Learn / The Addiction Cycle: What Are the 5 Stages of Addiction?
The Addiction Cycle: What Are the 5 Stages of Addiction?
October 8th, 2024| Clinically Reviewed by
Key Points
- Addiction often follows a cycle with distinct parts.
- Relapse is a key initiator in the cycle.
- Treatment breaks the cycle, and can do it over and over.
Addiction often follows a cycle with distinct stages. It’s repetitive in nature since the act of taking addictive drugs releases dopamine, which reinforces the behavior—causing repetition.
As this cycle repeats, the likelihood of addiction grows until it’s realized. Thankfully, treatment works at each stage, whether you’ve just started or have been in active addiction for years.
Stages of The Addiction Cycle
The stages of addiction typically involve initiating substance use, developing dependence, and eventually becoming addicted. This cycle can repeat through relapses, but it can also be broken with the proper support and intervention.
1: Initial Use
Your first time taking a substance counts as the initial use. This could be a beer on your 21st birthday or marijuana between classes in high school. You may consciously decide to take the substance or initiate it due to external factors like peer pressure and a desire to connect with others.
2: Regular Substance Use
After the first use, you may come back to the substance occasionally. These occasional uses can then become a regular part of your routine, like drinking every day after work instead of just during social events.
You may start to plan your day around substance use or start canceling plans that might keep you from it.
3: Tolerance Development
As your use increases, you’ll grow more tolerant to the substance1 and its pleasurable effects. This means you need more, more often.
Regular use means your brain receives a flood of dopamine. It can get so used to this, becoming tolerant, that it starts making less naturally2, which can mean you’ll need more of the substance to make up for the loss and take the substance more often to not experience a low.
4: Dependence Formation
You can become dependent on the substance to function without discomfort or unhappiness3, especially as your brain learns to make less dopamine and simply wait for more to come from the substance.
Physical dependence shows when you feel sick without taking the substance. Your body starts using the substance to meet a sense of homeostasis, and if you stop taking it, you’ll likely feel sick. In particular, opioids can make you feel highly unwell if you stop taking them4 without a professional detox. Alcohol withdrawals5 can lead to tremors, hallucinations, and seizures.
5: Full-Blown Addiction
At this final stage, substance use fully dominates life. It becomes all you think about and what you feel you need to function. Along with feeling physically sick without it, you’ll experience cravings and urges to use the substance. Obtaining and taking more becomes as necessary as eating or sleeping, especially since addiction affects your judgment and decision-making skills3.
People in stage five may show signs of addiction in other areas of life, like having financial issues, losing their job, and having trouble with their relationships.
The Role of Relapse in the Addiction Cycle
Relapses can trigger the start of another addiction cycle. They can also happen between stages, like tolerance development and dependence formation, when someone tries to stop their use but starts again.
Understanding Relapse
Relapses occur more often than you might think,6 and they’re a common part of the addiction cycle. They typically have a trigger related to your environment and/or emotional state.
For example, if you’ve been sober a few weeks but meet a friend at a bar you used to go to, the environment could trigger an intense urge to drink that leads to relapse. Overwhelming stress or sadness can also lead to relapse as someone reaches for their old coping tool.
Relapse as a Learning Opportunity
Sometimes, you don’t know about a trigger until it happens. For example, you might unexpectedly realize scenes of drinking or drug use in a movie trigger an urge to take the substance, even though the depiction isn’t real. You might leave the theater feeling frustrated, uncomfortable, and disappointed in yourself—but you shouldn’t.
Now you know to avoid those types of movies. Even if the trigger led to a relapse, you’ve still gained a tool for your future recovery and sobriety. You gain the same learning opportunity from any relapse, regardless of its cause or trigger.
Preventing Relapse
Most people’s ideal recovery journey doesn’t include relapsing. It’s okay if it happens, but it’s also something you can proactively work to prevent. You may practice these skills in professional treatment, like joining a relapse prevention group in rehab. Therapy can teach you how to regulate your emotions and how you respond to them. You can also keep a few strategies in hand to mitigate a relapse before it happens.
