What are the 4 Stages of Alcoholism?

What is Alcoholism?

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), within the year of 2019 alone, approximately 14 million American adults were diagnosed with alcohol use disorders. Unfortunately, these numbers have only continued to increase over time.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), having even one of the following symptoms indicates a mild disorder, with anymore more than this indicating a more severe dependency:

• Finding that drinking or being sick from drinking regularly interferes with your ability to take care of home, family, job and/or school responsibilities.
• Having gotten into situations during or after drinking that increased your risk of injury on more than one occasion (e.g., driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex).
• Making an active choice to continue drinking even in the event that this behavior is causing issues with your family or friends.
• Having to consume more alcohol than usual in order to achieve the same effect as when you first started to drink.
• Finding that when the effects of alcohol start to wear off, withdrawal symptoms begin occurring, including sleeping problems, shakiness, restlessness, nausea, sweating, rapid heart rate, or seizures.
• Having times when you end up drinking more, or for longer amounts of time, than you originally intended.
• Having wanted or tried to cut down or stop drinking, but were unsuccessful, particularly if this has occurred on more than one occasion.
• Spending large amounts of time drinking, or being sick/getting over the after effects of your drinking behaviors.
• Giving up or cutting back on previously enjoyable activities and hobbies in order to continue drinking.
• Continuing to consume alcohol despite this causing or worsening feelings of depression or anxiety, adding to another health problem, or after having experienced a memory blackout due to drinking.

It is important to acknowledge that alcohol abuse is not something that happens instantly. Rather, it is a disorder that gradually develops over time. Thus, knowing the stages of alcoholism can help prevent your development of an alcohol dependence, before it’s too late.

The Stages of Alcohol Addiction

While not every case of substance abuse will look exactly the same in its cause, progression, or potential side effects, those struggling with an alcohol use disorder will likely exhibit several similarities within the stages of this addiction.

There are four main stages of alcoholism, each reflecting the progressive worsening of a person’s habits of alcohol consumption. Both the beginning and end stages of alcohol abuse present their own causes for concern, and are as follows:

• Pre-Alcoholic Stage
• Early-Stage Alcoholism
• Middle Alcoholic Phase
• End-Stage Alcoholism

Pre-Alcoholic Stage

Of all the stages of alcoholism, the first serves as a formative phase, often determining how an individual’s alcohol addiction will progress from there out. During this phase, one may begin to drink regularly or use alcohol as a tool for relaxation, a social booster, or sleep aid.

If unable or unwilling to find an alternative method of achieving these ends, specifically one that does not involve alcohol consumption, they will likely end up developing more problematic habits of alcohol abuse.

Signs of the Pre-Alcoholic Stage

Unfortunately, it can be quite difficult to determine if you or someone else is in this stage of alcoholism, as this behavior has likely not progressed past habits of social drinking.

While individuals who fall into the pre-alcoholic stage will likely consume alcohol more regularly than others, this will probably not be super noticeable or overtly problematic. With that being said, there are a few signs that may indicate if someone is in this phase, including:

• Need for alcohol to relax or unwind during or after stressful situations.
• Needing to drink while engaging in social situations.
• Using alcohol as a way of coping with or avoiding uncomfortable feelings, thoughts, or emotions.

Early-Stage Alcoholism

While not every person will progress past the pre-alcoholic stage, those who do typically move into early-stage alcoholism. Also known as the prodromal phase, this signifies the point when people begin binge drinking on regular occasions, often resulting in blackouts and memory loss.

Someone is considered to be binge drinking if they have more than four-five alcoholic beverages within the span of two hours. Many binge drinkers do this as a means of becoming inebriated as quickly as possible, usually to mask or alleviate unpleasant feelings.

While a singular case of this, such as amongst young adults experimenting with alcohol, may not be a large cause for concern, repeat incidents most certainly are.

Although people in this stage may not be drinking on a regular basis, they may be incapable of limiting or avoiding their consumption. This, unfortunately, paves the way for them to develop a more severe drinking problem.

