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The 5 Stages of Addiction – A Psychological and Behavioral Roadmap

Last Updated on February 10, 2019 by Inspire Malibu

Logistically, it’s impossible to know exactly how many people in the United States battle addiction issues.

Narrow the focus solely to alcohol, opioids and other drugs, such as marijuana, cocaine and methamphetamines, experts believe an estimated 24 million struggle with the disease.

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

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 key to interrupting the cycle.

In general, most healthcare professionals agree there are five stages to addiction.

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, neurotransmitters in the brain responsible for pleasure – dopamine – are weakened over time. 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 a stage of physical and psychological dependence.

What Are The 5 Stages of Addiction?

1. First Use

First Use encompasses experimentation with alcohol or drugs, but also includes a person taking medication that their physician prescribed them for a specific issue.

Whether the first use is out of a sense of adventure, peer pressure or a medical necessity, they learn how the substance makes them feel at this point.

2. Continued Use

Continued Use of the 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.” This is because it’s taking the brain longer to chemically repair itself and return to normal balance.

3. Tolerance

Tolerance arrives after a period of continued use, the duration of which varies among individuals and whatever substances their using.

This is one of the first warning signs of addiction.

Tolerance means the brain and body have adjusted to the drug and it now takes a greater amount to feel the effects of it.

A person that’s developed a tolerance to a prescription painkiller their doctor prescribed might start to notice that the same dosage no longer takes care of their pain.

4. Dependence

Dependence is the stage where a substance abuser will 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 physically, sending a person into withdrawal where they can experience flu-like symptoms with opiates, or sweats and shakiness with alcohol.

These symptoms often disappear when they’re able to get a drink or a fix of their drug.

With dependence to drugs or alcohol, individuals don’t feel “normal” if they’re not using. This stage is a sign that addiction is taking hold.

5. Addiction

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

They might last for periods of time where they don’t use drugs or alcohol, but are unable to stop themselves just when things seemed to be going well.

On other side of the coin, a person in the throws of addiction who’s lost everything might be in total denial, unwilling or unable to face the disease.

The Stages Are Simply a Roadmap

As with all chronic diseases, there are variations within the stages 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.

Research has shown that segments of the population are genetically predisposed to addiction, but that the disposition is not a guarantee a person will become an addict.

An individual with no predisposition can just as easily develop and addiction under the right circumstances.

Knowing the five stages of addiction as a roadmap, if we’re being honest with ourselves, can save us from getting lost or lend someone else some well thought out directions.


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The 5 Stages of Addiction - A Psychological and Behavioral Roadmap
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The 5 Stages of Addiction - A Psychological and Behavioral Roadmap
Most healthcare professionals agree there are five stages of addiction. But what are the five stages?
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Inspire Malibu
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