Jodi Tarantino, LICSW

Watching someone you care about change because of substance use is confusing and painful. You might be wondering how things got to this point, or maybe you’re seeing patterns in your own life that feel unsettling. It’s easy to get lost in questions and self-blame, but what you’re seeing often follows a clear, predictable path. Addiction isn’t a mystery, and it’s certainly not a moral failing. It’s a progressive condition with recognizable stages. Understanding these addiction stages is more than just an academic exercise. It’s about replacing confusion with clarity. When you can see the map of how substance use deepens its hold, you can also see the off-ramps, the moments where change is possible. This knowledge gives you the power to identify what’s happening, find the right kind of help, and approach the situation with the empathy and understanding it deserves, whether it’s for a loved one or for yourself. The stages of addiction While everyone’s journey is unique, the progression from casual use to a substance use disorder often follows a recognizable pattern. Understanding these addiction stages can help you identify where you or a loved one might be, making it easier to see when and how to seek help. Think of it as a path; once you know the route, you can find the exits. Each stage is marked by shifts in behavior, mindset, and the physical and psychological risks involved. By breaking down this progression, we can demystify the process and see it not as a sudden fall, but as a series of steps, each one moving further away from health and closer to dependency. Stage 1: experimentation and social use The journey often begins with voluntary or initial use, frequently driven by curiosity, peer pressure, or the desire to fit in. At this stage, substance use is typically infrequent and tied to social situations, like trying a drink at a party or using a drug with friends on a weekend. For many, it may not seem like a big deal. However, this is a critical point because even early exposure can be risky. Research shows that the majority of people with an addiction tried their drug of choice before age 18 and had a substance use disorder by 20. For some, what starts as experimentation can become the first step down a slippery slope toward dependency. Stage 2: regular use and high-risk behavior In the second stage, use shifts from sporadic and social to a more predictable pattern. It might be having a few drinks every night after work or using a substance every weekend. The substance often becomes a coping mechanism to deal with stress, boredom, loneliness, or other uncomfortable feelings. This is also where high-risk behavior can begin to emerge, such as driving under the influence or letting responsibilities at work, school, or home slide. As the pattern of regular use becomes more established, a person may start to use more often by themselves, creating a sense of isolation that can accelerate the progression of the addiction. Stage 3: Misuse or abuse This stage is defined by the emergence of clear, negative consequences. The person’s substance use is now causing noticeable problems in their life, whether it’s damaging relationships, causing issues at work or school, or leading to legal trouble. At the same time, their body is adapting. They may develop a tolerance, meaning they need more of the substance to achieve the same effect. This creates a difficult internal conflict: a part of them knows the use is causing harm, but the urge to continue is powerful. If these patterns feel familiar, it’s a critical time to consider that professional support, such as an intensive outpatient program (IOP) or partial hospitalization program (PHP), can offer a path forward. Stage 4: Substance use disorder and dependency In the final stage, the person has developed a dependency, meaning their body and mind now need the substance to feel "normal." If they try to stop, they experience painful or uncomfortable withdrawal symptoms. The addiction cycle is now in full control. The substance has become the central focus of their life, overriding everything else that once mattered, like hobbies, goals, and even relationships. The behavioral shifts that began in earlier stages often grow to extremes, with the person giving up old hobbies and actively avoiding friends and family to hide their use. Life becomes organized around obtaining, using, and recovering from the substance. Factors that increase the risk for the addiction cycle No single factor can predict whether someone will develop a substance use disorder. Instead, it’s a complex interplay between a person's biology, their environment, and their life experiences. Think of it like heart disease: genetics might make someone more vulnerable, but lifestyle choices and environmental stress also play a huge role. Understanding these risk factors can help create awareness and foster a more empathetic view of addiction. Here are some of the key factors that can increase a person's risk: Genetic and molecular factors Family history plays a significant