What Are The Four Cs of Addiction?

Home | What Are The Four Cs of Addiction?

At St. Gregory Recovery Center, we believe in a holistic and compassionate approach to substance use, substance dependence, and addiction/substance use disorder (SUD). Part of having compassion for someone who suffers from SUD is understanding what it is, how it functions, and how to best recover from it. The four Cs are a helpful way of conceptualizing what it means to be dependent on substances like alcohol, amphetamines, prescription meds, or opioids. 

Think of the four Cs—control, compulsion, craving, and consequence—as windows into the complex and nuanced experience of being dependent on substances. At the same time, I feel encouraged in knowing that these four Cs can be overcome with a powerful, scientifically informed recovery program like the one we offer here at St. Gregory.

  1. Control:

    The first C involves two elements: loss of control while under the influence and an inability to control how and when the substance is used.  One of the first signs of SUD is the inability of the individual to control themselves, their actions, or elements of their environment that they normally could if they weren’t under the influence. Whether the substance is alcohol, pain meds, opioids, intravenous drugs, marijuana, or others, the inability to control how much one consumes or what one does post-consumption is the first C of SUD. Ultimately, once the individual has reached a point where they can’t refrain from drinking, smoking, or using regardless of the situation or time of day, it’s safe to assume an SUD has fully developed. For example, a person who can’t control their drinking at a funeral, while they’re working, while driving, or while carrying out important tasks is considered deeply entrenched in an SUD.


  2. Compulsion:

    The compulsive element of SUD is the next C. When we speak about compulsion, we’re referring to carrying out actions that we don’t necessarily desire to perform. Many people battling substance dependence don’t want to—or at the very least wish they didn’t want to—engage in substance abuse. They may often feel compelled, overwhelmed, or pushed to use. It’s the inability to choose to stay away that characterizes compulsion. In other words, the presence of compulsion is the absence of choice.


  3. Craving:

    The third C can often be the most challenging to overcome when it’s time to enter recovery—and especially while maintaining sobriety afterward. Cravings manifest in a myriad of ways: tremors, headaches, irritability, insomnia, nausea, discomfort, fatigue—the list goes on and on. Cravings make people feel like they must indulge to return to a bodily equilibrium—or in some cases to simply eliminate the symptom that is driving the craving. St. Gregory treats the most dangerous of craving symptoms—withdrawal—when you enter into our renowned detox services.


  4. Consequence:

    Consequence refers to the clear presence of destruction in a person’s life due to substance use. It becomes a C when an individual continues to use their drug of choice despite any negative consequences that result. Often, you can observe a person’s life deteriorate professionally, socially, romantically, or medically as they continue to misuse substances. This is a well-known indicator of an SUD.  

How Do I Identify The Four Cs In My Life or Someone Else’s?

Keep the description of each C in mind and then look for frequency. If you find that each C seems to make an appearance in your life or that of a loved one and with noticeable frequency, you’ve most likely identified the presence of a substance use disorder.  

Remember that one C on its own does not suggest the presence of SUD in an individual. It’s the culmination of all four that should alert you to a serious problem. Once a person acknowledges the four Cs at work in their lives, it’s much easier to accept the need for professional treatment. 

Learn More About The Four Cs With St. Gregory in Iowa

With locations in Bayard and Des Moines, IA, St. Gregory works hard to make each community and its surrounding areas aware of how substance misuse can be detected and addressed at our facility. Equipped with knowledgeable medical staff, state-of-the-art equipment, and passion that turns people’s lives around, we’re here for you. Contact us at any point to learn more about how we can help. 


Our graduates tell their stories…

When first arriving at St. Gregory I had mixed feelings about the health and wellness workouts. I came in at 136 lbs and didn’t think it was possible to reach...
- Chris
The good life is not merely a life free from addictions, physical and/or psychological—addictions that usually are the outward manifestations of deeper problems—but a life lived in harmonious balance, free...
- Matt
I came to St. Gregory’s at my all-time worst—physically, emotionally, and mentally. Having gone through a bad rehab experience once before, I had been very reluctant in succumbing to that...
- CJ
No matter where I start my thought process when reflecting upon my time before, during and after St. Gregory’s, I always seem to end up in the same place in...
- Kaele


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