Understanding the stages of drug and alcohol addiction

Most people who wind up dependent on a substance start out by simply trying the substance, whether it be drugs or alcohol, in a social setting. From there, they dabble a bit more, taking the substance on a more regular basis.

During these beginning phases, there typically are no red flags or noticeable consequences. It isn't until later in the stage of abuse or misuse that minor consequences begin to surface. These can include frequent absences from work, poor decision-making, increased fatigue and depression symptoms.

If you or a loved one are struggling with drug or alcohol addiction, it's essential to understand the stages of substance use disorder to better navigate the path to recovery. By recognizing the progression of addiction, you can take proactive steps towards seeking help and overcoming substance abuse.

Stage 1: Experimentation and social use

The first stage of substance abuse disorder is often a crossroads of experimentation and social use.

At this point, people may try drugs or alcohol out of curiosity, peer pressure or the desire to feel more confident in social settings. This stage may appear harmless because the use is occasional and often tied to specific events. However, the act of experimenting plants the seeds for potential dependency.

Melissa Sheekey, MA, behavioral health therapist at Mirmont Treatment Center explains.

"What makes this stage so tricky is that it doesn't always look concerning. A young adult trying alcohol at a party or someone taking a pill when a friend encourages them might not raise alarms, but repeated experimentation increases the risk of developing a pattern. Addiction often starts much more subtly than people realize."

Recognizing this early phase matters because it's the easiest point for intervention. Parents, friends or partners who notice frequent social use can have conversations about boundaries and risks before the addictive behavior progresses.

Stage 2: Regular use and high-risk behavior

The second stage marks the shift from experimentation to consistent use, often accompanied by risky behaviors.

People may begin to drink or use drugs during the week and outside of social events. They might do this when they're alone or to cope with stress. Substances can quickly become a way to manage anxiety, depression or emotional pain.

Melissa notes, "When people start turning to substances for comfort rather than connection, that's a red flag. The line between casual use and harmful use is crossed when someone uses to escape rather than to enjoy."

As control weakens, high-risk behaviors emerge. This may include:

• Driving under the influence.
• Unsafe sexual activity.
• Neglecting responsibilities.
• Lying to loved ones about the extent of use.

Even if major consequences haven't appeared yet, the person is entering dangerous territory.

Stage 3: Misuse or abuse

When someone begins using substances more frequently or in larger amounts than intended, they enter the misuse or abuse phase.

At this stage, many people are still able to function day to day by holding a job, caring for family, maintaining some routines. But small cracks begin to show. Relationships may grow strained, performance at work or school can slip and mood swings or irritability become more noticeable.

From a biological perspective, the brain begins adapting to the substance. Dopamine, the brain's "reward" chemical, starts to rely on the drug or alcohol for release. This change creates cravings and agitation when the substance isn't available.

"I often hear people in this stage say, 'I can stop anytime I want.' But their actions tell a different story. They may start to notice that without the drug or drink, they feel easily frustrated or unsettled," explains Sheekey. At this point, these types of reactions are red flags that the substance is beginning to control a person's mood and daily functioning.

Treatment at this stage can be especially effective because the individual may still have more stability and insight. Outpatient therapy, peer support groups or early intervention programs can help break the cycle before dependency develops.

Stage 4: Substance use disorder and dependency

The final stage is chemical dependency, where substance use becomes a necessity for daily functioning.

Tolerance has increased, meaning the person needs more of the substance to achieve the same effect. At this point, stopping suddenly often triggers withdrawal symptoms that can range from uncomfortable to life-threatening.

"Dependency changes how the brain and body function," Melissa says. "It's no longer about choice: it's about survival. That's why medical support is so important during withdrawal and early recovery."

Withdrawal symptoms vary by substance. With opioids, people may experience intense flu-like symptoms, nausea and muscle pain. With alcohol or benzodiazepines, the risk can be even greater, with seizures or hallucinations possible if someone quits abruptly.

The dependency stage often feels overwhelming, but it is not hopeless. With the right support, treatment and care, people can and do recover, even after years of use.

The dangers of laced drugs

One modern complication in all stages of use is the prevalence of laced substances. Fentanyl, a powerful synthetic opioid, is often mixed into other drugs without the user's knowledge. Xylazine, also known as "tranq dope," has emerged as another dangerous additive, causing severe medical problems and increasing overdose risks.

Even substances sold legally in gas stations or smoke shops can be addictive and dangerous. These products are often marketed as safe alternatives but carry serious risks of dependency.

Melissa stresses the importance of awareness: "The drug supply today is more unpredictable than ever. People often don't know what they're taking, which makes every use more dangerous. Education and harm reduction can save lives."

Seeking help — the path to recovery

Embarking on recovery requires courage and the decision to reach out for support.

Help can take many forms. It can include talking to others in individual therapy, group counseling or peer support meetings. Or it can be medication-assisted treatment to reduce withdrawal symptoms and cravings and help with the detox process. Comprehensive rehabilitation programs also address underlying trauma, co-occurring mental health conditions and coping skills for long-term recovery.

"Recovery isn't just about removing the substance," Melissa explains. "It's about building a life where you don't need the substance to cope. That means addressing mental health, relationships and self-esteem alongside physical healing."

Recovery and relapse prevention

Recovery is not a one-time event but an ongoing process. Leaving treatment is just the beginning of a lifelong commitment to wellness and sobriety.

Relapse can occur, but it should be seen as a learning opportunity rather than a failure. A strong relapse prevention plan helps individuals recognize triggers, develop healthy coping strategies and lean on supportive networks when challenges arise.

Self-care practices, such as exercise, mindfulness and meaningful hobbies, help maintain balance. Continued therapy or peer support can also provide accountability and encouragement.

Substance use disorder is a progressive condition but it's also treatable. By understanding the stages — from experimentation to dependency — you can better recognize the signs and seek help sooner. Recovery is possible at any stage, and no one has to face it alone.

Next steps:

Understanding the stages of addiction is just the first step. The next is finding the right support.

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