Waismann Institute on Stages of Addiction


Addiction to opioid pain medications usually happens over a long period of time. It doesn’t happen with the first dose, the first prescription, or the day you decide to take the drug. In fact, you can see a progression from simple use of a drug or medication to full blown addiction.

The rate of addiction to street opioids, such as heroin, is staggering. However, you should realize that you can become addicted to prescription pain medications, such as morphine derivatives, in much the same way. Merely having a prescription from a doctor does not mean that the risk of addiction is not present. You should always take your medications in accordance with your doctor’s instructions.


Use is the first step, and some people do not go beyond this level. This means that you take the medication as ordered, and it does not have any adverse effects on your life. Most people start out at this level of usage, and it is not an addictive state. However, you can develop physical dependence on the medication at this point. Physical dependence includes needing higher dosages and feeling withdrawal symptoms.

Although these are not signs of addiction, they are can lead you to take more of your medication without your doctor’s permission. Since you need more of that Lortab to make your pain go away, you start taking two or three instead of the one your doctor prescribed. This is when you descend into the realm of misuse.


Misuse is when you start feeling the adverse effects of the drug. You may pass out after shooting up heroin. You may start crushing and snorting your prescription pain medications. This is not the recommended usage of these medications, and it can lead to lifestyle problems. For instance, you may be arrested for possession or driving under the influence.

Use of street drugs most commonly starts in this category because no accepted usage is possible for street drugs. Street drugs are taken without the supervision of a medical professional, and they can lead to problems with family, friends, and the law.


It may seem a fine line between misuse and abuse, but the two are distinct. For those who abuse a drug, they encounter problems in their lives, but continue to take the drug anyway. An abuser will have multiple hospital stays for overdoses or will have multiple arrests for possession. The abuse stage is far more than getting into a small amount of life difficulty. It is about long-term, repeated issues that are ignored by the user.

It is more important to have the drug than to keep relationships intact, protect your health, or stay on the right side of the law. Users can live in this stage for a long while without it escalating. You can keep yourself just under detection and use your family to help you get your drug. However, this is a precarious state, and it often does not end well for the growing addict.


This is the final stage, and it marks a complete disregard for anything but the drug. Your family may have disintegrated around you, you may have multiple arrests, and you will likely have multiple hospital stays, as well. Addicts run the risk of losing their life if they don’t get help. They continue to take stronger and stronger doses of the medication more frequently to get the high. At this stage, nothing matters but the drug, and death is a real possibility.

It is at this stage that the addict’s life is completely destroyed and revolves around the drug, its procurement, and use. Some addicts decide – or are forced – to get help at this stage. However, this stage is also known for relapses. It is common for an addict to attempt to quit and then wind up using again. Once the problem extends to this stage, it takes focused medical and mental health care to regain the life that has been lost.

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