role. In fact, genetic factors are thought to account for 40 to 70 percent of an individual's differences in risk for addiction. This doesn’t mean that if you have a parent or sibling with a substance use disorder, you’re destined to develop one too. It simply means you may have a higher genetic vulnerability. These genetic influences can affect how your body and brain respond to a substance, how much pleasure you derive from it, and how likely you are to develop a dependence. It's one piece of a much larger puzzle, but an important one to be aware of. Use of multiple substances and co-occurring mental health conditions Substance use disorders often go hand-in-hand with other mental health conditions like depression, anxiety, or post-traumatic stress disorder (PTSD). This is known as a dual diagnosis or co-occurring disorders. For many, substance use begins as a way to self-medicate the painful symptoms of an untreated mental health condition. For example, it's estimated that 30-60 percent of patients seeking treatment for alcohol use disorder also meet the criteria for PTSD. This creates a dangerous cycle where the substance temporarily masks the symptoms but ultimately makes the underlying mental health condition worse, deepening the dependence on the substance for relief. Frequently asked questions What are the stages of addiction, and how do they develop over time? The stages of addiction explain how substance use can move from initial or occasional use into a chronic condition that affects the brain’s reward system and behavior. The first stage often involves experimentation influenced by peer pressure or risk factors like family history. As repeated use continues, the person may enter the second stage, where substance misuse increases and negative consequences begin. In the final stage, drug or alcohol addiction develops, marked by drug dependence, withdrawal symptoms, mood swings, and significant impacts on mental health and daily functioning. How do substance abuse and substance use disorder differ across addiction stages? Substance abuse and substance use disorder represent different points along the addiction cycle. Early stages may include alcohol abuse, prescription drug misuse, or drug use that causes some negative impact but remains occasional. As addiction progresses, substance misuse can turn into drug abuse or alcohol addiction, with physical symptoms and loss of control. In later stages, substance use disorder is recognized as a chronic disease that often requires professional disorder treatment in clinical settings. Can someone recover from the final stage of addiction, and what does treatment involve? Yes, recovery is possible even in the final stage of addiction with appropriate addiction treatment and ongoing care. Treatment programs often include addiction medicine, individual therapy, and approaches like motivational interviewing to support behavioral change. Because addiction is a chronic illness, long-term recovery focuses on maintaining sobriety, addressing mental health needs, involving family members, and supporting sustained recovery over time. Find treatment, no matter what addiction stage you're in No matter which stage of addiction someone is in, it’s never too late to seek help. Recognizing the stages of addiction is a powerful first step, but taking action is what truly changes lives. It’s a journey that requires courage, and you don’t have to walk it alone. At Red Ribbon Recovery Colorado, we offer access to compassionate, expert outpatient care designed to meet you where you are. The recommended programs, including intensive outpatient (IOP) and partial hospitalization (PHP) options, provide the structure and support needed to build a foundation for lasting recovery. Whether you need help for a dual diagnosis or are seeking flexible telehealth services available nationwide, our team is here to help. If you or a loved one is struggling with any addiction stage, please reach out. Call us at (303) 219-3980 or contact us to request a free, confidential assessment. It’s time to take the first step toward a healthier, more hopeful future. Sources National Center for Biotechnology Information. The neuroscience of drug reward and addiction. Physiological Reviews. National Center for Biotechnology Information. (November 10, 2016). The neurobiology of substance use, misuse, and addiction. National Institutes of Health. University of Pennsylvania. (February 5, 2025). Neuroscience and addiction: unraveling the brain's reward system. University of Pennsylvania. National Center for Biotechnology Information. (May 3, 2022). An extended amygdala–midbrain circuit controlling cocaine withdrawal–induced anxiety and reinstatement of drug seeking. Nature Neuroscience. National Center for Biotechnology Information. (October 20, 2011). Dysfunction of the prefrontal cortex in addiction. Neuropsychopharmacology.

Jodi Tarantino, LICSW

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Jodi Tarantino, LICSW

Content reviewed by Jodi

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