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The Stages of Substance Addiction (In the Correct Order!)

Updated on March 6, 2018

Substance addiction affects more people than many realise. For some, it is obvious for the world to see. Meanwhile, others can keep it well hidden, within a secret world of torment.
Either way, there is only one outcome.


Destruction of self. Destruction of relationships. Destruction of morals. Destruction of all that is good.
The buzz overtakes everything, to such an extent that reality, a way out, and even the reasons why, become completely lost.

Many people write about addiction in ascending order. But this makes no sense. The addict doesn't consciously work their way up the ladder of destruction. Rather, they reach a crisis point, at some stage, a wake up call, and wonder how to begin the way down.

Here, I will explore the stages of substance addiction from the top, down... or bottom, up... whichever way you choose to see it.

Physical Damage, Disease, and Death

There are no words in this case that can be referred to as scaremongering. This is real. Get used to it.

Whether the vice is heroin, alcohol, amphetamines, or a whole concoction, substance addiction eventually leads to physical damage, disease, and in many cases, death.

The human body is a highly complex organism, it's a tough critter, but it has a breaking point. When the detoxifying systems can no longer cope with the poisons, the mind can no longer see through the haze, the blood can no longer bluff its way through nutrient deficiencies, and when the body just can't take another battering, it rolls over.

Sadly, for many addicts, this stage has to be reached before any true realisation and appraisal can take place. I know, I've been there. More than once. Not so damn powerful and in control with a drip in your arm and your butt sticking out the back of a gown! (Top Tip- ALWAYS ask for two gowns).
Welcome to a scary place where you get a chance to glimpse your own mortality. Don't look away.

On a positive note, for the receptive, this is the stage at which the most help should be on offer.

Take it.

Rehab... counselling... medicines... all those other goodies.

Take it.

It is not weak to ask for and accept help. In fact, the opposite is true.


Physical Need

Physical need occurs when your body requires a certain amount of a substance, just to function, or even just to survive.

If you take too much of virtually anything for too long, you will develop a physical need.

It is important to know that, even with the most determined mind, this stage must be cracked first before you can even think about cold turkey. Denying the body when it is in NEED of a substance can result in serious health issues and even death.

Among the worst culprits for physical need are opiates, alcohol, cocaine, and benzodiazepines. In these cases, sudden withdrawal can result in seizures, heart attacks, strokes, and death. Not much fun.

At the upper end of the physical need scale, you can find yourself in the unenviable situation of needing a drug to stay alive, and also risking death by ingesting said drug. This is hospital time.

Luckily, treating physical need is a priority in hospital situations. Outside of hospital, I highly recommend that you seek professional help with a detox and gradual reduction.

Reduction is the word here. And gradual is the key. Let's throw a figure out there...
Say you're drinking two bottles of vodka per day. Suddenly reducing this by half could land you in the danger zone. Seek trained, professional help and get a plan together.

Take back control of your body.


Mental Need

Mental NEED is not present in all cases of substance addiction.

By mental need, I refer to those with mental health issues. Specifically those who rely on the effects of a substance to control their symptoms.

Mental health issues are real. It is more common than people realise, and there are many pathways to recovery.

This is not a stage of addiction that I have personal experience of, but I have seen others go through it.

One of the biggest culprits here is cannabis, whether people want to hear it or not. Especially heavy users are often using it to combat certain issues, and can easily find themselves in a place where they cannot function in their day to day lives without it.
It leads nowhere good. Seek help.



Once the body no longer needs the drug, and the addict may even be completely clean, this highly vulnerable and volatile stage occurs.


Most addicts, although free from physical addiction, still have a mental tie to a substance, a want.

It's time for willpower to take over.

At this stage, it can help to have an easily accessible memory to a good and healthy place. That is, a clear memory of what it feels like to be free of addiction and fully functional again. When you lose the reference point of what it feels like to wake up, feeling refreshed, relaxed, and stress free, you can easily slide back a few steps. Hold onto that memory and ask yourself if you want to lose that.

Hobbies. Everyone has at least one hobby. A hobby can be mountain-biking, metalwork, or simply looking at trees. Everyone enjoys doing something. Now is the time to embrace your hobbies and even seek new ones.

