The Progressive Stages Of Substance Abuse2

Use of the substance is occasional, and experimental in nature. Usually, there's been some peer pressure, or personal curiosity, or just a desire to explore something new. Normally the first substances used are cigarettes, alcohol, marijuana and increasingly today, prescription drugs taken from the home.

In this stage, only small quantities are needed, as the tolerance levels at this point are generally low. Outward behavior will remain fairly normal, but a parent or someone else around the individual may detect the smell of alcohol or some erratic behavior, particularly on weekends, or following a party or unsupervised outing. But for the most part, it will be "business as usual."

At some point during this stage, the individual will first experience what they will remember as the "perfect buzz," or the "perfect high." If they've had difficulty adjusting to life in the past, or if they've been uncomfortable with who they perceive they are, within the perfect buzz or perfect high, those problems are gone. And for some, this is an extremely attractive phenomenon. It's like having a headache all your life and suddenly, someone hands you an aspirin and the headache is gone. And from this point forward, the "addict-to-be" will chase that "perfect buzz" all the way to the steps of a treatment center, or even more serious destinations.

Now there's more regular use, no longer just restricted to weekends. As tolerance has increased, so have the quantities required and accordingly, more physical side-effects will begin showing up depending on the substance in question. The key point here is that there will probably be a fundamental change in behavior. The introvert suddenly becomes the extrovert, or vice-versa. Or the person who was timid has suddenly become aggressive. Behavioral changes are a normal part of growing up, but remember, the substance that's being taken is being used as a vehicle to get from point A to point B psychologically. As a result, dramatic and/or erratic personality change is almost a given with substance abuse. It's an attempt to get away from who you really are and your normal perception of reality.

For example, a "normal" drinker will generally stop drinking when they start becoming different from who they normally are. That's because more or less, these people like who they normally are. In contrast, a potential addict will keep drinking or drugging until they are anybody other than who they normally are. And that's because they're not at all comfortable with who they normally are. This is a key point and a major distinction between the person with a healthy self-image and one with a poor self-image.

"Blackouts" (total loss of memory) or "brownouts" (partial or hazy recollection of events) may also occur now. "What happened last night?" or "What did I do?" become frequent questions. There's now real anticipation on the part of the individual as to when the next experience will occur. And because more time is being spent pursuing the substance and using it, social interactions change - normal extra-curricular activities are dropped, new friends are acquired who "think" the same way, and old friendships fall off.

It's at this point, as the use of the substance begins to occupy more and more of the person's time, money and energy, that other things start to happen. More time might be spent out of the house and return times become later and later, or turn into "all-nighters." School attendance and grades suffer, and you may find money or other valuables missing that have been used to buy or trade for the substance. The person begins to get caught up in different lies, and begins to withdraw from family and their normal social circle. They often become sullen, hostile and resentful. And that "perfect buzz" that was first experienced in Stage One is experienced more frequently now, although it's never exactly the same, or rarely as good as the first one was.

The substance has almost become the primary focus of energy and attention. The amount of money, time and energy spent on the substance has reached even higher levels, and there may be an upgrade to more powerful substances. Getting high is no longer recreational, it's a daily event and a part of a routine and ritual. It's in this stage that dealing, theft, fraud, etc. may be used to finance the use of the substance, and it won't be unusual to find "stashes" hidden throughout the home. A psychological cycle will begin to develop within the individual where they are always at one of three mind-sets:

And how do you "medicate" away guilt and remorse? You use again! That's how the cycle continues.

Conflicts with friends, family and co-workers will escalate, (if they're still in the picture,) the individual will isolate more and there will be little, if any contact with anyone who does not in some way enable or facilitate use of the substance. As the appetite for the addiction grows, there will be more constant use which inevitably leads to more use in isolation. This isolation in turn leads to more distancing of the individual socially.

