The Disease of Addiction
Addiction manifests itself in many forms and there are many different types of addiction that are recognized in today’s society. Some of the more common addiction types are formed when a person becomes dependent on alcohol, drugs, gambling, sex or any other compulsive or pathological behaviors. In this article we will be looking at addiction as a disease, the different stages of the disease including treatment, the addiction cycle and the wheel of change.
The following video serves as a good introduction to understanding addiction and substance use disorder and starting with the actual addiction definition, sets up this page nicely.
Various theories about drug addiction, alcoholism and addiction in general have emerged over the times and the most commonly accepted one happens to be the Disease Model.
Addiction basically is a disease that has certain causes, symptoms, and that can be treated in certain ways. Moreover, the disease also has different stages, starting from the adaptive or early stage and right till relapse. In between this there are other stages, the middle, the final or late stage and the treatment stage.
The term “Disease” is not popularly used these days since it creates an impression of being unwashed or dirty. However, it is important to understand its relation to the addiction terms. It is “Dis – Eased”, which suggests a mind which is “Not at Ease.”
The following video shows just how powerful this disease of addiction really is.
Though it is not totally necessary to describe each of the stages, understanding them would surely be helpful.
In this article I hope to describe the signs and symptoms of each stage in the addiction process as well as exploring some treatment options.
- Adaptive, Early or the Starting Stage
- The Middle Stage
- The Late or Final Stage
- Addiction Treatment
- Relapse or Returning to Drug Abuse or Drinking
1. The Early or Starting Stage of Addiction
The symptoms of the early or the starting stages of alcoholism or addiction are an increased tolerance towards the drugs or the alcohol. The body also starts getting adapted to these substances, but these physical changes might not be noticeable.
As there is an increase in tolerance, the addict is able to consume larger quantities of drug or alcohol, and still there is hardly any effect and the person can continue to function quite normally. This tolerance is not a result of the addict taking too much drugs or drinking too much alcohol, but because the addict can now consume a greater quantity owing to the physical changes that his or her body is now experiencing.
It is not easy to detect the beginning stage. As far as appearance is concerned an addict might easily be able to take a large quantity of drugs or drink lots of alcohol, and yet there will be no noticeable signs of intoxication, hangovers or any other ill-effects. It is difficult to differentiate between a starting stage addict and a non-addict who might drink heavily or might consume drugs only occasionally.
Even while at work there will hardly be any noticeable impact of the drugs on the addict’s conduct or performance, so even here it is very difficult to identify. In the early stage the addict will not notice any problem arising from his or her drug or alcohol dependence and thus if anybody would make attempts to show him or her possible side effects, he or she would likely laugh it off. The addict does not even have any idea of what is happening within his or her body.
The video directly below explains the stage of early addiction.
2. The Middle Addiction Stage
Though there is not a very big difference between the beginning and the middle addiction stage, but certain characteristics certainly hint at the beginning of a new stage.
The benefits or pleasures that the addict was so long deriving from taking drugs or alcohol is now replaced by some destructive aspects. Earlier taking drug or drinking alcohol was just to enjoy a high but now it is taken to bear and fight the difficulties and pain and that earlier drinking and drug consuming has resulted in.
Dependence is one of the noticeable symptoms of the middle stage. The body of the addict starts getting used to a higher amount of drugs in the starting stage. Together with getting used to higher amount of drugs, the body starts displaying withdrawal symptoms when it does not get alcohol or drugs.
Craving is yet another characteristic that is noticeable in the middle stage. The drug or alcohol addicts, at this stage, have developed a strong urge towards taking drugs or alcohol, and controlling this urge becomes very difficult. With the tolerance and physical dependence of the addict increasing it becomes almost impossible for the addict to control taking drugs or drinking alcohol, and he or she keeps on craving the same.
Losing control is the middle stage’s third noticeable characteristic. The addict is no more able to limit his or her alcohol consuming or drug taking times, places and patterns to an extent that is socially acceptable. It is due to the decrease in tolerance and increase in withdrawal symptoms that the addict now suffers from. It now becomes difficult for the addict to handle high amount of alcohol or drugs as he or she earlier could, but still needs a higher amount just to avoid withdrawal.
Blackouts are also one of the characteristics of the middle stage. The addict or alcoholic, as you might be assuming, does not pass out while taking drugs or alcohol. The addict does function very normally but fails to remember what he or she had seen or done. It becomes difficult for the addict to remember these things because his or her brain either stored memories improperly or did not store it at all. Such blackouts might also be seen in the beginning stages of addiction.
In the middle stages the harm starts getting noticed. The addict has to fight withdrawal symptoms, lack of control and cravings. Even during work it becomes quite evident because of: being absent regularly, poor performance, improper behavior with other workers, lack of concentrations, accidents, improper demeanor and overall appearance, and a higher sick leave usage. At this point the addict might have to suffer from disciplinary action in his or her workplace.
The video directly below explains the stage of middle addiction.
