Stages of Addiction and Recovery

By Hugh C. McBride
In the opening to his classic novel, Anna Karenina, the author Leo Tolstoy observed that "all happy families resemble one another, but each unhappy family is unhappy in its own way."

People who are struggling with addiction might feel that they are experiencing a similar unique unhappiness, as each addicted individual endures an intensely personal misery. But experts in the field of addiction and recovery have noted that, though no two experiences are exactly the same, the process of addiction often follows a common linear progression that begins with initial exposure to a substance or behavior and terminates in an all-encompassing obsession with – and dependence upon – a drug or action.

Early Stages

Many experts refer to the early stages of addiction as the "use" and "misuse" periods. This time includes an individual’s first experience with a substance or behavior and the subsequent negative effects that result from increased or continued involvement.

Dr. Julian I. Taber, a retired clinical psychologist, has described the beginning of an addiction as the "delight and discovery" stage. He has written that individuals often recall experiencing euphoric emotions when they describe their initial encounters with the substances or behaviors to which they eventually become addicted.

One example of this stage is a person who is prescribed a painkiller after an accident. This individual may be justifiably thrilled at the resultant improvement to her quality of life. But if she continues to pursue this positive reaction by taking the medication after the condition for which she was being treated has been resolved, then she has moved into the "misuse" phase – and taken a step toward addiction.

People whose addictions are focused on behaviors follow the same path as those who abuse substances. For example, a person who travels to Las Vegas for the first time and discovers the thrill of the casino floor may begin engaging in potentially harmless "use" of gambling. But if that same person finds himself compelled to gamble repeatedly or for extended periods of time, he may be advancing to the "misuse" stage.

Middle Stages

The middle stages of addiction occur when an individual moves beyond misuse of a substance or behavior and begins abusing the object of his addiction. For example, an individual who is developing an alcohol addiction may progress from drinking (use) to drinking and driving (misuse) to drinking and driving multiple times, often after being convicted of a DUI offense (abuse).

Taking a drink or even being arrested for drinking and driving does not necessarily mean that an individual is an alcoholic. But an inability to curtail a behavior with negative consequences (for example, continuing to drink and drive after getting a DUI conviction) is evidence that the behavior has advanced from misuse to abuse.

Individuals in the middle stages of the addiction process may not yet be physically or psychologically dependent upon the substance or behavior, but their continued abuse – especially in the face of negative consequences to themselves and the negative effects their behavior is having on their close friends and family members – indicates that dependence and full-blown addiction may not be far away.

Final Stages

In the final stages, the addicted person becomes dependent on a certain substance or behavior, and experiences withdrawal symptoms if the object of the addiction is withheld.

Dependence occurs when the substance or behavior becomes the primary focus of the addicted person’s life. Work, personal relationships, and other fundamental aspects of life become, to the addicted person, a means of acquiring the drug or participating in the behavior. Drug addicts and alcoholics may begin borrowing (or stealing) money from friends and family members in order to buy more of what they crave. Gambling addicts may find themselves risking larger and larger sums of money in a quest to either re-experience their initial high or get themselves out of debt.

The final stages, what Taber terms the "defense and denial" and "resentment and relapse" phases, are marked by an obsession with the object of one’s addiction and the onset of withdrawal symptoms in the absence of the substance or behavior. Engaging in the addictive action is done not so much to experience the positive "high," but to stave off the pain and anger that occur when one is not using.

To individuals who are in the final stages of addiction, the substance or behavior to which they are addicted becomes all-encompassing. And neither the destruction they wreak on the addict’s own life nor the pleas of friends and family members are enough to convince them to stop.

The Road to Recovery

Though some individuals find themselves unable or unwilling to overcome their addictions, the good news is that recovery is possible. And like the descent into addiction, the journey back to healthy living is a phased and well-documented process.

The addiction recovery experts who contribute to the eGetgoing website have identified the following four stages as the critical steps in an addicted individual’s return to sobriety:

1. Recognition – Recovery begins when an addicted individual recognizes that he has an addiction, or is willing to admit that there is a problem with his behavior. In many cases, recognition occurs after "hitting bottom" – that is, a situation in which the addicted person is hurt badly enough (or threatened or scared so severely) that he realizes he has no other choice but to get help.


2. Cessation – After admitting that she has a problem, the next step a recovering individual needs to take is stopping the unhealthy action. Depending upon the object of one’s addiction, the cessation stage may be accompanied by withdrawal symptoms that require medical attention. Detoxifying one’s body, especially in the cases of severe alcoholism or certain types of drug addiction, can be a painful process, but it is an essential phase in the recovery experience.


3. Early Recovery – During the first two years or so of abstinence, the formerly addicted individual will likely make a concerted effort to change his lifestyle and behaviors to support his newfound sobriety. Twelve-Step programs such as Alcoholics Anonymous and Narcotics Anonymous often play key roles in this phase of the process, providing a supportive environment and a focused philosophy for the recovering individual.


4. Ongoing Positive Change – The fourth phase of the recovery process is a lifelong effort to maintain and improve one’s clean and sober lifestyle. As with the early recovery stage, continued participation in a 12-Step program is encouraged, as are additional personal-enhancement efforts such as therapy, education, career advancement, and connecting with positive and supportive social groups. Maintaining a healthy and addiction-free lifestyle is an ongoing effort that encompasses all aspects of an individual’s existence.

Though Tolstoy implied that sadness and dysfunction are the more complex (and perhaps more interesting) experiences, countless recovering individuals and experts would likely beg to disagree. While the stages of addiction are, by their nature, encroaching, divisive, and destructive, the promise of recovery is an achievable state that offers limitless opportunity for personal growth and development.