The Cycle of Addiction: Stages of On-Going Disease

Over the years, there has been a misconception about individuals who suffer from substance dependence. “Try it once and you are addicted!” are the words most of us grew up hearing. And while that holds true in some cases, many variables lead to addiction. Most people do not wake up one day and decide that they are going to develop an addiction; substance dependence is a journey with different stages.

The Stages of Addiction:

  • Initial Use or Infatuation
  • Abuse or Honeymoon
  • Tolerance or Betrayal
  • Dependence or On the Rocks
  • Addiction or Trapped
  • Relapse or Recovery

The American Psychiatric Association defines substance dependence as a complex condition, a chronic brain disease that is manifested by compulsive substance use despite harmful consequences. The desire/need for the next high becomes more important than family, jobs, and hobbies. Like any chronic disease, the stages of addiction progress over time. The stages vary for each individual, some people progress rapidly, and some people take years to proceed to the addiction stage.

The Stages of Addiction: A More In-Depth Look

Initial Use or Infatuation Stage

There are several reasons why a person’s journey leads them to their first time using it. It could start with something as simple as a prescription for pain or a mental health condition, a drink at a party, or peer pressure to try a drug. But whatever the reason for that initial use, it starts to rewire your brain. You start to become “starry-eyed” and in love with the feeling. As humans, our brain tells us, “if it feels good, do it.” And as that feel-good feeling increases, the brain and body begin to crave what creates that feeling. 

Whether or not that initial use and infatuation will cause a person to progress through the stages of addiction depends on many factors. A few of the risk factors that can lead to dependence are but not limited to:

  • A Family History of Addiction- Like many chronic diseases, substance use disorder can be passed down through genes. And as difficult as it is to talk about drug and alcohol use in the family, it is important for people to know if they have a propensity toward dependence and can make a choice to stay away and not tempt fate.
  • Physical, Mental or Sexual Abuse- People who have been a victim of abuse or trauma of any kind are more likely to turn to substance abuse to escape the emotional and physical pain. That is why it is so important to have true, deep conversations with the ones you love, if they feel heard and seek the right kind of help, it can lessen the chances of a life of substance dependence. 
  • Peer Pressure- The company we keep is indeed the person we become. That is especially true for the person looking for acceptance that they never got at home. Drugs and alcohol do not turn anyone away. And when your high, you feel loved and accepted. 

Abuse or Honeymoon Stage in Addiction

The next stage of addiction is abuse or the honeymoon stage. In this stage, people start moving on from trying to mask the hurt and pain they feel to using for the euphoric response. Once you begin to enter the abuse stage of addiction, you quit noticing the negative feelings that would alert you to issues that you need to focus on. You know that you should pay attention to these feelings, but it’s difficult to ignore the desire to get “high”. You believe the illusion the substance creates in your brain. You feel more attractive, more powerful, more outgoing, and you feel like you can do anything but substance use is actually causing more problems in your life.

Substance Tolerance or Betrayal Stage

Continued substance abuse builds up a tolerance which leads to a decrease in the “euphoria” and physical effects you are used to experiencing. When your body starts to build up a tolerance, it is an indication that your brain has changed. Your brain rewires the way it behaves with and without the drug. The individual’s biggest fear is feeling inadequate. In the beginning, the drug makes you feel on top of the world. But that feeling is an illusion that leads down the road of betrayal. You feel betrayed because the substance that made you feel all-powerful and made all your emotional problems disappear is no longer doing the trick. So you try to find that initial feeling and high you once found, which leads you to take more or to try other substances. 

Moreover, the cycle just continues on a downward spiral. The person will find him/herself lying, stealing, and even missing work in order to find and score their next high. Family members may start to question your behaviors, but because of excessive substance use, you can no longer see the negative consequences of your dependence. Once your brain is rewired, you have begun your journey onto the next stage of addiction.

