What Are the Stages of Addiction?

May 7, 2024

Explore what the stages of addiction are, from initial use to treatment options, and navigate the path to recovery.

Understanding Addiction

Before one can fully comprehend the stages of addiction, it's crucial to understand what addiction is and the factors that influence its development. This knowledge is vital in understanding the nature of addiction and implementing effective treatment strategies.

Definition of Addiction

Drug addiction, also referred to as substance use disorder, is a disease that impacts a person's brain and behavior, leading to an inability to control the use of a legal or illegal drug or medicine. As defined by Psychology Today, addiction involves the use of substances or behaviors for which rewarding effects provide a compelling incentive to repeat the activity, despite detrimental consequences. It may involve substances such as alcohol, opioids, cocaine, and behaviors like gambling.

Addictions are characterized by impaired control over usage, social impairment, craving, and continued pursuit of the activity despite physical or psychological harm. Over time, tolerance to the substance increases as the body adapts, necessitating higher amounts to achieve the same effect.

Factors Influencing Addiction Development

The development of addiction can start with experimental use of a recreational drug in social situations, and, for some people, the drug use becomes more frequent. For others, particularly with opioids, drug addiction begins when they take prescribed medicines or receive them from others who have prescriptions [1].

The risk of addiction and the speed at which one becomes addicted varies by drug. Some drugs, such as opioid painkillers, have a higher risk and cause addiction more quickly than others.

Multiple factors can influence the development of addiction, including genetic predispositions, environmental factors, the type of substance used, the frequency of use, and the individual's mental health. Understanding these factors is essential in comprehending the complex nature of addiction.

Stages of Addiction

Understanding the journey of addiction is crucial for both individuals and their loved ones. By recognizing 'what are the stages of addiction?', one can gain insights into the progression of substance use disorders and seek timely intervention.

Initial Use

The initial use, often the first step toward addiction, is triggered by reasons such as a prescription, trying a first drink, or being pressured by friends or family to try illicit drugs [2]. This stage is also referred to as the initiation stage, where an individual tries a substance for the first time, often before 18 years old, and reasons for initiation can vary from curiosity to peer pressure [3].


The second stage of addiction is Abuse, where individuals start to exhibit patterns of problematic use of substances. This stage is also known as experimentation, characterized by using the drug in different contexts to see how it impacts life. Dependency has not yet developed at this stage, and the user is consciously choosing whether to use the drug or not.


The third stage is Tolerance, where prolonged substance use results in the body needing higher doses to achieve the same effect, leading to a progression into heavy substance abuse [2]. This stage can also be referred to as regular use, which involves a pattern of drug use that may impact the person's life negatively, such as showing up to work hungover or high. There is no addiction at this point, but a mental reliance on the drug may begin.


Dependence, the fourth stage of addiction, occurs when the body or brain becomes reliant on the substance to function properly. This can lead to a condition like anhedonia where the person cannot feel pleasure without the drug. Dependence is characterized by a person no longer using the drug recreationally but out of reliance on it. This can be physical, psychological, or both, with withdrawal symptoms occurring if drug use is abruptly stopped.


The fifth stage is Addiction, which is diagnosed based on experiencing defined symptoms and behaviors as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), including 11 signs and symptoms of substance use disorders like addiction.

Recognizing these stages of addiction not only helps in understanding the progression of substance use disorders but also aids in identifying the need for intervention and selecting the appropriate treatment options.

Treatment Options

Once someone has traversed the stages of addiction, treatment is paramount. This section will explore various treatment options, including medication approaches, behavioral therapy, and a holistic recovery approach.

Medication Approaches

Effective treatment for addiction often involves medication as the primary approach, particularly for opioid, alcohol, and nicotine addiction. These medications do not cure the addiction but aid in recovery by reducing cravings and helping to prevent relapse. For opioid addiction, medicines like buprenorphine, methadone, naltrexone, or a combination of buprenorphine and naloxone can be prescribed. However, there are currently no medications available for stimulant or cannabis addiction treatment, so behavioral therapies are used instead.

Behavioral Therapy

Behavioral therapies play a critical role in helping individuals modify their attitudes and behaviors related to drug use. This therapy helps them better handle stress and triggers that could lead to a relapse. Additionally, these therapies can enhance the efficacy of medications and promote longer treatment retention.

In a drug treatment program, behavior therapy can be conducted by a psychologist, psychiatrist, or licensed alcohol and drug counselor. There are also self-help support groups, such as Narcotics Anonymous, that follow the 12-step model developed by Alcoholics Anonymous, which can assist individuals dealing with addiction.

Holistic Recovery Approach

Treatment for drug addiction should not be limited to addressing the physical aspects of the addiction. Instead, it should address the holistic needs of the individual. This includes medical, mental, social, occupational, family, and legal aspects to support a successful and comprehensive recovery process [5].

A holistic approach might involve traditional therapies combined with alternative or complementary treatments, such as acupuncture, yoga, meditation, and nutritional therapy. This approach focuses on the whole person and aims to achieve balance in all areas of life, leading to long-term recovery.

In conclusion, various treatment options can be beneficial for individuals who have traveled through the stages of addiction. The right combination of treatments will depend on the individual's unique circumstances, the severity of their addiction, and their personal preferences. It's important for anyone dealing with addiction to consult with a healthcare provider to determine the best course of action for their recovery.

Genetic and Environmental Factors

Understanding the factors that contribute to addiction is crucial in developing effective treatment and prevention strategies. Among these factors, genetics and environmental influences play key roles in determining an individual's susceptibility to addiction.

