Addiction | 4 min read

The Four Stages of Addiction

Medically Reviewed

Medically Reviewed By

Dr. Po-Chang Hsu

Dr. Po-Chang Hsu

On September 5, 2022

Written By

Amanda Stevens

Amanda Stevens, B.S.

On January 30, 2019

Heroin Withdrawal Symptoms
Reading Time: 4 minutes

Except for those who fall into addiction accidentally – usually due to prescription medication – addiction to substances follows a formulaic path. What starts as fun or relaxing can become traumatic and even deadly. It is helpful to be aware of these stages and to use the knowledge to prevent the eventual outcome of addiction.

Stage 1: Experimentation

Very few people set out to become addicted. A common scenario is that a friend or family member offers the user a substance, usually intending to use the drug as fun or helpful. A candidate may view this instance of getting high as a one-time occurrence, but the first time can be what opens the door to the downward spiral of addiction.

Peer pressure is a prime culprit in this type of experimentation. Young people, in particular, are in a crucial developmental period when it comes to the need to feel accepted by their peers. However, while teens have the reputation of going along with the crowd, adults are not immune to this pressure either. Measurable stress levels tend to increase for all when we experience ourselves as not being accepted within a group. Those without a good defense against social ostracization will often use an offered drug to feel included.

When peer pressure is not implicated, it is often the case that the user is suffering from some mental discomfort. The drugs alleviate workplace stress, ease social anxiety, or cope with a distressing life situation. If the substances work well to ease these complaints, the temptation toward using them regularly becomes stronger.

Others will begin to take an offered drug to alleviate physical discomfort. While purportedly safe when taken as prescribed, pain-relief medications used outside of a prescription are currently the main factor in developing an addiction. An overwhelming amount of current heroin users cite misuse of prescription drugs as the starting point in their opiate addiction.

Stage 2: Regular Use & Abuse

In this next stage on the road toward addiction, something that was once considered recreational or temporary becomes a lifestyle. The user finds that life is not as comfortable or satisfying without using the substance and begins to use it as a crutch for getting through everyday life. Experiences, as considered without the drug, may be boring, and users may not see viable options for improving their sober circumstances.

Ironically, what begins as a relief from boredom or stress can become the very factor that creates it. Due to the nature of the substances, regular users often report that they are no longer interested in activities that once produced enjoyment, and they can suffer from exaggerated mood swings between doses. And while some users start abusing substances to alleviate anxiety and depression, they find that their instances of experiencing these negative moods have increased during their time on the drug. This phenomenon becomes more apparent as true dependency upon the drug is developed.

Stage 3: Dependency & Tolerance

As regular usage progresses, physical and psychological reliance on the drug develops. The brain stops releasing chemicals naturally and instead relies on the outside substance to dictate the regulation. The body can stop functioning normally, needing more of the drug to regain homeostasis. Psychologically, the user may start finding that manageable situations have become unbearable while sober.

Over time, tolerance for the drug becomes an issue, with the brain needing more and more of the substance to obtain a sense of normal function. After a person has developed a tolerance to the particular drug, they will find that stronger or more frequent doses are needed to obtain the relief sought.

As a sub-category of this process, there are often increases in risk-taking behaviors along the way. Once dependency and tolerance have taken hold, users may be surprised at their actions. Money intended for bills may start being funneled toward obtaining the substance. The user may find that they associate with people who are not the safest choice for social interactions. Users may start justifying dangerous behaviors, such as driving while intoxicated, as necessary undertakings. Work obligations may be postponed or neglected in favor of getting high, and relationships can begin to suffer from abuse and neglect.

Stage 4: Addiction

With full-blown addiction, the user has become comfortable with the abovementioned changes. Less time is spent on self-contemplation, as most thoughts are centered on how to obtain the next high. An addict may not even resemble the person whom you knew before.

In addition, users will feel as though they cannot refrain from using the substance. They may make a resolution to quit, only to disappoint themselves by using again. They may be aware of the misery of their loved ones, but their concern cannot override the need to use. Friends and family can take a backseat to associating with others who are using and supplying the drug.

Someone in the throes of drug addiction may begin to neglect basic needs. Grooming habits may deteriorate, meals are skipped, and sleep becomes impossible without the influence of the drug to dictate the schedule. Jobs can be lost, resulting in a loss of income. Having no income can contribute to increased criminal behaviors and seeking of charity and become a revolving door to sustained poverty.

Detox, Treatment & Recovery

Similar to becoming addicted, there are stages on the way back out of addiction. The recovering addict must go through steps that include acknowledging the problem, developing a plan to quit, and putting the plan into action. Many helpful treatment resources are available when the addict is ready to make changes. Medical detox is the safest and most effective way to break the chemical dependence on a substance and develop the tools needed for lifelong sobriety.

If you or a loved one are struggling with addiction and seeking a New York or New Jersey detox, Ascendant is here to help. Our drug treatment center and detox in New York is staffed by caring, experienced professionals who can help you get your life back on track. We also offer an IOP program in New York.

Please speak to one of our compassionate counselors to begin your journey to a life free from drug dependency.

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Here at Ascendant New York, we understand the importance of having access to accurate medical information you can trust, especially when you or a loved one is suffering from addiction. Find out more on our policy.

Amanda Stevens


Amanda Stevens, B.S.

Amanda is a prolific medical content writer specializing in eating disorders and addiction treatment. She graduated Magna Cum Laude from Purdue University with a B.S. in Social Work. Read more

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