• Rane Wallace, MS, LPC, LCDC, SAP

The Continuum of Addiction and When to Reach Out For Help

Updated: May 30

A lot of people have a difficult time truly understanding addiction and alcoholism and why some people become addicted to drugs and alcohol.  While there are some differences between the two, this article uses terms addiction and alcoholism interchangeably.  A lot of times you’ll hear people say things like, “Why don’t they just stop?” or “They said they want to stop so how come they just don’t?”  A lot of times people mistakenly think that it’s due to a lack in willpower, and that it is just a matter of choice.  Unfortunately, sometimes it is just not that easy and not that black and white. Drugs and alcohol can change the brain in ways that makes quitting drugs a lot harder than someone who drinks or uses recreationally.  Addiction is a very complicated disease that requires interventions beyond willpower.  Back in the 1950s, the American Medical Association classified alcoholism as a disease. Alcoholism is a progressive disease that has the potential to have devastating effects. While at the beginning of drug or alcohol use choosing to say no might be easy, to others further into the cycle it is not that easy.

According to research, there are several stages in the continuum of addiction.  These stages are: abstinence, experimentation, abuse, dependence, addiction, and death. Here’s a quick explanation of the different stages:

Abstinence: The first stage in the progressive model of addiction is just simply not using at all. This is the time period prior to any type of use whatsoever.

Experimentation: This is the first time that people use and usually has to do with curiosity in social settings and is amplified with peer pressure. While some use because they are curious and for social reasons, others might use as a way of acting out.  Another potential reason is due to emotional problems, such as problems dealing with grief and loss or feeling lonely.   More often than not, the ones that use for the emotional reasons have a higher likelihood of progressing in this cycle.

Abuse: Substance abuse is simply the continued use despite negative consequences. These consequences can be a failure in fulfilling major role obligations at work, school, or home. It can also be continued use despite legal problems, despite persistent and recurrent social or interpersonal problems.

Dependence: A big shift happens in this stage and this is most notably defined with the onset of increased tolerance and withdrawals. The want becomes a need. Tolerance can be defined as the fact that it takes more and more to get the same effect.  For instance, 2 drinks to get a buzz now takes 4 drinks.  Tolerance can also be defined as a diminished effect.   The diminished effect can be that no matter how much the person uses they are no longer able to get the same desired effect. Withdrawals can be physiological and psychological. The withdrawal symptoms vary depending on the substance and as a general rule of thumb whatever effect a substance has going into the body will have the exact opposite effect going out of the body. 

Addiction:  This is when the substance takes priority. It is when the substance causes people to do things that they otherwise would not have ever done. Just because someone is “highly functioning” doesn’t mean that they cannot have a problem. Chronic drug use leads to individuals having a clouded perspective that shifts what is actually reality.  There's a good chance the “highly functioning” is not the work output the person would be doing if they were on their “A game.”

Death:  Unfortunately, addiction can lead to death and can have an extreme impact on individuals, families, and society as well. Whether it is from an accidental overdose, liver failure, heart attacks or other major health problems caused by chronic drug or alcohol use, thousands of people die every year from the fatal disease of addiction.

Here are some signs and symptoms that indicate a need to reach out for help:

  • You cannot stop using the substance.

  • Your drug or alcohol use has led to unsafe behavior and become impulsive.

  • You are having withdrawal symptoms.

  • You need the substance in order to function.

  • Someone that cares about you or even a physician tells you that you should stop.

  • Lying

  • Spending too much money on your substance

  • Problems at school or work

  • Health problems

  • Decreased hygiene

  • Changes in behavior

  • Continued use despite a desire to stop.

If you or a loved one is struggling, then I highly encourage you to reach out for help. Chances are if you are questioning whether or not you should reach out, then you should.  The severity of the presenting issues will dictate the type of substance abuse treatment that is needed. Treatment options range from inpatient treatment in a residential setting to outpatient therapy. The bottom line is that if it is causing problems in your life, I would highly encourage you to reach out to someone for help.  It all starts with a phone call and putting the right team in place to help you on your journey. When one door closes another one opens.

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References 1. American Medical Association

2. Addiction Center Statistics

3. Web MD - Signs of Addiction