The 5 stages of addiction to alcohol and drugs
Are you worried that you may have a problem with alcohol or drugs? What may be defined as addiction by one person, could be viewed as habitual behaviour and lifestyle choices by another. The key is to be honest about the impact of your usage on other aspects of your life. For example, is your alcohol consumption or drug taking interfering with your capacity to perform well at work or maintain relationships and honour commitments in your personal life? Do you use drink or drugs to regulate your emotions? An honest appraisal of these questions could help you to decide whether you need to seek help.
In order to explore whether you have a problem, let’s take a look at five stages of addiction to alcohol and drugs (and there is a lot of overlap for behavioural or process addictions too). Addiction cycles can, of course, be very personal but may typically follow five broad patterns:
All addiction starts off in this phase when occasional use on a voluntary basis is the norm and this stage may last quite a long time. Throughout this period you may feel that you have complete control over your alcohol and drug use. When you are experimenting, you can stop at any time. Indeed, there may be times in your life when you don’t use anything whatsoever. But, in addiction cycles the experimentation stage will eventually be replaced by more usage.
2. Social/regular use
The next stage of progression in addiction, will see a gradual uptake in usage when you begin to incorporate the habit into your daily routines. There is still a measure of control in this stage and you could probably stop if you set your mind to it. You are content with the effects of the alcohol/drugs and do not want to give it up. You may be thinking that your habit is not negatively impacting with other aspects of your life; it just makes life appear more fun, exciting or less boring.
Affect dysregulation is when you turn to an addiction to soothe emotional discomfort (stress).
3. Problem/risky use
It is during this stage that you may begin to realise that you have a problem. When alcohol and drug taking starts to become more risky and problematical, you might notice that your performance at work starts to suffer, or your grades at school or university begin to turn negative. Your family and social relationships might also begin to turn sour and there might be pressures on your finances.
In this phase, alcohol and drugs begin to affect your judgement, perhaps prompting you to do things that you would never have considered in the past. You may start taking risks by driving whilst drunk or high, engaging in illegal activity to secure the money to fund your habit or engaging in risky sexual activity under the influence. Perhaps there are also brushes with the law such as getting arrested or ending up in fights when drunk or high. It could be that a partner ends your relationship or you get fired from a job because of your habit.
These wake-up calls might make you seek help but not necessarily so. You may be thinking that you just need to control things more efficiently and everything will be okay if you just manage your usage better.
At this stage, quitting on your own is very difficult. By now the drink or drug is controlling your life and it is less easy to deny the fall-out from your habit. You become tolerant to a drug when you find yourself needing higher doses to experience any noticeable effects (tolerance). The dose you took when you first started using seems increasingly minimal; you need a lot more of the drug to get high or to relax. You are spending more and more cash on sustaining your lifestyle. Blackouts (when you can’t remember what happened) become more regular. There is increased shame and remorse surrounding your behaviour.
You may become mentally obsessed with drinking or using. You start to think about it even when in work meetings and can’t wait for lunchtime or when you finish work. Activities in life seem boring unless it involves using.
This is when things turn chaotic and disorganised. You may feel unable to stop despite negative consequences in your life. Your dependence takes on a compulsive quality and your behaviour increasingly lacks control. You feel you need drink or drugs just to function, and you might find that you will do just about anything to get it. When addicted, you never seem to have any spare cash. If not working you will do anything, including steal, to finance your habit.
When you can’t have your drink or drug, your cravings will feel unbearable, and your whole life will seem out of control. Chronic relapse can be a feature of this stage as there may be times when you quit.
Addiction is essentially a search for emotional satisfaction. Your addictive behaviour is ultimately serving a need, and the outcome of counselling/therapy could be to uncover what it is you are avoiding. This might involve reviewing the impact of past traumas and bad experiences. Successful objectives for therapy in relation to addictive behaviour will invariably involve an abstinence based approach, at least initially. It could be fruitful to search for more healthy alternatives in life to provide emotional satisfaction and more natural levels of excitement and meaningful social connection.
12 step fellowships such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) can help to normalise your feelings of shame and potentially provide vital moral support through storytelling.Having meetings to attend can help you to cope with the vacuum left in your day by quitting your active addiction. The 12 steps of recovery can also offer a useful framework for personal transformation, provided you are comfortable with the disease concept of alcoholism and drug addiction and the notion of a higher power.
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About Noel Bell
Noel Bell is a UKCP accredited clinical psychotherapist in London who has spent over 20 years exploring and studying personal growth, recovery from addictions and inner transformation. Noel is an integrative therapist and draws upon the most effective tools and techniques from the psychodynamic, CBT, humanist, existential and transpersonal schools.