Addiction should be viewed as a process, not as a fixed point in time. Each person’s progression will look different depending on their own life experiences and circumstances. The following section describes the developmental stages of addiction and their potentially appropriate level of intervention.
Quick Answer
The educational material available provides many examples of different addiction patterns with some common features. The different models show that there are usually 5–7 stages in the development of addiction. These include initial experimentation, repetitive, regular use of a substance, risk-intensive or abusive use, tolerance or dependency forming, and addiction.[1] Some models also include relapse as a stage.[2]
How Many Stages of Addiction Are There?
Why There Are Differences Between Models
There are five to seven stages of addiction from different sources. Each model is ultimately geared toward educating the public and informing clinical intervention.
Elements of All Models
Regardless of different terminology, most addiction models include:
- Increased frequency and intensity of substance use
- The eventual development of tolerance, which means needing to ingest larger amounts of the drug to achieve the same effects
- Developing dependence on the substance to perform daily functions
The Seven Stages of Addiction: A Model for Addiction Recovery
Stage 1: Exposure/Initial Use
What it looks like: First experience with a substance through experimentation, social influence, stress, or due to a healthcare provider’s prescription.
What is changing: The brain begins to create connections between the substance and the reward center in the brain.
Warning signs: Minimal warning signs of developing addiction exist at this stage.
Stage 2: Social Use (Experimentation/Occasional Use)
What it looks like: Intentional but not frequent use, generally in a social situation.
What is changing: Emotionally based connection between relief and enjoyment and the drug.
Warning signs: Using a substance as a coping mechanism for stress and emotional discomfort.
Stage 3: Regular Use
What it looks like: Developing predictable patterns of use; an increasing amount of use in solitude may begin.
What is changing: Tolerance is developing.
Warning signs: Increasing time spent either with a substance or thinking about using it.[3]
Stage 4: Risky or Problem Use
What it looks like: Continued use of a substance despite negative impacts on finances, relationships, responsibilities, and well-being.
What is changing: Decision making is impaired along with executive function skills like self-management, planning, and goal-setting.
Warning signs: Further missed financial obligations, more intense and frequent mood swings, and greater secrecy about use.[4]
Stage 5: Developing Tolerance
What it looks like: Needing increasing amounts of the substance to feel the same level of effects.
What is changing: Risk of overdose and health risks increase as frequency of use and amount of drug ingestion increase.
Warning signs: Increasingly certain, escalating use. Negative consequences increase.
Stage 6: Developing Dependence
What it looks like: Compulsion to use a substance to avert becoming sick, nauseous, or emotionally distressed.
What is changing: The central nervous system relies on substances to maintain function.
Warning signs: Developing withdrawal symptoms before the next use, intense cravings or desire to use the substance, and being unable to stop.[3] Failure to meet responsibilities such as work and school. Relationship problems.
Stage 7: Compulsive Use and Addiction
What it looks like: Complete loss of control over using and continued use of substances despite their negative consequences to life.
What is changing: Life revolves around using and abusing substances (declining functioning on all levels).
Warning signs: Worsening of any health issues, extreme isolation, and more greater risk of dying from a drug overdose than non-addicted individuals.[2]
How Do People Progress Through Each Stage?
Addiction Progression
A person could go quickly through the stages of addiction, or they could remain in a particular stage for a long time before progressing to the next stage. The progression of addiction is influenced by various factors, including substance type, mental health, genetics, and environment.[5]
Tolerance
Tolerance develops when the body becomes accustomed to repeated use of a substance. Tolerance is significant because, as someone develops a tolerance to a substance and continues using greater amounts to continue feeling the same effects, there is an increased risk of overdose.[3]
Dependence
Dependence can be identified as physical dependence and/or psychological dependence. A person with physical dependence experiences withdrawal symptoms when they stop using a substance.[4] Psychological dependence is present when a person mentally and emotionally relies heavily on the substance.
Addiction and Loss of Control
Addiction manifests itself through compulsivity, where a person continues to use despite their desire to stop using, and despite negative consequences. This is not a weakness of willpower, but rather an ongoing and complex medical condition.[6]
Recovery Throughout the Stages of Addiction
Recovery from addiction does not have to wait until a person reaches a crisis. A person experiencing any stage of addiction can seek help and get support for recovery.
Support at Early Stages of Addiction
Counseling, screenings, and outpatient care are available and can interrupt the progression of alcohol or drug addiction early on.[5]
Support for Mid-Stages of Addiction
Structured programs, relapse-prevention planning, and coping skills development provide individuals with the stability they need.
Support for Later Stages of Addiction
Having medical detox when necessary, intensive treatment, and long-term planning will provide individuals with the safety they need.
Relapse In The Cycle Of Addiction
Relapse (returning to use of the substance) can happen to anyone within the cycle of addiction and does not mean that an individual has failed in their recovery.[2]
Evidence-Based and Holistic Support Types at Marietta Springs
Evidence-Based Therapies
Cognitive behavioral therapy (CBT) helps to identify and change unhelpful thoughts and behaviors. Dialectical Behavior Therapy (DBT) supports the ability to manage extreme emotions and behaviors.[6]
Holistic Recovery Services
Mindfulness (the practice of intentionally focusing on the present moment), yoga, Reiki, and sound bowl therapy are used to help individuals manage stress and develop better structure for recovery.
Dual Diagnosis Support
Counseling is available for those who are experiencing substance abuse associated with other mental health disorders such as depression, anxiety, or post-traumatic stress disorder (PTSD).
If these stages sound familiar to you or someone you know, you don’t have to wait for a crisis to occur before accessing Marietta Springs, which offers evidence-based (research-validated) support, flexible treatment programs, and a personalized continuum of care. Reach out to us today for more information on how to take your next step towards recovery.
