No one turns around one day and is suddenly an alcoholic. Alcoholism is progressive, with the addiction becoming more destructive over time. The speed of progression is different for each individual, and some fall deeper into the addiction before deciding to get help. After treatment, many dependent drinkers can look and see that they went through several distinct stages in their drinking. This blog will look at the early signs and stages of alcoholism. In another article, we will discuss the facts about alcoholism.
Alcohol Abuse
In American society, it is socially acceptable to drink alcohol on a regular basis. It’s even considered a rite of passage to drink heavily during your teens and early twenties. This leads to a lack of understanding about just how damaging alcohol can be. It makes it easy to become a heavy drinker without even considering that it could become a problem.
Women who consume more than three drinks in a day and men who consume more than four are, by definition, heavy drinkers. So are binge drinkers who have more than seven per week for women or fourteen per week for men.
Heavy drinking is considered alcohol abuse when it leads to one of more of these consequences:
- It harms the health of the user.
- It puts them in dangerous situations, i.e., DUI, falls, fights, risky sex.
- It negatively impacts their work and social relationships.
Some alcohol abusers never advance further into early-stage alcoholism, often because they have suffered one or more of these consequences. Their priorities start to shift, and alcohol becomes less important than pursuing a career, starting a family, driving a car safely, being respected in the community, etc.
Early-Stage Alcoholism
For others, alcohol stays front and center, though they may not realize it at the time. They continue to abuse alcohol to the point where the three trademarks of addiction start to appear: cravings, tolerance, and withdrawal.
Cravings
The person’s day starts to revolve around alcohol and how to get it. He or she may stop socializing in places where alcohol is not available. Thoughts of alcohol start to dominate the brain.
Tolerance
This person can drink a lot and outwardly show no effects. Bystanders may not even be able to tell they are impaired after they’ve been drinking heavily. It takes a lot for an early-stage alcoholic to get drunk. Some consume cases of beer single-handedly.
Withdrawal
Some early-stage alcoholics feel anxious or depressed when they’re not drinking. At this point, these feelings could be from withdrawal, or they could simply be the feelings they sought to mask with alcohol in the first place. Either way, hangovers become more extreme and more difficult to recover from.
Mid-Stage Alcoholism
Mid-stage alcoholism becomes difficult for a person to hide from friends, family and employers. A person in this stage of alcoholism is compelled to drink just to maintain normal functioning. This often looks like having a drink when they first wake up, sneaking drinks in during the day (maybe during lunch or when driving from place to place), and drinking at night. If they don’t have a drink, cravings take over and withdrawal symptoms become apparent. The person doesn’t drink just to get drunk anymore, but because they brain and the body “need” alcohol.
Many in the mid-stages of alcoholism feel ashamed of their addiction, so they drink alone at home or they spend most of their time with other addicts. In both cases, family members and friends from before the addiction just don’t matter as much as they used to.
This is a stage where many alcoholics do seek help, finding it very hard to manage their lives when they’ve basically dismantled their own support system. If they don’t seek help of their own volition, they may find themselves in treatment anyway, due to legal problems associated with their drinking or a mandate from their employer.
Contrary to popular belief, there is no distinct “rock bottom” stage where all alcoholics begin to see the error of their ways and decide to sober up. Some continue to drink even as problems mount, or because problems mount and they don’t know how to handle them. Some give up on trying to stop drinking because it can be hard and often takes several tries. Without a concerted and continuous effort to change, alcoholism continues to progress.
Late Stage Alcoholism
Late stage alcoholism is where the body and the mind begin to fail. It may take weeks or it may take years to get to this point. It depends on a lot of factors, including the person’s health before they started drinking; how often, how much and how long they drink; their age and gender, etc. In other words, there is no delineating line or time frame to go by, but once someone is this far advanced, it can be hard, if not impossible, to come back.
At this point, life is an unending battle with withdrawal. The person cannot feel normal no matter how much they drink, and they feel anxious, confused, and physically sick when they are not drinking. Their liver may be so damaged it cannot metabolize much alcohol at all, so very small amounts of alcohol will get the person intoxicated. Tolerance also begins to fail because the body no longer tries to adapt to the sheer amount of alcohol coming in.
The person has likely lost their job, close relationships and maybe even housing at this point. Cognitive function and memory are severely impaired. Some will already have permanent brain damaged due to WK Syndrome, while others will have reversible impairments. It’s likely they have quit eating due to digestive issues and may be dangerously underweight. Their immune systems are compromised, putting them at risk for infections.
Obviously, this is not a happy place to be. Alcohol might seem like the only comfort left for these people. Choices at this stage of alcoholism are few: keep drinking and face more isolation, liver failure, coma or death, or try to stop drinking and face the hardest uphill climb of their lives. Again, like in mid-stage, the legal system may step in, especially if the person is a threat to others or has dependent children.
If not, it doesn’t mean that this person can’t get sober, but it will take a lot of treatment, including medically assisted detox and likely months of inpatient therapy. This may seem like a lot of effort for someone seen as a “no good drunk” but the transformation can be amazing once a person truly believes he has value.
Stages of Alcoholism Summary
Most individuals in the early stages of alcoholism deny that they have a drinking problem, and many of their loved ones believe them when they say they can stop whenever they want. This is unfortunate, since an intervention at this point saves a lot of future heartache for all involved. In part two, I will go over the more advanced stages of alcohol dependence.
About the Author
Kathleen Esposito is a certified addictions counselor in the Pacific Northwest. She helps individuals recover from drug, alcohol and gambling dependencies through group and individual therapy and regularly speaks at treatment centers.