Levels of Care for Substance Use Disorders. Nearly 88 years ago, the first 12-Step program was created by two individuals who discovered that the only way they were going to recover from addiction was by working with each other and giving themselves over to a power greater than themselves. These individuals were Bill Wilson and Dr. Bob Smith, and the program they created was Alcoholics Anonymous (AA). They also discovered that there are different stages of substance use disorder (SUD), all of which can greatly impede a person’s ability to live a safe, healthy, and fulfilling life.

The Importance of Treatment for All Stages of Substance Use Disorder

Perhaps the most important thing to remember regarding the stages of SUD is that help is available and recommended at every stage. No one has to wait for SUD to get worse before they get help. Even if the symptoms and signs may not seem too severe, the fact that someone may be considering they may a problem is often a good indicator that there is a problem.

SUD is a chronic disease, and just like any other chronic disease, it is going to get worse without professional help and recovery intervention. Someone struggling with addiction rarely gets better on their own. 

The good news is that there are plenty of treatment methods and programs that are highly effective in getting someone with SUD onto the path of long-term recovery and living the kind of life they both deserve and desire. However, to get there, one first has to realize that they have a problem. Being able to recognize the stages of SUD can greatly help with this.

Understanding the Stages of Substance Use Disorder

While some opinions may vary regarding the number of stages of SUD, the primary consensus is that there are four. These four stages are often referred to as experimentation, regular use, high-risk use, and addiction.

#1. The Experimentation Stage

This first stage, the experimentation stage, is something that many people will experience in their lives. It is not uncommon for individuals to experiment with legal substances, like alcohol or nicotine. Still, some may choose to experiment with illegal substances. In either case, experimentation can open the door to the following stages, especially if a person is already at risk of developing SUD. 

#2. The Regular Use Stage

Again, many people will experience this stage in their lives. In fact, many people will remain in this stage for quite a while without experiencing any, or many, real consequences. 

However, for those at risk of SUD, this is often the stage that determines whether or not they will continue onto the next two stages. This is the stage where an individual at risk of SUD may begin to witness their substance use become second nature. They may also begin to feel some negative emotions regarding their substance use.

#3. The High-Risk Stage

The third stage, the high-risk stage, is where substance use ultimately shifts to substance misuse and substance abuse. Moreover, the high-risk stage is when a person’s substance abuse starts to cause serious consequences.

During the high-risk stage, an individual will also begin to engage in risky behavior to fuel their substance abuse. At this stage, a person will also begin to recognize more of the negative physical effects of substance abuse. Some examples include gastrointestinal problems, severe dehydration, and trouble sleeping (insomnia), to name but a few.

#4. The Addiction Stage

This is the stage that most people associate with SUD because it is the most visible and creates the most consequences. However, it is important to note that it takes the previous three stages to get to this stage.

This is the “end of the road” stage. As Bill Wilson put it, when someone gets to this stage, there are only three places left to go. Those places are “jails, institutions, or death.” This is why it is critical to get help as soon as possible no matter when this stage develops.

Substance Abuse Levels of Care

There are many treatment options for individuals struggling with SUD. They range from general outpatient with community integration to inpatient treatment with greater structure.

The key to treating someone struggling with SUD is to do so on an individualized basis. For someone struggling with severe addiction, it is critical that they first go through a medically administered detox. From there, the best option for this individual is probably an inpatient program. However, for some individuals, an intensive outpatient program (IOP) may be their best option.