What are the Stages of Alcoholism?

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Medically Verified: January 8, 2025

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What are the Stages of Alcoholism

What are the Stages of Alcoholism?

Most adults in the United States consume alcohol at least occasionally. While some people drink as part of a generally healthy lifestyle, some people struggle with alcohol abuse and addiction. 

Alcohol addiction is a serious condition that requires intensive treatment and ongoing support. Without treatment, the effects of alcoholism may become life-threatening. It is important to seek treatment as soon as you recognize the signs and symptoms of alcohol abuse or addiction.

But how can you determine what behaviors are part of normal drinking habits and which ones indicate a problem? This article will explore the stages of alcoholism. You will learn:

  • How alcoholism develops
  • The stages of alcoholism
  • What to expect in alcohol addiction treatment
  • Where to find comprehensive alcohol addiction treatment options

If you or someone you love struggles with alcohol use disorder, you are not alone. Contact the intake team at The Living Room to learn about our programs or to schedule an intake appointment. 

What is Alcoholism?

Alcoholism is a common term for alcohol addiction. Alcohol abuse and alcohol addiction are forms of alcohol use disorder (AUD), which is a serious condition requiring intensive treatment and support.

But how do people develop AUD or dependence on alcohol?

Alcohol use disorder can develop slowly over time. The Centers for Disease Control and Prevention (CDC) advises people to drink moderately. According to the CDC, moderate drinking means:

  • One or fewer alcoholic drinks per day for women
  • Two or fewer alcoholic drinks per day for men

Heavy drinking means regularly consuming more than the CDC recommends over the course of a week. For men, this means consuming 15 or more alcoholic drinks per week. For women, it means consuming eight or more alcoholic drinks per week.

People who drink heavily may develop signs of addiction. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), signs of AUD or addiction include: 

  • Needing to drink more to feel the effects of alcohol or being able to drink a lot without appearing intoxicated
  • Experiencing alcohol withdrawal symptoms if they stop drinking
  • Craving alcohol
  • Continuing to drink even when facing severe medical conditions or other serious issues related to their drinking

Once someone develops alcoholism, it can be very challenging for them to overcome it. People with alcoholism require intensive treatment options to address the physical, behavioral, and psychological aspects of their drinking. 

What are the Four Stages of Alcoholism?

Alcoholism is a severe, complex condition that affects every part of a person’s health and well-being. It requires comprehensive treatment and ongoing support. Recognizing alcohol abuse and addiction early on allows people to address the complex roots of this condition and move forward.

Alcoholism typically develops in four stages. Here is an overview of the four stages of alcoholism. 

Pre-alcoholic stage

Alcohol addiction often begins before people are aware of a problem. Early alcoholic stages may involve problem drinking, self-medicating, and other destructive patterns of drinking.

During the pre-alcoholic stage, people may use alcohol to self-medicate physical or emotional pain. They may drink more during stressful times or after experiencing a traumatic event. Over time, people may depend on alcohol to cope with challenging emotions or pain. 

Early-stage alcoholism

People with early-stage alcoholism may begin to develop tolerance to alcohol. They may notice they need to drink more than they did before to feel buzzed. For instance, someone may notice that their usual after-dinner glass of wine doesn’t make them feel good anymore, so they begin to have a second.

People may also be able to drink a lot without appearing or feeling drunk. They may develop more problematic drinking behaviors, such as binge drinking or experiencing blackouts while intoxicated. 

Middle-stage alcoholism

Without getting treatment in the early stages of alcoholism, the condition may worsen. MIddle-stage alcoholism involves higher tolerance and the beginning of physical symptoms related to alcohol abuse. Common physical symptoms of middle-stage alcoholism include: 

  • Increased fatigue
  • Skin changes
  • Excessive sweating
  • Bloating
  • Red or puffy face
  • Shaking or tremors
  • Gaining or losing weight quickly

Drinking may occupy most of a person’s time and energy. They may begin to neglect their responsibilities, hobbies, and relationships. People may spend a lot of time getting alcohol or dealing with hangovers. 

End-stage alcoholism

End-stage alcoholism is the final phase of alcohol addiction. It typically involves severe, life-threatening physical symptoms and the inability to control your drinking. Without treatment, people with chronic alcoholism may die from related complications, which may include:

  • Alcohol overdose
  • Cancer of the colon, breast, stomach, throat, or mouth
  • Alcoholic hepatitis
  • Heart failure
  • Liver disease or failure
  • Brain damage
  • Pancreatitis
  • Cirrhosis of the liver
  • Esophageal damage
  • Pneumonia

While the damage alcoholism causes can be life-threatening, it can be very challenging for people to stop drinking. People with end-stage alcoholism cannot simply choose to give up alcohol. Without alcohol, they are likely to experience severe, life-threatening withdrawal symptoms, including:

  • Seizures
  • Elevated blood pressure
  • Faster heart rate
  • Excessive sweating
  • Tremors
  • Elevated body temperature
  • Anxiety
  • Insomnia
  • Hallucinations

People with end-stage alcoholism require intensive medical treatment, supervision, education, and other forms of ongoing support to maintain sobriety. 

Treatment for alcoholism typically begins with a medical detox program, followed by a comprehensive treatment program that includes:

  • Behavioral therapies
  • Individual, group, and family counseling
  • Relapse prevention education
  • Medications and medical care
  • Holistic therapies like exercise, nutrition support, and mindfulness
  • Aftercare planning

Comprehensive treatment programs provide critical support for the physical, emotional, and behavioral aspects of a person’s alcohol addiction. It also helps people develop an aftercare plan that can help them stay sober after rehab. 

Find Treatment Now

If you or someone you love struggles with alcohol abuse or addiction, you are not alone. Contact the intake team at The Living Room to learn about our treatment and recovery support programs or to make an intake appointment. 

References:

  1. Psychiatry Online: Overview of Alcohol Use Disorder
  2. National Institute on Alcohol Abuse and Alcoholism (NIAAA): The Cycle of Alcohol Addiction
  3. Taylor & Francis Online: The onset and progression of alcohol use disorders: A qualitative study from Goa, India

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