There is a serious problem with the “face” of addiction. We, as a society, have managed to pigeonhole addiction into certain stereotypes. Generally, when someone thinks about addiction, they either see the zombie-like homeless person on Skid Row or the famous celebrity zonked out of their mind, causing all sorts of trouble and concern. 

But these images are fundamentally flawed and can actually cause a lot of harm. This article explores why we’ve put addiction into certain boxes, the damage this type of labeling can do, and what the real cycle of addiction looks like.

Why do we stereotype addiction?

There are many reasons why we stereotype addiction. These include the following:

Disassociation: it can never happen to me

One of the reasons we like to label things and put them in certain boxes is that it’s a type of coping skill. “We are always trying to create distance between us and the bad things that happen in the world, so we create narratives making it so far removed from our realities that it becomes a complete improbability in our lives,” explains Kay Saffe, Clinical Director of Coastal Detox of Southern California. This is why we think about addiction in the form of these extremes, such as “I don’t go to clubs and use drugs; therefore, I’m safe against addiction, etc.”

Denial: it’s not me

The other reason is that we don’t want to accept (or change) our current reality. Someone who’s in the thick of being a functioning addict simply refuses to believe that they have a serious problem on their hands because they don’t look like the person with an addiction on Skid Row and don’t fall into any of our stereotypical boxes of addiction.

Why are these stereotypes so detrimental?

“These stereotypes can be incredibly harmful,” says Steve Carleton, Chief Clinical Officer of Porch Light Health. “It can either leave doors open to potential addiction because someone doesn’t really understand how the cycle of addiction works, or it can prevent someone in active addiction to seek help because they’re unable to recognise that there’s already a problem.” 

The real face of addiction

But if all these stereotypes represent extremes and a small margin of people struggling with addiction, then what does the real face of addiction look like? “The real face of addiction can be the stay-at-home mom that never drops the ball, the CEO of an international public-listed company, or the couple that’s drinking a bottle of wine on the patio every night after work. 

In other words, the real face of addiction can be anybody, including you and me, which can be a scary thought,” clarifies Kosta Condous from Higher Purpose Recovery. “Once people truly understand the cycle of addiction and how easily one can slip into it, it’s impossible to keep up the illusion regarding certain stereotypes.” 

The cycle of addiction we don’t like to think about

Addiction actually has two legs; there’s a psychological addiction, which is habitual, and then there’s a physiological addiction, which is when the body becomes physically dependent on something. This can sometimes be a bit of a chicken and egg situation since it’s not always clear what came first. 

There are instances when someone uses a substance and almost gets instantaneously addicted. But there are a lot of hidden factors to this, such as genetics, and is not nearly as prevalent as those “Just say ‘no!’” campaigns back in the day wanted us to believe. So, in most cases, addiction is a very gradual process that starts with something that becomes a habit. 

It can be the ice-cold beer you have after mowing the lawn on a Saturday that turns into two, then three, a six-pack that then flows over into Sunday and later starts from the Friday (it’s the weekend, after all). And so the physical tolerance and dependence of addiction builds. 

Once again, the slippery slope to addiction can move faster for some than others due to underlying factors such as genetics, but often, the road to active addiction can take months. Irrespective of how long it takes, the addiction cycle is characterised by the following phases:

Stage 1: Initial use

This is when the substance is introduced, which can have many sources. It can be the student who needs a little something for the exam period, the drink after work, the mom trying to “help out” another tired mom, the doctor prescribing medications after an injury, etc. As we’ve already discovered, most addictions don’t start out as insidious as we’d like to think. 

Just keep in mind that while this may be stage 1 of the addiction cycle, it doesn’t mean that everyone who uses a substance ends up going through the rest of the stages and down the road to active addiction. So, don’t throw away those headache tablets just yet because it’s the next stage that really makes the difference.

Stage 2: Misuse

There is a big difference between use and misuse. Use can be having that celebrity toast at a wedding and drinking the pain meds as per the instructions of your doctor. Misuse is when you start pushing and crossing those boundaries (for example, finishing that bottle of celebrity champers all by yourself or popping an extra pill). Once again, it needs to be emphasized that misuse is not addiction yet. 

There are those who, for example, binge drink their livers away on holiday and, while a very unhealthy way to live life, return home to their everyday lives without continuing this drinking habit. However, binge drinking is still classified as misuse. Anything done outside the scope of recommendations by health practitioners and experts constitutes misuse. And when misuse becomes habitual, it can be a sign of psychological addiction already being at play.

Stage 3: Tolerance

When misuse starts becoming more and more frequent, specific physiological changes that occur. The body builds a tolerance against a substance, so you need more to get the same effect. And, because these substances mess with our hormones (they make us “feel good” for a reason!), they can rewire the brain to reproduce less of certain chemicals since it’s become accustomed to us receiving them from external sources. It’s at this point that serious physical addiction issues start creeping in.

Stage 4: Dependence

Now you’re trapped. It might’ve been fun and felt good for a while, but you’ve caused so many physical changes (not to mention the psychological aspects) that your body can no longer function without the substance. Where you were once using the substance to feel good, you’re now using the substance to avoid feeling bad. 

We’re not just talking about countering painful physical withdrawals but also the fact that certain substances can actually make it physically impossible to feel pleasure without the substance. Many start realizing that they’re in serious trouble at this stage, and it also becomes challenging to hide the addiction from others (just think about Matthew Perry’s candid conversations about his co-stars admitting to smelling the liquor sweating through his pores, despite claiming not to have used substances while on set). 