Role of Genetics in Addiction

Studies suggest that about half of a person's risk of developing drug addiction is based on their genetic makeup, with specific genes passed down in the family putting individuals at a higher risk for addiction. This is evident in cases such as when one identical twin may develop a drug addiction while the other doesn't, due to different influences in their surroundings as they grow up [6].

Moreover, research has shown that the risk of drug addiction increases significantly in adopted children if their biological parents were addicted to drugs. This risk further amplifies if the biological parent had alcoholism, criminal convictions, or severe psychiatric illness.

In terms of how genetics influences addiction, experts believe that analyzing a specific dopamine receptor called D2 may help predict addiction to substances like heroin, cocaine, or alcohol. Research on the interaction between genes and the environment aims to reduce the stigma of addiction, provide faster addiction treatment, and develop tailored prevention and treatment plans for individuals with addictions.

Influence of Environmental Factors

While genetics account for about half of a person's risk of addiction, environmental factors also play a crucial role in determining the likelihood of developing an addiction. Early drug use is strongly linked to environmental factors like family and social influences. As a person grows into young and middle adulthood, however, genetic factors become more significant in determining the risk of drug addiction.

Various environmental factors can influence the risk of drug addiction. These include access to drugs, peer pressure, family involvement, community activities, the age at which drug use starts, barriers to treatment, disadvantaged neighborhoods, and stress levels. Stress, in particular, can trigger addiction by affecting the body's reward system. Research has also indicated that exposure to environmental disruptions by adoptive parents can impact an adopted child's risk of addiction.

The interplay of genetics and environmental factors is complex, and understanding this relationship is crucial in the stages of addiction. By considering both genetic and environmental factors, healthcare professionals can develop more effective strategies for preventing and treating addiction.

Diagnosis and Withdrawal Therapy

Recognizing the stages of addiction is the initial step towards recovery. Following that, the next crucial phase involves diagnosing the substance use disorder and implementing the appropriate withdrawal therapy.

Diagnosing Substance Use Disorder

Diagnosing drug addiction, also known as substance use disorder, requires a comprehensive evaluation. This often includes an assessment by a psychiatrist, a psychologist, or a licensed alcohol and drug counselor. The assessment process involves careful consideration of the individual's behavior, medical history, and symptoms.

Most mental health professionals use the criteria set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. This manual provides a standard framework for diagnosing substance use disorder and other mental health conditions. The DSM-5 criteria for substance use disorders are designed to identify the physical and behavioral symptoms that can indicate substance abuse or dependency.

Withdrawal Therapy and Medication

Once a diagnosis of substance use disorder has been made, the focus shifts to treatment, which often includes withdrawal therapy. The goal of withdrawal therapy is to help individuals stop using the addicting drug as safely and quickly as possible. Different categories of drugs, such as depressants, stimulants, or opioids, require different withdrawal therapy approaches [4].

There are several medications available that can aid in the withdrawal process. For instance, Naloxone is a medication that can temporarily reverse the effects of opioid drugs in case of an opioid overdose. New forms of Naloxone, such as a nasal spray (Narcan, Kloxxado) and an injectable form, are now available, although they can be expensive. Immediate medical care is recommended after using Naloxone [4].

Additionally, medicines like buprenorphine, methadone, naltrexone, or a combination of buprenorphine and naloxone can be recommended as part of treatment for opioid addiction. These medicines do not cure opioid addiction but can aid in recovery by reducing cravings and helping to prevent relapse.

The process of diagnosing and treating substance use disorder is a critical aspect of overcoming addiction. With the right approach and support, individuals can navigate the stages of addiction and embark on the path to recovery.

Support Systems

Support systems play a crucial role in the treatment and recovery process for individuals navigating the stages of addiction. These systems, which can include behavioral therapy and self-help support groups, provide the necessary guidance and assistance to help individuals overcome their addiction and maintain a drug-free lifestyle.

Behavior Therapy

Behavioral therapies are often a vital part of drug treatment programs. They aim to modify the attitudes and behaviors related to drug use, equipping individuals with the tools they need to handle stress and triggers that may lead to relapse. These therapies can also increase the efficacy of medications and promote longer treatment retention.

Behavior therapy can be conducted by a psychologist, psychiatrist, or licensed alcohol and drug counselor. These professionals use various therapeutic techniques to address the root causes of addiction, helping individuals develop healthier coping mechanisms and strategies to prevent relapse. In addition, behavior therapy also addresses the holistic needs of the individual, including medical, mental, social, occupational, family, and legal aspects, supporting a comprehensive recovery process.

Self-Help Support Groups

Self-help support groups provide a supportive community for individuals dealing with addiction. These groups, such as Narcotics Anonymous, follow the 12-step model developed by Alcoholics Anonymous. They offer a platform where individuals can share their experiences, gain insight from others who have faced similar challenges, and receive encouragement and support throughout their recovery journey.

Participation in self-help support groups can complement formal treatment programs by providing ongoing peer support. These groups can be particularly beneficial for those who have completed a treatment program and are looking to maintain their recovery in the long term.

In conclusion, both behavioral therapy and self-help support groups can play significant roles in the recovery process, helping individuals overcome addiction and build a healthier, drug-free life. By utilizing these support systems, individuals can navigate the stages of addiction more effectively and achieve lasting recovery with the necessary support and guidance.


[1]: https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112

[2]: https://americanaddictioncenters.org/the-addiction-cycle

[3]: https://brookdalerecovery.com/7-stages-of-addiction/

[4]: https://www.mayoclinic.org/diseases-conditions/drug-addiction/diagnosis-treatment/drc-20365113

[5]: https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery

[6]: https://www.webmd.com/mental-health/addiction/drug-addiction-genes-environment