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What Is Substance Use Disorder

According to a Substance Abuse and Mental Health Services Administration survey, about 3 million people (age 12+) used an illegal drug or abused a legal prescription for the first time in 2018. In addition, the same survey showed that 4.9 million people drank alcohol for the first time. The initiation stage generally happens during the teen years. In 2017, nearly 20% of teens (ages 12-20) reported drinking over the past month. What Is Substance Use Disorder? Basically, the first step to addiction is trying the substance.

Many adolescents or teenagers try drugs or alcohol for reasons like:
  • Curiosity
  • Peer or social pressure
  • Lack of development in the prefrontal cortex, which manages decision-making and controlling impulses

Once someone has tried alcohol or drugs, they may move along to experimentation or stop once their curiosity has been satisfied. This depends on a few factors, including:
  • Availability of drugs and alcohol within the community
  • Whether or not friends use drugs or alcohol
  • Family environment, including physical or emotional abuse, mental illness, or alcohol or drug use in the house
  • Mental health conditions like depression, anxiety, or ADHD

What Is Substance Use Disorder
Stages of Drug Use

It is vital for users and loved ones alike to understand the various stages when it comes to substance use. Using a substance does not always lead to an addiction. However, overuse, social pressures, and other factors could lead to becoming physically and psychologically dependent on a drug or substance.

These factors are not always obvious and are often mistaken in teens or young adults as rebellious and acting out. To better understand the difference between experimentation and addiction, one must learn how to recognize the behaviors that lead to them.

Substance use among adolescents ranges from experimentation to severe substance use disorders. Even practical use puts adolescents at risk of short-term problems, such as accidents, fights, unwanted sexual activity, and overdose. Substance use also interferes with adolescent brain development.

Stages of Substance Abuse or Experimentation

The truth is that there are many stages of addiction, each with its signs and symptoms to monitor in yourself and others.

Stage 1: Experimentation

Upon the initial first try, drug use can quickly become experimental, occurring more frequently.  Some people start this by only using drugs in a specific situation, like a party or during concerts.  This exploratory phase is usually a more social matter that involves drugs to relax or have some fun.  At this point, people generally don’t seem to think about these substances too much other than right before the time they plan to use them. 

Cravings naturally do not exist at this phase, but the anticipation of the social event of using the drug may become a factor.  At this time, people will decide to consume drugs consciously, understanding the potential consequences, or they will take the drugs impulsively, without much pre-planning.  Still, their thoughts and concerns aren’t centered on their drug use and will only take place when convenient.

Stage 2: Regular Use

At this point, substance use is more frequent for you.  May not use it every day, but there may be a predictable pattern (using every weekend), or you may use it under the same set of circumstances (when you’re stressed, bored, lonely, etc.).  Probably use drugs or alcohol with other people at this stage, but you may begin to use it alone too.  You may miss school and work due to hangovers.  There may be worries about losing your drug source since substance use has become tied to the idea of escaping negative emotions or situations.

Recreational drug use is more common than most people realize.  Some use drugs to “party,” while others use them to unwind.  When someone is regularly buying and ingesting drugs, it qualifies as recreational use that can be as frequent as every weekend or several times a week.  At this stage, people are more aware of their intake and usually have a ritual surrounding their obtaining and preparing the drugs.

Sometimes they may miss work or school due to the after-effects of using the drugs.  This drug use often goes hand-in-hand with people looking for drugs to escape their situations or cope with other issues.  Others may use drugs regularly because they feel that it makes their social interactions much more exciting and enjoyable.  At this point, they prefer to use medicines socially rather than stay sober.

Stage 3: Problem/Risky Use

As the name suggests, substance use at this point has begun to take a negative toll on your life. If you drive, you may do so under the influence.  You may have gotten a DWI/DUI or had other adverse legal consequences.  Your performance at work or school may be suffering, along with your relationships with others.  You may have changed your circle of friends, and your behavior has almost certainly changed.

In short, risky or problem use threatens your safety and the safety of others but may not meet the criteria for a substance use disorder.

Stage 4: Dependence

There are three steps to dependence:

  • Tolerance:  describes the effect that happens when you start to require more of a substance to achieve the same “high.”
  • Physical dependence:  has been achieved when going without drugs or alcohol elicits a withdrawal response.  it is important to note that physical tolerance can happen even when prescription drugs are taken as your doctor has instructed.
  • Psychological dependence:  describes the state where you experience drug cravings, a high rate of substance use (using more, using more frequently, or both), and using again after attempting to quit.  This can also be known as “‘chemical dependency.”

These stages are cumulative.  For example, you can have a tolerance for a substance without being physically dependent and be physically dependent without being psychologically dependent.  Still, you cannot be psychologically dependent without being physically dependent and having developed a tolerance.

A Substance Use Disorder

A substance use disorder (SUD) is diagnosed when you meet a specific set of criteria.  Substance use disorders can be mild, moderate, or severe, depending on the number of measures met.  The assessment will include criteria like:

  • You “cannot face life” with drugs or alcohol
  • You continue to use a substance despite the harm that comes to your health and life
  • Avoiding friends and family
  • Lying about your usage, especially about how much you are using
  • You have given up activities you used to enjoy
  • You cannot recognize the problems with your behavior or with your relationships with others

A substance abuse disorder is more than its symptoms.  It is a chronic disease, meaning that it is slow to develop and of long duration.  In addition, substance use disorders are often relapsing, meaning that recovery will usually entail setbacks.  Relapse rates for substance use disorders are similar to relapse rates for other chronic diseases like asthma and hypertension.

SUDs affect the memory, motivation, learning, movement, emotion, judgment, and reward-related circuitry in the brain.  This happens because chronic substance use floods the brain with dopamine, first teaching you to use more of the substance that produced such a pleasurable effect, then keeping your brain from producing enough dopamine on its own.  You then have to continue to use the sense to feel happy or even expected.

What Is Substance Use Disorder Treatment?

There are ways to treat SUDs, though, so you can regain control over your life, health, and wellbeing.  After an initial detox period, behavioral therapy combined with medication is often the best course of treatment.  A high-quality addiction treatment program can help you identify and heal the root cause of your addiction and teach you coping skills that will help prevent relapse.

There is also counseling available for you, your family, and friends to help with recovery after leaving treatment, as well as support groups like AA, NA, Al-Anon, and Nar-Anon.  These groups and types of therapy help support long-term recovery.

Understanding The Stages Of Addiction

Understanding the stages of addiction is essential to help you understand how substance use can evolve into something that harms your relationships, sense of self, and overall health.  If you or someone you love is on the path of addiction, We Level Up can help.  Our compassionate intake coordinators can answer your questions and help you understand treatment options that can work well for your specific situation.

At We Level Up Treatment Center, we provide world-class care with round-the-clock medical professionals available to help you cope.  All are working as a team to provide you with the optimum substance use disorder with one of our treatment specialists.  Our specialists know what you are going through and will answer any of your questions.

Your call is private and confidential, and there is never any obligation.


[1] SAMSHA –