3. The Late or Final Stage of Addiction
At the final deteriorative or the late stage the damage that the body suffered owing to the toxic effects of alcohol or drugs clearly gets noticed, and the addict now starts suffering from many different health concerns. It definitely is the most disturbing and difficult stage of addiction.
In the final stages the addict might be seriously ill, might always be mentally confused, or might keep on taking drugs or alcohol too frequently. The regular consumption of drugs or alcohol largely affects the vital organs of the addict and owing to this the addict now suffers from various psychological and physical problems. The ability of the addict’s body to fight diseases or health problems lowers greatly, and he or she suffers from an extremely unstable mental condition.
There are various health problems that the drug and alcohol addict starts suffering from at this stage and some of them are kidney failure, heart failure, hepatitis, fatty liver, liver cirrhosis, malnutrition, brain damage, pancreatitis and infections in the respiratory system. Some of these health problems are reversible.
Even after knowing about the various side effects and difficulties that regular consumption of drugs or alcohol can bring about, why does an addict or alcoholic still continues with his or her ways? The answer here is very simple. When in the beginning stages, the tolerance of the addict is increasing, and this makes him her believe that he or she is not at all sick. When the addict reaches the middle stage he she starts getting dependent on alcohol or drug without even realizing. All that the addict knows is if he or she continues taking drug or alcohol then he or she will not have to suffer from withdrawal symptoms. So just to avoid the troubles and pain of withdrawal the addict keeps continuing with his or her addiction. When the addict actually reaches the final stage he or she mostly is irrational and does not even have the ability to decipher what is actually happening.
Together with suffering from the effects the various changes brings about, the addict also has to face the strongest outcome of addiction, which is denial. The addict never agrees to the fact that he or she has a problem, and in fact he or she will most likely deny the fact. Now, this denial has a very important role to play. If he or she agreed to the fact the there is a problem, he or she would probably ask for help when suffering from the various consequences that taking drugs or drinking alcohol brings about. Though denial cannot be said to be a physical disorder or one of the physical symptoms of addiction, but it definitely does describe the way the addict thinks or behaves, and is indeed real.
The video directly below explains the stage of late addiction.
4. Addiction Treatment Stage
It is almost impossible for a drug or alcohol addict to stop taking drugs or drinking and staying normal unless he or she gets some help from the outside. Moreover, unless he or she gets some real pressure from the outside he or she will not do away with his or her habit of drinking alcohol or taking drugs. Various people can help bring about this pressure including friends, family, clergy, various health care professionals, judicial authority, law enforcement or even an employer. A spouse, for example, may threaten a divorce, or the addict might be arrested for drinking and driving. This intervention is sometimes a pivotal point in the addiction treatment stage.
An Addict can Quit in Any Stage of the Cycle
Earlier it was believed that unless an addict and alcoholic had hit rock bottom he or she could not be helped. There is a reason behind this theory. Many addicts in their beginning and middle stages did stop taking drugs or drinking alcohol when they were threatened with consequences like a divorce, losing a job or a physician’s persuasive warning that reflected the consequences the addict might have to face if he does not stop taking drugs or drinking alcohol.
Getting Treated as Early as Possible
It obviously will be great to get the addicted person treated as early as possible. One of the advantages of getting addiction treatment on time is that there will be brighter chances of opting for a treatment that is not too expensive, like outpatient care. The chances of a treatment succeeding increases when the addict has not made his life much miserable, and can still easily move back to a normal healthy life with his family and friends, and can still continue with his job. The employer also is at a lower risk since he knows that if the disease is treated at an earlier stage his employee will recover soon and will be able to start working properly quite fast. If treated at an early stage there are fewer chances of disruptions and further poor performance or misconduct can also be avoided. However, if the addict gets help at a very late stage, then various harm already will be done that perhaps cannot be repaired ever.
In the initial stages the alcoholic or addict might not really need help or a push to go and opt in for a treatment. People generally opt in for a treatment since they get threatened with a loss of job, an incarceration or may be a divorce. Even if an individual does not to be forced to opt for a treatment, it is important that he or she understands its importance for it to actually work. Employers generally have a very strong role to play in making the addicts opt for a recognized addiction treatment. The fear of losing a job usually is a big push for the addicts, making them consider a treatment.
To get rid of addiction there are various types of programs and treatment. There are some drug addicts and alcoholics who themselves stop taking drugs and alcohols, but then this is very rare. Most addicts or alcoholics need some kind of help or treatment.
5. Returning Back or a Relapse
A very frustrating part of getting treated is the chance of returning back to taking drugs or drinking alcohol. There are various reasons why an addict, even after treatment, again starts taking drugs or alcohol including:
- Improper treatment, or lack of follow-up or after care
- Inability to control the urge for drugs or alcohol
- Unable to follow the treatment instructions strictly
- Inability to bring about the required changes in lifestyle
- Using other types of drugs for mood changes
- Other physical or mental concerns that are left untreated
It is not necessary that a relapse means starting consumption of drugs or alcohol regularly, as it can also be just for once. However, if there is a relapse it must be treated on time and must be considered as a part of the recovery program that has not been treated properly. Relapse has been gaining immense importance and researches too are going on to find a solution for the same. Relapse prevention should be a part of any highly effective treatment plan.
