What Are the Stages of Alcoholism?

Alcoholism isn’t something that develops in a day; it is a progressive and complex disease that stems from excessive drinking. Causing people to drink more frequently, many find it challenging to quit despite harmful consequences to their day-to-day life, physical or mental health, and social relationships.

Alcohol use disorder is an alteration of the brain that control’s one’s motivation and ability to make healthy choices. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) describes alcohol use disorder as a drinking problem that becomes severe. Moderate drinking is not a cause for concern in most cases.

Causes of Alcohol Addiction

It is important to remember that no two individuals who experience alcohol abuse are the same. As alcohol use disorders have no single cause, many different psychological, genetic, and behavioral factors contribute to alcohol addiction.

The development of an alcohol use disorder is dependent on how much, how often, and how quickly a person consumes alcohol. However, some factors repeatedly come up when determining who might have an issue with alcohol addiction. These include:

• Drinking at an early age – Research has found that people who begin drinking before the age of 15 are five times more likely to develop an alcohol use disorder than those who start drinking at age 21 or older.
• Genetics and family history – A person’s genes and environment often influence alcohol use disorder. A parent’s drinking behavior may also influence a child’s likelihood of developing an alcohol addiction later in life.
• Mental illness – Many psychiatric disorders, including depression, anxiety disorders, bipolar, and post-traumatic stress disorder (PTSD), are associated with alcohol use disorder. However, it is unclear if these mental disorders are a result of alcohol abuse or contribute to the development of alcohol addiction.

The Four Stages of Alcohol Abuse

E. Morton Jellinek was among the first researchers to take a scientific approach to understanding alcohol use disorders. Jellinek viewed alcohol use disorders as a chronic relapsing condition requiring professional treatment. Following his research, he suggested that alcohol abuse follows a common trajectory through various stages of decline.

After many studies and publications, Jellinek created the Jellinek Curve, a model of addiction that attempts to identify the progressive stages of alcoholism. His contributions to this field of research helped the medical world understand alcohol addiction today. The four main stages are:

• Pre-alcoholism
• Early-stage alcoholism
• Middle alcoholism
• End-stage alcoholism

The four stages of alcoholism can be a helpful guide to determine whether someone has a problem with alcohol. Not every person will go through these stages, but they are useful in identifying warning signs associated with alcohol misuse. Any signs of alcohol abuse should be taken seriously.

Pre-Alcoholism Stage

In the early stages of alcoholism, alcohol abuse is extremely difficult to notice. This is because alcohol is yet to create any problems, and there is no compulsive pattern. It generally starts with experimentation with different forms of alcohol. For example, a person will begin drinking in social settings for many reasons.

Drinking alcohol and binge drinking are typically seen as ways of socializing among younger people. While they may not drink regularly, they consume a large amount of alcohol in a short period. Binge drinking for men includes consuming five or more beverages within two hours. For women, binge drinking is classed as drinking four or more drinks within two hours.

Binge drinking and negative drinking habits are widespread, especially among young adults. Binge drinking does not necessarily mean an alcohol use disorder will develop, but it does increase the risk.

Early symptoms in the pre-alcoholism stage are hard to spot, and not all early symptoms will result in an addiction. During this stage, alcohol tolerance is developing, and problem drinking can lead to mental health issues.

Early-Stage Alcoholism

Early-stage alcoholism is often considered the transitional stage, where people begin binge drinking regularly and slowly start to abuse alcohol. Alcohol consumption becomes more frequent, and people may find themselves drinking every weekend.

Individuals start to use social settings and gatherings as an excuse to drink, often stating they cannot have a good time without alcohol. A person in this early stage often drinks to feel confident in themselves and their social settings.

In addition to binge drinking socially, people use alcohol as a form of stress relief. A person may frequently drink to cope with sadness, loneliness, or other negative emotions, rather than dealing with the issue itself.

People in this stage often drink to the point of blacking out, and they do not see it as a problem and will continue this repeatedly. It becomes an unhealthy cycle of passing out and swearing never to drink alcohol again.

Early-stage alcoholism is easier to notice than the pre-alcoholism stage, and it is also easier for a person to stop drinking at this stage. A critical difference between the first two early stages is that those in the early stage often have issues limiting alcohol consumption compared to those in the pre-alcoholism stage.

Middle Alcoholism Phase

In the middle stages of alcoholism, alcohol use becomes a part of everyday life. A person’s drinking problems are likely to become more apparent, and they begin to drink more frequently, often in the morning and throughout the day.

Alcohol use in this stage is high, and the effects of obsessive drinking and addiction are evident in daily life. People around those with a drinking problem are also more likely to become aware of what is going on, especially as alcohol use starts to affect the person in different ways.

Frequent drinking can lead to alcohol dependence, which causes people to regularly think of alcohol. When somebody becomes dependent, they will also experience alcohol withdrawal symptoms, which can have severe consequences on their physical and mental health.

Alcohol withdrawal symptoms can range from:

• Alcohol cravings
• Agitation
• Anxiety
• Loss of appetite
• Nausea
• Mental illness

One may even experience physical dependence symptoms such as:

• Weight gain
• Weight loss
• Stomach bloating
• Facial redness
• Sweats

Alcohol abuse treatment and alcohol rehab are most effective for those in this middle stage, as they can prevent more severe withdrawal symptoms from arising. This is because those at this stage can still change their lives to avoid any alcohol-related medical problems.

End-Stage Alcoholism

In this final stage, the effects of long-term alcohol abuse are evident. At this stage, a person no longer drinks for pleasure and feels a loss of control over their alcohol use. Typically, people with severe alcohol addictions are consumed with acquiring alcohol and, as their priorities change to facilitate drinking, relationships are often lost with loved ones.

Without treatment, severe alcoholism can cause life-threatening health problems and extreme medical conditions such as:

• Liver disease
• Brain damage
• Heart failure
• Cirrhosis

People in end-stage alcoholism are known to feel as though there is no way out. They may think that they are beyond help and recovery is too much of a painful process to pursue. However, addiction treatment has been proven to be effective.

People in this end-stage will experience life-threatening and severe alcohol withdrawal symptoms if they continue to consume alcohol. For this reason, it is recommended that they seek treatment in a safe and structured environment where there is either a doctor or treatment specialist to support their recovery.

Treatment Options

There are various treatment providers and treatment options available for addiction treatment. However, it is essential to remember that someone with an addiction cannot be forced to stop drinking; they must be willing to seek alcohol disorder treatment.

The severity of alcohol use deters which treatment is most effective. However, a combination of behavioral therapy, medication, and attending support groups has proven effective for alcohol or substance abuse problems.

Inpatient treatment provides constant care in a safe environment where those in recovery have access to a medical and mental health professional. They also have the opportunity to complete behavioral therapy, focusing on the psychological aspects of addiction.

In contrast, outpatient treatment is a little more relaxed. Those who choose to attend outpatient rehab will continue to live at home, and treatment is fitted around their schedule. Attending support groups can be the first step towards recovery or part of an aftercare plan for some. They are open to anyone with a substance use disorder and are peer-led.

When an addiction arises, it is best for anyone suffering to speak to a doctor. In doing so, support and guidance can be provided surrounding local programs and treatment options. Help is available for those at all stages of alcoholism, so those suffering should not be afraid to seek help.