- Learn a few grounding techniques to distance yourself from the negative emotions caused by a trigger. Here are some examples:
- Box breathing. Breathe in for 4 seconds, hold for 4 seconds, and breathe out for 4 seconds until you feel your mind and body calm.
- Urge surfing. This practice teaches you to “ride the wave” of an urge, showing you you’re capable of getting through them.
- Progressive muscle relaxation. You’ll start by tensing your muscles, holding the tension, then relaxing them. People often work from their toes to their head, tensing and relaxing before moving to the next muscle group, but you can take any direction.
- Write down the trigger and how it made you feel. For example, you might say, I went out for dinner with a friend and I kept smelling the wine at the table next to us. I really wanted some and felt angry that I can’t anymore.
- Stay connected to professional support. Maintain regular contact with a therapist, counselor, or mentor.
- Attend peer meetings focused on recovery, like the Alcoholics Anonymous (AA) meetings of the 12 Steps or secular SMART Recovery groups.
- Stay mindful of your emotional landscape. Stressors at work, relationship conflicts, or big decisions can quickly build up and become overwhelming, even if they happen in the background. Being mindful of your emotions can help you know when you need to practice self-care or seek professional help.
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Understanding the Signs and Symptoms of Addiction
Knowing how addiction looks is a key step to finding treatment—and recovery. You can look for these signs in someone you love or in yourself.
Identifying Initial Use Signs
Someone who’s started using substances may show signs of inebriation, like stumbling when they walk, slurring their words, or seeming spaced out. Hiding and spending more time alone can be a sign too, as this would keep other loved ones from noticing some of the more obvious signs.
You might notice your loved one going to bars more frequently or attending parties with drinking or drug use. As another example, maybe your spouse starts having a glass of wine every night after trying some at a restaurant.
Recognizing Symptoms of Escalating Use
As use escalates, you’ll likely notice signs like these:
- They’re around less, spending more time procuring substances and taking them. Young adults especially may spend more and more evenings at parties or bars.
- Acting secretive or making excuses for why they’re having more of the substance. For example, they might try to subtly refill their wine glass and, when caught, give an excuse as to why.
- They start struggling with money, spending considerably less on their usual purchases or voicing their worries about paying bills.
Signs of Tolerance and Dependence
As someone’s substance use increases, so does their tolerance and physical dependence on the substance. Signs of this happening often include consuming more of the substance; more enough for you to notice. For example, one glass of wine might turn into one and a half, and then two in a relatively short amount of time. They may seem the same after two glasses as they did after one—that’s because their tolerance increased.
You might also notice they seem distracted and uncomfortable if they don’t have the substance regularly. As their dependence on it grows, they can feel sick, irritable, and unfocused until they have more.
Indicators of Addiction
Once the cycle reaches the addiction phase, you’ll likely notice all the signs from before grow in intensity. For example,
- They spend more time away to find and take their substance and come down from its effects.
- Their struggles become more pronounced—money worries turn into missed payments and evictions. Trouble prioritizing work responsibilities deepens to job loss and unemployment.
- Their friend group changes, likely to include others who use the substance and can connect them to more of it.
What may stick out most is this: they keep using despite consequences to themselves and others. They lose control of their ability to stop. Their reward system has rewired, combining with their physical dependency to create an overwhelming need for the substance.
Triggers That Contribute to Addiction
Addiction doesn’t happen on a whim. It’s often triggered by something, like the environment you live in, stressors, and mental health conditions.
Environmental Triggers
Where and how you grow up can contribute to addiction. If your environment gives you easy access to substances, is highly stressful, or includes others who use substances (and encourage or pressure you to, too), you’re more likely to develop an addiction.
Emotional Triggers
Mental health conditions, stress, and grief can all trigger the need for soothing and distraction. Drugs and alcohol can serve as a tool for self-medication, providing temporary relief from symptoms of depression, anxiety, trauma, and others.