Signs of Early-Stage Alcoholism

As the more noticeable of the early stages of alcoholism, this phase consists of a few indicators of a person’s progression to developing a full-blown alcohol use disorder. The most significant sign of this stage is consistent heavy drinking, particularly if this often leads to blackouts.

While it is possible that an individual may not progress past this stage, their frequent drinking, particularly if they drink heavily, can still be a major cause for concern.

This is because their occasional tendency to abuse alcohol can have negative consequences not only for themselves, but for the people around them as well.

Thus, if you or someone you know presents signs of being an early alcoholic, it is highly recommended that you seek out professional help. These signs include:

• Regularly engaging in binge drinking.
• Frequently blacking out, or losing memory after drinking heavily.
• Having difficulty with limiting or attempting to stop drinking.
• Often making jokes or comments about cutting back on alcohol, but never actually doing so.

Middle Alcoholic Phase

Recently, a disease concept has begun to become increasingly applied to addiction. This idea suggests that individuals struggling with alcohol and drug abuse have no control over their physical dependence on a specific substance.

In extension to this concept, addiction has also become increasingly recognized as a family disease, recognizing how families affected by substance abuse may suffer just as much as the abuser themselves.

While there are people that may be particularly skilled at hiding their alcohol addiction, those who fall into the middle alcoholic phase have reached a point where their habits have become more noticeable to their friends and family members.

Signs of the Middle Alcoholic Phase

While someone in this stage of alcoholism may be able to lie to themselves about their increased drinking habits, this behavior will likely not be so easily ignored by the people around them.

Individuals in this stage will have begun extending their alcohol use past private or social situations. This includes drinking while at work or caring for children, or in other inappropriate settings, such as while driving or participating in other recreational activities.

Furthermore, a person’s problem drinking may make them more irritable, and require them to have to drink more in order to experience the same effects as when they first started drinking.

This may also increase their chances of blacking out and suffering other alcohol-related consequences, as well as put them at a greater risk of abusing other drugs. Individuals may also begin to develop several changes to their body during this middle stage, including:

• Redness in the face
• Bloating
• Loss or gain of body weight
• Shaking and tremors
• Frequent sweating
• Minor or significant memory loss

Those who are in the middle stage of alcoholism are strongly encouraged to seek out professional substance abuse treatment services as soon as possible, before their addiction can progress any further.

End-Stage Alcoholism

When someone has officially passed the point of problem drinking into a fully-developed alcohol addiction, they are considered to have reached the end stage of alcoholism. It is during this stage that the effects of long-term alcohol abuse will become undeniable.

These individuals typically have severe alcohol dependencies, which will require medical treatment in order to be properly addressed. This is because their obsessive drinking will likely have resulted in a number of physical and mental health problems.

Signs of End-Stage Alcoholism

There are several warning signs that can be looked out for when determining if someone is struggling with this level of alcohol abuse. These may include social, physical and psychological aspects and side effects of addiction.

Socially, a person’s drinking problem may be apparent through their loss of work, withdrawal from social engagement and breakdowns within their personal relationships, and an inability to focus on anything other than acquiring alcohol and continuing to drink.

Furthermore, severe alcohol abuse can lead to a number of physical health conditions, some of which can become life-threatening if not properly addressed. These include damage to or failure of the liver and kidneys, as well as the development of nutritional deficiencies or heart problems.

Those with a severe alcohol use disorder may also experience several psychological side effects from their substance abuse, including:

• Paranoia
• Anxiety
• Depression
• Cognitive dysfunction
• Memory loss

The Relationship Between Mental Health and Alcohol Abuse

According to the Substance Abuse and Mental Health Services Administration (SAMSHA), simultaneous substance use and mental health disorders are quite common within the United States.

Also known as co-occurring disorders, or dual diagnoses, these occur due to the fact that many people will turn to substance abuse as a means of self-medicating the negative thoughts and feelings caused by their mental illness.

This, unfortunately, is rarely ever effective, and only offers temporary relief from these difficult emotions. Furthermore, continuing this drug or alcohol use as a coping mechanism over long periods of time may actually make a person’s mental condition worse.

