The Different Stages of Alcoholism


Man Suffering From Alcoholism

Alcoholism is a serious physical and mental illness caused by an inability to control one’s intake of alcohol. Its effects can be both physical and mental, and are often fatal, but a person doesn’t go from being an occasional drinker to an alcoholic overnight. There are four distinct stages of the disease, from the beginning of the loss of control over drinking until alcohol’s physical effects have ravaged the body’s organs and caused death. If the disease is caught early, and if the sufferer is receptive and responsive to the idea of treatment, alcoholics can live normal and fulfilling lives without needing to consume alcohol on a regular basis.

Social Drinking

Not a stage of alcoholism, social drinking is an activity that almost 90% of the population of the western world will participate in at some point in their lives. Social drinking is a broad term used to refer to occasional, even rare, drinking. Having a glass of wine with dinner, or a beer with colleagues isn’t harmful in itself, and has even been shown to have health benefits like reducing the risk of heart disease and certain cancers. The social drinker doesn’t necessarily have to drink in a “social” setting. Someone having one cocktail after returning home from work can still be considered a social drinker, even if it’s consumed alone. This person might even drink to excess on the rare occasion. While becoming intoxicated isn’t necessarily healthy, it rarely causes problems in those who don’t make it a regular occurrence. Consuming alcohol in limited quantities is not problematic for most people.

Stage I: Early/Adaptive Stage of Alcoholism

The early/adaptive stage is the beginning of the stages of alcoholism. This is when drinking stops being occasional and starts to become regular, even daily. This is usually an attempt to escape emotional pain or reduce anxiety. The person may start to experience blackouts, or being unable to remember events that occurred while intoxicated. The early stage drinker also begins to develop a tolerance to alcohol, requiring more and more to feel “buzzed” or intoxicated. Thinking about alcohol increases, and cravings begin to take hold. Social activities are planned around the consumption of alcohol, and a first-stage alcoholic might have drinks before social events, as well as during them. Hiding alcohol, whether to have unfettered access to it or to hide evidence of its use from family or friends, is also a symptom of early alcoholism.

Stage II: Middle Stage Alcoholism

Middle stage alcoholics become almost powerless over their cravings, and as such will begin drinking earlier and earlier in the day. Some may even feel they require an “eye-opener”, or a drink immediately after waking up in the morning. Tolerance to alcohol continues to increase, leading to higher and more dangerous levels of consumption. Attempts to control this increased drinking, either by making promises to one’s self not to drink before a certain time of day, or to only drink on certain days or on certain occasions, become more frequent and unsuccessful. The middle stage alcoholic will also break promises made to others, and his professional and private life will begin to suffer as a result. Legal problems could also arise, either in the form of a DUI or public intoxication charges. Irrationally, the alcoholic will blame these problems on everything except alcohol.

Stage III: Late Stage Alcoholism

Marked physical dependence is a hallmark of late stage alcoholism. Without alcohol, the person will experience very real, physical withdrawal symptoms. Tremors, nausea, vomiting, diarrhea, sweating, and even hallucinations and seizures are all indications of delirium tremens- also called the “DT’s”. To avoid the DT’s, addicts might start drinking unconventional, even poisonous, substances simply because they have alcohol in them, things like hair spray, anti-bacterial hand gel, mouthwash, or nail polish remover. This can result in major health consequences for the drinker’s health. Alcoholics may also begin to isolate from family and friends to avoid conflict, and might be having financial difficulties due either to legal problems or to an inability to maintain employment. Food, shelter, and hygiene stop being priorities, and the person concerns himself only with being able to obtain the next drink.

Stage IV: End Stage Alcoholism

End stage alcoholism is fatal without professional intervention and complete abstinence from alcohol. Alcoholic cirrhosis is a liver disease caused by heavy drinking that is irreversible, and is characterized by severe abdominal pain, jaundice, nausea, vomiting, and something called ascites- an accumulation of fluid in the abdominal cavity that causes severe swelling, discomfort, difficulty breathing, and eventually kidney failure and death. Werneicke Korsakoff Syndrome, also called “wet brain”, is a dementia related to prolonged alcohol addiction. Caused by a vitamin B1 deficiency, those addicted to alcohol are more likely to contract wet brain, both because alcohol interferes with B1 absorption and because end stage alcoholics do not usually receive adequate nutrition. Left untreated, wet brain is fatal. Alcohol addiction is also a major factor in suicide. By lessening impulse control and creating an ideal situation for long-term depression, alcohol becomes a catalyst for those already suffering from mental illness; often, the sufferer is drinking to control the symptoms of that same illness.

If caught early enough, and if the alcoholic is motivated to receive help and stop drinking, alcoholism is a controllable and treatable disease, but we know very little about its origins. There is no way to accurately pin alcoholism on a single cause. Factors like genetic predisposition, physical and mental health, and even upbringing can all influence someone’s propensity for addiction. Many people drink to lessen feelings of isolation, guilt, or regret. Regardless of the cause, by the time an alcoholic reaches the end stage, the person has usually rejected multiple offers of help made by loved ones. At this point many families give up on being able to influence the addict at all. But, even at the end stage, it is possible to receive help for this disease. It may not change the deadly outcome, but it can certainly delay it, possibly even long enough to allow an alcoholic to make amends with loved ones. Alcoholism is a fatal, ugly disease. Professional intervention is the only way to ensure an alcoholic avoids its physical and mental ravages.


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