Social Influences
Substance use and addiction can become normalized by your social circle and culture. If everyone around you, whether friends or family, uses substances and struggles with addiction, you’re more likely to as well7. These influences can start the first stage of the cycle: initial use. When substance use is normalized and even a way you bond with others, it can progress through the 5 stages more quickly.
Treatment Strategies for the Addiction Cycle
You can break out of the addiction cycle at any stage. Professional treatment aims to treat both the physical and emotional aspects of addiction, helping you detox safely and process the underlying causes for addiction.
Detoxification Approaches
Detox is often the first step in addiction treatment. It’s the medical process of removing drugs and toxins from your body and bringing it back to homeostasis. Detox professionals may use medication-assisted treatment (MAT) to make the detox process safer and more comfortable.
Many rehabs offer detox as part of their residential programs, or you can detox at a hospital. Once your body is free of toxic substances, you can begin the emotional side of healing.
Therapeutic Interventions
Therapy addresses the root cause of addiction in 1:1, group, or family settings. Your therapist will work with you to uncover how your addiction developed and what purpose it serves in your life. Together, you’ll begin to heal past wounds and learn coping tools to use in the future. Common therapies for addiction include
- Cognitive behavioral therapy (CBT), which teaches you to catch and correct untrue thoughts or beliefs before they lead to distress. You’ll learn to challenge unhelpful beliefs and black-and-white thinking that can make you feel worse.
- Dialectical behavioral therapy (DBT) reflects CBT in some ways, but differs in how you respond to emotions and the beliefs you have. It focuses on validating your emotions and experiences and altering how you react to them—like going for a run instead of drinking.
- Eye movement desensitization and reprocessing (EMDR) helps heal trauma and lower the effects of post-traumatic stress disorder (PTSD). EMDR uses eye-tracking as you recount (verbally or in your head) what happened to you. By following an object back and forth and busying your mind, the memories lose their emotional impact and can be easier to process in just a few sessions.
- Individual therapy happens with just you and your therapist. You may learn a variety of skills from CBT, DBT, and other approaches during your sessions. You’ll likely explore key issues and develop coping strategies to use once you’re out of treatment.
- Group therapy can also use skills specific to CBT or DBT, but in a group setting. For example, you may learn a new way to manage a negative emotion and then practice it with others in your group through an imaginary scenario.
Aftercare and Support Systems
Aftercare contributes to an effective recovery journey8. It supports your recovery after you leave more intensive treatment, like residential rehab. Aftercare can include sober living, ongoing therapy sessions, and continued contact with staff from your treatment center. Many rehabs also have strong alumni communities with events, 12-Step groups, and more to keep patients connected and supported long after they leave treatment.
Importance of Prevention and Early Intervention
Early intervention can be one of the most effective forms of ‘treatment,’ but preventing substance use altogether offers the greatest crop of benefits. Here’s how that can happen.
Preventing Initial Use
Education on addiction and the risks of substance use can encourage people to not take substances in the first place. Open discussions on addiction, especially with children, can teach the realities of substance use. When people know more about it, they can make informed decisions about their use.
Early Intervention Techniques
The earlier an intervention happens, the less likely substance use is to cause addiction8. Studies have shown early interventions from people like doctors, nurses, or counselors during routine appointments can “educate and motivate many individuals who are misusing substances to understand and acknowledge their risky behavior and to reduce their substance use.”
Loved ones can also intervene early and motivate change. This could look like a casual conversation, or something more structured and planned. It depends on your situation and how far their use has progressed.
Breaking The Addiction Cycle
The addiction cycle isn’t a vortex whirlpool-ing you to despair. It can be broken at any point, no matter how many times you’ve spun through it or how long you’ve been spinning. Early intervention, professional addiction treatment, and relapse-prevention strategies offering a mooring line of hope.
You can connect with addiction treatment providers on Recovery.com, comparing prices, amenities, treatment services, and more to find the best treatment for you.
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