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Understanding Pre-addiction: Signs and Treatment

Understanding Pre-addiction: Signs and Treatment

Pre-addiction is a serious but treatable condition that precedes full-blown addiction. Here's how to distinguish pre-addiction from addiction.

Understanding Pre-addiction

If a person is using drugs or alcohol in an unhealthy way but their symptoms are not severe enough to be considered an addiction, they may be experiencing pre-addiction. Pre-addiction can present with different patterns of use, from regular use to binge use.

Ignoring the early symptoms of pre-addiction can lead to the development of a full-blown addiction. And by the time it is recognized, the individual may have already suffered significant physical, emotional, or social damage.

That is why recognizing and intervening in the pre-addiction phase is vital.

This article provides the signs you should look out for and proper treatments to combat and reverse pre-addiction.

What is Pre-addiction?

Pre-addiction means that an individual is using substances in an unhealthy way but may not be diagnosed with a “severe substance use disorder,” or the clinical term for addiction. Individuals with pre-addiction may experience negative consequences to their health, job, relationships or safety due to their substance use. 

At this stage, individuals are at risk of developing addiction if changes are not made. Lifestyle changes and behavioral health support at this stage can help prevent the onset of addiction and improve overall quality of life. Addiction treatment is typically not appropriate for someone experiencing pre-addiction, who would benefit from lower levels of support. 

Pre-addiction treatment focuses on developing healthier habits and lifestyle changes that support improved overall mental health and well-being. For some, pre-addiction means improving your relationship with substances so they can be used in a healthier way. For others, it may mean giving up substances altogether.

Recognizing Pre-addiction: Signs and Symptoms

The elements that precede addictive behaviors define pre-addiction. According to the DSM-5, the symptoms below can indicate that someone is in the early stages of developing an addiction.

If you meet five of the criteria or less, you may be diagnosed with moderate or mild SUD, often known as pre-addiction.

Risky Behavior

Using substances in risky settings that put you in danger such as drinking and driving or blacking out. This also includes participating in sexual activities that you have no control over.

High Alcohol Tolerance

When you drink for longer periods of time or use more of the substance than recommended, you may be showing signs of pre-addiction. You also feel the need to drink more to get the desired effect. And if you're not consuming alcohol, you're feeling the effects of withdrawal.

Neglecting Responsibilities

Neglecting duties at home, job, or school due to substance use could be a sign of pre-addiction.  The same goes true if your substance use persists despite the negative effects it has on your relationships

Failed Attempts to Quit

Multiple failed attempts to quit substance use is a sign of pre-addiction. If you still feel the constant urge to drink and can’t stop yourself from doing so, then it could be a pre-addiction.

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How Pre-addiction Can Be Treated

In pre-addiction treatment, the focus is to improve resilience and protective factors against addiction and to reduce the negative consequences of substance use. Here are some treatment options available for pre-addiction:


Coaches provide non-clinical assistance, such as:

  • Defining and reaching your wellness goals 
  • Forming and sticking to an action plan
  • Identifying resources to support you
  • Providing judgment-free support as well as accountability 
  • Serve as a sounding board 
  • Share strategies to reduce cravings and deal with setbacks
  • Add motivational support


There are a variety of therapeutic interventions that can be used; Cognitive Behavioral Therapy (CBT) is one of the most common. Therapy can be used to improve overall mental health and challenge negative behaviors. Some therapies are better suited at dealing with past trauma, such as Eye Movement Desensitization & Reprocessing (EMDR). The type of therapy that is best suited to your needs should be identified by a trained professional, but it can be helpful to ask about these practices. Therapy can help with:

  • Changing problematic behaviors
  • Reversing negative thinking
  • Coping with past trauma 
  • Defining and reaching your wellness goals
  • Overcoming fears
  • Treating mental health conditions 
  • Improving your relationships 


While medications are often a frontline treatment for individuals with addiction, they’re used less commonly for individuals with pre-addiction. That said, there may be cases where medications are appropriate. 

Some individuals looking to cut back their drinking may benefit from naltrexone, a medication that can help change drinking behaviors. Additionally, if an individual's substance use is related to a mental health condition, such as anxiety or depression, they may be a candidate for medications to treat these conditions. Medications might be prescribed to people with:

  • Problem drinking
  • Opioid use disorder 
  • Anxiety or panic attacks
  • Depression 
  • Insomnia
  • Other related mental health conditions 

Support Groups and Mutual Aid Groups

Groups can be focused on different philosophies or topics. Some meet on a regular basis, others are curriculum-based. Groups can help with:

  • Building community, connection, and support systems
  • Accountability
  • Acceptance
  • Identifying resources
  • Building skills such as communication or self-care

Creating a Plan to Address Pre-addiction

Change is hard. But it helps to think about it as a process with many “steps” along the way. Plans for change are about the journey, not the destination. A runner is not ready for a marathon overnight. So let's think about the steps that can help increase your chances of success.

