Addiction and Recovery Are Not Random - Part One
One of the many benefits of studying something is that we often see patterns. These patterns can present in phases, and because of this, we can often see things coming our way. The phases of the moon have become predictable. We look to the sky and we know if it’s waxing, waning, or full. And we know what’s coming next. Addiction and recovery are not so different. The benefit of this is we can zoom out and find some stability in the phases of addiction and recovery.
The Phases of Addiction
Addiction isn’t something that “just happens” overnight. If you’ve experienced addiction from any angle you have probably asked yourself, “How in the world did we get here?!” That question often comes with fear, confusion, and sometimes even shame. Once addiction starts, it tends to get worse if nothing changes. It’s a chronic disease, which means there is no cure, but it can be managed. Sometimes people may seem to drink or use “normally” for a while, but eventually the addiction takes over again. This is often why complete abstinence works best for people who have crossed that threshold into addiction territory.
Addiction is a primary condition. It’s not solely caused by stress, poverty, a bad relationship, or anything else outside of the person. We can identify it, too. The DSM-5 lays out the signs and symptoms. The good news is, it’s both preventable and treatable with the right combination of recovery support, treatment, and awareness.
The phases of addiction I discuss here come from Vernon Johnson’s “I’ll Quit Tomorrow.” Phase one shows up as experimentation. Someone tries a drink or a drug for the first time, experiences a sense of fun or euphoria, and always returns to normal after use. They may notice that the substance feels better than their “usual” mood, and because of this, a sense of trust is established because it always seems to work.
Phase two, however, starts to introduce some sense of discomfort. Someone starts off by feeling “normal,” then when they drink or use they experience times of euphoria that lead to some discomfort (like a first hangover. Ugh!) The emotional cost here is minimal, so they may still see this as worth it. People in phase two can still control their drinking and use appropriately, but some mild habituation can begin in this phase.
In phase three, people experience increasing dependence or reliance on the substance. They notice it takes more to reach euphoria and tolerance begins increasing. Emotional costs begin to pop up with feelings of guilt, shame, or remorse around use. Lifestyle and behaviors start changing around the substance, and people even start breaking their own self-imposed rules. People rationalize with themselves about why they “deserve” to drink or use, and they start planning use in advance. They may even romanticize their use and become more rigid about when and where they drink (“I cannot miss this happy hour! That’s my priority for today.”)
After all that, phase four is generally right around the corner. This is when people begin in a sense of pain and drink or use just to feel “normal.” They may experience multiple-day hangovers, physical health problems, mental and emotional struggles, and intense withdrawal symptoms. This is when things really start to get scary as the risks for severe injury, incarceration, or even death increase exponentially. As family members, this is when fear really escalates.
Why Me?
So if addiction follows patterns, then why do some people get addicted and others don’t? That is a question that I wish I had a hard and fast answer to, but it is unfortunately quite complex. So many things can have an impact, including but certainly not limited to: genetics, family of origin experiences, social connections, education, trauma, culture, environment, and work history. One of these or the right combination of these can lead someone over the threshold from misuse into addiction.
Statistics tell us that rates of addiction are 3-4 times higher for those with multiple relatives who live with addiction. We also know that one out of every four children in the United States live in a household with addiction of some kind. Addiction is more prevalent than we realize, and the numbers suggest that we are not alone. According to American Addiction Centers, 48.5 million Americans aged 12 and older met the criteria for a substance use disorder in the last 12 months. Addiction knows no age, gender, social class, race… addiction does not discriminate.
How Do We Know?
As I said before, addiction is not random. The DSM-5 lays out the symptoms we explore to identify where someone fall on the spectrum. As of the latest version, the DSM breaks Substance Use Disorders into three categories: mild (2-3 symptoms present), moderate (4-5 symptoms present), and severe (6 or more symptoms present). Because there is no brain scan that can show addiction in the brain, we rely on symptoms identification, which are the things loved ones and family members often see clearly:
Often taking more of the substance for a longer period of time than intended
Recurrent unsuccessful attempts to cut down or control use
Repeated use in physically hazardous situations
A lot of time spent obtaining, using, and recovering from the substance
Failing to fulfill obligations at work, home, or school
Continued use despite social or relational consequences
Giving up or reducing social or recreational activities
Craving
Increased tolerance
Withdrawal or withdrawal avoidance
These don’t always show up all at once, and they don’t always look dramatic at first.
According to the Jellinek Curve of Addiction and Recovery, addiction is a process in the same way recovery is a process. Nothing happens overnight. Recovery begins when the individual has an honest desire for help, and then change can occur. As family members, it can be difficult to release the control we wish to have over our loved one’s recovery process. While we cannot control, it is common that we are the first to observe and see the symptoms clearly.
This Is Not The End
What I hope you take from this is not just information, but a sense of orientation. When we understand that addiction unfolds in patterns and phases, it can soften some of the confusion and chaos that so many individuals and families feel. It doesn’t make it easy, but it can make it make sense. We we can make some sense of something, it can be stabilizing.
If addiction is not random, then neither is recovery.
Recovery has its own phases, its own rhythms, and its own predictable turns (and challenges). There are moments of resistance, willingness, setbacks, breakthroughs, and everything in between. Just like with addiction, when we zoom out, we begin to see that change is happening. It may just not always feel that way in the moment.
For those who love someone struggling, this can be both grounding and challenging. You may see the patterns clearly. You may anticipate what’s coming next. And yet, you are still powerless to change it. That tension is real. This is also where your own work begins. As family members and loved ones, we learn how to respond rather than react, how to set boundaries while staying connected, and how to care for ourselves while everything is uncertain.
This is not the end of the story.
In part two, we’ll explore the phases of recovery. We’ll see what they look like, what to expect, and how to support both yourself and your loved one through the process. Addiction and healing both follow patterns, even though no one path is the same as another. Understanding patterns can make all the difference for your own individual path.