What is the Path From Substance Abuse to Addiction?

I could get technical and discuss what clinicians, researchers, doctors, and advocates believe. I could also separate the physiological from the behavioral. I think the path from substance abuse to substance addiction is complex and the best way to discuss this is to share part of my story.

Alcohol Abuse to Alcohol Addiction

I do not know if I was always an addict or if abusive behavior led to addiction. If you look at my family history of alcoholism, many would predict that I was always at-risk for developing an abusive or addictive relationship with alcohol. It’s probably more complex than that. After all, we are not only our biology, but our experiences, personality and temperament as well.

Yet, it’s indisputable. I know I never had a healthy relationship with drinking. I was always a binge drinker, and while my alcohol use didn't start until college, I always had high tolerance, which is a marker for many people who develop an addiction. In college, I abused alcohol and experienced some negative consequences, but nothing that made me question my behavior as dangerous or needing to stop. I don't know if within the throws of our substance abuse we can clearly see when we go from abusing a substance to being addicted to it.

Crossing the Line into Drug and Alcohol Addiction

I remember in IOP (intensive out-patient treatment), my relapse prevention counselor told us about substance use and how people would experiment, go on to use, and some would abuse. She said once they crossed this invisible line into addiction, they could never go back to being a recreational user. At the time, I thought it was hogwash. But at some point, when you are hiding alcohol bottles around the house, are unable to have a job and can’t wake up without a shot, then something has gone terribly wrong.

The Path From Substance Abuse to Drug and Alcohol Addiction Isn’t Clear

I think when we are abusing substances, we cannot clearly see the path we are on. I can now look back and realize the point when I had to drink throughout the day in order to “function” is where I crossed the line into alcohol addiction. I couldn't function in life without it and couldn't stop using despite all the negative consequences.

I struggled for years. There were periods of relapse where I thought I could go back to being a “normal drinker” (which I never could do). Despite wanting to stop (while at the same time wanting to be a normal drinker), I felt trapped by it all. I knew I was physiologically dependent on the alcohol because I would have withdrawal, anxiety and tolerance; since I could drink a ridiculous amount of alcohol at a time. But even when I was sober and no longer dealing with withdrawal and tolerance, I felt the need to use alcohol. I would be triggered and want to cope with life by using.

I don't have the “ah-ha moment” when I know the switch was flipped and I had moved from alcohol abuse into alcohol addiction. I don't know because a lot of those years were clouded by alcohol use and just trying to function. I think this is why it is so important to recognize signs of substance abuse and work on early intervention.

What do you think about the path from abuse to addiction? What was your experience?

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