What is The Cycle of Addiction?

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NIDA (National Institute on Drug Abuse) defines addiction as a chronic and relapsing brain condition, but what is the addiction cycle?

Like most chronic conditions, alcoholism or drug addiction doesn’t manifest overnight. Instead, the process of developing an addiction typically occurs over several stages with a vicious cycle of addiction and treatment followed by abstinence and relapse.

Learn about the various phases of addiction and discover how to break the addiction cycle by engaging in evidence-based treatment.

Cycles of Addiction

The different addiction cycle stages may occur in rapid succession, and the substance abuse stage may take months or years to develop.

All addictions are unique, but the entire cycle of substance abuse typically includes these stages include:

  • Initial substance use
  • Substance abuse
  • Tolerance
  • Physical dependence
  • Addiction (substance use disorder)
  • Relapse

4 Stages of Addiction

Setting aside initial use of substances and relapse after breaking addiction cycle, these are the four stages of addiction:

  • Substance abuse: Using an addictive substance on a recurring and recreational basis is considered substance abuse. WHO (World Health Organization) defines substance abuse as using any addictive substance harmfully.
  • Tolerance: Abusing any addictive substance will trigger functional and structural brain changes that cause physical tolerance to build. When this occurs, you will need more of the substance to achieve the same effects.
  • Physical dependence: When you use an addictive substance long-term, you can become physically dependent on it. Dependence does not always mean addiction, but it does often leads to addiction.
  • Addiction (substance use disorder): The clinical descriptor for addiction is substance use disorder. This chronic brain condition is diagnosed according to the criteria outlined in DSM-5-TR, the most current edition of APA’s Diagnostic and Statistical Manual of Mental Disorders.

First Stage

Any harmful use of an addictive substance is considered substance abuse. This may involve taking higher or more frequent doses of prescription medications like opioids or benzos, or it may involve concurrent episodes of binge drinking and cocaine use.

With some addictive substances – illicit drugs like meth, crack, cocaine, and heroin for instance – abuse occurs with the first use.

If the substance is legal like alcohol or prescription medications, abuse may be defined as the stage at which someone begins using a substance for its euphoric effects rather than its medical utility or social aspect.

Substance abuse also occurs in the case of self-medication – using drugs or alcohol to treat the symptoms of a physical or mental health complication rather than consulting a physician. Self-medication may provide fleeting relief but will inflame the symptoms and lead to the development of an addiction that requires dual diagnosis treatment.

Second Stage

Any sustained use of addictive substances will provoke functional and structural brain changes that result in tolerance to the substance forming. When tolerance to a substance develops, you will require higher or more frequent doses to produce the initial effects.

Tolerance prompts many people using addictive substances to increase the frequency of use or dosage. Over time, tolerance continues to grow and the cycle of substance abuse deepens, typically leading to physical drug or alcohol dependence.

Third Stage

Long-term substance use, whether alcohol, prescription medications, or illicit drugs, causes physical dependence to develop. When you become dependent on a substance, you require it to function normally. In the absence of the substance, you will experience intensely uncomfortable withdrawal symptoms.

It is possible to be physically dependent on a substance without being addicted to it. In the context of substance abuse, though, addiction almost always follows.

Fourth Stage

Addiction is a non-clinical term for substance use disorder, a diagnosable mental health condition that results in the presentation of diagnosable symptoms.

These are the symptoms of addiction:

  1. Using more of the substance than intended.
  2. Trying and failing to control or discontinue use.
  3. Ongoing substance use even though it is causing problems in your personal relationships.
  4. Spending lots of time using the substance and recovering from substance use.
  5. Failing to fulfill personal or professional commitments.
  6. Experiencing cravings for the addictive substance.
  7. Spending less time on hobbies and interests due to substance use.
  8. Continuing substance use in spite of adverse health effects.
  9. Using addictive substances in dangerous situations.
  10. Developing tolerance for the addictive substance.
  11. Withdrawal symptoms presenting when the effects of the substance wear off.

Addiction is diagnosed according to the number of symptoms that present as mild (2 or 3), moderate (4 or 5), or severe (6 or more).

How to Break the Cycle of Addiction

Addiction is complex. Often someone with a substance use disorder may have an underlying mental health disorder that drives their addiction. Accessing a quality treatment program will help you to get an accurate assessment.

