Substance Use

Stages of Alcoholism: Recognizing Signs and Seeking Solutions

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Alcoholism is a complex issue that affects millions of people worldwide. Recognizing these stages is crucial for anyone seeking to overcome alcoholism or help a loved one on their journey to recovery.

By understanding the signs and seeking appropriate solutions, we can take important steps towards a healthier and alcohol-free life. Now, let’s look more at the stages of alcoholism, from early signs to full-blown addiction, in a way that’s easy to understand.

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What is Alcohol Use Disorder?

According to the National Institute on Alcohol Abuse and Alcoholism, more than 14.1 million adults suffered from an alcohol use disorder in 2020. (1)

The NIAAA defines alcohol use disorder as a medical condition characterized by the inability to control or stop drinking despite adverse consequences. AUD encompasses conditions that are commonly referred to as alcohol abuse, alcohol dependence, and alcohol addiction. (2)

The symptoms of alcohol use disorder include: (3)

  • Not being able to limit or control the amount of alcohol consumed.
  • Wanting to cut down or stop drinking but being unable to do so.
  • Feeling strong cravings and urges to consume alcohol.
  • Experiencing a loss of control that forces you to neglect work, school, and familial obligations due to alcohol use.
  • Continuing to drink even though drinking alcohol is causing damaging health conditions, mental health problems, social problems, and problems in relationships and at work.
  • Continuing to use alcohol even in unsafe conditions, like when driving or caring for your children.
  • Experiencing alcohol withdrawal symptoms when attempting to cut back or stop drinking, such as: (4)

A Brief History of Alcoholism Research

The definition of alcoholism stretches back to 1956 when the American Medical Association (AMA) identified it as a disease that alters the brain and controls a person’s motivation and ability to make healthy choices. (5)

The AMA’s recognition of alcoholism as a disease was a profound shift in perspective. Before that, many viewed alcoholism as a moral failing or a lack of willpower. This change in classification opened the door to a more nuanced understanding. Researchers began to investigate how alcohol affects the brain, behavior, and overall health.

As research progressed, scientists uncovered that alcoholism goes beyond mere physical dependence. It was a complex interplay of genetic, psychological, and environmental factors. This realization led to more targeted treatments and support for individuals struggling with alcoholism.

Since 1956, alcoholism research has continued to advance. The development of medications, therapy approaches, and support systems has offered hope to those seeking recovery. (6) A deeper comprehension of the disease has led to more effective interventions and a reduction in the stigma surrounding alcoholism.

The Stages of Alcoholism

Alcoholism is not merely a matter of excessive drinking; it involves genetic, psychological, and social factors that have been gradually unraveled through extensive research. (7) This historical overview reveals how the understanding of alcoholism has evolved, culminating in the recognition of alcoholism as a disease, opening new doors for compassion, research, and innovative treatments.

Here are some of the initial warning signs that someone you love may have a negative use of alcohol. These symptoms indicate problematic alcohol consumption.

While the severity of these warning signs can vary from person to person, recognizing them is crucial for early intervention and seeking help. (8)

  • Increased Tolerance: Needing more alcohol to achieve the desired effect or experiencing reduced effects from the same amount of alcohol.
  • Withdrawal Symptoms: Experiencing withdrawal symptoms when not drinking or attempting to quit, which can include tremors, anxiety, nausea, or sweating.
  • Loss of Control: Inability to control or reduce alcohol intake, despite the desire to do so.
  • Unsuccessful Attempts to Quit: Repeated attempts to quit or cut down on drinking that are unsuccessful.
  • Spending Time Obtaining or Consuming Alcohol: Spending a significant amount of time obtaining, using, or recovering from the effects of alcohol.
  • Reduced Social and Occupational Activities: Neglecting important social, occupational, or recreational activities in favor of alcohol consumption.
  • Continued Use Despite Problems: Using alcohol despite it causing or worsening physical or psychological problems.
  • Neglecting Prior Interests: Giving up or reducing important social, occupational, or recreational activities because of alcohol use.
  • Craving Alcohol: Strong, recurring desires or cravings to consume alcohol.
  • Use in Hazardous Situations: Continued alcohol use in situations where it is physically hazardous, such as drinking and driving.
  • Legal or Social Problems: Legal issues or social problems resulting from alcohol use, such as arrests for drunk driving or interpersonal conflicts.
  • Neglecting Personal Care: Neglecting personal hygiene and health due to excessive alcohol consumption.

The Pre-Alcoholic Stage

Early alcohol abuse is often hard to distinguish from social drinking. This stage usually starts when young adults or college kids are introduced to drinking at parties, particularly binge drinking. (9) (10)

Some binge drinkers or party drinkers never progress past the experimental phase to start drinking regularly, but some people with an increased risk of developing alcoholism, including family history, are four times more likely to progress from the experimentation phase of alcohol use to alcohol use disorder. (11

Early Stage Alcoholism

When someone is a problem drinker, they have lost control over their alcohol intake as it begins to infiltrate every area of their life. This is the first stage.

