Struggles with Dependencies: Identifying Stages, Symptoms, and Paths to Recovery
In a world where substances and behaviors can become more than just a pastime, understanding addiction is crucial. Addiction, which encompasses not only substance misuse but also activities like gambling, is a chronic disease that can lead to a variety of physical and emotional changes.
According to a commonly used three-stage framework, the key stages of addiction are:
- Binge/Intoxication: This stage involves the initial and repeated consumption of an addictive substance, characterized by excessive use that generates rewarding effects or euphoria.
- Withdrawal/Negative Affect: In this stage, the individual experiences negative emotional states and physical symptoms when not using the substance, due to neurobiological adaptations leading to discomfort and distress.
- Preoccupation/Anticipation: Also called the craving or relapse stage, this phase involves persistent thoughts about and desire for the substance, which can lead to compulsive use and relapse.
This framework is grounded in neurobiology, with each stage linked to specific brain circuits and functional domains. For instance, the binge/intoxication stage is related to reward and habit formation, while the withdrawal/negative affect stage is linked to negative emotions. The preoccupation/anticipation stage involves impaired executive control and craving.
Relapse, returning to a previous condition or state of being, is a hallmark of addiction. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) lists the key signs of Substance Use Disorder (SUD) as a powerful craving, inability to stop a particular behavior or using an addictive substance despite expressing a desire to quit.
In many cases, people with addictions develop a physical dependence, causing withdrawal symptoms when they try to quit. Continued use despite affecting physical and mental health, neglecting life responsibilities such as work, and engaging in addictive behaviors even in dangerous settings are also common signs.
Fortunately, treatment options for addiction are available. These include medication, inpatient or outpatient rehab, psychotherapy, 12-step programs and other support groups, and lifestyle and environmental changes. It's essential for those who think they may have an addiction to seek support from a healthcare professional.
In 2021, the National Institute on Drug Abuse (NIDA) reported that 20.4 million people in the United States received a diagnosis of SUD relating to addiction. If you or someone you know is struggling with addiction, remember that help is available, and recovery is possible.
- Science has profoundly contributed to our understanding of addiction as a chronic disease, particularly by uncovering the links between specific brain circuits and functional domains during the binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation stages.
- Addressing addiction, both in terms of substance misuse and behavioral addictions like gambling, necessitates a holistic approach that encompasses mental health, health-and-wellness, and the pursuit of recovery, which can be achieved through various treatment options like medication, therapy, support groups, and lifestyle changes.