Knowing When to Seek Alcohol Addiction Treatment

It can be all too easy for people to ignore that they may have a drinking problem. This, of course, only further allows their alcohol use to become more and more problematic, not just for the physical and mental health of the user, but for their loved ones’, as well.

Thus, whether concerned about potential habits of substance abuse in yourself or in a loved one, it is absolutely crucial to know when is the right time to start seeking treatment options for addiction.

Even more mild alcohol dependencies will still require some sort of professional treatment, whether this be for the addiction itself, or the underlying issues that caused it.

Some signs that may serve as strong indicators that it would be a good idea to start looking for a professional addiction treatment provider include:

• The development or worsening of mental conditions, such as depression or anxiety.
• The development or worsening of a physical health condition, particularly one with alcohol-related causes.
• Becoming dependent on alcohol use in order to function.
• Experiencing withdrawal symptoms when attempting to stop or limit alcohol use.

Treating an Alcohol Use Disorder

There are several addiction treatment options available for those struggling with alcohol use disorders today, each of which will have their own benefits and approaches to addiction recovery.

When it comes to alcohol abuse, this will most likely include participating in a medically supervised detox process and inpatient treatment programs. Individuals may also benefit from outpatient treatment services, including sober support groups and relapse prevention services.

Furthermore, seeking out a mental health professional can serve as an additional form of treatment for someone with an alcohol use disorder. This can help them to address and resolve the cause of their addiction, and further help them to maintain sobriety.

Many treatment centers will provide behavioral therapies and other services designed to treat mental disorders as an additional or integral part of their approach to addiction recovery.

Medical Detox

Many substances can have particularly intense withdrawal periods; some of which can even be life-threatening if not properly managed. The most dangerous substances to withdraw from are opioids, benzos, and, of course, alcohol.

Attempting to overcome an addiction to these substances on ones own rarely ever works, and is highly likely to have extreme consequences for their physical and mental well-being.

This is why medical detox programs are such a critical part of substance abuse treatment. They allow individuals to be gradually weaned off of an abused substance in a safe, supportive, and structured environment.

This treatment process will likely include the constant monitoring of a person’s vitals and blood alcohol content, as well as nutritional counseling and dietary planning. They may also be given medications designed to help manage and prevent more intense withdrawal symptoms.

Alcohol Withdrawal Symptoms

There are several side effects that can result from alcohol withdrawal, of which can vary in their intensity and duration. These may include:

• Anxiety
• Shaking or tremors
• Headache
• Nausea and vomiting
• Insomnia
• Sweating

More severe symptoms may include hallucinations and seizures, as well as heart issues. Failure to properly manage or address these problems can result in a coma, or even death.

Inpatient Treatment

Inpatient alcohol rehab centers, like detox programs, focus on providing regular professional addiction support and supervision as a core aspect of their treatment process. This form of substance abuse treatment will likely include a variety of additional services, including:

• Therapy and counseling sessions
• Nutritional counseling
• Holistic treatment services (i.e. yoga, meditation, etc.)
• Stress reduction services
• Vocational training programs
• Social skill training programs
• Relapse prevention services
• Addiction education resources and services

Finding the Right Alcohol Treatment Near Me

Now that you know how to recognize the stages of alcoholism, you may find yourself faced with the reality that you or a loved one is struggling with an addiction to alcohol. This can be an incredibly difficult thing to process, let alone start to find solutions for; but you’re not alone.

At Rehabs Of Armerica, we are dedicated to connecting you with addiction treatment providers and alcohol rehab facilities that can serve all of your personal care needs. Just by using our 24/7 hotline, you can break free from the grasp of addiction.

So don’t wait; call today, and let us help you take that first step on your path to overcoming alcohol abuse, and finally achieving a happier, healthier, and substance-free life!

Nicole R.( Content Writer )

Nicole R. is an experienced and accomplished writer with special interests in the fields of Anthropology, English, and behavioral health, and has written countless articles for newspaper publications, institutional research journals, and Find Addiction Rehabs.

Her alma matter is Florida Atlantic University in Boca Raton. Nicole hopes to spread awareness of and combat the stigmatization surrounding addiction and substance abuse treatment through her writing and work in the field.