The Stages of Addiction

By Jim Harvey

Forget zombies. Forget aliens. A single addictive substance can take over the world. Our own world, as individuals, at least.

There is a Japanese saying about the rice wine, sake. The first cup, the man drinks; the second, the man and the cup drink together; by the third, it is the cup that drinks the man.

Addiction can begin innocently enough. Usually by experimenting with various substances. The first drink when one comes of age (and in many cases, much earlier), is almost an obligation. The first joint, perhaps even the first line of coke, is like a rite of passage. And recreational use of drugs is part and parcel of parties and clubbing for vast numbers of young (and less young) people.

Though drugs like cocaine and LSD may be illegal, they are socially acceptable. It’s fine to wake up bleary-eyed and talk about the wild drug and alcohol-fuelled excesses of the night before. Don’t they say you should try everything once? And alcohol, at least, is legal, right? And then there are prescription drugs. Take Adderall, for example, usually prescribed for ADHD, and abused by countless students as a “study drug”, which they think can make them study longer and better. Not to mention benzodiazepines, antidepressants, and more.

Alcohol and drugs have, in fact, already taken over part of the world. Let’s look at alcohol alone. It is estimated that 300 million people around the world have an alcohol use disorder (AUD). In the United States, the NIH (National Institute of Health) puts the proportion of American adults suffering from alcoholism at 6%. And that’s only the sufferers that have been identified. The same source identifies 3 million Americans, and 16 million people worldwide as having an opioid addiction. These figures have led them to coin the term, “opioid crisis”.

But the truth is, in many countries, there is no real awareness of substance abuse as a disorder, and so there are no meaningful statistics. In the world’s most populous countries, China, India, and Indonesia alone, innumerable individuals, unquestionably numbering in their millions, abuse alcohol, drugs, and dangerous homemade concoctions. In North America, Russia, and Europe, drugs like heroin, fentanyl, crack cocaine and their derivatives are all “recruiting” new addicts every day. Marijuana is present throughout Africa, in India and Nepal, and Afghanistan, to name but a few. In short, to paraphrase the rock band Aerosmith, “From San Antone to Marrakesh, from Boston Mass to Bangladesh, from the Mississippi River to the highest mountain in Tibet…Everybody’s gotta get… high!”

How does this happen, you may ask? How does seemingly harmless experimenting, or one first use of a drug, lead to some 100 000 drug overdose deaths in the US alone in 2021, or the 3 million alcohol-related deaths each year worldwide? The answer is – insidiously. And progressively. Let’s look at the stages in which the destructive process unfolds.

1. Experimenting

As explained above, at this stage people are only dabbling in alcohol and various drugs, for the sake of new experiences and out of curiosity. The main danger at this point is that a person may lay the foundations for developing a drug of choice (DOC), a substance which “hits the spot” for them, and gives them a pleasant feeling they want to experience again.

2. Regular use

At this point, a person is making frequent use of one or more substances they particularly enjoy using. In short, their use of their DOC(s) becomes habitual, and integrated into their lives. There may even be a ritualistic aspect to it – the Friday night ‘piss-up’, the lines of coke before the night shift, the Adderall before exams or sporting events. At this stage, a person may already be consuming substances to excess, but if it does not affect their ability to function in everyday life, they may be unaware of it. They are also unlikely to suspect that they are on a slippery slope, and one step away from:

3. Dangerous use

At this stage, people are using substances in quantities dangerous to their health. They are no longer always in control of how much or how often they use, and may begin to exhibit dangerous behaviors, such as driving under the influence. Studies, work, relationships and finances start to be impacted negatively.

4. Dependence

This is when a person has developed a tolerance to their substance, which means they need increasingly large amounts of it to obtain the desired effect. Going without the substance for prolonged periods may produce withdrawal symptoms, as the body and mind crave for the next dose or hit. Dependence may induce behavioral changes, mood swings and other traits that are uncharacteristic in the person when they are not using.

5. Substance Use Disorder (SUD): in layman’s terms, addiction

By this time, the person has become powerless to stop using their DOC. They have a physical and emotional need for it in order to function or feel ‘normal’. Dramatic events can occur – serious health concerns, accidents, loss of jobs, families, and serious problems with the law. Generally, the only way out at this point is to seek help from qualified professionals in the field of addiction.

For those of us who have experienced actual addiction, it is easy, in hindsight, to see the progression that got us there. It is less easy to see when a person is in the midst of it. Describing the process leading to addiction in stages makes it sound like it could unfold over many years – and sometimes it does, in particular with substances like alcohol. Unfortunately, it can also unfold with astonishing speed – a single experience of drugs like heroin, crack cocaine or fentanyl can, in some people, be enough to lead to habitual use and very rapid abuse.

Honesty with ourselves, and openness with friends and family, are essential once we realize our substance use is slipping out of control. It goes without saying that the earlier the path leading to addiction can be stopped, the better. But for this to happen, an individual needs to be both aware of how their drug or alcohol use is escalating, and honest with themselves about how it is becoming problematic. If, for whatever reason, speaking to friends and family is difficult, professional help is always available.

Kembali Recovery Center can help

Here at Kembali, we encourage anyone struggling with substance abuse or addiction to reach out to us, even just for a conversation. Sometimes, simply talking to professionals in the field of addiction can help you assess where you’re at, and what help would be most appropriate for you.

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