Five Stages of Addiction: Treatment at Smarmore
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What Are The Stages of Addiction
While many factors contribute to drug addiction, including genetics, environmental influences, socioeconomic status, and co-occurring mental health conditions, research has made clear five stages in the evolution of the illness of addiction — experimentation, social or regular use, risky use or abuse, addiction and dependency, and relapse. Those who experiment with drugs may not develop an addiction, but others using drugs regularly are at an increased risk of developing drug dependence and should seek help.
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The Five Stages of Drug Addiction
Experimentation
Although it might not necessarily lead to addiction, drug experimentation is considered the first of the four stages of addiction. Experimentation is defined as the voluntary use of drugs without experiencing any negative social or legal consequences. Experimentation is particularly prevalent in young people amongst who experimentation is accepted and even encouraged. For many, this might look like trying drugs at a party or festival, enhancing academic performance, or boosting their confidence in social settings.
Experimentation in adults can occur when changing social groups, or being part of a work culture that encourages drug use. They might find themselves using drugs as part of a spiritual ritual or trying drugs to alter their mood in the short term.
The experimentation stage isn’t always harmless, particularly if someone exhibits risk factors for addiction such as genetics, environment, medical history, and co-occurring disorders such as anxiety, depression, and schizophrenia.
Regardless of when and why someone starts using drugs, experimentation can be a dangerous gateway to drug addiction and/or other substance use disorders. If drugs are being used by someone when they are particularly vulnerable, there is a greater chance drug their use will become problematic. Similarly, if someone’s drug use has positive outcomes, this reinforcement could lead someone to use drugs more regularly and develop a dependence.
Social or Regular Use
The second stage of addiction can act as a fork in the road. Some people will be able to enter the stage of regular use without developing an addiction and stop using on their own. Others when entering this stage of regular use will move on to risky use and develop a dependence.
The risk of substance abuse greatly increases during this stage. Regular use of drugs also increases the likelihood of participating in high-risk behaviours such as driving under the influence, violence, depression and anxiety, and emotional volatility.
During this stage, you might notice in yourself or a loved one changes in mood and behaviour, avoidance of responsibilities and early signs of addiction such as withdrawal, failed attempts at controlling social drug use, lying about drug use, withdrawing from friends and family, feelings of shame about their behaviour, and justifying or making excuses for drug use.
Risky Use or Abuse
There is a thin line between regular use and risky use/abuse that many dances over. What might have begun as a temporary form of escape and the positive reinforcement of stages one and two, can move someone into the more serious third stage of addiction. The transition between these two stages may occur quickly and be difficult to spot in yourself or someone else. Risky use or abuse is usually defined as the continued use of drugs despite negative consequences.
Repeated exposure to a drug causes some people to become sensitised to its effects meaning they need to take increasing amounts of the drug more often to achieve the same desired results. The combination of a physical need and psychological craving will reveal the warning signs of addiction such as prioritising drug use over other parts of their life, physical or psychological cravings, and depression/irritability or fatigue if the drug cannot be used.
Drug Addiction and Dependency
Drug addiction and dependency is the final stage of drug addiction. Those in this final stage will continue to use drugs regardless of the negative consequences. Personal relationships are jeopardised or completely lost, physical and mental health is severely impacted, performance at work is reduced, jobs may be lost, and criminal activity may have begun.
During stage four, someone with an addiction may not understand how they moved from the first stage of experimentation to developing a drug addiction. Denial is a key hallmark of addiction which gets stronger as someone moves through the stages. By stage four, if someone with a drug addiction or dependency seeks help, it is usually a result of a rock bottom experience — arrest, near-death experience, loss of loved one to addiction — or an intervention. Someone with drug addiction would need to experience the most extreme of consequences before seeking help as stopping drug use may feel impossible.
Safe Detoxification from Drugs & Alcohol
Relapse
Addiction relapse is common. By the time most people seek help for addiction, they have already tried to quit on their own unsuccessfully and are looking for a better solution. Relapse is a gradual process with distinct stages. The goal of treatment is to help those recovering recognise the early stages, in which the chances of relapse-avoidance are greatest.
Emotional Relapse
During an emotional relapse, recovering people are not thinking about using but their emotions and behaviours are setting them up for relapse. This might look like bottling up emotions, isolating, not following relapse-prevention plans, attending 12-step meetings but not participating, and poor eating and sleeping habits. When people live in emotional relapse long enough, eventually they start to feel restless, irritable, and discontent and start to consider ways of escaping this experience.
Mental relapse
Once in and falling deeper into a mental relapse, people are less resistant to physical relapse and their need for escape increases. They may be conflicted about using drugs. The signs of mental relapse to look out for are craving for drugs or alcohol, euphoric recall of positive experiences associated with drug use, minimising consequences of past use, lying to themselves and others, thinking about how to use safely, looking for relapse opportunities, and planning a relapse. A physical relapse may be imminent if thoughts of using drugs become more insistent.
Physical Relapse
Physical relapse is when someone starts using drugs again. Once a drink or drug has been consumed, it may quickly lead to obsessive thinking about using and eventual uncontrolled use.