You already recognize that you want to make a change. Now what? Here are some tips to follow to help you create a plan that works for you.

Step 1: Create Your Goals

Goals come in all shapes and sizes. You may have a goal of stopping the use of alcohol completely, or you may want to reduce your drinking by 1-2 drinks a week. Or maybe you want to switch from liquor to beer when you choose to drink.

Whatever your personal goal is, start by writing it down. Keep it somewhere you can see it and recognize that it might take time to get there.

You may update your goal as you work through Confidant's program, or with your coach or counselor. That's okay!

Step 2: Identify Your Support System

You don’t have to do this alone. It is okay to reach out for that helping hand when you need assistance!

Identify a circle of friends, family, and/or professionals that can provide helpful support and feedback as you work towards change.

People need people, and the more you connect, the more confident you will feel in your change process.

Sometimes the fear of asking for help overrides our ability to reach out for support. But you might be surprised how encouraging those around you can be.

Step 3: Create Your Trigger Journal 

What is a trigger journal? This type of journal helps you to identify and write down situations, people, places, and/or things that may make it more likely for you to drink alcohol in a way that is not in line with your goal.

Once you have those triggers written down, you can begin to write down activities that you can do to help support your goal of reducing your alcohol use.

Much like the runner, the more you train for and practice these new activities, the stronger you will feel when triggers happen.

Step 4: Continue Adjusting

You have started down this path because your current habits are not working for you, and you have decided it is time to make a change. There may be some strategies you try that work better than others.

As you go forward, continue to adjust your plan based on what works for you. No two people are the same, and research shows some strategies work better for some people. That's why we will give you many things to try and help you to customize your approach.

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Pre-addiction FAQs

Can you reverse pre-addiction?

Yes, it is possible to reverse pre-addiction. It’s advantageous to make changes at the pre-addiction stage to prevent the onset of full-blown addiction, reduce negative consequences, and improve quality of life. For some people, this includes abstinence or sobriety but others may choose to work toward moderation.

How do I talk to someone about pre-addiction?

If you’re concerned about someone’s substance use, it can be hard to start a conversation with them. You don’t want to offend them, but you obviously care about their well-being. If you think someone might be experiencing pre-addiction, try following these steps:

  • Ask if they have ever heard of pre-addiction, and let them know that you just learned about it.
  • Ask if they’ve ever evaluated their relationship with alcohol and drugs.
  • Listen openly and non-judgmentally to whatever they have to say about their relationship with drugs or alcohol.
  • Educate them that pre-addiction is similar to pre-diabetes. Getting support during this time can improve quality of life and prevent bad things from happening due to using drugs or alcohol, including preventing full-blown addiction. 
  • Keep the focus on their health and well-being.
  • Engage in a conversation that encourages them to think about why they use drugs and alcohol and whether or not using is helping or hurting them.
  • Ask if they know about the benefits of getting support early. 
  • Ask if they’ve ever considered support. 
  • Ask them if they would like you to send them some information about how to successfully achieve the lifestyle changes that reverse pre-addiction.

How do I know if I have pre-addiction?

Without intervention, pre-addiction may become a full-blown addiction. Some questions to ask yourself to determine whether you might be experiencing pre-addiction:

  • Have you ever drunk or done drugs to relax, feel better about yourself, or fit in? 
  • Have you ever drunk or do drugs to feel less anxious?
  • Have you ever blacked out as a result of drinking?
  • Have you ever felt you ought to cut down on your drinking or drug use?
  • Have people annoyed you by criticizing your drinking or drug use? 
  • Has your drinking or drug use impacted your personal, professional, financial, or romantic goals?
  • Have you ever felt bad or guilty about your drinking or drug use?
  • Do you drink alcohol or use drugs when you are alone? 

If you answered “Yes” to any of these questions you might be experiencing pre-addiction. This means you may benefit from lifestyle changes or support in building healthier habits.

Manage Pre-Addiction Symptoms Before It Worsens

Getting support during the pre-addiction stage should be personalized and comprehensive. Typically, it is focused on establishing healthier habits, breaking negative thoughts and habits, and implementing lifestyle changes. 

Some people improve their relationship with substances and reverse pre-addiction symptoms without necessarily ‘going sober’ or giving up substances altogether. 

If you or your loved one is showing signs of pre-addiction, Confidant Health is here to help and is committed to making sure that your well-being is in optimal condition. Our virtual behavioral health clinic offers unmatched privacy, ensuring that your treatment remains confidential and respectful of your personal space. Additionally, the convenience of our online services means you can access professional help from anywhere, fitting easily into your daily routine without the need for travel.

Schedule an appointment today to address pre-addiction concerns and ensure proactive care in managing your well-being.

This article has been medically reviewed by
Erin Hillers
Erin Hillers
Erin Hillers
Nurse Practitioner

Erin is a Nurse Practitioner with 8 years of experience in midwifery and women's health. She has spent the past 5 years specializing in the treatment of opioid and alcohol use disorders.

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