When Does Drug Use Become Drug Addiction?

There’s a saying about a frog in a kettle: If you throw him into boiling water he’ll reflexively jump out. But, if you put him in warm water and let it heat slowly to a boil, he’ll get cooked. The point is that by the time he recognizes danger, it’s too late to extricate himself.

Most addicts are like the frog that gets cooked. Denial keeps them from recognizing the truth of their condition until it becomes so dire that it is irreversible without help.

Peer pressure and curiosity are usually the first motivators for drug experimentation. Although harm can result from early use (i.e. poor decision-making while high, accidents, and overdose), it is not the case that early use inevitably leads to addiction. On the other hand, there is the possibility that a predisposition to addiction exists, either genetic or psychological, that can contribute to future problems. Many alcoholics and addicts come to realize—once they are in recovery and have some perspective on their problem—that the first time they used their substance of choice, it “rang their bell” and set the pattern for years of trying to recreate the initial sensation.

For others, addiction comes gradually over a period of years as habits form, tolerances grow, and consequences of stopping become more severe. Additionally, the addict’s lifestyle is often one of poor decisions, impulsive actions, increasingly risky behavior, compromised relationships and other life problems. This feeds a vicious cycle of either neglect of the problems or further ill-advised actions to correct them, increasing the problems and the addict’s desire to escape them through more ingestion of drugs (“You’d get high too if you had my problems.”).

Drug addiction is recognized in the medical community as a brain disease, in which initial ingestion of a substance triggers a reaction of compulsive repetition in order to maintain or further stimulate the initial effect (usually with diminishing returns). When this sequence is repeated enough times, the brain itself is tricked into becoming unable to connect the attendant consequences of the drug use with the taking of the first hit.  Thus, there is no inhibition or disincentive to start again. Meanwhile, the addict’s inner experience of life—in terms of perception, feelings, and motivation — becomes less and less satisfactory, making the altered state a de facto preference.

The intermediate stage between use and abuse usually looks to the user as if he or she is merely indulging in “social use,” often referred to as “recreational use.” Some can get away with this; they buy and take a drug like someone buys a ticket and goes to a movie. When the movie’s over, they go on with their life. Others find that at some point they reach a critical threshold where what seemed like a luxury has become a necessity. There is a joke in recovery that goes along the lines of “Doing cocaine is like dancing with a gorilla. You’re not through until the gorilla is through.”

Fortunately, treatment for drug addiction is available. Addiction treatment medications, combined with behavioral therapy, have been shown to be highly effective in breaking the cycle of addiction. A continuing regimen of recovery-oriented activity is then recommended in order to prevent relapse.


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