If you are addicted to alcohol, prescription medications, or illicit drugs, it’s vital to get a comprehensive psychological assessment of your mental health. Many people who seek treatment discover they have a mental health disorder like depression, anxiety, or PTSD (post-traumatic stress disorder).

It helps to be clear about the early stages of addiction so you can arrest a cycle of addiction before it sets in.

Identify The Early Stages of Addiction

Identifying the early stages of addiction can be challenging, as it often starts with occasional and seemingly harmless behavior. However, there are some signs and symptoms that may indicate the onset of addiction. Here are some possible indicators:

  • Increased tolerance: You start needing more of the substance or more frequent doses to deliver the initial effects.
  • Preoccupation with the substance: You are becoming increasingly preoccupied with the substance and spending more time and resources engaging in substance use.
  • Withdrawal symptoms: You experience withdrawal symptoms in the absence of the substance.
  • Changes in behavior: You may find that behavioral changes like mood swings, irritability, or social isolation from friends and family are triggered by substance abuse.
  • Neglect of responsibilities: Substance abuse causes you to neglect your personal and professional responsibilities.
  • Denial: If confronted about your substance abuse, you may deny the existence of a problem.

Seek Treatment for Addiction

Engaging with formal addiction treatment can help you to get back on track before tolerance and abuse slide into dependence and addiction.

The following treatments are all beneficial for treating addictions:

  • Medication-assisted treatment
  • Cognitive behavioral therapy
  • Motivational interviewing
  • Contingency management

Medication-Assisted Treatment

MAT (medication-assisted treatment) is proven effective for the treatment of alcohol use disorder and opioid use disorder. MAT involves the administration of prescription medications in combination with psychotherapies like CBT (cognitive behavioral therapy).

FDA-approved medications can streamline cravings and withdrawal symptoms during drug or alcohol detox. Medications may reduce the frequency of cravings and promote ongoing abstinence in ongoing addiction recovery.

Cognitive behavioral therapy

Cognitive behavioral therapy is a form of psychotherapy or talk therapy that encourages you to identify the root causes of negative thought patterns and emotions that compel you to use substances or engage in damaging behaviors.

You will also create healthy coping techniques to help you deal with everyday stressors without kickstarting another vicious circle of addiction.

Motivational interviewing

Motivational interviewing may help those who are struggling with cravings in their recovery from addiction. An effective motivational counselor uses interviewing techniques that help to keep you motivated when you feel compelled to relapse.

MI is often combined with cognitive behavioral therapy to strengthen the chance of addressing the root causes of addiction and reversing negative trains of thought that may trigger you to relapse.

Contingency management

Contingency management is a form of motivational therapy that encourages the reinforcement of positive behaviors like a negative drug screen with small rewards like vouchers or retail goods. This type of therapy may be especially beneficial during the early stages of addiction treatment.

Get Help With Breaking the Cycle of Addiction at Ohio Recovery Centers

If you need help breaking the cycle of addiction, kickstart your Cincinnati addiction recovery at Ohio Recovery Centers.

We specialize in the intensive outpatient treatment of all types of addictions and mental health conditions. We also offer integrated dual diagnosis treatment.

All treatment programs involve individualized treatment that may include MAT, psychotherapy, counseling, and holistic therapies.

Whether you are in the first stage of the addiction cycle or in one of the later addiction phases, call (877) 679-2132 for immediate assistance.

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Joseph Gilmore

Joseph Gilmore has been working in the addiction industry for half a decade and has been writing about addiction and substance abuse treatment during that time. He has experience working for facilities all across the country. Connect with Joe on LinkedIn.
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Christopher Glover CDCA

My name is Christopher Glover, and I am from Cincinnati, Ohio. I am currently in school and working to grow in competence to better support our community. As a recovering individual I know the struggles that you or a loved one can go through and that there is help for anything you may be struggling with.

The hardest part is asking for help and we are here as a team to best support you and your decision to start your journey towards a better future. Connect with Chris on LinkedIn

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Amanda Kuchenberg PRS CDCA

I recently joined Ohio Community Health Recovery Centers as a Clinical Case Manager. I am originally from Wisconsin but settled in the Cincinnati area in my early 20s.  My career started in the fashion industry but quickly changed as I searched to find my drive and passion through helping others who struggle with addiction. 

