The Stages of Alcoholism

Most research seems to indicate that alcohol has been with us nearly as long as human civilization. People have been consuming alcohol for at least 9,000 years. (1) It’s safe to say then that alcoholism has probably been around just about as long as that. Unfortunately, there was little proper understanding of the nature of alcoholism or effective strategies to abate it until the early 20th century. Prior to Dr. William Silkworth’s illness concept of alcoholism (2), it was largely treated as a moral failing in the individual. A lack of self-control and nothing more. Alcoholics were, at best tolerated and at worst, seen as a nuisance to be locked away in institutions once they reached later stages.

Fortunately, we live in a more enlightened age where alcoholism is much more well understood and effective treatments are available and accessible. Alcoholism or Alcohol Use Disorders are generally broken down into four stages. There is no predetermined length for each stage and not every alcoholic will experience all four stages, thankfully.

Here are the four main stages of alcoholism:

Stage 1: Pre-Alcoholism

In the pre-alcoholic stage, casual onlookers would probably not notice anything wrong. Often the drinker doesn’t either. In this stage, the person often isn’t even drinking daily. What they are beginning to do though is drink alcoholically. That is, they don’t have a drink or two with dinner. They are drinking with purpose. Drinking to deal with anxiety or depression. Drinking to forget. Binge drinking. Drinking to relieve physical or mental pain. These are all red flags.

Stage 2: Early Alcoholism

At the second stage, there is beginning to be a physical need for alcohol. The alcoholic finds they cannot sleep restfully without drinking. They may find themselves lying to friends or loved ones about how much or how often they drink. They may hide alcohol or mix it into beverages to conceal drinking.

Stage 3: Middle Alcoholism

The middle stage of alcoholism is when the problem becomes difficult to conceal from others. Consequences begin to mount. The alcoholic is late to work or hungover frequently. They may drink at inappropriate times, like in the morning. Drinking and driving are likely. The alcoholic usually begins experiencing health problems related to their drinking at this time. Fatigue, weight loss or gain, stomach bloating, and digestive problems or ulcers are common.

Stage 4: Late Alcoholism

In late-stage alcoholism, the toll alcohol is taking on the body is readily apparent. Everything in the alcoholic’s life revolves around drinking. Drinking occurs all day out of necessity because when they stop drinking, they become extremely uncomfortable. Late-stage alcoholics often have sallow skin, bloodshot eyes, and/or a swollen, bulbous nose. They may develop cirrhosis of the liver, severe cognitive difficulties, memory problems, and paranoia. This is when Wernicke-Korsakoff syndrome, often called ‘wet brain’ is typically developed. Life expectancy is invariably compromised at this stage.

If you or someone you care about has a problem with alcohol, we can help. No matter which of these stages you may be in, there is hope. Call us today.