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Stages of Substance Use
Stages of Substance Use include experimentation, regular use, risky use, dependence,
and addiction.
Substance use can be addressed and treated at any stage – despite popular myths,
people do not need to “hit bottom” before they can benefit from help.
Stage One: Experimentation
The first stage, experimentation, is the voluntary use of alcohol or other drugs. Quite
frequently, the person experimenting is trying to erase another problem. An older person
may start drinking to cope with depression after losing a spouse. A teenager, angry about
his parents’ divorce, could start smoking marijuana or huffing inhalants. Experimentation
may even include a husband taking his wife’s prescription painkillers to cope with a back
problem. The substance seems solve the problem. So the person takes more, and moves
from experimentation to regular use, the next stage.
Stage Two: Regular Use
Some people stay in the regular use stage indefinitely. They will not develop a problem,
and stop by themselves. Others start using substances in a manner that is risky or
hazardous to themselves or to others. Risky behaviors include: smoking marijuana and
driving; binge drinking (consuming more than the recommended amount of alcohol at one
occasion); and unexplained violence, to one’s self or another.
Stage Three: Risky Use
When and how the transition from regular to risky use happens differs for every individual.
So, what constitutes “risky behavior” by another person can be difficult to gauge. Just
the same, if someone’s behavior concerns you, say so. People can pass quickly from risky
use to dependence.
Stage Four: Dependence
Characteristics of dependence include: Repeated use of alcohol or other drugs that leads
to failure to fulfill major responsibilities related to work, family, school or other roles. Or,
repeatedly drinking or using drugs in situations that are physically hazardous, such as
driving while intoxicated or using heavy machinery when intoxicated. Or repeated legal
problems. Or any combination of these.
Many dependent people are able to work, maintain family relationships and friendships,
and limit their use of alcohol or other drugs to certain time periods, such as evenings
or weekends.
Stage Five: Addiction
The last phase of the spectrum of substance use problems is addiction. Addiction is a
medical condition involving serious psychological and physical changes from repeated
heavy use of alcohol, other drugs, or both.
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Symptoms include uncontrollable alcohol or other drug craving, seeking, and use,
that
persists even in the face of negative consequences.
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Addiction is a progressive illness. If left untreated, it gets worse. It is also chronic,
or
long-standing (versus acute, or short-term).
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Addiction is a treatable illness. Recovery rates for people who go through treatment are
very similar to those who get treatment for other chronic diseases such as
diabetes and asthma. There are a number of treatment methods and community
resources, including outpatient or residential treatment programs and
twelve-step groups These approaches can be customized to fit the
needs of the individual and family.
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