The highs & lows of addiction

Substance use disorder generally tends to follow a formulaic path and develops over the course of four stages. Awareness about these stages can help one identify the symptoms, writes Rashikkha Ra Iyer

I love the science of addiction more than I have loved anything else in the world. I also tend to make this quite obvious with me devouring addiction-related literature, podcasts and research all the time. Thus, most often conversations with friends or family members always begin with the same.

On a jocular note, people speak only addiction to me. In these conversations, I’ve always been amused by some common remarks around the disorder. “Then she became an addict.” Or “He went to that party and then became an addict.” I’ve wondered how addiction is mostly thought of as an overnight development. On the contrary, substance use disorder generally tends to follow a formulaic path. Most experts in the field of addiction agree that it develops over the course of four
stages. Awareness about these stages can help people identify symptoms for themselves or that of a loved one. The first stage is experimentation. Every experience has a first time. What this experience offers for the first time determines the individual’s motivation towards it in future. My mom who was always terrified of riding two-wheelers went on to learn and pass a four-wheeler driving test. She also made the endpoint fruition by buying herself a car. Back then, as a 12-year-old, I couldn’t quite juggle this idea into logic in my head. However, as I grew older, I was able to bring the pieces together. While I thought her fear was being on a vehicle and manoeuvring it, turned out it was more specific to a two-wheeler. This was because many years prior to that, she had attempted learning one. On the very first attempt, she had had a nasty accident that threw her off the idea.

Many years later, when private transport to work became a necessity, she decided to learn to drive. However, still daunted by the idea of two-wheelers, she turned to a four-wheeler this time. The experience turned out supported and positive. This enhanced her learning and association with driving. Likewise, every experience has both negative and positive attributes to offer. That said, the first use of a substance or alcohol mostly offers few or no negative consequences. Due to this, the first encounter mostly serves as a euphoric positive experience. Experimental substance use is defined as a voluntary act. This is the stage when individuals decide to get high or drunk thinking of it as a one-time exploration. This is mostly done in a social context which is free of cultural barriers or legal consequences.

The second stage — regular use is somewhat dual-ended. After the first experimentation, some people may continue to use it every now and then. They may be using it recreationally with close monitoring on frequency. They may not be necessarily addicted to the substance yet. That said, this is also the stage when an individual’s risk for dependence greatly increases. This is when people may realise that they’re able to do things when high or drunk that they otherwise won’t. For instance, an individual may get anxious in social gatherings. When he finds out that taking a drink before one helps him get through, it serves as positive reinforcement. He begins associating the ability to be anxiety-free in a social event with alcohol or the substance. People may also engage in some foolhardy, high-risk behaviours while under the influence such as driving or unsafe sex. These aspects further exacerbate the risks of this stage. The third stage is high-risk use. The line between the former stage and this one is often blurry and unclear. This is a stage when involuntary use begins. These stages progress to the malicious final stage of addiction and dependency. This is when the body and mind become the juggernaut and remind the person to take the substance. This surfaces through symptoms such as tremors, stomach aches, sweats, anxiety and frantic behaviour. Avoiding the substance is not even an option anymore. Regardless of the stage in which a person is, it is never too late. Recognising the need for help is the first step.