The Stages of Alcoholism: From Social to Severe

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Just like with all other major disorders, there are stages of alcoholism that progress over time. In each stage, there are signs and symptoms, or red flags to be aware of. With the right knowledge, you can stop alcohol abuse before it turns into a full-on addiction.

Stage 1: Pre-Alcoholism (It’s a Social Thing)

The first of five stages of alcoholism is pre-alcoholism, when you drink for social reasons and are fine with or without alcohol, although may drink too much here and there. Whether you attend a party, sporting event, wedding, or a night out with friends, you overindulge or binge drink while celebrating in the pre-alcoholism stage.

Binge drinking is often defined by how much alcohol you consume within a specific time frame:

• Men who drink 5 or more drinks within 2 hours
• Women who drink 4 or more drinks within 2 hours

For those with a potential alcohol use disorder, drinking higher amounts is likely. There is an emerging trend called high-intensity drinking, where people consume 2 or 3 times the amount defined as binging.²

Because you are still functioning at work and completing daily routines, you may not see drinking alcohol as a problem. You can overcome mild hangover symptoms with a couple of aspirin and a good laugh about making the poor decision to party too hard the night before.

Over time, your alcohol tolerance increases. Meaning, you must drink more alcohol to achieve the same buzz you did when you first started drinking. Tolerance can signal entrance into the next alcoholism stage.

Stage 2: Mild Alcoholism (Always on the Mind)

In this stage, drinking alcohol has become the way to cope with all emotions. You celebrate good days and cope with sadness or disappointment. Some drink simply out of boredom. No matter how you feel, you think alcohol will make it better.

While you may not be drinking every day of the week, it is in this stage that many begin searching for excuses to drink, even if at home and alone. You drink to take the edge off a stressful day at work, or so you can sleep better at night. You drink to reward yourself for all the hard work you’ve been putting in on the job. These are examples of excuses justifying drinking.

During the mild alcoholism phase, problem drinking may not be interfering with your ability to function at work and home. Even though the hangovers are more challenging to overcome, you still get the job done. Friends and families are not too worried about your consumption. However, if they knew how difficult it is for you to stop thinking about alcohol, they would be more concerned.

Obsessive thoughts about alcohol make it hard to concentrate on completing essential tasks. You look forward to that end-of-the-day alcoholic beverage. You were once able to wait until you got home to drink, but now, you may find yourself stopping at a bar to have a drink before you can get home to have more drinks. You do this for two reasons:

1. Your family won’t know the exact number of drinks you have had
2. The sooner you can drink, the sooner your withdrawal symptoms will disappear

Slowly, you move into the next stage of alcohol abuse. Call 800-948-8417 Who Answers? to speak to a rehab specialist about your options to get help for your alcohol addiction, even in the early stages.

Stage 3: Moderate Alcoholism (Can’t Catch a Break)

As drinking habits increase, consequences begin appearing.³ One example is getting a DUI which can be followed by spending time in jail, attorney fees, court costs, loss of your driver’s license, treatment, and probation.

Some with moderate alcoholism receive multiple DUIs. With each one, the punishments increase.

Another consequence is spending more time in isolation. Whether you choose to drink alone or your friends and family refuse to be with you while you’re drinking, isolation can be damaging. It can lead to mental health issues like depression and anxiety.

In the beginning, alcohol made you feel happier and more sociable. Because alcohol is a depressant, it produces opposite effects when drinking over time. Negative mental health symptoms are enhanced.

Other consequences can include:

• Wrecked vehicles
• Injuries from the loss of balance that occurs when drinking
• Broken relationships
• Declining work performance
• Your partner or spouse may complain about the use of alcohol, causing you to start hiding alcohol and lying about how much you consume.
• Drinking too much interferes with personal and professional functions.
• Financial problems appear because you have been spending money on alcohol-related activities rather than meeting obligations.

Acquiring new friends—drinking friends—is a characteristic of moderate alcoholism. It’s easier to hang around people who won’t criticize you or care if you drink excessively.

While you may still see yourself succeeding in all areas of your life, you are in denial. You can’t understand why so many bad things are happening to you. Everyone else seems to catch all the good breaks. When someone suggests you may have a problem with alcohol, you get defensive and swear you can quit anytime you want and without help.

This kind of thinking and staying in denial can lead to further troubles related to an alcohol use disorder. It can also lead to the next stage, alcohol dependence.

Stage 4: Significant Alcoholism (Being Dependent)

To this point, hiding withdrawal symptoms have been somewhat doable. But now, the shakiness, trembling, nausea, and headaches only seem to disappear when you take another drink. So, you do, take another drink. And another and another. Significant alcoholism means your body is dependent on alcohol. Essentially, your body has become reliant on alcohol to function.⁴

If you take a good look at your body, you may recognize the changes externally and internally. A beer belly is not only a sign of how calorie-filled alcohol is but also that your liver is struggling to do its job.

