Addiction develops in three stages
The learning processes that govern addiction are not inherently pathological.
Addiction develops in three stages.
The first stage is sampling: trying a drug for the first time.
Sampling is usually driven by social factors. We try things that the people around us are doing. There will always be early adopters, but novelty-seeking isn’t the reason most people try drugs.
Sampling is best understood through social learning theory, a model that describes the ways we learn from imitation and observation.
It’s also why drug-refusal training is an important tool in adolescent drug-use prevention. A delay in sampling is associated with better lifelong outcomes.
The second stage is reward-driven use.
In this stage, we keep using a drug because it does something for us. Caffeine improves energy and focus. Alcohol is a social lubricant.
Reward-driven use is explained by operant conditioning. Operant conditioning describes the way we learn in terms of reward and punishment.
Most reward-driven substance use is not a significant issue. Problems only arise when we favor the immediate rewards of drug use (like the pleasure of six drinks) over the negative consequences we experience (like missed work or drunk driving). Diagnostically, problematic reward-driven use is typically associated with a mild substance use disorder.
The third stage is habitual use.
In this stage, drug use becomes much more automatic. This process is typically driven by classical conditioning, a learning process where simple cues become linked with substance craving.
For caffeine, these cues might be an alarm clock or the light coming through the curtains. Cues may also be internal signals: feeling tired prompts caffeine use; feeling bored leads to alcohol consumption.
Importantly, withdrawal is only one driver of habitual use. “Detox” may be the first step in recovery, but the risk of relapse persists long after withdrawal subsides.
Of course, habitual use alone does not constitute addiction. (You can keep joking about it, but very few of you are actually addicted to caffeine 🙂.)
Addiction is only present when habitual use continues despite significant ongoing consequences. From a diagnostic standpoint, this process usually fits a moderate or severe substance use disorder.
But the learning processes that govern addiction are not inherently pathological. The ability to chase rewards and develop habits is normal and often advantageous. That’s why we can mindlessly shower or type without looking at the keyboard. Drugs are just really good at hijacking the brain’s learning machinery.
People with substance use disorders often wonder “Why do I keep doing this?” I like to respond with the simplest, correct answer: “Because it’s something your brain knows how to do.” There’s always more to the story, but this is an accurate, shame-free place to start.
And although I have never found a reliable tool for unlearning addiction, I have witnessed hundreds of unique ways that people were able to learn recovery. That is the ultimate goal.