Stages of Alcoholism – Disease Models Inevitable Progression

Defining the Stages of Alcoholism

stages of alcohol addictionThe stages of alcoholism are not as predictable as blood alcohol concentration. It is not a steady 0.02 for each beer (minus what the liver metabolizes). It is far less predictable.

Generally each stage of alcoholism takes a few years, but they do not have to. They can escalate rapidly, especially if combined with a co-occurring disorder or a genetic predisposition. Alcoholism can go into a kind of remission. It can plateau and stay at a sage for a decade.

To be obvious; the beginning of stage two looks very much like the end of stage one.

Please keep that in mind when you are looking over these stages.

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(image from Juan Blea blog)

The Most Widely Used Stages Alcoholism

Stage One of Alcoholism

The first stage of alcoholism arises when the alcoholic starts drinking in circumstances other than social settings: as a means of relieving stress, for example, or to calm nerves before an important meeting. This is called utilitarian usage. The alcoholic is using alcohol like a tool. This stage of alcoholism also has a significant increase in the amount of alcohol consumed, along with an increase in tolerance to alcohol. In many cases, the alcoholic’s ability to drink becomes a source of pride, he may brag about it and is always looking to hang out with friends who are also heavy drinkers. He will normally always pick an evening of bowling (with beer) over something that doesn’t serve alcohol like a movie theatre. He will hold his liquor like a champion. When other people are staggering around in the street, he will be walking and talking fine. He may seem to never have hangovers.

Stage Two of Alcoholism

The second stage of alcoholism is marked by an increased need to drink. He drinks alcohol earlier and earlier in the day, and raised tolerance levels mean that the alcoholic drinks a lot more to get the same effect. Signs of guilt may arise as well, marked by efforts to stop drinking. The increase in alcohol consumed translates into increased physical effects during the second stage, including blackouts, hangovers and occasional loss of control over one’s drinking. He may begin to miss work. He may begin to minimize the bragging he had once done because he doesn’t want to draw attention to himself.

Stage Three of Alcoholism

The third stage of alcoholism show the first real signs that the alcoholic has lost control of his drinking. One drink turns into several with distressing ease, and the alcoholic begins adopting covert behavior such as drinking in secret and inventing elaborate lies to cover it up. Drinking also starts to spill over into work and home life, as previous important commitments fall by the wayside. In many cases, the alcoholic’s physical appearance begins to deteriorate as well. Insomnia may be a real issue. He doesn’t eat regularly. His family is a mess if they are still around.

Stage Four of Alcoholism

By the time the alcoholic reaches the fourth stage of alcoholism, he can no longer control his drinking at all. He often goes on lengthy drinking sprees lasting for days, which usually precludes the ability to hold down any kind of a job. Physical symptoms such as shakiness and anxiety attacks may appear, and drinking becomes an all-consuming obsession dominating the alcoholic’s life. He cannot sleep unless he drinks or he passes out and this rest is not refreshing. His family is almost certainly gone.

Addiction Recovery Guide

How People In Recovery Define The Stages Of Alcohol Addiction

The have taken a less defined model of alcoholism and adapted it to addiction

stages of alcoholism
Stage 1 Alcohol Addiction : Abstinence

If an individual has attitudes and perceptions consistent with those that addicts typically exhibit, alcohol addiction can actually begin before the drinking commences. Yes, alcohol addiction can begin well before you take your first drink. If you have a genetic predisposition to develop addiction or if you have attitudes and perceptions consistent with what addicts typically exhibit, your alcohol addiction can start before you begin drinking

 Stage 2 Alcohol Addiction : Initial Use

Stage two can mean experimental use, occasional use of alcohol or very occasional binge drinking (i.e., once or twice a year). Initial use of alcohol is not necessarily problematic for the user or those who love him or her. Though the occasional drinking experience may cause problems while he or she is under the influence or the next day during a hangover, it isn’t yet at the stage of addiction.

Stage 3 Alcohol Addiction : High Risk Use

High risk use of alcohol means lots of drinking and bad choices made under the influence. The pattern and frequency of alcohol abuse is high enough in this stage that it is dangerous for the drinker and those around them.

Stage 4 Alcohol Addiction : Problematic Use

Problematic use of alcohol occurs when the negative consequences of drinking becomes evident. Health concerns become issues, including impaired liver function and/or STDs (sexual transmitted diseases). DUI (driving under the influence) charges may occur, and/or other legal issues relating to drinking to excess and making poor decisions. Family and friends notice there is a problem.

  Stage 5 Alcohol Addiction : Early Stage of Dependency

The early stage of alcohol addiction is characterized by noticeable issues with the drug. Missing work starts to happen as do fights with family members while under the influence. Occasionally the alcoholic will choose to drink despite negative consequences. This stage is the best time for alcohol rehab because early treatment is most effective.

 Stage 6 Alcohol Addiction : Middle Stage of Dependency

During the middle stage of alcoholism, negative consequences begin to compound themselves. Missing work multiple times results in losing the job. Too many fights due to alcohol abuse results in the end of the relationship. The consequences of alcoholism begin to pile up and the physical negative effects are irreversible.

 Stage 7 Alcohol Addiction : Crisis Stage of Dependency

When alcohol addiction has reached a crisis point, the effects of alcoholism are clear to everyone, including the alcoholic. Serious health problems are at issue and the alcoholic is rarely without a drink. He or she will usually believe that no one can tell that they are drunk, but few are fooled. The end of this stage is almost always an alcohol-related death if they don’t get into treatment.

Compiled from:

The first four stages of alcoholism I know. I lived them.

The second set of stages of alcoholism is something that I know can happen but I want to point out that step 7 rarely happens. Most people quit before they die.

Most alcoholics die sober, but still from alcohol related issues. The most, on point, side issue would be liver disease but, alcoholism, can cause a whole host of problems. It can aggravate existing conditions. Alcoholism can even cause cancer.

I want to make sure that you are cautious when considering stage seven. It is rare.

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