What is the Path From Substance Abuse to Addiction?

May 26, 2011 Kendra Sebelius

I could get technical and discuss what clinicians, researchers, doctors, and advocates believe. I could also separate the physiological from the behavioral. I think the path from substance abuse to substance addiction is complex and the best way to discuss this is to share part of my story.

Alcohol Abuse to Alcohol Addiction

Alcohol Abuse

I do not know if I was always an addict or if abusive behavior led to addiction. If you look at my family history of alcoholism, many would predict that I was always at-risk for developing an abusive or addictive relationship with alcohol. It’s probably more complex than that. After all, we are not only our biology, but our experiences, personality and temperament as well.

Yet, it’s indisputable. I know I never had a healthy relationship with drinking. I was always a binge drinker, and while my alcohol use didn't start until college, I always had high tolerance, which is a marker for many people who develop an addiction. In college, I abused alcohol and experienced some negative consequences, but nothing that made me question my behavior as dangerous or needing to stop. I don't know if within the throws of our substance abuse we can clearly see when we go from abusing a substance to being addicted to it.

Crossing the Line into Drug and Alcohol Addiction

I remember in IOP (intensive out-patient treatment), my relapse prevention counselor told us about substance use and how people would experiment, go on to use, and some would abuse. She said once they crossed this invisible line into addiction, they could never go back to being a recreational user. At the time, I thought it was hogwash. But at some point, when you are hiding alcohol bottles around the house, are unable to have a job and can’t wake up without a shot, then something has gone terribly wrong.

The Path From Substance Abuse to Drug and Alcohol Addiction Isn’t Clear

I think when we are abusing substances, we cannot clearly see the path we are on. I can now look back and realize the point when I had to drink throughout the day in order to “function” is where I crossed the line into alcohol addiction. I couldn't function in life without it and couldn't stop using despite all the negative consequences.

I struggled for years. There were periods of relapse where I thought I could go back to being a “normal drinker” (which I never could do). Despite wanting to stop (while at the same time wanting to be a normal drinker), I felt trapped by it all. I knew I was physiologically dependent on the alcohol because I would have withdrawal, anxiety and tolerance; since I could drink a ridiculous amount of alcohol at a time. But even when I was sober and no longer dealing with withdrawal and tolerance, I felt the need to use alcohol. I would be triggered and want to cope with life by using.

I don't have the “ah-ha moment” when I know the switch was flipped and I had moved from alcohol abuse into alcohol addiction. I don't know because a lot of those years were clouded by alcohol use and just trying to function. I think this is why it is so important to recognize signs of substance abuse and work on early intervention.

What do you think about the path from abuse to addiction? What was your experience?

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APA Reference
Sebelius, K. (2011, May 26). What is the Path From Substance Abuse to Addiction?, HealthyPlace. Retrieved on 2024, June 16 from

Author: Kendra Sebelius

Rebecca Tishman
May, 26 2011 at 3:25 pm

Great post Kendra. I'm so glad you're talking about that merky area between abuse and addiction. One can exist without the other but more often than not they bleed into one another and it's not always clear when that occurs. Thanks so much for sharing your story

In reply to by Anonymous (not verified)

Kendra Sebelius
May, 26 2011 at 3:46 pm

Rebecca thank you so much! I agree that one can absolutely exist without another, but often that murky area isn't talked about. I think it is often in reflection we can see more clearly, but within a struggle cannot see things clearly. This is why it is important to talk about, spread awareness. Thank you again for coming on here to share your voice. I always appreciate your wise, beyond your years, thoughts.

Jaclyn Hammond
May, 26 2011 at 11:24 am

LOVE it. So proud of you. You are amazing. ♥

In reply to by Anonymous (not verified)

Kendra Sebelius
May, 26 2011 at 11:28 am

Thank you so much Jaclyn!!! Truly appreciate that. <3 you!

May, 26 2011 at 11:14 am

Great discussion. I used to look back and try to figure out when things switched for me. When my drinking went from partying with friends, to using alcohol for emotional regulation or pills to get through a day. I used to think that if I could figure out what that point was, I could go back to using those substances because I would know what to look for. I was wrong though. There are so many other factors built into addiction (a whole other article) that just using on a moderate level wasn't possible. The addiction was instantly back. Those feelings of control and instant relief hit me right away.
Thanks for sharing!

In reply to by Anonymous (not verified)

Kendra Sebelius
May, 26 2011 at 11:27 am

Awe yes!!! Us wanting to pinpoint the where things went wrong so we can figure out what to look for. I think I spent a LOT of time trying to find ways to continue using versus even consider stopping :) Now I see the insanity!

May, 26 2011 at 5:25 am

Kendra, you've started an excellent conversation that is, as you said, very complex. I think the invisible line between abuse and addiction can be different depending on the substance (or behavior, in my case, sex) and the person. As you know, some substances are immediately addictive, while others become psychologically addictive over time with physical dependancy.
In my case with sex, I started out dependent on it emotionally before I was physically addicted. Which I think can even happen with some substances, like alcohol for instance.
From my world view, unless God is in the proper place in our lives, it's easy to allow ourselves to lean on substances, things, activities, even people to make it through the day. It helps me to check my heart motive when I feel weak, then decide where my heart should be.
Thanks for the great post! ... Blessings:)

In reply to by Anonymous (not verified)

Kendra Sebelius
May, 26 2011 at 5:34 am

Thank you Tamara!!! An excellent point about the differences between substances and behavior. I so agree on the emotionally part of it as well. I know with self harm and sex I had similar thoughts and that gives me excellent ideas for future blogs. So thank you!

May, 26 2011 at 5:23 am

Great blog, Kendra. Welcome to HealthyPlace!

In reply to by Anonymous (not verified)

Kendra Sebelius
May, 26 2011 at 5:34 am

Thank you so much Patricia!! Glad to be here :)

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