The 3 Stages of the Cycle of Addiction
In This Article
- The cycle of addiction includes three stages: binge/intoxication, withdrawal/negative effects, and preoccupation/anticipation.
- Risk factors for addiction include biology, environment, and development.
- Steps for breaking the cycle of addiction include identifying problem behaviors, learning and practicing healthy habits, and attending therapy.
- Treatments for drug addiction include detox, medication, and behavior therapy.
- Regardless of the approach to breaking the cycle of addiction, success requires an ongoing commitment to recovery with a determination to continue abstinence.
The 3 Stages of the Cycle of Addiction (According to Science)
Sometimes the cycle of addiction stages co-occurs. For example, when it comes to illicit drugs used to feel a ‘high,’ even one use is considered abuse.
Some of these illicit substances can also lead to tolerance within one or two uses. Nevertheless, in most cases, all these steps are part of the chronic cycle of addiction.
The addictive potential of some substances may be so strong that what seems to be an instant addiction may develop.
However, for most people struggling with addiction, there are stages of substance use that lead to the person becoming addicted.
Stage 1: Binge and Intoxication
The binge and intoxication stage occurs when a person uses substances and experiences the pleasurable effects of being high or under the influence.2
This stage starts in an area of the brain called the basal ganglia. It involves an intense rush of pleasure as the drugs activate the brain’s dopamine system.
This rush of pleasure reinforces the act of using substances. It triggers people to seek out drugs regularly in an attempt to achieve the same feeling.
Furthermore, the rewarding effects of drugs can cause the brain to associate other things with the pleasurable feeling of being high.
For example, the brain could start to feel pleasure in response to the:
- Places a person uses drugs
- People a person is with when they use drugs
This means a person is more likely to desire and seek out drugs when they’re around certain people and places.
Stage 2: Withdrawal and Negative Effects
Once a person passes through the intoxication stage, they move to the withdrawal and negative effect stage of the cycle of addiction.2
This stage involves an area of the brain called the amygdala. It occurs when a person stops taking drugs and begins to experience withdrawal symptoms.
These withdrawal symptoms include negative emotions and symptoms similar to what a person would share with a physical illness.
When a person experiences withdrawal, the reward system in the basal ganglia shuts off. The amygdala, which is the brain’s stress system, becomes active.
This soon sets up a cycle. A person desires to return to the intoxication stage of addiction to feel pleasure again and find relief from withdrawal symptoms.
Stage 3: Preoccupation and Anticipation
During the third stage of the cycle of addiction, the brain’s prefrontal cortex becomes active as a person starts to experience drug cravings. The prefrontal cortex is responsible for planning and decision-making.2
This stage starts after a person has had some abstinence from drugs. This could be a few hours for someone with a severe drug addiction.
Once a person becomes intent on finding drugs, the prefrontal cortex activates the brain's ‘go system.’ This triggers a person to have a strong urge to seek out drugs.
This final stage circles back to the intoxication stage once a person uses drugs again.
Addiction refers to behavior patterns where people continue seeking and using habit-forming substances. People with addiction keep using habit-forming substances, which cause tolerance and withdrawal symptoms. Addiction leads to harmful consequences and lasting brain changes, setting it apart from other substance misuse.
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What is the Cycle of Addiction?
Addiction is a chronic brain disease. Like many chronic diseases, addiction doesn’t just develop in one day.
Addiction often involves both brain and body changes. This results in a combination of brain-centered compulsion and physical need for the addicting substances in the body.
Often, several circumstances line up over time. This can cause a person who’d otherwise enjoy casual drinking or avoid substance abuse to become addicted to alcohol or drugs.
The process of developing addiction tends to occur over a series of stages. Then, it can turn into a cycle of addiction, treatment or abstinence, and relapse.1
The various stages of addiction can occur over a short period. Or they can take months or years to develop.
Over the years, a person who occasionally drinks or uses drugs casually may develop a habit that can become an addiction.
How Does the Cycle of Addiction Happen?
No single factor can predict if a person will experience addiction to drugs. Usually, a combination of factors influences the risk of addiction.
The more risk factors someone has, the more likely drug use will result in addiction.
Here are some examples of risk factors:
The genes people are born with contribute to about half of a person’s risk for addiction. Gender, ethnicity, and mental disorders may also influence the risk for drug addiction.
A person’s environment includes various influences, such as family, friends, and economic status.
The following factors can significantly affect a person’s likelihood of drug use and addiction:3
- Peer pressure
- Physical and sexual abuse
- Early exposure to drugs
- Parental guidance
The risk of developing addiction is influenced by genetic and environmental factors that impact crucial developmental stages throughout a person's life.
Drug use at any age can lead to addiction. However, the earlier substance use begins, the more likely it will become an addiction.3
This is particularly problematic for adolescents. The areas in their brains that control decision-making, self-control, and judgment are still developing. Therefore, teens may be especially prone to risky behaviors like taking drugs.
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Other Treatment Options for Addiction
There isn’t an end-all cure for drug addiction. However, various treatment options are available to help people on the path to recovery from substance use disorders.
The treatment recommended for drug use and any coexisting medical or mental health conditions can vary. To prevent relapse, ongoing monitoring, and support are crucial.
Treatment programs for drug addiction usually offer:
- Individual, group, or family therapy sessions
- A focus on understanding addiction
- Becoming sober and preventing relapse
- Levels of care and settings that vary based on your requirements, such as outpatient, residential, and inpatient programs
Detox is otherwise known as detoxification or withdrawal therapy. Detox focuses on helping people to stop taking the addicting drug as quickly and as safely as possible.
For some, it may be safe to undergo detox on an outpatient basis. However, many need admission to a hospital or a residential treatment center.
Withdrawals from different categories of drugs produce various side effects and require separate approaches.
For example, there are:
Your healthcare provider may suggest medication as part of your addiction treatment. These medicines can reduce your drug cravings and can help you avoid relapse.
Medication for opioid addiction may include:
- A combination of buprenorphine and naloxone
Behavior therapy is often provided as part of a drug treatment program. Behavior therapy is a type of psychotherapy provided by a psychologist, psychiatrist, or alcohol and drug counselor.
Therapy can be provided for individuals, families, or groups.
A therapist or counselor can:
- Help you learn ways to cope with your drug cravings
- Suggest techniques to avoid drugs and prevent relapse
- Provide suggestions on how to deal with a relapse if it occurs
- Discuss issues surrounding your job, legal problems, and relationships with friends and family
- Help family members develop better communication skills and learn how to be supportive
- Address other mental health conditions
Many support groups follow the 12-step model first developed by Alcoholics Anonymous.
Support groups, like Narcotics Anonymous, help people with drug addiction issues. The support group message is generally that addiction is an ongoing disorder with a high risk of relapse.
These support groups can help reduce the sense of shame and isolation that can lead to relapse.
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- Drug addiction (substance use disorder), Mayo Clinic, 2023.
- Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health Washington (DC): US Department of Health and Human Services; 2016 Nov. Chapter 2, the Neurobiology of Substance Use, Misuse, and Addiction.
- NIDA. "Understanding Drug Use and Addiction DrugFacts." National Institute on Drug Abuse, 2018.
- Fluyau D, Charlton TE. Drug Addiction, 2022.
- Kranzler, Henry R, and Ting-Kai Li. “What is addiction?.” Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism, 2008.
- Heilig, Markus et al. “Addiction as a brain disease revised: why it still matters, and the need for consilience.” Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2021.
- McLellan, A Thomas. “Substance Misuse and Substance use Disorders: Why do they Matter in Healthcare?.” Transactions of the American Clinical and Climatological Association, 2017.