Those who abuse mind-altering substances will tend to progress through stages which may ultimately lead them to addiction. In the beginning such people will feel in control, but with each passing stage they will lose more of their power. It is possible to treat the problem at any time, but it is much easier to do this before physical dependency has developed. Dealing with substance abuse earlier also means the individual is able to escape a lot of unnecessary suffering. Just as there are stages of substance abuse there are also stages of recovery.
Addiction involves a physical and psychological dependency on a drug, alcohol being one such drug. The individual will experience cravings, and find it hard to imagine life without it. They will also have developed a tolerance for the substance, and will experience withdrawal symptoms should they stop using it. Just because an individual abuses alcohol or drugs does not mean that they are addicted. It does mean that if they continue with such abuse it will be highly likely to happen. All substance abusers are not addicts, but all addicts are substance abusers.
Each person will experience things differently. However, those who abuse alcohol or drugs will tend to follow a similar path. The stages of substance abuse are:
* Experimentation. People will often take drugs the first time out of curiosity. They have heard all about them, and just want to see what the fuss is about. They might also have friends that use these substances and feel peer pressure to join in.
* Becoming a regular user. The individual enjoyed their early experimentation with drugs so has now start to use this substance regularly. Some people will never go beyond this stage of substance abuse.
* Substance abuse is when the individual starts to use alcohol or drugs so much that it leads to harmful consequences. Some will respond to these negative consequences by cutting down or by completely abstaining from the substance. Other people will ignore these warning signs and continue to abuse the drug. It is possible to call substance abuse simply the dangerous use of a substance at a single time, such as binge drinking one time, with particularly horrible consequences. Usually though substance abuse refers to a habit of abuse.
* Dependence is a stage where the individual now feels that they need the drug in order to make it through the day. The consequences of their drug use will have increased, but so will their reluctance to give it up.
* Addiction is when the individual is not only psychologically dependent on the drug, but also physically dependent. Their tolerance for the substance will have increased, and they will suffer withdrawal symptoms should they try to stop.
The incentive sensitization theory of addiction offers a more biological view of the stages of addiction. It suggests that substance abuse leads to addiction in four steps:
* Repeated exposure to a substance causes some individuals to develop hypersensitization. This means that neurobehavioral system has been affected so that the individual will experience greater pleasure the next time they try the substance.
* Hypersensitization leads to a subconscious event called incentive salience. The drug has now become associated with the body’s reward system. The individual starts to want the drug at an intensity much greater than just liking it.
* Incentive salience ensures that the individual keeps on repeatedly taking the drug.
* The unconscious desire for the drug drives the conscious behavior of the individual.
Just as there are stages of substance abuse there are also stages of recovery which include:
* The first step involves admitting that there is a problem. The individual is able to get past their denial to see how much their substance abuse is damaging their life.
* They decide that they have had enough, and become willing to do something to escape the problem.
* The substance abuser begins to investigate different options for addiction recovery.
* They take action to end the substance abuse. This could mean going it alone or they may decide to enter rehab. The best choice will depend on the extent of their problem.
* If they have become physically dependent on the drug they will need to go through detox. If they are at risk of severe withdrawal symptoms then this may need to be medically supervised.
* In early recovery the individual will need to learn how to live life without resorting to substance abuse. This can be a challenge if they have been using a chemical crutch for many years. Those who seek out support tend to find it easier to make it through this period without relapsing.
* Recovery maintenance is an ongoing process that never really ends. If the individual ever returns to substance abuse they will likely take up exactly where they left off. It is therefore vital that they keep on doing the things that keep them sober.
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