But this is also where things turn dangerous. You’ll often have friends and family begging the person “to stop,” and realizing how bad the situation got, it can also be tempting to “just stop” on your own, which can actually be a fatal decision. “Once you’ve reached the physical dependency stage, we don’t recommend going about stopping alone and definitely not going the cold turkey route. 

You need to properly detox with the help of a medical professional. Otherwise, you might end with serious health issues such as severe dehydration from constant nausea and vomiting, or seizures, and your body can even go into shock and just completely shut down,” warns Kay Saffe. 

”We’ll always recommend booking into a treatment center. But if that’s not possible, you’ll need to (at the very least!) book into a detox program where medical professionals can slowly wean you off the substance, monitor your progress and symptoms, and help ease some of the discomforts of withdrawals. This is not only safer but has a much higher success rate since many simply cannot handle the physical torture of withdrawals and just end up using again.”

Stage 5: Relapse

This stage can almost immediately follow stage 4 or take months or years before stage 5 occurs. But most addicts will admit to relapsing (some even multiple times). Here, it’s a battle of wills after the physical fight has been won. Psychological addiction is the silent assassin of any addiction because it’s not as easy to shake as physical addiction (which is already hard to believe when breaking the grips of physical addiction can be such torture). 

To some, it can be a favorite habit (like the morning cigarette with your coffee) that can be tough to overcome. To others, it could’ve become a coping mechanism for dealing with the difficult times in life. Either way, relapse is often accompanied by guilt and shame, triggering someone to use more of the substance to feel better, throwing someone right back into the thick of active addiction, and an ever-repeating cycle if not careful.

Did you know that addiction is not just about substances?

We have been talking a lot about substances, but this is another common misconception when it comes to addictions. An addiction is defined as “a compulsive, chronic, physiological or psychological need for a habit-forming substance, behavior, or activity having harmful physical, psychological, or social effects.” This can include a wide range of things, including things generally considered positive. For example, you can become addicted to work, to a favorite hobby such as birding, and even to going to the gym and working out!

So, how will I know if I’m at risk of an addiction?

Whether playing TV games, having drinks with friends, or using recreational drugs – how do you know if you’re entering the danger zone of addiction? Ask yourself the following questions, and if you’re answering yes to one or more of these, you may need to reevaluate your relationship with the substance/behavior:

• Do you ever self-medicate? In other words, use alcohol or drugs to feel better or use medication as and when not prescribed by a doctor.
• Do you use these substances more than once a week?
• Have you ever tried to stop using a substance or doing certain things but found it extremely hard, and you ended up going back to using and doing it again?
• Do you ever feel guilty or ashamed after using certain substances or doing certain things?
• Have you ever tried to hide your use of certain substances or some of your behaviors or activities from others?
• Has your substance use or behavior started to impact your daily functioning (for example, being tired at work because you’ve been playing games till the early hours of the morning or calling in sick because you’re hungover)?
• Has your substance use or behavior started to impact your social life (for example, you’d rather stay at home drinking alone than go to a family dinner, or people don’t want to invite you out anymore because of your behavior while on certain substances)?
• Have you begun self-isolating from friends and family to be able to use more of the substances or partake in more of the particular behavior or activity?
• Has your friend circle started to shift to those also using these substances and participating in specific behaviors or activities?
• Have others raised concerns regarding certain substances or activities?
• Have you ever had run-ins with the law due to certain substances, behaviors, or activities?
• Have you ever had to resort to illegal or unethical means to support the use of certain substances or participate in certain activities?
• Do you have a physical reaction to stopping the use of certain substances or partaking in certain activities?
• Have you ever wondered whether you might have a problem regarding certain substances or activities?

Why recovery is not just solving an addiction problem

As you may have already gathered, addiction recovery can be tricky since it goes far beyond the realms of just physical addiction to a substance. Any addiction is merely the symptom of another deep-seated problem. 

For some, it can be undiagnosed serious mental health disorders, while for others, it can be self-esteem issues or insufficient coping skills. Whatever the case, this is exactly why most treatment centers have a holistic approach and follow a dual diagnosis model. In other words, to truly treat addiction, you need to tackle it from its root causes. For active addiction, we’d recommend booking into an in-patient treatment center and continuing treatment with either in-person or virtual outpatient care. 

If you’re not yet in the throws of active addiction but have some concerns regarding the use of certain substances or behaviors, we suggest reaching out to a professional as soon as possible (prevention is better than cure, after all). Today, it’s also not difficult to seek mental health support. One can even make online appointments via various platforms, irrespective of where you sit in the world!

The real cycle of addiction: knowledge is power

Armed with the knowledge and insight provided in this article, you’ll be able to understand the cycle of addiction better, not fall trap to society’s stereotypical views, and even do some self-reflection and evaluation on your own behaviors and substance use to see if there are any red flags. 

If you don’t like what you find, we encourage you to reach out to the pros – whether for a chat, to answer a few questions, or to officially start your recovery journey. As many, including legends such as Elton John, Robert Downey Jr., Drew Barrymore, and Anthony Hopkins, can attest, there is life in abundance on the other side of addiction. Don’t let fear, shame or guilt keep you from being present and living life to the fullest!

George Andersson, a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle.