Drug dependence or drug addiction is an illness with serious physical, psychological and social consequences. It shows itself as a maladaptive pattern of behaviour, in which the use of substances such as alcohol, cocaine, cannabis or psychotropic medication becomes a priority for the person, above the fundamental aspects of their life. This shift in priorities often leads to marked deterioration in various areas of personal life. In addition, there are also addictions without a substance, known as behavioural addictions, which include gambling, compulsive internet use, shopping, sexual activity or certain repetitive behaviours that create dependence.
In general terms, all drugs affect the central nervous system by releasing neurotransmitters that disrupt its natural functioning. Over time, the body loses its ability to produce these substances by itself, which creates a physiological need to use in order to maintain internal balance and avoid the physical and emotional discomfort associated with withdrawal.
From a psychological perspective, addictive substances usually serve a specific function for the person who uses them. They can temporarily relieve painful emotions, provide a sense of escape or meet inner needs such as the search for euphoria, disinhibition or control. This experience reinforces the belief that using is necessary in order to feel good, creating an ever stronger bond with the substance.
As the addiction progresses, the person loses the ability to control their use, even when they recognise its negative consequences. One of the central features of this illness is alteration of the brain, especially in the areas related to self-control and decision-making. This neurobiological change means that use is no longer voluntary: the person does not use by choice, but because they feel they cannot stop.
Becoming aware of an addiction
The process of recognising an addiction and stopping use goes through several phases or stages. These were defined by the psychologists James Prochaska and Carlo DiClemente, who developed a model that explains how people move from denial to change and recovery.
Pre-contemplation stage:
At this stage, the person uses without recognising or being aware of the negative consequences of their behaviour. They do not yet see their use as a problem, which makes it difficult to begin change or seek help.
Contemplation stage:
At this stage, the person begins to recognise that their use may be problematic and considers the need to make a change. Cognitive dissonance then appears: a feeling of inner conflict between what they do and what they believe they should do, which marks the beginning of awareness of the addiction.
Preparation stage:
At this stage, the person reflects more deeply on the changes they need to make in their life in order to change their pattern of use. There is greater motivation and commitment to change, which is a key step in the process of recovering from an addiction.
Action stage:
At this stage, the person starts to put into practice the changes they have planned in order to reduce or stop using. It is a decisive moment in the recovery process, when action replaces intention and new, healthier habits take hold.
Maintenance stage:
At this stage, the person integrates the new habits into their lifestyle and manages to keep them up steadily. The maintenance stage is considered to have been reached when these healthy behaviours are sustained for more than six months, thus consolidating the recovery process and relapse prevention.
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Despite the progress made, relapses can occur and lead the person to restart the cycle of change. This model reflects the complexity of the process and explains why it is so hard for someone to recognise their addiction, even when those around them point it out. Each stage involves a different mindset and requires tailored professional intervention to support progress and consolidate results. It is therefore essential to have the guidance of addiction specialists who design a personalised treatment, both for the person affected and for their family.