Substance Dependence or On the Rocks

There are different types of dependencies when it comes to pharmaceuticals. A person with Asthma is dependant on medication in order for their lungs to function properly. This type of dependency does not lead to addiction as long as the medicine is continued to be used as prescribed and monitored by your doctor. But a person with a chronic illness that starts to use their medicine for reasons other than prescribed is a type of dependency that leads to addiction. Individuals who are in this stage find themselves “chasing” the initial high despite the obvious negative consequences their substance use has caused. There are three main factors that continue the person’s journey:

  • The Fear of Withdrawal – Depending on what you are dependent on, the withdrawal symptoms will vary. Fever, sweating, chills, pain, nausea, headaches, insomnia, changes in breathing, and changes in heart rate are just a few of the symptoms you may experience. 
  • The Rewired Brain – Continued use of drugs and/or alcohol lessen the brain’s neurotransmitters, which makes it harder to feel happy. So deep depression kicks in, and the addict searches for the honeymoon phase again.
  • People, Places, and Things – Your surroundings can trigger your brain to “crave” the substance you are dependent on. Seeing a family member or friend that mentally or physically abused, you can trigger a “craving.” 

Addiction or Trapped by the Substance

Addiction is defined as the inability to stop consuming a substance even though it is causing harm. You become trapped by the substance that has a tight hold on you that it is almost impossible to escape. Substance dependence is a chronic mental illness that has defined symptoms and behaviors. Some of those behaviors may include:

  • Continued use despite the consequences
  • Experiencing relationship problems involving your substance abuse
  • Spending your day searching for your next high
  • The inability to stop using
  • Intense cravings
  • Putting yourself in dangerous situations
  • Pulling away from family and friends
  • Giving up activities that you once loved
  • Denial that you have a problem
  • Having withdrawal symptoms

In this stage of addiction, the individual feels trapped with no way out. The person has lost the ability to cope with life sober. Almost all signs of life before dependence are gone. Mentally, your brain only focuses on getting “high”. Physically, your body only knows how to function under the influence. Being high becomes the new normal for your body. You feel like you are in a pit of despair with no way out. Those feelings of hopelessness are so overwhelming that you need to get high so you don’t feel the pain. It becomes a vicious cycle that feels impossible to escape. This stage of addiction is the longest. People can spend years in this stage, and some people never leave this stage alive. 

Addiction Relapse or Long Term Recovery

Most people don’t realize how bad their addiction is until they have hit rock bottom. For each individual, their “rock bottom” looks different. For some, they have lost their job, their friends, their home, any resemblance of a normal life. And for some “rock bottom” is overdosing and almost dying. For others, it may be jail time that forces sobriety. And for some, they may develop devastating health problems that make them seek help. But, rock bottom is when you can no longer deal with the devastating effects of your addiction. It means that the substance use has gotten so severe that your defense mechanism is failing, and your body goes into survival mode. At this stage of addiction, the individual starts to see the reality of their life and how bad it has gotten.

The relapse rate for substance abuse is 40-60% in the first year. But relapse should not be seen as a sign of failure. Studies show that the first 90 days see the most relapses. Your brain takes time to rewire back to a sober life. An individual has to remove themselves from any resemblance to their life of addiction. That is why it is best to be in a treatment center in a controlled environment. People who know what you are going through can help you recognize your triggers and can help you get sober and find happiness again. 

Recovery is a genuine possibility for each and every one. With the right support group and the will to be the best person you can be, sobriety is possible! Dependence is a chronic disease that requires a lifetime of treatment and hard work. 

Discovery Institute is here for you. Contact us today.

Reviewed for Medical & Clinical Accuracy by Dr. Jeffrey Berman, MD

Dr. Jeffrey Berman, MDDr. Jeffrey Berman is a psychiatrist in Teaneck, New Jersey and is affiliated with Robert Wood Johnson University Hospital. He received his medical degree from State University of New York Upstate Medical University and has been in practice for more than 20 years. He also speaks multiple languages, including French and Hebrew.