If you are concerned that yourself or a loved one is struggling with a drinking problem, being able to understand the four stages of alcoholism can help you determine whether or not you need professional treatment. The various alcoholic stages were first outlined in the 1960 book “The Disease Concept of Alcoholism” written by an American biostatistician and physiologist, E. Morton Jellinek. While his book refers to the various types of alcoholism, modern psychologists diagnose problematic drinking using the term “alcohol use disorder” as laid out in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V).

Diagnosing Alcohol Use Disorder

Alcohol use disorder (AUD) is thought to affect nearly 15 million people in the United States. In order to be diagnosed with AUD, individuals have to meet certain criteria that are outlined in the DSM-V. Since no two individuals are the same, the DSM-5 outlines 11 different symptoms of alcohol abuse to see how many an individual can relate to within a one-year period of time. Individuals who relate to 2-3 symptoms have a mild alcohol use disorder, individuals who experience 4-5 symptoms have a moderate AUD, while six or more is considered severe.

The diagnostic criteria for AUD are as follows:

1. Drinking for longer or drinking larger amounts than intended
2. Trying to stop drinking or cut back but being unable to do so
3. Spending a lot of time drinking or getting over the effects of drinking
4. Finding that drinking or being sick from drinking interferes with home, family, work, or school
5. Continuing to drink even though it is causing problems within relationships
6. Giving up on activities that one once enjoyed in order to drink
7. Getting into dangerous or risky situations as a result of drinking
8. Continuing to drink even if it is worsening a mental or physical health problem
9. Needing to drink more and more to achieve the desired effects (tolerance)
10. Experiencing withdrawal symptoms when not drinking
11. Having intense cravings or desires to drink

If you or a loved one are experiencing any of these symptoms, you may already be showing signs of early alcoholism, so it is important to speak with a treatment provider to learn about your rehab options.

Stage One: Pre-Alcoholism

Typically, there is little to no evidence of drinking or alcohol abuse during the pre-alcoholic stage. After all, individuals in this stage of alcoholism are typically drinking socially, so their behaviors look normal. However, pre-alcoholism is characterized by associating drinking with some type of positive reward – whether it be stress reduction or anxiety relief.

As the pre-alcoholic continues to drink, he or she will begin developing a tolerance for alcohol, so the person will be able to drink more without experiencing the desired effects, provoking them to drink larger and larger quantities of alcohol. Towards the end of this stage, individuals may begin binge drinking frequently in order to consume enough alcohol to feel drunk.

If you are wondering whether or not you are in the pre-alcoholic stage, ask yourself these questions:

• Do you drink to make yourself feel better, avoid emotions, or forget certain memories?
• Do you drink because you feel like it is the only way you can socialize?
• Are you drinking to feel more confident in yourself?

If you answered yes to any of these questions, your drinking may begin to escalate if you don’t seek help from a trusted alcohol rehab.

Stage Two: Early Alcoholism

The second stage of problematic drinking is characterized by increased drinking, regular blackouts, and alcohol cravings. People in this stage may not be able to say no to a drink, even if they know they have to drive or go to work. In addition, they may find themselves sneaking around, lying to loved ones, hiding alcohol bottles, or spiking one’s drinks when nobody is looking. During this stage, a person’s tolerance for alcohol will grow tremendously, causing them to begin struggling with obsessive thoughts about drinking.

If you have found yourself lying to your loved ones about how much you drink, making secret trips to the liquor store, or simply feeling as though you need to drink to get through the day, you are likely in the early stage of alcohol addiction.

Stage Three: Middle Alcoholism

During the middle stage, the signs and symptoms of alcoholism start to become more apparent to friends and family members. The middle-stage alcoholic may begin calling in sick to work, showing up drunk to class, or drinking at other inappropriate times. In addition, the drinker may become increasingly irritable and friends and family may begin noticing visible changes, such as redness in the face, weight fluctuations, or fatigue.

The middle-alcoholic stage is usually when friends and family members begin showing their concern. At the same time, tensions in the home may run high and relationships may be harmed as a result of the alcoholic’s drinking.

Some people may begin to suspect they have a problem once they have reached the third stage of alcoholism. If you have reached this stage, you may have tried to quit drinking and been unsuccessful or even considered visiting a support group to see what they are all about. People who seek treatment while in this stage typically have very high success rates in treatment. However, if individuals continue drinking past this stage without seeking help, their alcoholism will continue to progress.

Stage Four: Late Alcoholism

Late alcoholism is considered the last stage as the long-term effects of alcohol abuse are severe and apparent. As a result, health problems may develop, drinking may become an all-day necessity, and alcohol ultimately becomes a person’s top priority. During this stage, individuals may struggle to maintain a job, keep healthy relationships, and stay healthy overall.

Late-stage alcoholics will experience severe and potentially life-threatening alcohol withdrawal symptoms when they stop drinking suddenly. These symptoms can include hallucinations, seizures, and delirium tremens (DTs). Individuals in late-stage alcoholism, also referred to as end-stage alcoholism, must begin the recovery process with the help of a medical detox facility. Medications are necessary during the detox process to prevent seizures and other life-threatening complications. If late-stage alcoholics fail to seek treatment, they are at risk of further health deterioration, liver failure, cirrhosis, dementia, and early death due to alcoholism.

Getting Help for Alcoholism

Alcoholism, at any stage in it’s progression, is a dangerous and deadly disease that only gets worse without professional treatment. The good news is that every stage of alcohol abuse is entirely treatable with the right substance abuse treatment program. Regardless of how far your drinking has progressed, you can always heal from the devastating effects of alcoholism. If you or a loved one is struggling and is ready to take back control over your life, contact us today to speak to a dedicated treatment provider.