The 3 Stages of Alcoholism

Last Updated on January 26, 2023

Updated on July 8th, 2020

Alcoholism (commonly referred to as alcohol use disorder or AUD¹) is a disease that develops gradually over time, slowly taking over a person’s life and affecting nearly every aspect of it, from the person’s physical health to their finances, relationships, and mental health.

It’s not always easy to see the progression of alcoholism in your own life, let alone a loved one’s, however, there are some clear red flags that can be identified at each stage in the development of alcohol addiction. The three stages of alcoholism described below are based on the Jellinek Curve of Addiction chart and Milam and Ketcham’s explanation of the descent into alcoholism.²

What Are The 3 Stages of Alcoholism?

Stage #1: Denial

The early stage of alcoholism is characterized by the following symptoms:

• Occasional drinks to relieve stress or other problems
• Gradual increase in drinking frequency and tolerance
• Thoughts become more focused on alcohol consumption
• Rationalization of alcohol abuse
• Others are unaware of the drinking problem

One of the primary early warning signs of alcoholism is using alcohol to cope with life stressors like financial problems, relationship issues, daily stress, sadness, or other negative emotions. Although there is nothing wrong with occasional social drinking, the problem manifests when you start using alcohol as a crutch to deal with stressful events or emotions in life.

As you rely more and more on alcohol to get through difficult times, you may eventually find yourself becoming increasingly fixated on your next drink, thinking things like, “If I can just make it through these last two hours of work, I can head straight to the bar and get some relief.” You may even rationalize your growing drinking habits by telling yourself you’re just having a rough few days, that the drinking isn’t that big of a deal, or that if you’re not going out getting wasted every night, you’ll be fine.

In the early stage of alcoholism, your friends, coworkers, and even family members may not realize that your drinking habits are getting increasingly more dangerous, and you yourself are likely still in denial that alcohol is gradually becoming a controlling force in your life.

Stage #2: Loss of Control

The second stage of alcoholism is characterized by the following symptoms:

• The desire to drink becomes more intense
• Alcohol-induced blackouts are common
• Withdrawal symptoms get more severe
• Loss of control over drinking habits
• Others realize drinking is a problem
• Begin to hide drinking from others
• Relationship problems and social isolation increases

In this stage, you’re gradually becoming more accustomed to drinking larger amounts of alcohol with little to no effect. You can still function well enough, despite your heavy drinking, and you become more and more focused on getting that next drink. In fact, it’s quickly becoming all you can think about.

Alcohol-induced blackouts are also a common part of this stage and may result in large amounts of time lost, such as several hours or even an entire day. During these blackouts, you may not remember where you went, what you did, or who you were with, which could have very harmful physical and mental consequences.

As others begin to realize you may have a drinking problem, you start to realize it too, although you may still be in denial. You begin hiding your drinking habits from friends and family members, spiking your coffee or soda, hiding empty bottles throughout your home, and lying about your whereabouts when you’re out drinking.

At this stage in the development of alcohol addiction, you probably also have severe withdrawal symptoms when the effects of the alcohol wear off, leaving you feeling nauseous, shaky, anxious, sweaty, and unable to sleep.³

Stage #3: Emotional and Physical Deterioration

The final and most severe stage of alcoholism consists of the following symptoms:

• An obsession with drinking
• Alcohol is needed to function
• Loss of other interests
• Depression, anxiety, insomnia
• Financial, legal, and relationship problems continue to worsen
• Serious health problems occur

In this third stage, you’ve developed a full-blown alcohol addiction and are likely seeing the severe physical and emotional consequences it brings. You may have become completely obsessed with drinking and you’re constantly drinking, thinking about when you will have your next drink, or recovering from drinking.

It’s common to feel like you need alcohol just to get through the day and you may wake up with the shakes, which can only be calmed with a tall glass of an alcoholic beverage. At this point, life outside of alcohol feels empty and you’ve lost all interest in the things you previously enjoyed doing. You’re suffering from anxiety, depression, and you can’t sleep unless you have a drink before bed. Your friends don’t talk to you anymore because you ran them all off after they confronted you about your drinking habits. You frequently isolate yourself and spend a lot of your time alone, drinking.

Physically, the alcohol starts taking a toll on your body at this point too. You may get sick much more often (especially frequent respiratory infections) and your doctor may have warned you about the damage to your liver or pancreas. You are also most likely suffering from malnutrition, as long-term alcohol abuse can inhibit the body’s ability to digest food properly and absorb nutrients.⁴

As your physical, emotional, and mental health continue to worsen, you realize you have a problem but feel like it’s too late for you to get help. The alcohol has completely taken over your life and you’re not sure you could ever come back from it.

What Are Common Symptoms of End-Stage Alcoholism?

During the final stage of alcoholism (also called end-stage alcoholism), the body and mind can endure several different terrible physical and mental health problems. These symptoms are the consequences of years of alcohol abuse and can often be life-threatening or fatal if alcohol addiction is left untreated.

