stages of alcoholism

Stages of Alcoholism: A Reference Guide

Mar 22 Published by

In the United States, an estimated 16 million people have alcohol use disorder (AUD). The National Institute on Alcohol Abuse and Alcoholism defines AUD as a “chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using”. Understanding the stages of alcoholism may help sufferers combat this chronic disease.

Read on to learn about the 5 stages of alcoholism.

Stages of Alcoholism

Most people can drink a moderate amount of alcohol with little impact on their health or life. For some, it can become a severe and uncontrolled addiction. The consequences for them and their friends and family can be very serious.

It may be useful to drinkers and those around them to be able to recognize some of the signs that alcohol is becoming a problem for them. Taking some action including appropriate treatment can prevent future problems.

There are many schools of thought that describe stages of alcoholism. This five-stage model recognizes alcoholism as a progressive disease. It has early, middle and later stages.

Stage 1: Building Tolerance and Binging

The earliest stages of alcoholism for many people are about experimentation. Drinkers may try different types of alcohol and also test their tolerance by drinking large quantities. This testing of their limits is sometimes called binge drinking.

Young adults may take part in this form of experimentation at parties where the main activity is drinking. This can be dangerous as drinking large amounts of alcohol can lead to coma or even death. Other safety concerns include injury by accidents and vulnerability to attack or sexual abuse.

At this stage, the drinker may not drink every day. They may hold down a job, have happy relationships and perform well in normal daily life. Drinking may not consume their thoughts or motivate their everyday actions.

Stage 2: Frequent Drinking

Once the alcoholic moves on from the experimental stage 1, alcoholic drinks become part of a coping mechanism. Alcohol becomes a means of coping with stress, anxiety and the challenges of daily life. Instead of just drinking at parties consumption becomes more regular and frequent.

This regular alcohol use is an emotional attachment to drinking. It produces feelings of wellbeing maintained by returning to drink.

This level of drinking may still not significantly affect daily life. The drinker may still be holding down a job and relationships but they may begin to be signs of drink being a major part of life. Alcohol is for good times and bad to enhance the mood and cope with life.

Stage 3: Problem Drinking

The frequent drinking stage can give way to problematic drinking. The ability for alcohol to provide support for the drinker reduces. Increasing frequency of drinking fails to work as a coping mechanism and the negative sides to drinking surface more.

Greater depression, anxiety, and other physical health effects start to emerge. The social impact of alcohol also starts to develop. This includes problems with relationships, inconsistent social behavior, and family difficulties.

Other legal problems may occur including drink driving offenses. Behavior such as public order offenses or even violence can start to be a problem.

Alcohol acts like a depressant and so when taken to escape problems or cope with anxiety it increases the feeling of depression. Feelings of isolation, unhappiness and hopelessness increase. A vicious circle of depression, alcohol drinking, and further depression result.

Stage 4: Alcohol Dependency

The physical impact of drinking every day is very damaging. The drinker often feels nauseous. They have tremors and regular sweats. Their body feels very irritated, they have periods of racing heartbeat and struggle to sleep well.

The physical appearance of the drinker at this stage is changing. The high blood pressure and liver damage results in a change to the appearance of the skin and they may have a distended stomach.

If the drinker is able to hold down a job they do so on a constant knife edge. Their performance and attendance may be variable. People around them may be aware of the signs of alcohol abuse including physical and behavioral problems.

Stage 5: Addiction

The last of the stages of alcoholism is when alcohol has become a physical and mental need. The alcoholic is addicted to alcohol and drinking has ceased to be a pleasure. It is simply necessary for existence.

The compulsion to drink takes over all other aspects of life to the detriment of work, relationships, and health. Drinking may happen at any and all times of the day. It may also take place in any location and is not limited to social or conventional situations.

The health impacts of alcoholic addiction include:

  • Ulcers
  • Sexual problems
  • Diabetes
  • Vision problems
  • Suppressed immune system
  • Increased cancer risk

Drinking at this level can also be associated with suicide, violence, and homicide. Life is a constant struggle for the drinker and possibly for those around them. Behavior and health issues threaten their wellbeing and even their life.

What Next?

Recognising the stages of alcoholism is key to addressing the problems of dependency. A major difficulty is recognizing the signs and acknowledging the potential problems. Denial is a common characteristic of risky drinkers.

Medical treatment may be necessary to detoxify before addressing the challenges of recovery. The detox is not easy and is accompanied by risks. Failing to get proper medical help with detoxification can be very dangerous and even fatal.

The symptoms of withdrawal are so severe that they themselves can result in a relapse. The patient can seek to reduce the distressing symptoms by self-medicating with alcohol. These symptoms include nausea, headache, anxiety, fever, hallucinations and more.

Many people with alcoholism recover through a combination of medical and psychological treatments. These include individual and group therapy.

If you would like to learn more about alcohol dependency and recovery, click here.