The Process of Addiction and the Wheel of Change
Below is the wheel of change developed by Prochasca & Di Clemente. This has been an exceptional visual tool to help A&D practitioners & clinicians explain the various stages of addiction and walk with clients through their journey.
The Addiction Cycle and the Road Towards Treatment – (Stages of Change)
The video directly below introduces the stages of change in relation to addiction.
The Denial Stage (Pre Contemplation)
Most addicts start off using the drug as a form of recreation. For them it is a harmless fun that they enjoy occasionally with some friends. Unknown to them, they are already exhibiting signs of addiction that is becoming a growing concern among family and closed friends. If confronted, they deny being an addict, asserting that they have control over the vice.
Becoming Aware (Contemplation)
The addict gives his habit a thoughtful observation and may think about stopping it. Usually this is not because he believes that his drug use is a serious problem, but because it could have triggered an unwanted situation that made him think of stopping or limiting his drug use. For instance, he may have failed to do his report at work or his mother made a big issue out of his bad habit. At this stage, though, the idea of actually ceasing from the use of drug is not taken that seriously.
Making a Firm Decision to Stop (Determination)
Here, the addict finally admits that drug use is affecting his life negatively and starts making plans to finally stop it. He may reach out to family and friends to discuss his plans, and he might even ask for help or suggestions. Despite this positive attitude towards quitting drugs, though, those close to him should exercise caution because some addicts use this tactic to make other people believe that they are stopping just to avoid the incessant nagging.
Making a Stand (Action Stage)
If the addict was actually not bluffing when he said that he is quitting, expect him to proceed to this stage, where he actually makes deliberate actions to seek treatment. He may join a therapy group that deals with reforming addict or, if his addiction is bad, he may confine himself in a rehab center. As his family and friends, you must support him every step of the way and aid him in seeking these treatments.
Continuous Treatment Plan (Maintenance)
Getting rid of drug addiction does not happen overnight. It may take weeks, months, or even years, depending on the degree of addiction, the determination of the addict to change, and the support that his family and loved ones are giving him. Hence, you cannot say that an addict is saved once he enters a rehab. It is a continuous process that requires the involvement of the family. As much as possible, family members should check on the status of the treatment and they should intervene, if necessary, if they think that not enough action is taken towards stopping the habit. Failing to give this stage the utmost importance it deserves could result to failure in treatment and the addict could slip back to the previous stages. Right here and now, the addict is showing signs of wanting to change, thus give him all the help he needs to achieve that.
The Return to Alcohol or Drugs (Relapse)
Unfortunately, relapses do occur among addicts, especially if they have been on the habit for far too long. It could also be because some addicts are not emotionally prepared to join back society after the ordeal, and so they easily get tempted to use drugs again. This is why it is important that the root cause of drug use be pinpointed during therapy so that counselors can address this and be able to work with the addict at facing these problems. A relapse is very devastating for both the addict and his family. All the effort put on treatment goes to waste in a snap. Even relationships that are starting to be rebuilt goes crumbling back down again. Everyone ends up going back to square one and if this happens over and over again, even the family that the addict relies on may finally give up and admit their limitations.
Support for the Family
The road towards treatment from addiction could become a vicious cycle if the addict fails to maintain being clean from drugs. He should understand that being in and out of rehab is not a game that should be taken lightly. His family, especially, will reach a point of exhaustion where they may want to raise the white flag and just give up. All the while, during the action plan, the family has always been there to carry part of the burden, but if they see that the addict is not doing his part seriously, they may let go of that burden and hand the full responsibility to the addict. This is why, during the treatment stage, families of the addict should also undergo some sort of therapy to prepare them for the task ahead. They can join support groups that were built specifically for families of addicts. These groups can offer sound advices, emotional support, and recommendations at handling the treatment of an addicted relative. Without this support, families of addicts may give up easily, which could affect the addict’s road to change.
The video directly below talks about the family system in relation to a family members addiction problem.
Full Addiction Recovery
It is important that the addict and his family should not give up hope in this intricate cycle of addiction because, believe it or not, a full addiction recovery does happen to many addicts. As mentioned, treatment from addiction does not happen overnight. It is a long process that the addict should adhere to if he really wants to change and improve his life. The road to full recovery is not easy, but it can be achieved if you do it right. For instance, if the treatment plan or facility that you have enrolled to is not helping you improve your condition, then the addict and his family should take steps to change their action plan. It may mean going to a new rehab center or seeking new counselors. In other words, do whatever it takes to achieve addiction recovery because it is better to do this right the first time than suffer the risk of a relapse. You should also give importance to aftercare services that will keep track of the addict’s progress. Counselors often hold meetings and one-on-one sessions with recovering addicts to ensure that they are doing well and to address any problem that they are encountering. This makes it easier for the addict to get back to his normal and healthy life, giving him and his family a bright new start.
The video below featuring renowned addiction specialist “Dr Gabor Mate” delves deeper into the state of addiction and how it can develop from childhood.
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