This person will now be extremely hard to communicate with and usually defiant of everyone and everything. It's also at this stage that we might begin to see (if we haven't already) problems with the law. This will include everything from drunk-driving charges or shoplifting, to spousal abuse, assault, etc. A version of the "perfect buzz" can still be achieved, although it is becoming increasingly harder to reach with certainty. Where at one time that perfect buzz was like being in Heaven, now it's just the only place the addict can get to where they don't feel like they're in Hell. Denial has now become a predominant theme in the person's life because they can't see the problem that everyone around them can plainly see. And hearing about it makes them anxious and uncomfortable, so they use more or drink more to medicate the feelings away.

Now the individual's system is used to having the alcohol or drug present. So each time the level begins to drop off, it begins to respond as almost a "survival reaction." It wants more and that becomes the all-consuming focus. GET MORE. And each time the withdrawal factor is teased and then given what it wants, the next time it appears it's stronger and more profound. This will have a major impact on continuing the cycle of addiction.

A state of being high is now the "normal" state that the addict (yes, they're now likely a full-blown addict) must constantly be trying to achieve and maintain. Blackouts and brownouts are now routine, physical appearance has deteriorated and again, an advance could have been made to even stronger substances. It's at this stage that pride and dignity start taking a back seat to the addiction and that can lead anywhere.

The person who once turned their nose up at drinking anything less than twelve year old scotch might now be willing to drink rubbing alcohol. The young lady who at one time wasn't comfortable kissing on the first date might be selling her body on the street for a ten dollar piece of crack cocaine. Addiction is simply that relentless, and pride is not an issue anymore because feeding the addiction comes before everything. The need for the substance has become all-consuming and now controls the individual mentally, physically, psychologically and spiritually.

Potential for criminal activity to finance the lifestyle is greatly increased at this stage because for all intents and purposes, the addict or alcoholic is not even in the general vicinity of reality. Guilt, self-hatred, and thoughts of suicide increase and the addict will often put themselves in extremely dangerous circumstances and situations.

Studies have shown that between one quarter to one third of all people serving time in Federal penitentiaries for violent offences say they were under the influence of drugs at the time. And alcohol? A 1990 review of 15 studies found that approximately 60 percent of people convicted of homicide were drinking at the time of the offense. And according to the National Institute on Alcohol Abuse and Alcoholism, over 50% of sexual assaults involve drinking by the victim, the assailant, or both.

So from this point in the addiction cycle, there are only a few eventualities. The addict might float along at this stage for quite some time. Slowly but surely things will get worse, but sometimes it takes a long time. The addict might end up in jail or an institution because of the lifestyle they're in and all that goes with it. Or, the addict might get help and get treatment and that too will be a brand new battle. Or the addict might die. One thing is certain, if they keep using they will never "spontaneously" get better.

The progression of substance abuse and addiction in general is illustrated nicely by the story of the "frog in the pot." Put a frog into a pot of boiling water and.....well let's just say it's a pretty ugly scene because obviously, there's enormous pain involved. But put a frog into a luke warm pot of water and gradually turn up the heat, the frog will die without ever putting up a fight because they don't even know it's happening. And that's because it's happening so gradually, at least from their perspective. And the addicted person is just like the frog in the pot. They're dying a slow death and yet they're completely oblivious to it.

The easiest time to stop this cycle is in the early stages before real damage has been done, but all too often, an addict has to hit their "bottom." And where that bottom is depends to a great degree on the individual in question.

It's terribly important to remember that the substance, or the destructive behavior is just the vehicle or "medication" being used to keep the "root" problems at bay. Deep inside the individual is an issue or issues that they either don't want to confront, or don't think they're capable of confronting. The addiction itself, whether it's alcohol, drugs, inhalants, gambling, or any number of other problems is just the "method of expression." And sooner or later, the addict has to be able to trust someone. And that will be someone who can look them in the eye and instead of just saying "I feel for you," can truthfully say, "I know exactly how you feel, because at one time, I was you."

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