As someone who is also in recovery, I wanted to provide hope, share lived experience, and support others on their journey.  I currently have my Peer Recovery Support Supervision Certification along with my CDCA and plan to continue my education with University of Cincinnati so I can continue to aid in the battle against substance addiction. Connect with Amanda on LinkedIn.

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Patrick McCamley LCDC III

 Patrick McCamley (Clinical Therapist) is a Cincinnati native who has worked in substance use disorder/co-occurring mental health disorder treatment since 2019. Patrick received his bachelors degree in psychology from University of Cincinnati in 2021 and received his LCDC III (Licensed Chemical Dependency Counselor) license from the Ohio Chemical Dependency Professionals Board in 2022. Patrick has worked in Clinical Operations, Clinical Case Management, and Clinical Therapy throughout his career.

Patrick has tremendous empathy and compassion for the recovery community, being in recovery himself since 2018. Patrick is uniquely qualified to be helpful because of the specific combination of his academic background and his own experience in recovery.

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Bill Zimmerman CDCA

Bill Zimmerman is a Greater Cincinnati Area native who has worked in substance use disorder/co-occurring mental health disorder treatment since 2018. Bill received his (Chemical Dependency Counselor Assistant) license from the Ohio Chemical Dependency Professionals Board in 2020.

Bill has worked in Clinical Operations in both support and supervision, and Program facilitating and 12 step recovery support during his career. Bill has a passion for the recovery community, having been in recovery himself since 1982. Connect with Bill on LinkedIn

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Taylor Lilley CDCA, PRS

Growing up in Louisiana with addiction running rampant on both sides of my family. A life away from drugs and alcohol seemed impossible for someone like me. I remember what it was like sitting across from someone thinking there is no way they could ever understand what I was going through.

Sharing my experience offers a credibility and a certain type of trust with clients that only someone who has walked down this road can illustrate. To immerse myself further into the field of addiction, I am currently studying at Cincinnati State for Human and Social Services.  I hope I never forget where I came from, if I can do it, so can you!

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Thomas Hunter LSW

Hello my name is Thomas Hunter. I was born and raised in Cincinnati, Ohio. I am a licensed social worker.In my scope of practice I have worked in the areas of mental health and recovery for thirty years. The clients I have worked with in my career have ranged in age from seven to seventy.

I strive each day to serve my purpose of helping those in need and I believe I do so by utilizing all of my experiences to accomplish my goal of supporting those who desire to establish their sobriety and maintain it in their recovery. Connect with Thomas on LinkedIn.

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Mary D.Porter,LICDC

 My name is Mary D. Porter. I received my Masters of Social Work in 2008 from The University of Cincinnati. I received My Licensed Independent Chemical Dependency Counselor Licensure in 2001. I retired from The Department of Veteran Affairs Medical Center on April 14, 2014. Currently, I am the Associate Clinical Director for The Ohio Community Health Recovery Centers in Cincinnati.. Due to the fourth wave of the Opioid Epidemic in 2019,  I decided to enter back into the workforce to assist the addicted population.

The overdoses were astounding and I wanted to help.  I consider myself  to be an advocate for the addicted population. My compassion, resilience, empathy, wisdom, knowledge, experience and  love I have for this forgotten population goes beyond words. I consider what I do for the addicted population as a calling versus a “career,” because I too was once an “addict and alcoholic.” Today I am 45.5 years alcohol and substance free.

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Ben Lemmon LCDC III

Hello, my name is Ben Lemmon, and I’m the Vice President and Clinical Director at Ohio Community Health Recovery Centers. I’ve been working in the addiction and mental health field since 2013 and decided to enter the field after overcoming my own challenges with addiction.

When I first meet a client, I always explain to them that the reason we are meeting is because they are not capable of obtaining or maintaining sobriety, and my goal is to create a person that can maintain sobriety. I believe a person’s personality is made up of their thoughts, feelings and actions and my job is to help clients identify the thoughts, feelings and actions that have them disconnected from recovery and provide them with the tools to live a healthy and happy life. Connect with Ben on LinkedIn