the speed and degree of a tolerance will vary among each person and often depends on the type of substance they are using.

Building up a tolerance to drugs or alcohol is one of the first warning signs of addiction.

When a person experiences a tolerance to something, it means the brain and body have adjusted to the drug and it now takes a greater amount to feel the same effects of it that they previously felt.

A person that has developed a tolerance to a prescription painkiller their doctor prescribed might start to notice that the dosage they have been taking no longer dulls their pain as effectively as it did when they first started using it.

When people develop a tolerance to alcohol, they realize they must drink more to feel drunk, even though their blood alcohol concentration doesn’t change. They will still be considered legally intoxicated after the same amount of drinks as when they first began drinking.

4. Dependence

Dependence is the stage of addiction where a substance user might first notice they become physically ill without alcohol or drugs, perhaps even developing serious withdrawal symptoms. There are several biological elements in play here.

Chemically, the brain has become accustomed to the substance and doesn’t function well without it.

This also presents as a physical symptom, sending a person into withdrawal where they can experience flu-like symptoms when not using opiates, or sweats and shakiness when they aren’t drinking alcohol.

The negative signs and symptoms of dependence often disappear when a person is able to get a drink or a fix of their drug of choice.

When a dependence to drugs or alcohol occurs, many individuals don’t feel normal if they’re sober and not using any substances. This stage of addiction is a possible sign the disease is probably starting to take hold, both physically and psychologically.

5. Addiction

With the last stage of addiction, individuals find it nearly impossible to stop using drugs or alcohol, even when they no longer enjoy it or their behavior has caused serious life problems.

In fact, this stage is one of the telltale signs of addiction and goes back to the definition provided above that, “people will compulsively seek and use drugs or alcohol despite harmful consequences.”

Many people might go for periods of time where they don’t use any drugs or alcohol, but they are unable to stop completely by themselves, even though things seemed to be going well.

On the other side of the coin, a person in the throws of addiction who’s lost everything important in their life might be in total denial. They are unwilling or unable to face the disease or see how it is impacting their life.

Some might enjoy it too much to stop despite any negative ramifications, while others simply see it as a normal part of their life that is under their control, even when it isn’t.

Many of these people say they can stop at any time, and others will make jokes about how much they can drink or how many drugs they take.

Sure, addiction is a disease. But it is the only disease that tries to convince you that you don’t have it. This is one reason why many people fail to seek help or treatment.

5 Stages of Addiction

The Stages of Addiction Are Simply a Roadmap

As with all chronic diseases, there are variations within the stages of addiction unique to every individual. For instance, a heavy drinker with a tolerance to alcohol might never develop dependence or addiction.

Still, others might unwittingly fall victim to heroin addiction after being prescribed opioid pain medication for routine injury. When they can’t get any more prescriptions, they look elsewhere and discover drugs can be found cheaper or more powerful on the street.

Opioids are notorious for creating a quick and powerful tolerance that requires using more and more. This can soon necessitate moving up to heroin, despite many users saying they would never go that far.

Research has shown that certain segments of the population are genetically predisposed to addiction, but that the disposition is not a guarantee a person will become an addict or have any problems stopping once they begin using any substances.

On the other hand, an individual with no predisposition can just as easily develop an addiction under the right circumstances.

If we’re being honest with ourselves, knowing and understanding the five stages of addiction as a roadmap can save us from getting lost and becoming addicted.

It also allows us the opportunity to lend someone else a few well thought out directions to the road to sobriety before it’s too late.

Even if a person succumbs to the throes of addiction along the way, there is a road to recovery that allows everyone a chance to get their life back to a healthy and happy state without relying on drugs or alcohol to feel normal.


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