Occupy yourself. Call that old friend that you haven't seen in a while. Get on with those chores that have been building up. Join a club or two. Keep yourself occupied and you will feel more fulfilled. A fulfilled life is less likely to be drawn into drink and drugs.
The want will subside. Every time you don't give in, is a win. Clock up the wins until your mindset changes.

Now is a good time to continue seeing a counsellor. Make the chat more relaxed, be honest, get it out of your system. Chances are, they've been there.

Personally, I don't subscribe to the idea that every addict wants their vice to escape from something. Though this may be true in many cases, I think it is a dim, simplified, and programmed view. I had nothing in my life that I needed to hide from, quite the opposite. I was just irresponsible, stuck, and thoughtless, with no empathy. The want took over.

This is a tough stage (they all are) but, with a little focus, you can do it.


Habitual Addiction

This is a stage that I had particular trouble with. The relapse potential is large, but, with some reasoning, this can also be the stage that breaks the addiction for good.

By habitual addiction, I am referring to those habits, events, and triggers that can pre-empt substance intake.

It is easiest to explain this with my worst vice, alcohol.

Alcohol, being the socially accepted and easily attainable drug that it is, can, throughout a lifetime, become totally meshed with many common life events.

A personal example is- The idea of watching a day of Six Nations rugby without a good stash of beer was anathema for many, many years. It just didn't happen. Made no sense not to drink. So, even without addiction, drinking would start way before kick off, continue through the games and intervals... and would I stop afterwards?? Probably not. In fact, there's every chance I would accelerate my intake.

So, when I think back at all the rugby games that I basically missed through intoxication. All the scores I had to look up the next morning... drinking makes no sense! I love watching rugby, yet I missed most of it.
This same protocol can be applied to music gigs. I've missed whole gigs of bands I'll probably never see again, due to drink and drugs. What good is that?
Another big problem situation is arranging to meet someone at a pub, for a 'couple'. Now, to the problem drinker, the mindset of 'better get a head start' is common. Then sneaking drinks between drinks, even popping to the shop for spirits, and all those great tricks. Yeah, you know what I mean? Because 'They can't handle as much as me'.... who said it was a competition??

When I think back at all the little drinks and cheeky ones that have gotten way out of hand, ended badly, and even badly upset those that I care most about, those little tricks don't seem so clever.

Basically, what I'm saying is, whenever a situation arises where drink and/or drug intake seems inevitable, don't be afraid to question it. You'll be amazed what you'll discover. Give it a go without, or at least with less. If you can't break these bonds, you'll have to change your habits, simple as that, or you'll find your way quickly back up this page.

I've seen more gigs and games of rugby, and had better times in pubs in the last year than I have in my entire life!


Relapse Prevention

I won't lie, relapses are common. I'm not saying that they HAVE to happen, but they often do sneak their way in.

Just take a step back, find your way back down, and make sure you learn something from each falter.

Make sure the blips decrease in size and that you find out more about yourself each time.

Keep a clear view of your goals in life, and don't be afraid to glimpse back at the worst of times. That will often be deterrent enough.
Some addicts can resume healthy lives and even still indulge with care. However, many have to simply stay well clear of all temptation. You need to know which type you are!

I'm lucky, in that I can have the odd drink, or responsibly use medication, without having to continue. In fact, I rarely ever want to drink, and I find that after two or three, I begin to recoil from the fuzziness. I pull out my trump cards on it!

My top tip for relapse prevention is this-

Sit down with those you care most about and ask them how they feel when you hit rock bottom. Ask them how they really feel, deep down in their gut, when you're scrambling about in a haze, trying to regain a foothold, risking your life. If you have a conscience, these answers may well be all that you need.

Good luck.


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      Christopher Turvey 6 weeks ago

      Agreed with the well written article. I've been through many addictions and actually managed to kick every one, solvents, nicotine, opiod based pharmaceuticals, even a crux with weed though i didnt consider that an addiction. but it took a complete change of my lifestyle and placing myself in a positioon where those things were no longer available to me. I can't say where i would be now if still on the Isle of Wight surrounded by the hippy haze. probably wouldn't have progressed very far at all. Hats off to those that can break free of addiction while still surrounded by them, choosing to still intergrate with those that continue to indulge in them. That's fucking willpower right there