During the problematic alcohol abuse phase, a person may not be physically dependent on alcohol. Still, their alcohol use will begin to start causing problems at home, work, school, and in their relationships. (12)

Middle Stage Alcoholism

People who severely abuse alcohol are heavy drinkers who are dependent on alcohol, sometimes experiencing blackouts commonly, but are still able to meet their financial, familial, work, etc., obligations. These people are often referred to as “functioning alcoholics.” (12) (13)

However, just because they can fulfill their responsibilities does not mean alcohol is not wreaking havoc on their bodies.

During this stage of alcoholism, health conditions, and chronic diseases can start to develop from the heavy drinking, including:

  • Anemia
  • Cardiovascular disease
  • High blood pressure
  • Dementia
  • Cirrhosis of the liver
  • Pancreatitis
  • Gout
  • Cancers
  • Seizures
  • Depression
  • Nerve damage

End-Stage Alcoholism

During this late stage, the person’s drinking problem has become so severe that they have lost the ability to stop drinking, and drinking begins to consume every aspect of their life. They may recognize the devastating effects that alcohol is having on their life and attempt to quit.

Still, when they do, they experience severe symptoms of alcohol withdrawal because their body and brain have become so accustomed to their drinking habits. (12)

During this stage, serious diseases can develop, including cirrhosis and an increased risk of injury from an accident and/or self-harm. Other symptoms of end-stage alcoholism include:

  • Jaundice from liver failure and onset liver disease (14)
  • Chronic pancreatitis
  • Fatigue
  • Itchy skin
  • Fluid retention
  • Malnutrition
  • Anemia
  • Heart failure

The Jellinek Curve: Mapping Alcoholism’s Progression

The DSM-5 stages are not the only way to measure alcoholism. Some healthcare professionals also use the Jellinek Curve, created in the 1950s by alcoholism researcher E. Morton Jellinek. He wanted to illustrate that alcohol addiction is a progression with a “vicious circle” that causes people to lose everything if they don’t seek help.

The curve shows that life can get worse if treatment is not sought, but it can also get better through recovery. (15)

The stages of the Jellinek Curve are:

  1. Pre-alcoholic: During this early stage of alcoholism, people may drink to numb emotional pain, stop worrying, or eliminate stress.
  2. Early alcoholic: Some warning signs that someone has entered stage two of the Jellinek Curve are blacking out from drinking too much, lying about drinking, and having obsessive thoughts about drinking.
  3. Middle alcoholic: During stage three, it becomes obvious to loved ones that someone is a problem drinker. They may start missing work, becoming irritable, and showing physical signs of alcohol abuse, like facial redness and stomach bloating.
  4. Late alcoholic: During this stage, alcohol consumes a person’s life at the expense of their livelihood, health, and relationships.
  5. Recovery: The final stage of the Jellinek Curve is when the curve starts to swing in the opposite direction during recovery. Once they are stable, the goal is to transition from detox to treatment to a sober life to the final step of recovery, transcendence.

The Path to Recovery: Comprehensive Solutions

Recovering from alcoholism is easier when you have treatment options and help from treatment providers with the right tools. While overcoming alcohol addiction can be challenging, there are various ways to help you find your way to recovery.

These are called comprehensive solutions because they address different aspects of the problem and improve the effects of alcohol.

  1. Detoxification: The first step to recovery often begins with detoxification, where a person stops drinking and lets their body rid itself of alcohol. This process can be tough because the body is used to having alcohol. However, it’s a necessary first step to becoming alcohol-free. A treatment center can help with all negative consequences during this process. (16)
  2. Counseling and Therapy: Counseling and therapy sessions can provide guidance, well-being, and support. There are different types of therapy, like individual counseling or group therapy, and these sessions allow you to talk about your experiences, learn about addiction, and develop coping strategies.
  3. Medication: Sometimes, medications can help. They may not be like a magic potion, but they can make the journey smoother. Medications can help manage cravings, alcohol misuse, and substance abuse, and reduce the risk of relapse. Your healthcare provider can help you decide if medication is a good option.
  4. Support Groups: Traveling with others can be comforting, and that’s where support groups come in. These are like fellow travelers who have faced similar challenges. They provide encouragement, advice, and a sense of belonging. Alcoholics Anonymous (AA) is a well-known example.
  5. Lifestyle Changes: Changes in your daily life can help you stay on the path to recovery if you have alcohol-related issues. This might include avoiding people or places that trigger drinking, finding new hobbies or interests, or improving overall health through exercise and a balanced diet. Additionally, behavioral health or outpatient treatment can be a great lifestyle change and something to consider incorporating into your life.

The path to recovery is unique for each person, and it can sometimes be bumpy. With the right support and comprehensive solutions, you can successfully navigate the stages of alcoholism and find your way to a healthier, alcohol-free life.

Zinnia Health: Your Partner in Recovery

No matter what stage of alcoholism you or a loved one are experiencing, it’s important to know that help is available. At Zinnia Health, we offer a wide range of alcohol treatment programs and alcohol hotlines to help stop problem drinking and replace old habits with healthy and productive ones. Contact us today at (855) 430-9439.


Call us
Ready to get help?
(855) 430-9439
Why call us? Why call us