Renaissance Ranch

The 5 Stages of Substance Abuse in Men: Know the Signs

Apr 6, 2023

No one is immune from drug and alcohol abuse, and some may be more at risk than others due to gender, heredity, socioeconomic status, and mental health issues. Since substance use disorder (SUD) most often happens in stages, it’s critical to recognize the signs early and intervene as quickly as possible.

While there are many similarities in how addiction affects men and women, studies indicate that men differ in some areas of the five stages rather significantly. These include how they initially become involved with drugs or alcohol and the level of risk-taking while in active substance abuse.

“Men get involved and deal with substance abuse differently than women, and it’s important to recognize the dissimilarities,” said Preston Dixon, COO of Renaissance Ranch, a men’s residential treatment program with locations throughout Utah and Idaho. “In light of this, we wanted to present the five levels of substance abuse from a male perspective.”

So what are the signals that may indicate you or your loved one is in trouble? Let’s go through each of the stages and find out the following:

Stages of Substance Abuse in Men: Know the Signs


1. Initiation

Men tend to start using illicit drugs (including marijuana, which remains illegal on the federal level) and alcohol at an earlier age than women. This has much to do with peer pressure and a desire to be part of the mainstream. Many male bonding activities among youth and young adults involve alcohol and illicit drugs and follow the ‘work hard, play hard’ mantra. It’s incredibly challenging and often isolating not to engage with your peers this way.

The family dynamic can also affect how and when one begins using drugs or alcohol. For example, if the parents regularly smoke marijuana, it’s very likely the child will, too, because they’re constantly in that environment.

2. Experimentation

Several factors can play into continued experimentation with different substances. While some want to continue enjoying the euphoric feelings created by drugs and alcohol, a growing body of evidence points to people, especially men, using substances to numb emotional pain associated with post-traumatic stress disorder (PTSD) from adverse childhood experiences (ACEs).

In terms of research, a higher ACE score means you grew up with more than one type of abuse, be it physical, sexual, or verbal/emotional. Typically, the higher the score, the higher the risk of substance abuse among men and women. However, one study found that men with lower ACE scores still had a higher chance of developing a SUD than women. Other research showed that nearly 52% of men with lifetime PTSD also have a SUD, compared to only 28% of women, indicating that a man’s response to childhood and other trauma more often manifests itself in a SUD.

3. Regular Use/Tolerance

This is the stage where alcohol and drug use happens more frequently and often outside social norms like special events or outings with friends. Getting drunk or high becomes a daily occurrence rather than only on the weekends.

Men are twice as likely than women to develop an alcohol disorder or illicit drug addiction, and some of this may result from men having slightly higher dopamine levels. Elevated levels of this neurotransmitter have been linked to aggressive behavior, poor impulse control, and addiction.

Men and women also become inebriated at different rates. This is due to a few distinct physiological differences. Males produce more of the enzyme alcohol dehydrogenase, which breaks down alcohol before it reaches their bloodstream. They also tend to have higher water content and lower body fat than women, causing the alcohol and its effects to move through their system more rapidly. Thus, it takes more time and more alcohol for the drinks to start having an impact.

As you can see, a man’s biology can contribute to increased drug or alcohol usage. Other reasons may include self-medication for physical and emotional hurts or a desire for a bigger high. Regardless, using harmful substances becomes a regular habit at this stage, and one begins to develop a larger appetite for them.

Eventually, your body reaches what we refer to as a tolerance level, where you need more of a drug to produce the same euphoric effect. The cycle repeats itself as these more significant highs come with equivalent crashes or lows, and you need increased substances to get back to a baseline feeling of ‘normal.’

4. High-Risk Use

To feed the habit of drug or alcohol use, substance abusers will often turn to increasingly risky behaviors. Some include lying, stealing (first from family members and friends, then the public), and hanging around dangerous people like drug dealers and criminals.

While under the influence, they may get involved in other high-risk situations, such as driving or operating dangerous machinery, continuing to work in a field where impairment can lead to severe mistakes (e.g., pilots, doctors, first responders, etc.), unmonitored needle-sharing, and engaging in unprotected or non-consensual sex.

Participating in these kinds of behaviors usually ends with jail time or injury and death. Roughly 65% of the prison population in 2020 qualified as having a substance use disorder. An additional 20% of people without SUD were under the influence of drugs or alcohol while committing their crimes.

According to a Centers for Disease Control factsheet, about 30% of the nation’s traffic fatalities in 2020 involved alcohol-impaired driving. That translates to about 32 deaths each day. The other community costs associated with substance abuse – disease, lost productivity, and property loss or damage, to name a few – reach into the billions annually.
Unfortunately, men often are more likely than women to engage in high-risk conduct. The CDC report also revealed that at least 22% of the male drivers involved in fatal crashes were under the influence, compared to just 16% of women. In addition, more men self-reported driving under the influence of alcohol, marijuana, or other illicit drugs.

“Statistics like this show us that there’s a real need for the Ranch and other rehabs for men across the nation,” added Dixon. “We believe that gender-specific, individualized care can help men heal faster and stay in full recovery longer than a typical one-size-fits-all substance abuse program.”

5. Dependence and Addiction

It’s important to note that dependence and addiction are closely-connected yet still different. You become drug- or alcohol-dependent when your body requires the substance to function at a certain level that you have become used to.

For example, you can be dependent on an antidepressant, but that doesn’t mean you’re addicted to it. You use the antidepressant to regulate your emotions, and when you stop using it, you will experience both physical and psychological withdrawal symptoms. These can include mood changes, headaches, nausea, and many others. Over time, these conditions pass, and you return to your original state before using the medication.

With addiction, medical stabilization often takes longer, and even in recovery, you will still face intense cravings and urges. Only after a significant period of sobriety do those cravings begin to moderate and become manageable. And since substance use disorder is a chronic disease, you will always live with the risk of relapse.

A clear sign that your loved one is in the throes of a SUD and would benefit from an addiction recovery center program is the inability to stop drinking or using drugs, no matter how hard they try. Their use may be affecting their job or school performance, negatively impacting their health, or even putting them at risk for physical harm, and yet they feel compelled to continue headlong down that path.

As we mentioned before, early intervention is best. However, real life doesn’t always happen that way. The essential thing to remember is that full recovery is possible at any stage. It’s never too late to start healing.