Addiction may take many forms. People may be addicted to sex, food, or other behaviors and substances. I have a keen understanding of addiction. I have over 17 years experience with working the 12 steps which has brought me the gift of abstinence.
When we are addicted to any substance we go through stages. These stages progress as we move through our disease. The first stage is when we move from occasional use of a substance/behavior to constant using to experience a relief. This relief is to experience some type of psychological escape (such as from stress, fear or depression). This stage may last months or years. If someone in this stage does not receive help they will build a tolerance and move to the next stage.
At this second level many addicts will experience periods of dissociation. Loss of control is a characteristic, as well as a preoccupation. Some addicts will be inclined to sneak their using at this level. The third level may involve the physical need for the substance or behaviors being abused. People tend to attempt to stop on their own at this level, and some may succeed at stopping at this level, but only to relapse. The periods of abstinence when trying to stop are usually short term.
The final and fourth level is when the addict is dominated by his/her using. This individual may experience his/her life as “falling apart” or debilitating. This person may demonstrate signs of physical withdrawal when unable to obtain the given substance or behavior of choice. Please note, it is essential that any individual who has become physiologically dependent on a some chemical substances receive medical attention and assistance before attempting abstinence. For example, withdrawal from alcohol can be extremely dangerous. Briefly participating in an inpatient facility to detox safely may be required.
Following is the AA Twenty Question List. This self-report is a good preliminary screening device which was developed at John’s Hopkins University Hospital to determine whether an individual has a problem with alcohol. I have often used this tool to determine whether an individual has a problem with different types of substances/behaviors. For example, you could substitute the words “drink” and “drinking” with “drugs, food, sex, gambling” and “using, compulsive overeating, or sexually acting out”.
