The Progressive Nature of Addiction

No one is born a full-blown drug addict. Addiction is progressive, from early stage, to middle stage, to late stage. In early stage it’s difficult to tell addiction from misuse. Lot’s of people go through periods in which they misuse alcohol or other drugs, but they aren’t necessarily suffering from addiction. The progressive nature of addiction makes addiction easier to diagnose in middle and late stages. Here’s a definition of addiction from NIH:

Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain; they change its structure and how it works. These brain changes  can be long-lasting and can lead to many harmful, often self-destructive, behaviors. 

This doesn’t mean that a person can’t control drug use at all. In the beginning, the addict can periodically control the use of drugs, and alcohol is a drug, but loss of control becomes progressively worse. The early stage addict might go to the bar one night with the intention of drinking three beers and leaving, and does so. Maybe the person does this for two or three nights, but then the next time the person winds up drunk and in jail for DUI, not understanding how they lost control and made such a bad decision to drive. Later on, the person will find it difficult to control at all.

A person in early stage addiction has to consider why they need to exert control. Most people who don’t have a problem with drugs don’t have to worry about controlling the use. A social drinker might have a couple of drinks or not, it’s not a big deal — they don’t lose control. There are some drugs, like opioids, that can cause physical dependence if taken long enough for pain, but if the person is not susceptible to addiction, they won’t have the psychological obsession that drives usage in spite of negative consequences, so that would be different from drug addiction or misuse. This person who has become physically dependent on opioids from long usage for pain management will need detox, but they’ll be glad the medication is no longer needed and they won’t crave the opioids after detox.

The structure of the addict’s brain changes, and it takes a while in recovery for the changes to reverse. The addict will often crave the drug months after detox. This is why a recovery plan is needed. Addiction is progressive and it gets worse with continued use, and it gets harder to quit when it progresses to middle and late stages. The progressive nature of addiction can be arrested at any time, but it takes willingness and effort.