That is not the only effect of physical dependence. You may also have:

• Heartburn
• Increased blood pressure
• Body tremors
• Sweats
• Mood swings
• Nausea present often, not just during withdrawal
• Heart palpitations
• Lack of quality sleep
• Weakened immune system

In this chronic stage, psychological health is also affected. Increased depression and anxiety are common, and you may find it hard to control your emotions. Whether you are crying uncontrollably one moment and exhibiting anger or rage the next, you cannot think rationally or logically. One emotion you are not experiencing is happiness, though.

Your obsession with alcohol grows, with most of your thoughts focusing on how to get and consume alcohol. It is interfering with all areas of your life. You may have even lost your job or are on the verge of losing it. Relationships with friends and family are unhealthy or nonexistent, except for those you have manipulated into enabling your alcohol use disorder.

The only things going up in your life are the negative consequences. More legal troubles, financial woes, and more trips to the hospital for injuries or overdoses are examples.

Drinking alcohol has not been fun for a long while. But even if you wanted to quit drinking alcohol at this stage, you can’t without the possibility of having potentially fatal seizures or organ failure.

Seeking help from a medically supervised treatment program is a must. Despite the adverse effects, some people are still not ready to stop drinking. Waiting to seek treatment will land you in the next stage, alcohol addiction.

Stage 5: Severe Alcoholism (Full-Blown Addiction)

Dependence is associated with the physical signs that accompany an alcohol use disorder. Your brain is traumatized by this end-stage alcoholism. Long-term use of alcohol changes its structure, which is why addiction is considered a brain disease.⁵

This stage of alcoholism can be marked by

• Memory problems
• Severe mood swings
• Inability to think clearly
• Difficulty making decisions
• Lack of control over bodily functions
• Internal ulcers
• Liver damage
• Heart disease
• Malnutrition
• Central nervous system problems
• Increased risk of suicide or accidental overdose

Thoughts of alcohol override everything else, leading to compulsions that satisfy the cravings and desire to drink. Even if it means you must engage in illegal activities to obtain more alcohol, you do it.

Consuming so much alcohol over a long period can lead to alcoholic hepatitis, cirrhosis, chronic pneumonia and bronchitis, cancer, and heart failure.

In this stage, your life is in more danger than in any of the others. Quitting drinking on your own is not possible at this stage. It is too dangerous.

However, you can still overcome your alcohol use disorder with the proper medical treatment and recovery plan.

Recovery from Alcoholism (Getting Your Life Back)

Recovery from an alcohol use disorder can start in any of the five stages listed above. With help, you can get back the healthy, happy life you deserve.

Alcohol recovery is a process with specific steps. In each one, you will experience noticeable, positive changes. While treatment plans differ for everyone, most successful recovery programs include the following treatment options:

• Medically-supervised detoxification at a treatment facility. Here, you get treatment for withdrawal symptoms so you can focus on learning new skills rather than dealing with cravings or withdrawal and detox symptoms.
• Learning that takes place in a residential setting. Often called inpatient treatment, you learn relapse prevention skills. Your teachers are mental health and addiction specialists who know what it takes to avoid drinking alcohol in the future.
• Sober living is an option for anyone who needs more time in a recovery environment before returning home. It is the perfect place to practice the coping skills you learned while in inpatient treatment.
• Intensive outpatient once you return home from treatment has helped many people avoid relapsing. With intensive outpatient, you can attend two to three group therapy sessions and individual therapy each week.
• Individual therapy is excellent for the maintenance of sobriety. It helps keep you accountable and on track with your sober goals.
• Support groups are beneficial because they allow you to work with peers who know what you are going through, including the highs and lows that may come with recovery. They also give you a chance to help someone else, give back and feel a sense of purpose and belonging.
• Family therapy is necessary for your recovery. If those who aided in your addiction do not change, you will likely relapse. Alcohol use disorder affects everyone in your life. Therefore, everyone should have an opportunity to receive help.
• Alternative therapies that incorporate your strengths, and hobbies you enjoy, can strengthen your ability to avoid relapsing. Art, yoga, meditation, massage, music, and animals are proven examples of such treatments.

Further, you can focus on education, vocation, and building the right support system.

Get Started Today

Nothing is more critical today than seeking help from professionals who can help you stop drinking. No matter which of the above stages you may be in, ask for help.

The National Institute on Alcohol Abuse and Alcoholism reports that treatment works.⁶

Join the millions of others in recovery from alcohol use disorder. Start your journey today by calling 800-948-8417 Who Answers? .

References

1. The National Institute on Alcohol Abuse and Alcoholism. (March, 2021). Alcohol Facts and Statistics.
2. Patrick, M.E., Azar, B. (2018). High-intensity drinking. Alcohol Research Journal. 39(1): 49–55.
3. Surgeon General. (n.d.). Sidebar: The Many Consequences of Alcohol and Drug Misuse.
4. Levi, A. (2018). 4 Warning Signs You Are Dependent on Alcohol: According to an Expert. Explore Health.
5. The National Institute on Alcohol Abuse and Alcoholism. (2004). Alcohol Alert no. 63. Alcohol’s Damaging Effects on the Brain.
6. The National Institute on Alcohol Abuse and Alcoholism. (2014). Treatment for Alcohol Problems: Finding and Getting Help. NIH Publication, 14(7974).