• Alcoholic liver disease and cirrhosis (scarring of the liver tissue)
• Severe malnutrition
• Chronic pancreatitis
• High blood pressure
• Damage to the heart muscle
• Angina
• Increased risk of heart failure, stroke, and heart disease
• Korsakoff’s syndrome (alcohol dementia)
• Involuntary rapid eye movement
• Weakness/paralysis of the eye muscles
• Increased risk of developing several types of cancers, including liver, throat, esophagus, breast, colon, and mouth cancer

If a person has reached end-stage alcoholism, it means alcohol has completely taken over their life. By this point, if he or she tries to quit alcohol cold turkey or on their own at home, they could suffer serious or life-threatening alcohol withdrawal symptoms, which may include hallucinations. Delirium tremens (DTs) is one of the most severe consequences of alcohol withdrawal and it can be fatal if it is not treated by a medical professional.

End-stage alcoholism is very dark and people tend to lose hope after years of suffering. However, it’s never too late to recover from alcoholism and it is possible to get sober, even after years of heavy alcohol abuse. Someone who is severely addicted to alcohol and is experiencing these symptoms of end-stage alcoholism will need professional assistance to overcome their alcohol use disorder. Often, the first step to recovery is a medical detox program.

How Many Drinks a Day is Considered an Alcoholic?

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), heavy alcohol use is defined as more than 4 drinks on any day for men or more than 3 drinks for women. Binge drinking is a pattern of drinking that typically occurs after 4 drinks for women and 5 drinks for men—in about 2 hours.⁵ Regular heavy use of alcohol or binge drinking greatly increases your risk of developing alcohol use disorder so the best rule of thumb is to drink responsibly or don’t drink at all.

Do You Have to Drink Every Day to Be An Alcoholic?

You do not necessarily have to drink every day to be an alcoholic, but that also doesn’t mean your drinking habits aren’t a cause for concern.

In the early stages of alcohol addiction, you may not need to drink every day. However, many people who are on track to develop an alcohol use disorder do need to drink more to reach their desired level of intoxication. This is because they have developed a tolerance for alcohol, which contributes to the likelihood that they will become addicted.

By the middle or late stages of alcoholism, a person will likely need to drink every day to stave off symptoms of alcohol withdrawal. As a result, he or she may resort to drinking first thing in the morning and throughout the day. Otherwise, the withdrawal symptoms may significantly affect the person’s ability to function normally at work, school, or just in general.

What Is Excessive Drinking?

According to the Centers for Disease Control and Prevention (CDC), excessive drinking includes binge drinking, heavy drinking, and drinking by pregnant women or people under the age of 21.⁶

• Binge drinking – This type of drinking behavior is defined as consuming four or more drinks during a single occasion for women and consuming five or more drinks during a single occasion for men.
• Heavy drinking – This type of drinking behavior is defined as consuming eight or more drinks per week for women and 15 or more drinks per week for men.

Research shows that most people who drink excessively are not alcoholics, but the overconsumption of alcohol definitely increases a person’s risk of developing an alcohol use disorder.⁷

Can You Be a Heavy Drinker and Not An Alcoholic?

Yes. A recent research report from the CDC found that the majority of heavy drinkers (90 percent) are not alcoholics.⁸ Many excessive drinkers are self-medicating, but often American culture and attitudes about drinking lead people to believe that you have to drink alcohol to have a good time. This can contribute to harmful drinking patterns that may gradually shift into alcoholism down the line.

Does Drinking Alone Make You An Alcoholic?

Drinking alone is frequently cited as one of the main signs of alcoholism. However, this isn’t always necessarily true. If you drink alone occasionally and in moderation, the behavior shouldn’t be cause for concern. On the other hand, if you start to drink alone often or regularly, this habit could quickly turn into something more sinister, such as alcohol addiction.

How Can I Recover from Alcoholism?

As illustrated in The Jellinek Curve of Addiction and Recovery, the obsessive alcohol abuse will continue in cycles until you decide it’s time to get help. If you have an honest desire for help, addiction treatment for alcoholism can work for you. In fact, for many people, it leads to a rewarding and fulfilling life in sobriety.

Although you must make the decision to break the cycle once and for all for yourself, there will be plenty of people along the way who support you and are willing to help you get sober and stay that way.

The recovery stage of alcoholism is characterized by the following things:

• A sincere desire for help
• Physical detox and medical treatment
• An assessment of clinical treatment needs for co-occurring disorders
• Establishing new ideas, attitudes, and goals for life
• Ongoing group, individual, and family therapy
• Rest, structured daily routine, and proper nutrition
• New circle of stable and sober friends and mentors
• Increase in self-care, confidence, and self-esteem
• Lasting sobriety

This final stage of recovery will take a lot of hard work and commitment, but it is entirely possible with the right treatment and support. Research has shown that treatment outcomes are contingent on adequate treatment length, and an addiction treatment program that lasts less than 90 days has limited effectiveness.⁶

To properly treat the whole person and not just the addiction, Nova Recovery Center offers a long-term alcohol rehab program that lasts a full 90 days. This individualized treatment program provides adequate time for clients to work through behavioral problems, emotional issues, and any psychological trauma that has contributed to their addictive behaviors. As the alcohol rehab program comes to an end, clients are given personalized recommendations for ongoing treatment that will help them achieve their recovery goals and sustain their sobriety for years to come.

If you or a loved one is suffering through one of the three stages of alcoholism described in this blog, you should know that you don’t have to wait until you reach the last stage when you hit “rock bottom” to ask for help. At Nova Recovery Center, we provide personalized alcohol addiction detox, rehab, sober living, and aftercare programs for people in all stages of addiction and recovery.

Call Nova Recovery Center today to learn more about our alcohol addiction treatment options and start your recovery journey now.