Many don’t understand that relapse prevention isn’t about saying no when they are just about to pick up a drug. This is the final stage of relapse. If someone does not look at the underlying causes of addiction and protect their clean time, they may quickly move through the stages of relapse and end up using again.
Breaking The Cycle
Those who have moved through the stages of addiction and relapse are in a cycle of addiction. The cycle of addiction can be defined in several ways but mainly follows the same path:
- Emotional pain or a experiencing disturbing event that serves as an emotional trigger
- Craving for drugs or alcohol to relieve the discomfort of the trigger
- Using drugs or alcohol and returning to regular drug or alcohol use
- Feelings of guilt and shame over a relapse leading to drug use cessation
- Symptoms of withdrawal from abrupt cessation can be debilitating, increasing the likelihood of relapse
- Returning to drug use to ease feelings of withdrawal
The more someone understands their pattern of addiction, recovery and relapse, the better-equipped they are to break the cycle and find long-term freedom. Breaking a cycle of addiction requires action and maintenance.
The following are effective strategies that can help break the addictive cycle:
- Identify problem behaviours and triggers
- Identify alternative healthy habits to replace destructive patterns of behaviour
- Attend therapy and recovery meetings to explore the reasons underlying addiction
- Practice healthy behaviours consistently such as balanced eating, getting enough sleep, exercising, and socialising
- Make a routine out of practising healthy behaviours in order to maintain them.
Drug Addiction Treatment
Addiction treatment programmes generally fall into one of two categories — inpatient and outpatient. Each type of programme has its benefits and an addiction assessment will help you decide which programme is right for you.
Inpatient
Research-informed inpatient rehab programmes are designed to help those struggling with addiction, giving them the tools they need to overcome their illness. The non-judgemental, caring environment that inpatient rehab provides, offers safety from everyday triggers as well as personalised treatment plans which include individual therapy, group work, 12-step meetings and holistic treatments that complement recovery.
The first step of treatment for addiction, depending on the substances you have been using, may be a detox which, for safety reasons, happens in an inpatient setting. This ensures you will receive clinical oversight, supervision and medication to help you through the withdrawal process. Post-detox, you will continue your stay in a treatment centre for the duration of your care. You may not require detox in which case you will join the therapeutic programme on admission.
Outpatient
Outpatient rehab is a programme structure for addiction and other mental health concerns that don’t require a residential stay. Outpatient programmes offered by addiction treatment providers mirror inpatient programmes but are less intensive than inpatient programmes with fewer treatment hours each week. As such, they tend to last much longer than inpatient treatment, frequently up to several months.
If you have a strong support network, feel confident you can stop using your drug of choice (a clinician will be able to advise if the cessation of drug use can be done without a detox), and don’t require round-the-clock care that inpatient rehabs provide, an outpatient programme may work well for you.
Finding Treatment for Addiction
There are several ways you can find help with addiction depending on your circumstances. These include treatment centres, private or NHS counselling, and support groups.
Private Rehab
Private addiction treatment can be accessed through private funding or health insurance. Private rehabs such as Smarmore Castle generally offer inpatient, outpatient, and aftercare services to those recovering from addiction.
Smarmore Castle is one of the world’s most renowned residential alcohol and drug rehab clinics. Our alcohol and drug treatment programme has been carefully constructed with decades of professional and practical experience and applies to patients from all walks of life suffering from addiction.
Counselling
Many psychotherapists specialise in addiction and can be accessed via an NHS referral or privately through research online or recommendations. Therapies can be practiced in a variety of settings, take many forms, and last for different lengths of time. Addiction is generally experienced as a chronic disorder and relapses are common. As such treatment is a long-term process that may involve different types of therapy along the way. Therapies that are helpful for addictions are Cognitive Behavioural Therapy(CBT), family therapy, eye movement desensitisation and reprocessing (EMDR), other trauma therapies, and/or grief counselling.
Support Groups
Support groups such as Narcotics Anonymous (NA) and SMART Recovery meetings are free resources for those who do not have the means to access residential care. Group therapy and support groups, key elements of recovery from addiction, enhance self-awareness and insight through the shared experiences and openness of peers. Recovery fellows work together to find freedom from addiction, empathise and support each other, and the positive change seen in others inspires hope. Groups can be accessed online and in person.
Getting Help Today
If you need emergency mental health advice or medical support due to drug misuse please call the NHS 24 helpline as soon as possible 111. The advice is free and could save a life.
If you need advice on accessing inpatient rehab treatment for addictions, please call our Smarmore Castle 24-Hour helpline on +353 041 214 5111 to arrange a free addiction assessment. We are here to help.
FAQs
What Is Psychological Dependence?
Psychological dependence involves emotional–motivational withdrawal symptoms upon cessation of prolonged drug misuse. Symptoms include anxiety, panic attacks, dysphoria, craving, and general stress.
What Are the Physical and Mental Stages of Addiction?
The key stages of addiction, which incorporate physical and mental symptoms, are experimentation, social use, abuse, and dependence. Denial is a key hallmark of addiction, so it can be difficult to identify which stage of addiction you are in. As such, it is important to seek professional help should you be worried about your and a loved one’s drug use.